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Synapsis: Philadelphia Campus 2014, Philadelphia College Of Osteopathic Medicine

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The 2014 Philadelphia Campus Synapsis includes Orientation, Anatomy, White Coat Ceremony, DO Day on the Hill, PCOM Military, Service in the Community, Missions Abroad, Osteopathic Manipulative Medicine Convocation, Relay for Life, Make-A-Wish Date Auction, Clubs such as ACOFP, AMA, AMOPS, AMWA, APAMSA, CNS, Dermatology, DO Council, Integrative Medicine, Internal Medicine, LGBT in Medicine, Students for Choice, Nutrition in Medicine, Ob/Gyn, Oncology, Ophthalmology, Orthopedics, PCOM East, Pediatrics, Running, SAAO, SGA Senate, SNMA, SOC Executive Board, Soccer, SOMA, Sports Medicine, Surgery, Leadership Banquet 2012, Peps, Sports, J Group, Clinical Rotations, Formal Events, Match, Class Chair.

Department Of Surgery Update, January 2014, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, recruitment for various depositions, a list of important dates, committee meetings and more.

Association Of Demographic Characteristics With Gestational Diabetes Mellitus And Gestational Hypertension In Ohio During 2012, Jared D. Klein

Master of Public Health Program Student Publications

Background: Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) are serious conditions that can arise during pregnancy. Both of these disorders can cause detrimental health effects to both mother and newborn. Methods: Ohio vital statistics birth data was obtained from Public Health- Dayton and Montgomery County. The data set included 137,268 women who gave birth during 2012 in Ohio and had a known GDM and/or GHTN status. IBM Statistical Package for Social Sciences for Mac Version 20 (SPSS, IBM, 2011) was used to analyze the data. Descriptive statistics, odds ratios, chi-square analyses, and multivariate logistic forward stepwise regressions were calculated …

Eating Disorders: The Hidden Hormonal Effect On Fertility, Esther Tessler-Karfunkel

The Science Journal of the Lander College of Arts and Sciences

Women who have a history of eating disorders, specifically anorexia nervosa, are more prone to suffer from infertility. There are several hormones which are the driving force in this system and are therefore responsible for this. Fortunately, there are treatments which can help women with a history of eating disorders to reproduce. Using information found on Pubmed and Touro College’s database, this paper will discuss why the body cannot reproduce when it is lacking proper nutrition, as well as the various dynamics in the human reproductive system which are compromised when the body is not properly nourished.

Pediatric Gastroesophageal Reflux Disease, Adina Mezrahi

The Science Journal of the Lander College of Arts and Sciences

This objective of this review is to present the known data in regards to Gastroesophageal Reflux Disease (GERD) in infants. Articles with relevant definitions, diagnosis and treatment options were evaluated. It is evident that much controversy exists in the diagnosis and treatment of this disease, and there is the question as whether this disease can be called GERD. Current ability to attribute the symptoms infants present with the disease is still difficult to clarify, despite the fact that as many as 60% of infants show symptoms of this disease. The current testing options have proven to be insufficient in concretely …

Toward The Development Of The International Classification Of Functioning Core Sets For Children With Cerebral Palsy: A Global Expert Survey, Veronica Schiariti, Louise C. Masse, Alarcos Cieza, Anne F. Klassen, Karen Sauve, Robert Armstrong, Maureen O’Donnell

Paediatrics and Child Health, East Africa

The goal of the International Classification of Functioning is to standardize the classification of health and function of children around the world. To facilitate the application of this classification, International Classification of Functioning-based tools like the "Core Sets" are being developed. We conducted an international survey of professional experts to identify the most relevant areas of functioning in children with cerebral palsy. The questionnaire covered each component of the classification. In total, 193 professionals completed the survey (response rate 78%). Overall, 9706 answers were linked to the classification (pediatric version) by 2 professionals. From the experts' perspective, movement-related areas and …

Immunization Manual For Medical And Nursing Students ''Hepatitis B Disease'', Rose Kamenwa

