Medical Specialties Commons^™

Nutri One-On-One: The Assessment And Evaluation Of A Single One-On-One Nutritional Coaching In Patients Affected By Metabolic Syndrome, Jennifer L. King

PCOM Biomedical Studies Student Scholarship

The Nutri One-on-One Program's aim was to positively modify participants' nutritional habits and lifestyles through a brief one-on-one health coaching session, which was conducted within a primary healthcare setting at the Philadelphia College of Osteopathic Medicine's Clinics. It is documented that 70% of deaths in the U.S. result from complications secondary to chronic diseases of metabolic syndrome. The participants were selected by physicians and classified as suffering from one or more of the five indicators of metabolic syndrome: abdominal obesity, elevated serum triglycerides, low HDL-cholesterol, elevated blood pressure, and insulin resistance. Evidence shows that health coaching positively assists individuals in …

Hippocampal Sclerosis Of Aging, A Prevalent And High-Morbidity Brain Disease, Peter T. Nelson, Charles D. Smith, Erin L. Abner, Bernard J. Wilfred, Wang-Xia Wang, Janna H. Neltner, Michael Baker, David W. Fardo, Richard J. Kryscio, Stephen W. Scheff, Gregory A. Jicha, Kurt A. Jellinger, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Hippocampal sclerosis of aging (HS-Aging) is a causative factor in a large proportion of elderly dementia cases. The current definition of HS-Aging rests on pathologic criteria: neuronal loss and gliosis in the hippocampal formation that is out of proportion to AD-type pathology. HS-Aging is also strongly associated with TDP-43 pathology. HS-Aging pathology appears to be most prevalent in the oldest-old: autopsy series indicate that 5-30 % of nonagenarians have HS-Aging pathology. Among prior studies, differences in study design have contributed to the study-to-study variability in reported disease prevalence. The presence of HS-Aging pathology correlates with significant cognitive impairment which is …

Ultrasound Based Evaluation Of Hepatic Steatosis And Fibrosis In Hepatitis C Non-Responders, Saba Sohail, Sina Aziz, Talat Mirza

Department of Radiology

Objective: To determine the accuracy of ultrasound in the diagnosis and grading of steatosis and fibrosis in Hepatitis C (HCV) patients not responding to ribavarin-interferon therapy.
Study design: A cross-sectional, analytical study.
Place and duration of study: Radiology Department, Civil Hospital, Karachi, from March 2008 to August 2010.
Methodology: Patients with positive HCV RNA despite 24 weeks ribavarin-interferon therapy (non-responders) were subjected to ultrasound and biopsy prior to institution of pegylated interferon therapy for detection and grading of steatosis and fibrosis. Using histopathology as the gold standard, sensitivity, specificity, negative and positive predictive values for ultrasound were determined.
Results: The …

Successful Aging And Creativity : An Investigation On Functional Status And Psychological Wellbeing In Older Adults, Mirie E. Levy

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: While the literature supports the maintenance of functional status as integral to successful aging, the relationship of creativity on functional status has received little attention. Creativity has been associated with health and aging in the research but only a small number of studies have examined creativity interventions to enhance functional status and boost psychological wellbeing.

Methods: A pretest-posttest quasi-experimental design was used to investigate an 8-week creativity intervention on functional status and psychological wellbeing in older adults. Sample subjects were 92 men and women all over age 60. A series of two-way mixed ANOVAs measured differences between treatment and …

Periocular Infantile Haemangioma And The Role Of Propranolol., Tanveer Anjum Chaudhry, Mustafa Kamal, Khabir Ahmad

Department of Surgery Docs

ABSTRACT This case of a four and a half-month-old girl describes periocular infantile haemangioma which was treated successfully with propranolol. She developed a red coloured lesion around the left upper eye lid at one week of age. A gradual increase was noticed in the size of the lesion and by the age of four and a half months, the swelling had increased enough to cover her visual axis, completely occluding her left eye. Oral propranolol therapy was initiated with a daily dosage of 1 mg/kg body weight. The dose was increased gradually, and there was an excellent response to propranolol …

Nutrition Political Economy, Pakistan. Province Report:Sindh, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Rozina Mistry, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Nutrition Political Economy, Pakistan. Province Report: Khyber Pakhtunkhwa, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Abdul Wajid, Gul Nawaz, Kashif Nazeer, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Mothers’S Education And Working Status; Do They Contribute To Corrosive Poisoning Among Paediatric Patients Of Karachi, Pakistan?, Emaduddin Siddiqui, Kiran Ejaz, Sayyeda Ghazala Irfan Kazi, Saif Siddiqui, Syed Jamal Raza

Department of Emergency Medicine

Objectives: To determine the causative factors behind corrosive poisoning in children like effect of working mothers, their educational status, financial background, family size and number of siblings.

