Medical Specialties Commons^™

Compliance For Latent Tuberculosis Infection Treatment Among Incoming Refugees At Jefferson Center For Refugee Health, Elizabeth Bates, Marc Altshuler, Md, Kevin Scott, Md

CwiC-PH

80% of active TB cases in the US originate from reactivation of Latent Tuberculosis Infection (LTBI), identifying treatment of LTBI as a public health imperative. All incoming refugees at the Jefferson Center for Refugee Health (JCRH) are screened for LTBI upon arrival. Incidence of LTBI and compliance rates were assessed using a retrospective chart review and analysis of prescription refill records. The study showed 23.1% of incoming refugees were diagnosed with LTBI. Once treatment was initiated, only 33.1% were completed, while 56.2% were lost to follow up. Nepali women showed the highest rates of adherence, while Iraqi women and Burmese …

The Contribution Of Schizophrenia To Homelessness: Analysis Of The Housing First Model And Possible Prevention Of Serious Mental Illness, Elijah Grillo

CwiC-PH

The Problem

• 2.6 million schizophrenics in the US accounting for more inpatient treatment days than any other medical illness (national cost: $62 billion/year).

• 6% (~160,000) are homeless or live in shelters

• Make up 36% of the 700,000 homeless individuals in the US.

Integrated Medical Pluralism To Sustain Health Care In The Indian Trans-Himalayas, Jane Babiarz

CwiC-PH

Inadequate health care delivery in the Indian trans-Himalayas arises from the harsh landscape and climate, poverty, the inaccessibility of health care centers, and a burden of chronic diseases and preventable acute illnesses that exceeds the number of traditional healers in the region. Systematizing a pluralistic healer network that integrates NGOs, international health organizations, mobile camps, district clinics, and traditional healers could address the issue of sustaining health care in this region. The backbone of this strategy would be a pre-existing resource relied upon by public and private health organizations: community health workers.

Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox

CwiC-PH

• Assessed needs and looked for solutions that are
• Executed and maintained locally Income-generating
• Provided skills trainings to CHWs on these topics
• Help initiate projects using these skills
• These projects show some modest continuing success

The Current State Of Health Care In China, Jonathan Yadlosky

CwiC-PH

After decentralizing health management in the early 1980s, China’s health care system developed many of the problems that we in the United States are currently working to solve. Though China is literally on the other side of the world, I think we might learn a few very important lessons from a close look at their successes, failures, trends, and goals in health care administration and delivery.

Wellbody Alliance, Sierra Leone, Kevin Rurak

CwiC-PH

Pharmacy Project:

Inventory database development

• Streamlined tracking of daily and monthly drug dispensing
• New database to plan requisitions based on trends

Jeffhealth Soil-Transmitted Helminths, David Maniscalco

CwiC-PH

Soil-transmitted helminth (STH) infections are known to be a significant problem in Rwanda. The Ministry of Health and individual villages are aware of its impact on people’s health and well-being as well as its impact on the country’s economy. The goal of the JeffHEALTH project is to educate poor, rural villages in Rwanda so that village members can take the knowledge they gain, put it into practice and share this knowledge with generations to come.

Increasing Human Papillomavirus (Hpv) Vaccination Rate Among Adolescent And Young Adult Males In A Primary Care Setting, Michele Fascelli, Anna Marie Quinn, Amy Leader, Christopher Chambers

CwiC-PH

Study Purpose:

To increase HPV vaccination rates among adolescent males through the use of an informational aid designed to increase knowledge and favorable attitudes about HPV vaccination.

Evaluate the educational aid for feasibility of use in a primary care setting, interest among patients for participating, and increases in intentions to vaccinate among patient and providers.

Prevalence Of Genital Chlamydia Infection In Urban Women Of Reproductive Age, Nairobi, Kenya, Ruchika Kohli, Walter P. Konya, Timona Obura, William Stones, Gunturu Revathi

Pathology, East Africa

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. Most infections are asymptomatic and remain undetected. Burden of disease in the Kenyan population is not well characterised. This study was done to define the prevalence of genital Chlamydia infection in a representative female population.