Paediatrics and Child Health, East Africa

Approximately 350 – 400 million people worldwide are chronically infected with the hepatitis B virus (HBV ), and approximately 1 million die annually of HBV -related disease. The worldwide prevalence of hepatitis B virus ranges from 0.1% to 20%). This wide range is largely due to differences in age at the time of infection. Following acute HBV infection, the risk of developing chronic infection varies inversely with age: 90% for perinatal infection, 25–35% for infection at age 1–5 years and less than 10% for adults. About 45% of the world population live in areas where chronic HBV is highly endemic …

Models Of Care For Orphaned And Separated Children And Upholding Children's Rights: Cross-Sectional Evidence From Western Kenya, Lonnie Embleton, David Ayuku, Allan Kamanda, Lukoye Atwoli, Samuel Ayaya, Rachel Vreeman, Winstone Nyandiko, Peter Gisore, Julius Koech, Paula Braitstein

Paediatrics and Child Health, East Africa

Background: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human rights framework using the United Nations Convention on the Rights of the Child to understand what extent children's basic human rights were being upheld in institutional vs. community- or family-based care settings in …

Association Between Parity And Rubella Seropositivity Among Older Reproductive-Age Women, Ibtisam Salim Awadh

Master of Medicine in Obstetrics and Gynecology

Background: Rubella virus when it infects a non-pregnant adult or child usually causes a mild febrile rash illness. However, infection in the first 12 weeks of pregnancy causes miscarriages, stillbirths or foetal anomalies known as congenital rubella syndrome (CRS). Factors associated with rubella immunity include age and parity. No studies have been done to isolate the association of parity independent of age. Objectives: To determine the seroprevalence of rubella IgG antibodies among nulliparous and multiparous women of the same age-group attending various clinics in Aga Khan University Hospital, Nairobi, Design: A cross-sectional study of women attending a tertiary hospital, Nairobi, …

A Mother's Paradox: Choosing A Birthing Method In The 21st Century, Jenae Franklin

Pitzer Senior Theses

Investigating childbirth, one of the biggest moments of a woman’s life, this thesis examines the reasons behind women’s preferred birthing methods. This research explores the fundamental decisions women make during the birthing process: the amount of prenatal care mothers will receive, the type of health care provider they will use, picking the place of delivery, views on technological and medical interventions, and outlooks on natural childbirth. In addition to an extensive literature review, in-depth interviews with mothers, midwives, and obstetricians are used to examine the various controversies of childbirth. This thesis begins with a review of the transition from midwives …

The Use Of Physical Restraints Among Nursing Home Residents: Do Disparities Exist?, Shekinah Fashaw

HIM 1990-2015

Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit …

Heart Valve Surgery: Euroscore Vs. Euroscore Ii Vs. Society Of Thoracic Surgeons Score, Muhammad Sharoz Rabbani, Irfan Qadir, Yasir Ahmed, Marrium Gul, Hasanat Sharif

Section of Cardiothoracic Surgery

Background: This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II with the previous additive (AES) and logistic EuroSCORE (LES) and the Society of Thoracic Surgeons' (STS) risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan.PATIENTS AND Methods: Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration.Results: There were 28 deaths (4.8%) among 576 patients, …

Neurosurgery Literature Highlights & Psychiatry Literature Highlights, Muhammad Waqas Shaiq, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

Today, a great challenge of our profession is to envision how we will deliver exemplary neurosurgical care in the future. To accomplish this requires anticipating how economic, political, and societal influences will affect our ability to provide the highest quality of patient care in an arena that will look increasingly different from today's world of medicine. Already, our profession is battling a relentless assault as numerous sectors implement change that impacts us and our community every day. Surviving this requires an effective strategy that will involve significant cultural change.

Utility Of Microwave Radiometry For Diagnostic And Therapeutic Applications Of Non-Invasive Temperature Monitoring, Paul R. Stauffer, Dario B. Rodrigues, Paolo F. Maccarini

Department of Radiation Oncology Faculty Papers

This paper describes the use of microwave radiometry for several diagnostic and therapeutic applications that can benefit from accurate non-invasive measurement of volume average temperature of tissue regions extending 4cm or more into the body. Design features are summarized for an appropriate high sensitivity long term stable system with 2.5 and 7 cm diameter receive antennas and integral 1.35 GHz total power radiometer electronics. Radiometer performance is characterized with electromagnetic and thermal simulations and experimental measurements in realistic models of two typical clinical applications. Results demonstrate sufficient sensitivity to track clinically significant changes in temperature of deep tissue targets for …

