Medical Specialties Commons^™

Intracranial Injection Of Aav Expressing Nep But Not Ide Reduces Amyloid Pathology In App+Ps1 Transgenic Mice, Nikisha Carty, Kevin R. Nash, Milene Brownlow, Dana Cruite, Donna M. Wilcock, Maj-Linda B. Selenica, Daniel C. Lee, Marcia N. Gordon, Dave Morgan

Sanders-Brown Center on Aging Faculty Publications

The accumulation of β-amyloid peptides in the brain has been recognized as an essential factor in Alzheimer's disease pathology. Several proteases, including Neprilysin (NEP), endothelin converting enzyme (ECE), and insulin degrading enzyme (IDE), have been shown to cleave β-amyloid peptides (Aβ). We have previously reported reductions in amyloid in APP+PS1 mice with increased expression of ECE. In this study we compared the vector-induced increased expression of NEP and IDE. We used recombinant adeno-associated viral vectors expressing either native forms of NEP (NEP-n) or IDE (IDE-n), or engineered secreted forms of NEP (NEP-s) or IDE (IDE-s). In a six-week study, immunohistochemistry …

Overcoming Erroneous Confirmation Bias, F. Matthew Mihelic

Faculty Publications

This paper will explore strategy for overcoming erroneous confirmation bias within the context of generalist versus specialist function as described in the paper entitled “Information Fusion and Quantum Logic in Family Medicine”.

Neurosurgery Concepts: Key Perspectives On Regulatory Proteins, Management Of Ossification Of The Posterior Longitudinal Ligament, And Radiosurgery For Intracranial Lesions, Jonathan H. Sherman, Zachary A. Smith, Jin Mo Cho, Michael Lim, Chaim B. Colen, Chae-Yong Kim, Vincent Yat Wang, Gabriel Zada, Gordon Li, Isaac Yang

Neurological Surgery Faculty Publications

No abstract provided.

Tgf-Beta Suppresses Vegfa-Mediated Angiogenesis In Colon Cancer Metastasis., Liying Geng, Anathbandhu Chaudhuri, G. Talmon, James L. Wisecarver, J. Wang

Journal Articles: Eppley Institute

The FET cell line, derived from an early stage colon carcinoma, is non-tumorigenic in athymic nude mice. Engineered FET cells that express TGF-α (FETα) display constitutively active EGFR/ErbB signaling. These cells readily formed xenograft tumors in athymic nude mice. Importantly, FETα cells retained their response to TGF-beta-mediated growth inhibition, and, like the parental FET cells, expression of a dominant negative TGF-beta type II receptor (DNRII) in FETα cells (FETα/DNRII) abrogated responsiveness to TGF-beta-induced growth inhibition and apoptosis under stress conditions in vitro and increased metastatic potential in an orthotopic model in vivo, which indicates metastasis suppressor activity of TGF-beta signaling …

Prevalence And Correlates Of Depression Among Chronic Kidney Disease Patients In Taiwan, Hsin-Hung Chiang, Hanoch Livneh, Mei-Ling Yen, Tsai-Chung Li, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Chronic kidney disease (CKD) is a progressive disease that causes a permanent impairment of renal function and premature mortality. The associated prognosis may result in serious psychological distress to the affected individual. However, there are limited data on the psychological correlates, and in particular depression, in Chinese CKD patients. This study aimed to examine the prevalence of depression, as well as the influence of other psychosocial factors on depression, among Taiwanese CKD patients.

Methods: We used a cross-sectional research design to recruit 270 CKD patients who were not undergoing dialysis treatment at a hospital in southern Taiwan during 2011. …

Development And Pilot Implementation Of A Locally Developed Trauma Registry: Lessons Learnt In A Low-Income Country, Amber Mehmood, Junaid Abdul Razzak, Sarah Kabir, Ellen J. Mackenzie, Adnan A. Hyder

Department of Emergency Medicine

Background

Trauma registries (TRs) play an integral role in the assessment of trauma care quality. TRs are still uncommon in developing countries owing to awareness and cost. We present a case study of development and pilot implementation of “Karachi Trauma Registry” (KITR), using existing medical records at a tertiary-care hospital of Karachi, Pakistan to present results of initial data and describe its process of implementation.

Methods

KITR is a locally developed, customized, electronic trauma registry based on open source software designed by local software developers in Karachi. Data for KITR was collected from November 2010 to January 2011. All patients …

Causes Of Death In Surgically Treated Patients With Type A Aortic Dissection - A Ten Year Review, James K. Wu Md, Eilizabeth Depaolo Bs, Theodore G. Phillips Md, Timothy S. Misselbeck

Department of Surgery

No abstract provided.