Methods: The multi-centre, prospective, case series of all paediatric patients presenting to the Emergency Department of the National Institute of Child Health and the Aga Khan University Hospital, Karachi from August 2008 to July 2009 is presented. It comprised all paediatric patients with a history of corrosive poisoning at the two hospitals. SPSS 20 was used for statistical analysis.

Results: Out of 105 cases, 56(53%) related to the private-sector Aga Khan University Hospital, …

A Multicenter, Prospective, Randomized Comparison Of A Novel Signal Transmission Capsule Endoscope To An Existing Capsule Endoscope., Eric H Choi, Klaus Mergener, Carol Semrad, Laurel Fisher, David R Cave, Milan Dodig, Carol Burke, Jonathan A Leighton, David Kastenberg, Peter Simpson, James Sul, Kanishka Bhattacharya, Roger Charles, Lauren Gerson, Luke Weber, Glenn Eisen, Warren Reidel, John J Vargo, Jamile Wakim-Fleming, Simon K Lo

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: MiroCam, a capsule endoscope, uses a novel transmission technology, electric-field propagation, which uses the human body as a conduction medium for data transmission.

OBJECTIVE: To compare the ability of the MiroCam (MC) and PillCam (PC) to identify sources of obscure GI bleeding (OGIB).

DESIGN: Prospective, multicenter, comparative study.

SETTING: Six academic hospitals.

PATIENTS: A total of 105 patients with OGIB.

INTERVENTION: Patients ingested both the MC and PC capsules sequentially in a randomized fashion.

MAIN OUTCOME MEASUREMENTS: Concordance of rates in identifying a source of OGIB, operational times, and rates of complete small-bowel examination.

RESULTS: Data analysis resulted in …

Population Genetics And Drug Resistance Markers: An Essential For Malaria Surveillance In Pakistan, Afsheen Raza, Mohammad Asim Beg

Department of Pathology and Laboratory Medicine

Plasmodium (P.) vivax is the prevalent malarial species accounting for 70% of malaria cases in Pakistan. However, baseline epidemiological data on P. vivax population structure and drug resistance are lacking from Pakistan. For population structure studies, molecular genetic markers, circumsporozoite protein (csp) and merozoite surface protein-1 (msp-1) are considered useful as these play an important role in P. vivax survival under immune and environmental pressure. Furthermore, these genes have also been identified as suitable candidates for vaccine development. While efforts for effective vaccine are underway, anti-malarial agents remain the mainstay for control. Evidence of resistance against commonly used anti-malarial agents, …

A Case Of Worsening Stridor In A Neonate, Richard J. Mazzaccaro Md

Department of Pediatrics

No abstract provided.

Surgical Management Of Traumatic Extra Dural Hematoma In Children: Experiences And Analysis From 24 Consecutively Treated Patients In A Developing Country, Muhammad Babar Khan, Muhammad Riaz, Gohar Javed, Fauzan Alam Hashmi, Maryam Sanaullah, Syed Ijlal Ahmed

Medical College Documents

Background: Children with epidural hematoma (EDH) present differently than adults. The outcome of treatment is also different. We aim to report our experiences with EDH in pediatric age group in terms of mode of injury, presenting features, management, and outcomes. We also aim to identify different prognostic indicators in pediatric patients with EDH.
Methods: We prospectively collected data from 24 consecutively surgically treated pediatric patients. The data collected included presenting features, radiological imaging, details of management, and outcomes. Descriptive analysis was performed and different variables were tested for any statistical significance with Glasgow Outcome Score (GOS).
Results: There were 19 …

Cancer Metabolism: New Validated Targets For Drug Discovery., Federica Sotgia, Ubaldo E. Martinez-Outshoorn, Md, Michael P. Lisanti

Kimmel Cancer Center Faculty Papers

Recent studies in cancer metabolism directly implicate catabolic fibroblasts as a new rich source of i) energy and ii) biomass, for the growth and survival of anabolic cancer cells. Conversely, anabolic cancer cells upregulate oxidative mitochondrial metabolism, to take advantage of the abundant fibroblast fuel supply. This simple model of "metabolic-symbiosis" has now been independently validated in several different types of human cancers, including breast, ovarian, and prostate tumors. Biomarkers of metabolic-symbiosis are excellent predictors of tumor recurrence, metastasis, and drug resistance, as well as poor patient survival. New pre-clinical models of metabolic-symbiosis have been generated and they genetically validate …