Immunotherapy In Combination With Behavioral Enrichment In A Canine Model Of Aging, Paulina R. Davis

Theses and Dissertations--Pharmacology and Nutritional Sciences

Alzheimer’s disease (AD) is characterized by cognitive decline and hallmark neuropathology, including β-amyloid (Aβ). Therapeutic strategies for AD are focusing on reducing Aβ. Canines develop Aβ neuropathology and cognitive decline with age similar to AD patients. In previous studies, immunization with Aβ1-42 (VAC) in aged canines decreased brain Aβ but did not improve cognition. Behavioral enrichment (ENR) improved cognition without reducing brain Aβ. We hypothesized that VAC combined with ENR would provide cognitive benefits and reduce Aβ neuropathology, as compared individual VAC and ENR treatments. Aged beagles were placed into groups: control, VAC with fibrillar Aβ1-42, ENR, and combination treatment …

Quantification Of Factors Governing Drug Release Kinetics From Nanoparticles: A Combined Experimental And Mechanistic Modeling Approach, Kyle Daniel Fugit

Theses and Dissertations--Pharmacy

Advancements in nanoparticle drug delivery of anticancer agents require mathematical models capable of predicting in vivo formulation performance from in vitro characterization studies. Such models must identify and incorporate the physicochemical properties of the therapeutic agent and nanoparticle driving in vivo drug release. This work identifies these factors for two nanoparticle formulations of anticancer agents using an approach which develops mechanistic mathematical models in conjunction with experimental studies.

A non-sink ultrafiltration method was developed to monitor liposomal release kinetics of the anticancer agent topotecan. Mathematical modeling allowed simultaneous determination of drug permeability and interfacial binding to the bilayer from release …

Phosphatidylinositol 3-Kinase (Pi3k) As A Therapeutic Target In Nsclc, Christopher W. Stamatkin

Theses and Dissertations--Pharmacy

Deregulated activation of phosphatidylinositol 3-kinase (PI3K) pathway is central to many human malignancies. The functions of this pathway are critical for normal cell metabolism, proliferation, and survival. In lung cancers, the PI3K pathway activity is often aberrantly driven by multiple mutations, including EGFR, KRAS, and PIK3CA. Molecules targeting the PI3K pathway are intensely investigated as potential anti-cancer agents. Although inhibitors of the pathway are currently in clinical trials, rational and targeted use of these compounds, alone or in combination, requires an understanding of isoform-specific activity in context. We sought to identify class IA PI3K enzyme (p110a/PIK3CA, p110b/PIK3CB, p110d/PIK3CD) activities using …

Primary And Secondary Prevention Of Hepatitis C Virus Among Rural Appalachian People Who Use Drugs, Dustin B. Stephens

Theses and Dissertations--Clinical and Translational Science

Hepatitis C virus (HCV) remains a major cause of morbidity and mortality worldwide, with 3% of the global population chronically infected. Clinical impacts in the United States are projected to increase for two decades, and mortality attributed to HCV now exceeds HIV. Injection drug use (IDU) is the most common route of transmission in the developed world. Advances in treatment offer hope of mitigating HCV impacts, but substantial barriers obstruct people who inject drugs (PWID) from receiving care, particularly in medically underserved regions including Central Appalachia. This study assessed IDU paraphernalia sharing longitudinally over 24 months in a sample of …

Nucleoside Reverse Transcriptase Inhibitors Are Anti-Inflammatory And Target Dry Age-Related Macular Degeneration, Benjamin J. Fowler

Theses and Dissertations--Physiology

Age-related macular degeneration (AMD) is a principal cause of blindness in the United States and other industrialized nations. An estimated 10 million Americans are afflicted with AMD, which is comparable in scope to the 12 million living with cancer, or the 5 million with Alzheimer’s disease. The prevalence of AMD steadily increases with age, affecting 2% of the population at age 40, and one in four people by age 80. For reasons that are not fully understood, AMD is more common in lightly-pigmented and female populations. Treatment of AMD is largely an unmet need: There are no FDA approved therapies …

Mothering And The Functional Self: A Hermeneutic Exploration Of Texts On Perinatal Mood And Anxiety Disorders, Kathleen M. Pape