Findings: A cross-sectional study design was employed. All women attending out-patient clinics (antenatal, gynaecology, family planning) and accident and emergency departments at two study sites over a five month period were invited to consent to completion of a questionnaire and vaginal swab collection. A rapid point-of-care immunoassay based test …

Transient Receptor Potential (Trp) Channels And Cardiac Fibrosis, Zhichao Yue, Yanhui Zhang, Jia Xie, Jianmin Jiang, Lixia Yue

UCHC Articles - Research

Cardiac fibrosis is associated with most cardiac diseases. Fibrosis is an accumulation of excessive extracellular matrix proteins (ECM) synthesized by cardiac fibroblasts and myofibroblasts. Fibroblasts are the most prevalent cell type in the heart, comprising 75% of cardiac cells. Myofibroblasts are hardly present in healthy normal heart tissue, but appear abundantly in diseased hearts. Cardiac fibroblasts are activated by a variety of pathological stimuli, such as myocardial injury, oxidative stress, mechanical stretch, and elevated autocrine-paracrine mediators, thereby undergoing proliferation, differentiation to myofibroblasts, and production of various cytokines and ECM proteins. A number of signaling pathways and bioactive molecules are involved …

Faculty And Staff Updates, Department Of Surgery, February 2013, Wright State University Department Of Surgery

Department of Surgery Updates

A two page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

The Treatment Of Cutaneous Abscesses: Comparison Of Emergency Medicine Providers' Practice Patterns, Gillian Schmitz, Tress Goodwin, Adam Singer, Chad S. Kessler, David Bruner, Hollyn Larabee, Larissa S. May, Samuel D. Luber, Justin Williams, Rahul Bhat

Emergency Medicine Faculty Publications

INTRODUCTION:

Cutaneous abscesses are commonly treated in the emergency department (ED). Although incision and drainage (I&D) remains the standard treatment, there is little high-quality evidence to support additional interventions such as pain control, type of incision, and use of irrigation, wound cultures, and packing. Although guidelines exist to support clinician management of abscesses, they do not clearly specify these additional interventions. This study sought to describe the ED treatments administered to adults with uncomplicated superficial cutaneous abscesses, defined as purulent lesions requiring incision and drainage that could be managed in an ED or outpatient setting.

METHODS:

Four hundred and seventy-four …

Perceptions Of Emergency Department Crowding In The Commonwealth Of Pennsylvania, Jesse M. Pines, Joshua A. Isserman, John J. Kelly

Emergency Medicine Faculty Publications

Introduction: The state of emergency department (ED) crowding in Pennsylvania has not previously been reported.

Methods: We assessed perceptions of ED crowding by surveying medical directors/chairs from Pennsylvania EDs in the spring of 2008.

Results: A total of 106 completed the questionnaire (68% response rate). A total of 83% (86/104) agreed that ED crowding was a problem; 26% (27/105) reported that at least half of admitted patients boarded for more than 4 hours. Ninety-eight percent (102/104) agreed that patient satisfaction suffers during crowding and 79% (84/106) stated that quality suffers. Sixty-five percent (68/105) reported that crowding had worsened during the …

Prenatal Diagnosis Of Long Qt Syndrome: Implications For Delivery Room And Neonatal Management, E. Anne Greene, Charles I. Berul, Mary T. Donofrio

Pediatrics Faculty Publications

This case describes the prenatal diagnosis and integrated peripartum management of a foetus with 2:1 atrioventricular block and torsade de pointes due to congenital long QT syndrome. The unique issues related to the detection of intrauterine conduction abnormalities and ventricular arrhythmias, along with the immediate postnatal care, have been described as an interesting teaching case with successful outcome.

Conditional Sox9 Ablation Reduces Chondroitin Sulfate Proteoglycan Levels And Improves Motor Function Following Spinal Cord Injury, William M. Mckillop, Magdalena Dragan, Andreas Schedl, Arthur Brown

Paediatrics Publications

Chondroitin sulfate proteoglycans (CSPGs) found in perineuronal nets and in the glial scar after spinal cord injury have been shown to inhibit axonal growth and plasticity. Since we have previously identified SOX9 as a transcription factor that upregulates the expression of a battery of genes associated with glial scar formation in primary astrocyte cultures, we predicted that conditional Sox9 ablation would result in reduced CSPG expression after spinal cord injury and that this would lead to increased neuroplasticity and improved locomotor recovery. Control and Sox9 conditional knock-out mice were subject to a 70 kdyne contusion spinal cord injury at thoracic …

Sickle Cell Disease In Pregnancy: Trend And Pregnancy Outcomes At A Tertiary Hospital In Tanzania, Projestine S. Muganyizi, Hussein Kidanto

Faculty of Health Sciences, East Africa

SCD in pregnancy is associated with increased adverse fetal and maternal outcomes. In Tanzania where the frequency of sickle cell trait is 13% there has been scanty data on SCD in pregnancy. With progressive improvement in childhood survival the burden of SCD in pregnancy will increase. We analyzed all deliveries at Muhimbili National Hospital (MNH) from 1999 to 2011. Fetal and maternal outcomes of SCD deliveries were compared with non-SCD. Data were analyzed using IBM SPSS statistics version 19. Chi square and Fisher Exact tests were used to compare proportions and the independent t-test for continuous data. To predict risks …

Pterygium Recurrence Related To Its Size And Corneal Involvement, Pir Salim Mahar, Nabeel Manzar

