Medical Specialties Commons^™

Dipstick Proteinuria Is An Independent Predictor Of High On Treatment Platelet Reactivity In Patients On Clopidogrel, But Not Aspirin, Admitted For Major Adverse Cardiovascular Events., Carlos D. Davila, Fernando Vargas, Kuan-Hsiang Gary Huang, Thomas Monaco, Anastasios Dimou, Janani Rangaswami, Vincent M. Figueredo, M.D.

Division of Cardiology Faculty Papers

Abstract The effectiveness of aspirin and clopidogrel in patients with chronic kidney disease (CKD) suffering from acute cardiovascular events is unclear. High on treatment platelet reactivity (HTPR) has been associated with worse outcomes. Here, we assessed the association of dipstick proteinuria (DP) and renal function on HTPR and clinical outcomes. Retrospective cohort analysis of 261 consecutive, non-dialysis patients admitted for Major Adverse Cardiovascular Events (MACE) that had VerifyNow P2Y12 and VerifyNow Aspirin assays performed. HTPR was defined as P2Y12 reactivity unit (PRU) > 208 for clopidogrel and aspirin reaction units (ARU) > 550 for aspirin. Renal function was classified based on the …

A Cross Sectional Study Of Medical Student Knowledge Of Evidence Based Medicine As Measured By The Fresno Test Of Evidence Based Medicine, Lauren Semler Ms, Elizabeth Rehman, Zachary Haddad Bs, Katie Ahmadzadeh Do, Steven J. Crellin Do, Katarzyna Falkowska Do, Kalif Kendig Do, Brent H. Steinweg Do, Amy B. Smith Phd, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Central And Peripheral Nervous System Demyelination Following Mycoplasma Pneumonia Infection With Review Of Literature, Brian Miller Do, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Olfactory Function In Migraine Both During And Between Attacks., Michael J. Marmura, Teshamae S Monteith, Waseem Anjum, Richard L Doty, Sarah E Hegarty, Scott W Keith

Department of Neurology Faculty Papers

INTRODUCTION: People with migraine often report being osmophobic, both during and between acute migraine attacks. It is not clear, however, whether such reports are associated with changes in olfaction such as hyperosmia, as measured by psychophysical testing. In this case-control study we quantitatively assessed olfactory identification ability, which correlates with threshold tests of olfactory acuity, in patients with migraine at baseline (no headache), during migraine episodes, and after a treated attack and compared the test scores to those of matched control subjects.

METHODS: Fifty episodic migraine subjects and 50 and sex- and age-matched controls without headache were tested. All completed …

Management Of Head And Neck Pseudoaneurysms: A Review Of 33 Consecutive Cases., Eliza Anderson, Nohra Chalouhi, Md, Aaron Dumont, Stavropoula Tjoumakaris, Mario Zanaty, Robert H. Rosenwasswer Md, Robert M Starke, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

Background. Endosaccular coiling, vessel occlusion, stenting, stent-assisted coiling, and flow diversion are all endovascular treatment options for pseudoaneurysms (PAs) of the head and neck. We explore different clinical situations in which these were selected for PA management at a single institution. Methods. Over a period of ten years, 33 patients presented to our hospital with PAs of the head and neck. Their outcomes and procedural complications are discussed. Results. We observed a complication rate of 18.2% (6 of 33), consisting predominantly of infarcts following vessel occlusion. As measured by the modified Rankin Scale, 25 (75.8%) patients had achieved favorable outcomes …

Comparison Of Airway Intubation Devices When Using A Biohazard Suit: A Feasibility Study, Kevin Weaver Do, Kayla R. Long Do, Gavin C. Barr Jr. Md, Jeffery P. Reboul Do, Aaron S. Ratner Do, Leonel Diaz Jr.,Do, Dougals A. Sturm Do, Bernadette Glenn-Porter Bs, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Improving Outcomes In Diabetic Patients, Daniel Tseytlin Do, Cheryl A. Bloomfield Md, Ranjit R. Nair Md, Carolyn Casey, Vlad Vlatsis Do, Maura Bucciarelli Do, Chris Kern Do, Stephen Awuor Md, Arsha Shreedhar Md, Ron Julia Jr. Md

Department of Medicine

No abstract provided.

Atypical Presentation Of Actinomyces, Brian Friel Do, Sarah Park Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Unchain My Heart: Constrictive Pericarditis In The Setting Of Chronic Kidney Disease And Monoclonal Gammopathy Of Undetermined Significance, Neiman Ramjattan Do, Justin L. Guthier Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Isolated Gastroduodenal Crohn’S Disease, Matthew Sullivan Do, Patrick Hickey Do, Saba Ahmad Md, Jeffrey Brodsky Md, Hiral N. Shah Md, Ronald Bross Md

Department of Medicine

No abstract provided.