Hippocampal Functional Connectivity Patterns During Spatial Working Memory Differ In Right Versus Left Temporal Lobe Epilepsy., Gaelle Eve Doucet, Karol Osipowicz, Ashwini Sharan Md, Michael R Sperling, Joseph I Tracy

Department of Neurology Faculty Papers

Temporal lobe epilepsy (TLE), affecting the medial temporal lobe, is a disorder that affects not just episodic memory but also working memory (WM). However, the exact nature of hippocampal-related network activity in visuospatial WM remains unclear. To clarify this, we utilized a functional connectivity (FC) methodology to investigate hippocampal network involvement during the encoding phase of a functional magnetic resonance imaging (fMRI) visuospatial WM task in right and left TLE patients. Specifically, we assessed the relation between FC within right and left hippocampus-seeded networks, and patient performance (rate of correct responses) during the encoding phase of a block span WM …

Evaluating The Utility Of Clinical Criteria For The Identification Of Lynch Syndrome Among Endometrial Cancer Patients, Amanda S. Bruegl

Dissertations and Theses (Open Access)

Background: Lynch Syndrome (LS) is a familial cancer syndrome with a high prevalence of colorectal and endometrial carcinomas among affected family members. Clinical criteria, developed from information obtained from familial colorectal cancer registries, have been generated to identify individuals at elevated risk for having LS. In 2007, the Society of Gynecologic Oncology (SGO) codified criteria to assist in identifying women presenting with gynecologic cancers at elevated risk for having LS. These criteria have not been validated in a population-based setting.

Materials and Methods: We retrospectively identified 412, unselected endometrial cancer cases. Clinical and pathologic information were obtained from the electronic …

Assessment Of Subacromial Space And Its Relationship With Scapular Upward Rotation In College Baseball Players., Stephen John Thomas, Charles Buz Swanik, Thomas W Kaminski, Jill S Higginson, Kathleen A Swanik, Levon N Nazarian

Department of Radiology Faculty Papers

CONTEXT: Subacromial impingement is a common injury in baseball players and has been linked to a reduction in the subacromial space. In addition, it has been suggested that decreases in scapular upward rotation will lead to decreases in the subacromial space and ultimately impingement syndrome.

OBJECTIVE: The objective of this study was to evaluate the relationship between acromiohumeral distance and scapular upward rotation in healthy college baseball players.

DESIGN: Posttest-only study design.

SETTING: Controlled laboratory setting.

PARTICIPANTS: 24 healthy college baseball players. Intervention: Participants were measured for all dependent variables at preseason.

MAIN OUTCOME MEASURES: Acromiohumeral distance at rest and …

Body Mri Artifacts In Clinical Practice: A Physicist's And Radiologist's Perspective., Martin J Graves, Donald Mitchell

Department of Radiology Faculty Papers

The high information content of MRI exams brings with it unintended effects, which we call artifacts. The purpose of this review is to promote understanding of these artifacts, so they can be prevented or properly interpreted to optimize diagnostic effectiveness. We begin by addressing static magnetic field uniformity, which is essential for many techniques, such as fat saturation. Eddy currents, resulting from imperfect gradient pulses, are especially problematic for new techniques that depend on high performance gradient switching. Nonuniformity of the transmit radiofrequency system constitutes another source of artifacts, which are increasingly important as magnetic field strength increases. Defects in …

The Efficacy Of Allergen Immunotherapy With Cat Dander In Reducing Symptoms In Clinical Practice., Aerik A Williams, John R Cohn, Shirley M Fung, Patricia Padams

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background. Allergy to cat dander is a common form of allergic disease. Allergen immunotherapy has been demonstrated to be effective in decreasing allergic symptoms. Objectives. To examine outcomes in allergic asthmatic patients on cat immunotherapy (CIT) compared to allergic asthmatics on traditional immunotherapy (IT) without cat sensitivity. Methods. A retrospective review identified allergic asthmatics on CIT for at least three years. An equal number of allergic asthmatics on IT were identified for comparison. Outcomes investigated include measurements of risk of asthma exacerbation. Results. Thirty-five patients were identified in each group. There were no differences in the CIT group versus the …

Airway Management In A Patient With Bullous Pemphigoid, Mohammad Yasir, Fauzia Anis Khan