Section of Ophthalmology

Objective: To establish the usefulness of grading system based on the size and extent of corneal involvement in predicting recurrence in patients undergoing primary pterygium excision with intraoperative use of adjunctive topical Mitomycin-C (MMC).
Study Design: A case series.
Place and Duration of Study: Section of Ophthalmology, the Aga Khan University Hospital, Karachi, from 2005 till 2010.
Methodology: One hundred and twenty male patients (120 eyes) underwent surgical removal of pterygium using bare sclera method with MMC in concentration of 0.2 mg/ml (0.02%) with exposure time of 3 minutes. Classification of subjects was done according to the grading of pterygium. …

Inflammatory Biomarker Changes And Their Correlation With Framingham Cardiovascular Risk And Lipid Changes In Antiretroviral-Naive Hiv-Infected Patients Treated For 144 Weeks With Abacavir/Lamivudine/Atazanavir With Or Without Ritonavir In Aries., Benjamin Young, Kathleen E Squires, Lisa L Ross, Lizette Santiago, Louis M Sloan, Henry H Zhao, Brian C Wine, Gary E Pakes, David A Margolis, Mark S Shaefer

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Propensity for developing coronary heart disease (CHD) is linked with Framingham-defined cardiovascular risk factors and elevated inflammatory biomarkers. Cardiovascular risk and inflammatory biomarkers were evaluated in ARIES, a Phase IIIb/IV clinical trial in which 515 antiretroviral-naive HIV-infected subjects initially received abacavir/lamivudine + atazanavir/ritonavir for 36 weeks. Subjects who were virologically suppressed by week 30 were randomized 1:1 at week 36 to either maintain or discontinue ritonavir for an additional 108 weeks. Framingham 10-year CHD risk scores (FRS) and risk category of

Mindfulness-Based Relapse Prevention For Substance Craving., Katie Witkiewitz, Sarah Bowen, Haley Douglas, Sharon H Hsu

Articles, Abstracts, and Reports

Craving, defined as the subjective experience of an urge or desire to use substances, has been identified in clinical, laboratory, and preclinical studies as a significant predictor of substance use, substance use disorder, and relapse following treatment for a substance use disorder. Various models of craving have been proposed from biological, cognitive, and/or affective perspectives, and, collectively, these models of craving have informed the research and treatment of addictive behaviors. In this article we discuss craving from a mindfulness perspective, and specifically how mindfulness-based relapse prevention (MBRP) may be effective in reducing substance craving. We present secondary analyses of data …

Acute Respiratory Distress Syndrome-A Concise Clinical Review, Erfan Hussain, Fahad Hamid

Department of Medicine

Acute Respiratory Distress Syndrome (ARDS) is a challenging and deadly disease faced by critical care specialists. The literature concerning ARDS has been increasing for the last 12 years and there are now many options available to treat this disease. However, not all of these options work and some may even be harmful to patients. The purpose of this paper is to provide the reader with a review of the new criteria for ARDS definition and to discuss the pros and cons of the various treatment options now available.

Etiology And Outcome Of Severe Community Acquired Pneumonia In Immunocompetent Adults., Ali Khawaja, Ali Bin Sarwar Zubairi, Fahad Khan Durrani, Afia Zafar

Department of Medicine

BACKGROUND: Community Acquired Pneumonia (CAP) is a commonly encountered disease, one third of which is Severe Community Acquired Pneumonia (SCAP) that can be potentially fatal. There is a paucity of data on etiology and outcome of patients with SCAP in South Asian Population.

METHODS: A retrospective cross-sectional study was conducted from March 2002 till December 2008 on patients of 16 years and above who were admitted with the diagnosis of SCAP in accordance to the criteria of American Thoracic Society Guidelines (2001). The patients underwent clinical and diagnostic evaluations to detect the severity of illness as well as the etiology …

Is Has-Bled Score Better Than Chads2 And Hemor2rhages Schemes In Assessing 1 Year Risk Of Major Bleed In Atrial Fibrillation Patients?, Syed Habibullah Kamran, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Characteristics, Sexual Behaviour And Risk Factors Of Female, Male And Transgender Sex Workers In South Africa, Marlise L. Richter, M. Chersich, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background. In South Africa, information on sex workers’ characteristics, sexual behaviour and health needs is limited. Current social, legal and institutional factors impede a safe working environment for sex workers and their clients.

Objectives. To describe characteristics and sexual behaviour of female, male and transgender sex workers, and assess their risk factors for unprotected sex.