Design And Development Of A Linked Open Data-Based Health Information Representation And Visualization System: Potentials And Preliminary Evaluation, Binyam Tilahun, Tomi Kauppinen, Carsten Keßler, Fleur Fritz

Publications and Research

Background: Healthcare organizations around the world are challenged by pressures to reduce cost, improve coordination and outcome, and provide more with less. This requires effective planning and evidence-based practice by generating important information from available data. Thus, flexible and user-friendly ways to represent, query, and visualize health data becomes increasingly important. International organizations such as the World Health Organization (WHO) regularly publish vital data on priority health topics that can be utilized for public health policy and health service development. However, the data in most portals is displayed in either Excel or PDF formats, which makes information discovery and reuse …

Ectopic Cushing Syndrome And Pancreatic Cancer: A Case Report, Mira Mitry Md, Nicole M. Agostino Do, Stacey Smith Md, Facp, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Rare Presentation Of A Massive Intermittent Upper Gastrointestinal Bleed, Bonnie Patek Do, Matthew Sullivan Do, Shashin Shah Md

Department of Medicine

No abstract provided.

Mechanisms Of T-B Cell Cooperation Important For Mog Antibody Mediated Demyelination, Dusanka S. Skundric

Neurology Faculty Publications

No abstract provided.

Rectal Polyp With Atypical Lymphoid Infiltrate; Rectal Lymphoma Or Rectal Tonsil, Dalya El Tawil Md, Adam R. Paul Do

Department of Pediatrics

No abstract provided.

Loss Of Hif-1Α In The Notochord Results In Cell Death And Complete Disappearance Of The Nucleus Pulposus., Christophe Merceron, Laura Mangiavini, Alexander Robling, Tremika Leshan Wilson, Amato J Giaccia, Irving Shapiro, Ernestina Schipani, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

The intervertebral disc (IVD) is one of the largest avascular organs in vertebrates. The nucleus pulposus (NP), a highly hydrated and proteoglycan-enriched tissue, forms the inner portion of the IVD. The NP is surrounded by a multi-lamellar fibrocartilaginous structure, the annulus fibrosus (AF). This structure is covered superior and inferior side by cartilaginous endplates (CEP). The NP is a unique tissue within the IVD as it results from the differentiation of notochordal cells, whereas, AF and CEP derive from the sclerotome. The hypoxia inducible factor-1α (HIF-1α) is expressed in NP cells but its function in NP development and homeostasis is …

Predictors Of Infections Following Cranioplasty: A Retrospective Review Of A Large Single Center Study., Mario Zanaty, Nohra Chalouhi, Md, Robert M Starke, Rohan Chitale, Md, Shannon Hann, Md, Cory D Bovenzi, Mark P Saigh, Eric W Schwartz, Emily S I Kunkel, Alexandra S Efthimiadis-Budike, Pascal Jabbour Md, Richard Dalyai, Robert H. Rosenwasswer Md, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

Introduction. The variables that predispose to postcranioplasty infections are poorly described in the literature. We formulated a multivariate model that predicts the risk of infection in patients undergoing cranioplasty. Method. Retrospective review of all patients who underwent cranioplasty following craniectomy from January, 2000, to December, 2011. Tested predictors were age, sex, diabetic status, hypertensive status, reason for craniectomy, urgency status of craniectomy, location of cranioplasty, reoperation for hematoma, hydrocephalus postcranioplasty, and material type. A multivariate logistic regression analysis was performed. Results. Three hundred forty-eight patients met the study criteria. Infection rate was 26.43% (92/348). Of these cases with infection, 56.52% …

Clinical Vignette: A Case Of Successful Surgical Decortication For Empyema With Trapped Lung, In A Patient With Decompensated Cirrhosis, Tripti R. Chopade, Md, She-Yan Wong, Md, David A. Sass, Md, Scott W. Cowan, Md, Jesse M. Civan, Md

Division of Gastroenterology and Hepatology Faculty Papers

Introduction

Hepatic hydrothorax (HH) is a difficult-to-control complication of cirrhosis. Chest tube (CT) drainage is an option for management of HH, but is associated with a high rate of secondary infection and other complications.

Markedly Elevated Ca 19-9 In A Case Of Mirizzi’S Syndrome: An Atypical Presentation, Saba Ahmad Md, Hiral N. Shah Md, Patrick Hickey Do, Matthew Sullivan Do

Department of Medicine

No abstract provided.