Antioch University Dissertations & Theses

Mothering is a rich and complex experience involving challenging tasks, a developing relationship with one's child, and socially defined roles. How mothering is viewed varies depending on the cultural norms and historical era under consideration. This study is a textual interpretation of three books written about perinatal mental health, especially how those texts describe the challenges and struggles of birthing and mothering. I develop understandings about how clinicians respond to those issues and in the process understand themselves, their practices, and their sociocultural roles. I consider the shape of the current social terrain that brings to light the experiences of …

Functional And Clinical Outcome Of Ileal (Studer) Neo-Bladder Reconstruction: Single Centre Experience From Pakistan, Syed M. Nazim, Muhammad Hammad Ather, Farhat Abbas

Section of Urology

Objective: To determine the medium and long-term outcome of orthotopic continent urinary diversion with ileal (Studer) neo-bladder following radical cystectomy. Study Design: Case series.
Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1998 to September 2010.
Methodology: Thirty eight patients underwent radical cystectomy for invasive bladder tumor with ileal neo-bladder (Studer type) reconstruction. Peri-operative and late complications, functional outcome of neo-bladder, urinary continence, metabolic and upper urinary tract status and overall survival were evaluated in all patients.
Results: A total of 29 patients (23 males and 6 females) with mean age of …

Lifelong Learning: Established Concepts And Evolving Values, Jamsheer J Jehangir Talati Professor

Section of Urology

Objective: To summarise the concepts critical for understanding the content and value of lifelong learning (LL).
Methods: Ideas generated by personal experience were combined with those of philosophers, social scientists, educational institutions, governments and UNESCO, to facilitate an understanding of the importance of the basic concepts of LL.
Results: Autopoietic, continuous, self-determined, informal, vicarious, biographical, lifelong reflexive learning, from and for society, when supported by self-chosen formal courses, can build capacities and portable skills that allow useful responses to challenges and society’s new structures of governance. The need for LL is driven by challenges. LL flows continuously in pursuit of …

Attrition In Surgical Residency Programmes: Causes And Effects, Mehwash Nadeem, M Shahrukh Effendi, Muhammad Hammad Ather

Section of Urology

Objective: To determine the rate and trend of attrition from a surgical residency programme and to identify the reasons for attrition.
Methods: A questionnaire-based survey was conducted at a university hospital. Separate questionnaires were designed for residents and programme directors (PDs). The residents who left the training voluntarily from one of the five surgical residency programmes (i.e., general surgery, orthopaedics, neurosurgery, otorhinolaryngology and urology) during the academic years 2005-2011 were identified from a departmental database. The residents who did not respond after three attempts at contact, or those who refused to participate, were excluded.
Results: During the last 6years, 106 …

Osteopathic Manipulative Medicine (Omm) And Reduction Of Nsaid Use In Low Back Pain: A Pilot Study, Kristopher Kelly

PCOM Biomedical Studies Student Scholarship

This randomized controlled pilot study is to determine if a combination of muscle energy and soft tissue techniques can reduce the amount of daily NSAID use in patients suffering from chronic non-specific low back pain (CNSLBP). Osteopathic manipulative treatment has been shown to be useful in treating low back pain. However, its role in reducing daily NSAID use in CNSLBP patients is unclear. This study was conducted at PCOM from January 2014 to April 2014. By design, patients were to be randomized into either a treatment group consisting of OMT or a control group consisting of a sham OMT. Of …

The Effects Of Dihydrobiopterin And Tetrahydrobiopterin On Hydrogen Peroxide And Nitric Oxide Release During Extracorporeal Shockwave Lithotripsy (Eswl), Brittany Deiling

PCOM Biomedical Studies Student Scholarship

ESWL is an effective, non-invasive therapy utilized to fragment stones in the kidney and subsequently be cleared in the urinary tract. Although lithotripsy provides a safer alternative to invasive treatments for removing stones, ESWL may cause vasoconstriction after ESWL treatment, reducing renal blood flow, which can cause kidney damage leading to acute to chronic hypertension clinically. This may be due to kidney vascular endothelial dysfunction, which is characterized as increased oxidative stress and decreased endothelial nitric oxide synthase (eNOS)-derived nitric oxide (NO) bioavailability. We hypothesized that ESWL would decrease NO and increase hydrogen peroxide (H₂O₂) in …

Successes And Challenges Of Establishing A Cervical Cancer Screening And Treatment Program In Western Kenya, Kareem Khozaim, Elkanah Omenge, Astrid Christoffersen-Deb, Peter Itsura, John Oguda, Hellen Muliro, Jackline Ndiema, Grace Mwangi, Matthew Strother, Susan Cu-Uvin

Obstetrics and Gynaecology, East Africa

Objective: To describe the challenges and successes of integrating a public-sector cervical screening program into a large HIV care system in western Kenya.