De-Branching Of The Aortic Arch During Thoracic Endovascular Aortic Repair, James K. Wu Md, Caitlin O'Connor Bs, Timothy S. Misselbeck, Theodore G. Phillips Md

Department of Surgery

No abstract provided.

Bapineuzumab Alters Aβ Composition: Implications For The Amyloid Cascade Hypothesis And Anti-Amyloid Immunotherapy, Alex E. Roher, David H. Cribbs, Ronald C. Kim, Chera L. Maarouf, Charisse M. Whiteside, Tyler A. Kokjohn, Ian D. Daugs, Elizabeth Head, Carolyn Liebsack, Geidy Serrano, Christine Belden, Marwan N. Sabbagh, Thomas G. Beach

Sanders-Brown Center on Aging Faculty Publications

The characteristic neuropathological changes associated with Alzheimer's disease (AD) and other lines of evidence support the amyloid cascade hypothesis. Viewing amyloid deposits as the prime instigator of dementia has now led to clinical trials of multiple strategies to remove or prevent their formation. We performed neuropathological and biochemical assessments of 3 subjects treated with bapineuzumab infusions. Histological analyses were conducted to quantify amyloid plaque densities, Braak stages and the extent of cerebral amyloid angiopathy (CAA). Amyloid-β (Aβ) species in frontal and temporal lobe samples were quantified by ELISA. Western blots of amyloid-β precursor protein (AβPP) and its C-terminal (CT) fragments …

Infective Endocarditis In The U.S., 1998–2009: A Nationwide Study, David H. Bor, Steffie Woolhandler, Rachel Nardin, David Brusch, David U. Himmelstein

Publications and Research

Background
Previous studies based on local case series estimated the annual incidence of endocarditis in the U.S. at about 4 per 100,000 population. Small-scale studies elsewhere have reported similar incidence rates. However, no nationally-representative population-based studies have verified these estimates.

Methods and Findings
Using the 1998–2009 Nationwide Inpatient Sample, which provides diagnoses from about 8 million U.S. hospitalizations annually, we examined endocarditis hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for endocarditis rose from 25,511 in 1998 to 38, 976 in 2009 (12.7 per 100,000 population in 2009). The age-adjusted endocarditis admission rate increased 2.4% annually. The proportion of patients …

Disseminating Childhood Home Injury Risk Reduction Information In Pakistan: Results From A Community-Based Pilot Study, Aruna Chandran, Uzma Rahim Khan, Nukhba Zia, Asher Feroze, Sarah Stewart De Ramirez, Cheng-Ming Huang, Junaid A. Razzak, Adnan A. Hyder

Department of Emergency Medicine

Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools.

Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. …

Calpain 1 Knockdown Improves Tissue Sparing And Functional Outcomes After Spinal Cord Injury In Rats, Chen Guang Yu, Yanzhang Li, Kashif Raza, Xin Xin Yu, Sarbani Ghoshal, James W. Geddes

Spinal Cord and Brain Injury Research Center Faculty Publications

To evaluate the hypothesis that calpain 1 knockdown would reduce pathological damage and functional deficits after spinal cord injury (SCI), we developed lentiviral vectors encoding calpain 1 shRNA and eGFP as a reporter (LV-CAPN1 shRNA). The ability of LV-CAPN1 shRNA to knockdown calpain 1 was confirmed in rat NRK cells using Northern and Western blot analysis. To investigate the effects on spinal cord injury, LV-CAPN1shRNA or LV-mismatch control shRNA (LV-control shRNA) were administered by convection enhanced diffusion at spinal cord level T10 in Long-Evans female rats (200–250 g) 1 week before contusion SCI, 180 kdyn force, or sham surgery at …

The Community As A Learner Group, Cathyann Feher Rn,Msn, Karen L. Kutner Mba, Robert Ruhf, Charles Scagliotti Md,Facs, Michael M. Badellino Md

Department of Surgery

No abstract provided.

The Value Of Bleeding Scans In The Evaluation Of Acute Lower Gastrointestinal Bleeding, K Beiermeister, L Smith, Robert J. Sinnott, John S. Park Md

Department of Surgery

No abstract provided.