Department of Anaesthesia

Airway management in patients with pemphigoid lesions has anaesthetic implications. We report a case of a 23 years old female with bullous pemphigoid who presented with laryngeal stenosis and critical airway narrowing. The airway was initially managed with jet ventilation. Anaesthesia was maintained with propofol infusion and ventilation was performed by introducing a size 10 French gauge suction catheter through the stenotic laryngeal orifice. Thirty minutes into anaesthesia, she developed subcutaneous emphysema and decreased air entry on right side of the chest but remained hemodynamically stable. The airway was further managed by tracheostomy. This case report highlights complications that can …

Sentinel Node Localisation Using Pre-Operative Lymphoscintigraphy And Intraoperative Gamma Probe In Early Oral Cavity Cancer, Mubasher Ikram, Shabbir Akhtar, Montasir Junaid, Tariq Dhari, Maseeh-Uz Zaman, Riffat Hussain, Zubair Ahmad

Section of Otolaryngology, Head & Neck Surgery

Objectives: To assess the diagnostic value of sentinel lymph node localisation using pre-operative lymphoscintigraphy and intra-operative gamma probe radio localisation in Pakistani patients suffering from early stage squamous cell carcinoma of the oral cavity.
Methods: The prospective case series was conducted between September 2007 and April 2010 at the Aga Khan University Hospital, Karachi. It comprised patients with T1and T2 oral cavity cancer with clinically and radiologically negative neck. Pre-operative lymphoscintigraphy was performed one day before surgery and intra-operative gamma probe was used to detect sentinel node. Final histo-pathological evaluation was taken as the gold standard.
Results: The study comprised …

Interventions For Common Perinatal Mental Disorders In Women In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Atif Rahman, Jane Fisher, Peter Bower, Stanley Luchters, Thach Tran, M. Taghi Yasamy, Shekhar Saxena, Waquas Waheed

Population Health, East Africa

Objective: To assess the effectiveness of interventions to improve the mental health of women in the perinatal period and to evaluate any effect on the health, growth and development of their offspring, in low- and middle-income (LAMI) countries.

Methods: Seven electronic bibliographic databases were systematically searched for papers published up to May 2012 describing controlled trials of interventions designed to improve mental health outcomes in women who were pregnant or had recently given birth. The main outcomes of interest were rates of common perinatal mental disorders (CPMDs), primarily postpartum depression or anxiety; measures of the quality of the mother-infant relationship; …

Failure Patterns In Resected Pancreas Adenocarcinoma: Lack Of Predicted Benefit To Smad4 Expression., Jordan M. Winter, Laura H. Tang, David S. Klimstra, Weiguo Liu, Irena Linkov, Murray F. Brennan, Michael I. DʼAngelica, Ronald P. Dematteo, Yuman Fong, William R. Jarnagin, Eileen M. OʼReilly, Peter J. Allen

Department of Surgery Faculty Papers

OBJECTIVE: To determine whether SMAD4 expression is associated with recurrence pattern after resection for pancreatic ductal adenocarcinoma (PDA).

BACKGROUND: SMAD4 expression status has been reported to be associated with patterns of failure in PDA, but studies have not examined recurrence patterns after resection.

METHODS: A tissue microarray was constructed including 127 patients with resected PDA and either short-term (<12 >months) or long-term (>30 months) survival. SMAD4 expression was evaluated by immunohistochemistry and categorized as present or lost in tumor cells. Conventional pathologic features (lymph node metastases, positive resection margin, poor grade, and tumor size) were recorded, and disease-specific outcomes …

Early Echocardiographic Changes After Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve In The Pulmonary Position., Shahryar M. Chowdhury, Ziyad M. Hijazi, John Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Lydia King, Jodi Akin, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To evaluate echocardiographic changes after SAPIEN valve implantation in the pulmonary position.

BACKGROUND: The feasibility of the SAPIEN transcatheter pulmonary valve (TPV) has recently been demonstrated. We evaluated changes in pulmonary valve function and the right ventricle after SAPIEN TPV placement.

METHODS: We evaluated echocardiograms at baseline, discharge, 1 and 6 months after TPV placement in 33 patients from 4 centers. Pulmonary insufficiency severity was graded 0-4. TPV peak and mean gradients were measured. Right ventricular (RV) size and function were quantified using routine measures derived from color, spectral, and tissue Doppler indices and two-dimensional echocardiography.