Methods: The present study was a programmatic description and a retrospective chart review of data collected from a cervical screening program based on visual inspection with acetic acid (VIA) between June 2009 and October 2011.

Results: In total, 6787 women were screened: 1331 (19.6%) were VIA-positive, of whom 949 (71.3%) had HIV. Overall, 206 women underwent cryotherapy, 754 colposcopy, 143 loop electrical excision procedure (LEEP), and 27 hysterectomy. Among the colposcopy-guided biopsies, 27.9% had severe dysplasia and …

Surgical Site Infection Rates In Breast Cancer Surgery At A University Hospital In Nairobi, Kenya, Andrew Nyangau Nyaoncha

Master of Medicine in General Surgery

Back ground: Surgical site infections (SSI)following breast cancer surgery remain a significant cause of morbidity with the use of single dose pre-operative antibiotic prophylaxis. As a result the use of peri-operative antibiotics is common and unregulated, with no knowledge of the infection outcomes with their use. Objectives: To establish the SSI outcomes with the use of peri-operative antibiotic prophylaxis, evaluate the common risk factors for SSI development and assess for other important outcomes following breast cancer surgery. Methods: A prospective surveillance study for patients undergoing breast cancer surgery using the National Nosocomial Infections Surveillance (NNIS) system. Analysis: Analysis for the …

A Double-Blind Randomized Controlled Trial Comparing Effectiveness Of 0.2% Topical Nifedipine Versus 0.2% Topical Glyceryl Trinitrate In The Treatment Of Chronic Anal Fissure, Mark Michael Wekundah Siboe

Master of Medicine in General Surgery

Background: The medical management of chronic anal fissure varies among clinicians because no single treatment has yet approached an overall healing rate similar to lateral sphincterotomy. However, chemical sphincterotomy has the advantage of not carrying the presumed high risk of faecal incontinence. Glyceryl Trinitrate is commonly used in our practice with varied response. This study set out to evaluate the effectiveness of a locally compounded preparation of 0.2% topical Nifedipine in the treatment of chronic anal fissure and to compare the investigational product to 0.2% Glyceryl Trinitrate in overall healing rate and relieving pain. Design: Single centre, parallel, double-blind randomized …

Intimate Partner Violence And Pregnancy: A Systematic Review Of Interventions, An-Sofie Van Parys, Annelien Verhamme, Marleen Temmerman, Hans Verstraelen

Obstetrics and Gynaecology, East Africa

Background: Intimate partner violence (IPV) around the time of pregnancy is a widespread global health problem with many negative consequences. Nevertheless, a lot remains unclear about which interventions are effective and might be adopted in the perinatal care context.

Objective: The objective is to provide a clear overview of the existing evidence on effectiveness of interventions for IPV around the time of pregnancy.

Methods: Following databases PubMed, Web of Science, CINAHL and the Cochrane Library were systematically searched and expanded by hand search. The search was limited to English peer-reviewed randomized controlled trials published from 2000 to 2013. This review …

Sexual And Gender-Based Violence In The European Asylum And Reception Sector: A Perpetuum Mobile?, Ines Keygnaert, Sonia F. Dias, Olivier Degomme, Walter Deville, Patricia Kennedy, Andras Kovats, Sara De Meyer, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and discusses determinants for ‘Desirable Prevention’.

Methods: Applying community-based participatory research, we conducted an SGBV knowledge, attitude and practice survey with residents and professionals in eight European countries. We conducted logistic regression using mixed models to analyse the data in R.

Results: Of the 562 respondents, 58.3% reported cases of direct (23.3%) or peer (76.6%) victimization. Our results …