Lymphotoxin-Α Is A Novel Adiponectin Expression Suppressor Following Myocardial Ischemia/Reperfusion., Wayne Bond Lau, Yanqing Zhang, Jianli Zhao, Baojiang Liu, Xiaoliang Wang, Yuexing Yuan, Theodore A. Christopher, Bernard Lopez, Erhe Gao, Walter J. Koch, Xin L. Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

Recent clinical observations demonstrate adiponectin (APN), an adipocytokine with potent cardioprotective actions, is significantly reduced following myocardial ischemia/reperfusion (MI/R). However, mechanisms responsible for MI/R-induced hypoadiponectinemia remain incompletely understood. Adult male mice were subjected to 30-min MI followed by varying reperfusion periods. Adipocyte APN mRNA and protein expression and plasma APN and TNFα concentrations were determined. APN expression/production began to decline 3 h after reperfusion (reaching nadir 12 h after reperfusion), returning to control levels 7 days after reperfusion. Plasma TNFα levels began to increase 1 h after reperfusion, peaking at 3 h and returning to control levels 24 h after …

Health-Related Resource Use And Costs In Elderly Adults With And Without Mild Cognitive Impairment, Carolyn Zhu, Peter J. Whitehouse, Marian B. Patterson

Faculty Scholarship

Objectives To assess differences in resource use and cost between older adults with and without mild cognitive impairment (MCI) over time. Design Multicenter, longitudinal study. Setting Sixty-eight Alzheimer's Disease Cooperative Study (ADCS) sites in the United States. Participants Two hundred fifty-nine individuals diagnosed with MCI and 107 cognitively normal elderly adults followed annually for 3 years. Measurements The Resource Use Instrument (RUI) was used to capture medical and nonmedical care use. Generalized linear latent and mixed models were used to estimate differences in resource use and costs in older adults with and without MCI after controlling for clinical and demographic …

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi A. Wright, Heather Stieglitz, Yankel M. Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid T. Katz, Francisco Munoz, Rachel B. Jimenez, Jan Mutchler, Lorna Rivera, Anthony L. Back, Holly G. Prigerson

Women’s and Gender Studies Faculty Publication Series

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

Obesity Interventions: Comparing Two Theoretical Approaches, Maria M. Ojeda

All Publications

Comparison of the Theory of Planned Behavior and the theory of Health as Expanding Consciousness, based upon their use in obesity intervention studies.

See link.

Pathogen-Specific Risk Of Chronic Gastrointestinal Disorders Following Bacterial Causes Of Foodborne Illness, Chad K. Porter, Daniel Choi, Brooks Cash, Mark Pimentel, Joseph Murray, Larissa May, Mark S. Riddle

Emergency Medicine Faculty Publications

Background

The US CDC estimates over 2 million foodborne illnesses are annually caused by 4 major enteropathogens: non-typhoid Salmonella spp., Campylobacter spp., Shigella spp. and Yersinia enterocoltica. While data suggest a number of costly and morbid chronic sequelae associated with these infections, pathogen-specific risk estimates are lacking. We utilized a US Department of Defense medical encounter database to evaluate the risk of several gastrointestinal disorders following select foodborne infections.

Methods

We identified subjects with acute gastroenteritis between 1998 to 2009 attributed to Salmonella(nontyphoidal) spp., Shigella spp., Campylobacter spp. or Yersinia enterocolitica and matched each with up to 4 …

School-Based Injury Outcomes In Children From A Low-Income Setting: Results From The Pilot Injury Surveillance In Rawalpindi City, Pakistan, Uzma Rahim Khan, Junaid A. Bhatti, Nukhba Zia, Umar Farooq

Department of Emergency Medicine

Background

School-based injuries account for one in five unintentional childhood injuries. Little is known about the epidemiology of school-based injuries in low-income settings. The objective of our study was to compare emergency department (ED) outcomes of the school-based injuries with respect to age, sex, and injury mechanisms in a Pakistani urban setting.

Findings

A pilot injury surveillance study was conducted at the EDs of three major tertiary-care hospitals of Rawalpindi city from July 2007 to June 2008 and included children of less than 15 years injured at school. The World Health Organization’s questionnaire for injury surveillance was used. There were …

Feasibility Of Tomotherapy-Based Image-Guided Radiotherapy To Reduce Aspiration Risk In Patients With Non-Laryngeal And Non-Pharyngeal Head And Neck Cancer, Nam P. Nguyen, Lexie Smith-Raymond, Vincent Vinh-Hung, Paul Vos, Rick Davis, Anand Desai, Thomas Sroka

Dartmouth Scholarship

Purpose: The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT) to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS) prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk.

Broadening Access To Medical Care During A Severe Influenza Pandemic: The Cdc Nurse Triage Line Project., Lisa M. Koonin, Dan Hanfling

Emergency Medicine Faculty Publications

The impact of a severe influenza pandemic could be overwhelming to hospital emergency departments, clinics, and medical offices if large numbers of ill people were to simultaneously seek care. While current planning guidance to reduce surge on hospitals and other medical facilities during a pandemic largely focuses on improving the “supply” of medical care services, attention on reducing “demand” for such services is needed by better matching patient needs with alternative types and sites of care. Based on lessons learned during the 2009 H1N1 pandemic, the Centers for Disease Control and Prevention and its partners are currently exploring the acceptability …

The Perfect Fit

Colby Magazine

From the classrooms and laboratories of Mayflower Hill, they found their niche in science. Microbiologist Carrie Harwood ’73, transplant surgeon Patrick Wood ’75, and marine biologist Paul Wade ’80 have passion for their professions.