RESULTS: At baseline, …

Coping With Pediatric Cancer: Conversational Methods Utilized By Parents And Children When Dealing With Pediatric Cancer, Chelsi Morgan Walls

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study analyzed how people perceived parents should communicate with their child regarding pediatric cancer treatments. When dealing with pediatric cancer, it is vital that parents and their child communicate about the illness in order to effectively cope with the cancer. Using Uncertainty Management Theory, appraisals, inferences, and illusions, are examined in this study to discover how much affect-management and buffering would be used to manage the illness. Under UMT, the coping mechanisms of affect-management (i.e., religious coping and behavioral disengagement), and buffering (avoidance and child distraction) depend upon how individuals appraise the uncertain situation (positive vs. negative), the inferences …

Nutrition Political Economy, Pakistan. Provincial Report: Balochistan., Shehla Zaidi, Zulfiqar Ahmed Bhutta, Suleman Qazi, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Assessment Of Competence For Caesarean Section With Global Rating Scale, Rahat Najam Qureshi, Syeda Kauser Ali

Department for Educational Development

Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents\' independent performance of Caesarean Section.

Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case.

Results: The observations per faculty ranged from 1-8 (mean 4.07± 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, …

The Relationship Among Ankle Function, Functional Capacity, And Body Composition To Balance In Geriatric Populations, Joseph Robert Chaney

Graduate Theses and Dissertations

The primary purpose of this research study was to identify significant relationships among measures of ankle strength, ankle range of motion, body composition, and functional capacity to balance ability in geriatric populations which may potentially assist in identifying older individuals with increased risk of falling. A battery of five test (ankle strength assessments, ankle range of motion , DXA, functional fitness, and balance) were administered to 20 participants (6 males, 14 females, mean age 69.78 ± 3.98) that had indicated to be at least 65 years of age or older and no history of falls within the previous 12 months. …

Efficacy Of Gold Silica Nanoshells And Gold Nanorods For Photothermal Therapy Of Human Glioma Spheroids, Suyog Jung Chhetri

UNLV Theses, Dissertations, Professional Papers, and Capstones

Gold-based nanoparticles including gold-silica nano-spheres and gold nano-rods have been investigated for a number of therapeutic and diagnostic applications. The ability of these nanoparticles to convert light into heat energy makes them particularly appealing for photothermal therapy in which cancer cells are destroyed via light-induced heat generation. The overall objective of the study is to compare the efficacy of gold-silica nano-spheres and gold nano-rods in an in vitro system consisting of human brain tumor (glioma) spheroids.

Delivery of the nanoparticles to the spheroids was accomplished using murine macrophages. Nanoparticles (spheres or rods) were incubated with macrophages for 24 hours. Thereafter, …

Association Between Obesity And Infarct Size: Insight Into The Obesity Paradox., Beatriz Cepeda-Valery, Md, Leandro Slipczuk, Md, Vincent M. Figueredo, M.D., Gregg S. Pressman, D Lynn Morris, Md, Carl J Lavie, Md, Abel Romero-Corral, Md

Division of Cardiology Faculty Papers

Abstract:

Background: In patients with coronary heart disease, being overweight or obese is associated with better outcomes, a phenomenon known as the 'obesity paradox'. Despite the high prevalence of obesity in the United Sates, its effects on infarct size are largely unexplored.

Methods: Prospective cross-sectional study of 102 consecutive patients admitted with acute myocardial infarction (MI). Standardized forms were used to collect data on body mass index (BMI), waist circumference (WC), cardiovascular risk factors, and medications. Peak troponin I and creatinine phosphokinase (CPK) were used to estimate infarct size. Epicardial and pericardial fat were measured by echocardiography. We used univariate …

Combination Of Sirna-Directed Gene Silencing With Cisplatin Reverses Drug Resistance In Human Non-Small Cell Lung Cancer, Shanthi Ganesh, Arun K. Iyer, Jan Weller, David V. Morrissey, Mansoor M. Amiji

Pharmaceutical Sciences Faculty Publications

One of the most challenging aspects of lung cancer therapy is the rapid acquisition of multidrug-resistant (MDR) phenotype. One effective approach would be to identify and downregulate resistance-causing genes in tumors using small interfering RNAs (siRNAs) to increase the sensitivity of tumor cells to chemotherapeutic challenge. After identifying the overexpressed resistance-related antiapoptotic genes (survivin and bcl-2) in cisplatin-resistant cells, the siRNA sequences were designed and screened to select the most efficacious candidates. Modifications were introduced in them to minimize off-target effects. Subsequently, the combination of siRNA and cisplatin that gave the maximum synergy was identified in resistant cells. We then …