Methods: Repeat cross-sectional surveys among sex workers were conducted in Hillbrow, Sandton, Rustenburg and Cape Town in 2010. Sex workers were interviewed once; any re-interviews were excluded from analysis. Unprotected sex was defined as any unprotected penetrative vaginal or anal sex with last two clients. …

Oncolog, Volume 58, Number 02, February 2013, Bryan Tutt, Jill Delsigne

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Chronic Viral Hepatitis in Cancer Patients Requires Personalized Management: Chronic viral hepatitis is life-threatening for many patients but curable or manageable for others. But in patients who have both viral hepatitis and cancer, cancer treatment may exacerbate the viral infection and lead to other complications, such as liver failure or even death
• Managing Sleep Disorders in Cancer Patients: Quality sleep is essential to healing, to proper immune function, and even to mental health. Conversely, lack of sleep has been associated with depression, anxiety, and decreased cognitive function. In cancer patients, poor sleep reduces quality of life; nevertheless, most cancer patients …

Management Of Upper Aerodigestive Tract Bleeding In Patients On Ecmo., Hitoshi Hirose, Md, Phd, Meredith Harrison, Md, Adam I. Baker, Md, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Introduction: Bleeding complications on Extracorporeal Membrane Oxygenation (ECMO) are often encountered. In a review of our own series, it was found that upper aero digestive tract bleeding was common and management was often difficult. We propose an algorithm to help manage upper aero digestive tract bleeding in the anticoagulated, ECMO patient. Hypothesis: Once an ECMO patient fails conservative management for upper aero digestive bleeding, more aggressive measures will prove successful, which will provide benefit to the patient. Methods: A retrospective chart review was performed of the patients who underwent venovenous or veno-arterial ECMO at our institution between July 2010 and …

Low Rate Of Recurrence Of Helicobacter Pylori Infection In Spite Of High Clarithromycin Resistance In Pakistan, Javed Yakoob, Shahab Abid, Wasim Jafri, Zaigham Abbas, Khalid Mumtaz, Saeed Hamid, Rashida Ahmed

Section of Gastroenterology

Background

The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy.

Methods

One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment …

Roadmap...Setting The Course For Patient And Family Involvement In Their Plan Of Care (Poster), Kristina Holleran, Tracie Heckman Msn, Rn, Cmsrn

Patient Care Services / Nursing

No abstract provided.

Major Perioperative Morbidity Does Not Affect Long-Term Survival In Patients Undergoing Esophagectomy For Cancer Of The Esophagus Or Gastroesophageal Junction., Brent T Xia, Ernest L Rosato, Karen A Chojnacki, Albert G. Crawford, Benny Weksler, Adam C. Berger

Department of Surgery Faculty Papers

INTRODUCTION: The incidence of cancer of the esophagus/GE junction is dramatically increasing but continues to have a dismal prognosis. Esophagectomy provides the best opportunity for long-term cure but is hampered by increased rates of perioperative morbidity. We reviewed our large institutional experience to evaluate the impact of postoperative complications on the long-term survival of patients undergoing resection for curative intent.

METHODS: We identified 237 patients who underwent esophagogastrectomy, with curative intent, for cancer between 1994 and 2008. Complications were graded using the previously published Clavien scale. Survival was calculated using Kaplan-Meier methodology and survival curves were compared using log-rank tests. …

A Case Of Orbital Apex Syndrome In A Patient With Malignant Otitis Externa, Rashid Baig, Qazi Assad Khan, Mohammed Ali Sadiq, Mohammad Sohail Awan, Khabir Ahmad

Department of Surgery Docs

Abstract

A rare case of skull base infection with a rapid clinical course leading to visual loss and eventually death in a poorly-controlled diabetic patient is presented. A 37-year-old woman presented with a history of visual loss and painful protrusion of the right eye for the preceding 3 days.This was accompanied by vertigo and right-side facial weakness. The patient had perception of light in her right eye and 20/25 (presenting visual acuity) in the fellow eye, accompanied by right-side proptosis, total ophthalmoplegia, optic disc pallor and central retinal artery occlusion. Magnetic resonance imaging showed the presence of oedema with soft-tissue …

Challenges In Testing Genetically Modified Crops For Potential Increases In Endogenous Allergen Expression For Safety, Rakhi Panda, H. Ariyarathna, Plaimein Amnuaycheewa, Afua O. Tetteh, S. N. Pramod, Steve Taylor, B. K. Ballmer-Weber, Richard E. Goodman

Department of Food Science and Technology: Faculty Publications

Premarket, genetically modified (GM) plants are assessed for potential risks of food allergy. The major risk would be transfer of a gene encoding an allergen or protein nearly identical to an allergen into a different food source, which can be assessed by specific serum testing. The potential that a newly expressed protein might become an allergen is evaluated based on resistance to digestion in pepsin and abundance in food fractions. If the modified plant is a common allergenic source (e.g. soybean), regulatory guidelines suggest testing for increases in the expression of endogenous allergens. Some regulators request evaluating endogenous allergens for …