Medical Education Digest, Vol. 15 No. 2 (March/April 2013), Nova Southeastern University

Medical Education Digest

No abstract provided.

Asynchronous Web-Based Learning, A Practical Method To Enhance Teaching In Emergency Medicine, Ali Pourmand, Raymond Lucas, Mehdi Nouraie

Emergency Medicine Faculty Publications

Objective: To compare medical knowledge acquisition among emergency medicine (EM) residents who attend weekly core content lectures with those absent but asynchronously viewing the same lectures in a Web-based electronic platform.

Subjects and Methods: During the study period all EM residents attending or absent from weekly educational conferences were given a quiz on the covered material. During Phase 1, absentees were not given supplemental educational content for missed lectures. During Phase 2, absentees were sent a link to an online multimedia module containing an audiovisual recording of the actual missed lecture with presentation slides. Scores between attendees and absentees during …

Bedside Teaching On Time To Disposition Improves Length Of Stay For Critically-Ill Emergency Departments Patients, Ali Pourmand, Raymond Lucas, Jesse M. Pines, Hamid Shokoohi, Kabir Yadav

Emergency Medicine Faculty Publications

Introduction: We tested the effect of a brief disposition process intervention on residents’ time to disposition and emergency department (ED) length of stay (LOS) in high acuity ED patients.

Methods: This was a quasi-experimental study design in a single teaching hospital where ED residents are responsible for administrative bed requests for patients. Enrollment was performed for intervention and control groups on an even-odd day schedule. Inclusion criteria were ED patients triaged as Emergency Severity Index (ESI) 1 and 2. In the intervention group, the attending physician prompted the resident to make the disposition immediately after the evaluation of resuscitation patients. …

Reducing Ambulance Diversion At Hospital And Regional Levels: Systematic Review Of Insights From Simulation Models, M. Kit Delgado, Lesley J. Meng, Mary P. Mercer, Jesse M. Pines, Douglas K. Owens, Gregory S. Zaric

Emergency Medicine Faculty Publications

Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED) crowding are unclear. We performed a systematic review of published simulation studies to identify: 1) the tradeoff between ambulance diversion and ED wait times; 2) the predicted impact of patient flow interventions on reducing diversion; and 3) the optimal regional strategy for reducing diversion.

Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent …

Supporting Rebuilding Efforts In Afghanistan, Dialogue

Data and Test Instruments

The Royal College has been quietly assisting in the reconstruction of Afghanistan’s residency education system, devastated by years of war, by supplying members of the NATO Training Mission-Afghanistan (NTM-A) with educational materials and advice to appropriately modernize the country’s training programs.“These efforts are essential for the training of Afghan physicians in medical and surgical specialties, to ensure a healthy future for the people of Afghanistan,” says Major Vivian McAlister, MD, FRCSC, member of Royal College Council and NTM-A participant.The capacity-building initiative is supported on the ground by the NTM-A team, which includes numerous Fellows of the Royal College, who advise …

Microglia-Derived Tnfα Induces Apoptosis In Neural Precursor Cells Via Transcriptional Activation Of The Bcl-2 Family Member Puma, J. Guadagno, X. Xu, M. Karajgikar, A. Brown, S.P. Cregan

Paediatrics Publications

Neuroinflammation is a common feature of acute neurological conditions such as stroke and spinal cord injury, as well as neurodegenerative conditions such as Parkinson’s disease, Alzheimer’s disease, and amyotrophic lateral sclerosis. Previous studies have demonstrated that acute neuroinflammation can adversely affect the survival of neural precursor cells (NPCs) and thereby limit the capacity for regeneration and repair. However, the mechanisms by which neuroinflammatory processes induce NPC death remain unclear. Microglia are key mediators of neuroinflammation and when activated to induce a pro-inflammatory state produce a number of factors that could affect NPC survival. Importantly, in the present study we demonstrate …

First Steps Phase I Initiative: Improving Immunizations For Children And Adolescents, Kimberley S. Fox Mpa, Carolyn E. Gray Mph

Population Health & Health Policy

This evalution report, authored by research staff at the USM Muskie School, assesses the change in immunization rates in participating pediatric and family practices that serve a high volume of children insured by MaineCare (Maine's Medicaid system). The authors also summarize lessons learned in implementing changes in practices and challenges in using the immunization measures at the practice-level to inform quality improvement.