Wearable Technology In Obstetrical Emergency Simulation: A Pilot Study, Jami Goodwin, Rayan A. Elkattah, Martin Olsen

International Journal of Health Sciences Education

Background: Medical student involvement in clinical care of obstetrical emergencies is limited. Wearable technology, namely Google Glass, has been used to enhance the simulation experience for trainees at our institution. We present a pilot study that examines the utility of this technology in medical students’ education through remotely-conducted exercises in obstetric emergencies.

Materials & Methods: A total of thirteen medical students accepted the opportunity to participate in an obstetric emergencies training exercise with remote monitoring. Students wore the Google Glass device while participating in two simulated obstetrical emergencies: shoulder dystocia and vaginal breech delivery. A remote instructor monitored the students’ …

Nutrition And Prevention Of Alzheimer's Dementia, Arun Swaminathan, Gregory A. Jicha

Neurology Faculty Publications

A nutritional approach to prevent, slow, or halt the progression of disease is a promising strategy that has been widely investigated. Much epidemiologic data suggests that nutritional intake may influence the development and progression of Alzheimer’s dementia (AD). Modifiable, environmental causes of AD include potential metabolic derangements caused by dietary insufficiency and or excess that may be corrected by nutritional supplementation and or dietary modification. Many nutritional supplements contain a myriad of health promoting constituents (anti-oxidants, vitamins, trace minerals, flavonoids, lipids, …etc.) that may have novel mechanisms of action affecting cellular health and regeneration, the aging process itself, or may …

Blood Levels Of S-100 Calcium-Binding Protein B, High-Sensitivity C-Reactive Protein, And Interleukin-6 For Changes In Depressive Symptom Severity After Coronary Artery Bypass Grafting: Prospective Cohort Nested Within A Randomized, Controlled Trial, Daniel M. Pearlman, Jeremiah R. R. Brown, Todd A. Mackenzie, Felix Hernandez, Souhel Najjar

Dartmouth Scholarship

Background: Cross-sectional and retrospective studies have associated major depressive disorder with glial activation and injury as well as blood–brain barrier disruption, but these associations have not been assessed prospectively. Here, we aimed to determine the relationship between changes in depressive symptom severity and in blood levels of S-100 calcium- binding protein B (S-100B), high-sensitivity C-reactive protein, and interleukin-6 following an inflammatory challenge.

Methods: Fifty unselected participants were recruited from a randomized, controlled trial comparing coronary artery bypass grafting procedures performed with versus without cardiopulmonary bypass for the risk of neurocognitive decline. Depressive symptom severity was measured at baseline, discharge, and …

Role Of A Genetic Variant On The 15q25.1 Lung Cancer Susceptibility Locus In Smoking-Associated Nasopharyngeal Carcinoma, Xuemei Ji, Weidong Zhang, Jiang Gui, Xia Fan, Weiwei Zhang, Yafang Li, Guangyu An, Dakai Zhu, Qiang Hu

Dartmouth Scholarship

Background: The 15q25.1 lung cancer susceptibility locus, containing CHRNA5, could modify lung cancer susceptibility and multiple smoking related phenotypes. However, no studies have investigated the association between CHRNA5 rs3841324, which has been proven to have the highest association with CHRNA5 mRNA expression, and the risk of other smoking-associated cancers, except lung cancer. In the current study we examined the association between rs3841324 and susceptibility to smoking-associated nasopharyngeal carcinoma (NPC).

Methods: In this case-control study we genotyped the CHRNA5 rs3841324 polymorphism with 400 NPC cases and 491 healthy controls who were Han Chinese and frequency-matched by age (±5 years), gender, and …

Regular Dipyridamole Therapy Produces Sustained Protection Against Cardiac Ischemia-Reperfusion Injury: Is It Time To Revisit Paris?, Vincent M. Figueredo, M.D., Chika Okusa, Kazuhiro Kaneda, Yoshitaka Inamura, Masami Miyamae

Division of Cardiology Faculty Papers

BACKGROUND: Increased activated Akt and eNOS expression coincide with this persistent cardioprotection. Emergent coronary reperfusion therapies are rarely carried out before considerable myocardial injury has occurred. Moreover, reperfusion after prolonged ischemia produces paradoxical ischemia-reperfusion injury, attenuating the efficacy of reperfusion therapies. This has provided impetus for identifying chronic therapies to protect against ischemia-reperfusion injury in those at risk. We previously found that regular dipyridamole therapy produces a chronic preconditioning-like effect mediated through adenosine A1 receptors.

METHODS: To determine how long this chronic preconditioning effect of dipyridamole remains present after discontinuing therapy, guinea pigs received 4 mg/kg/day in their water for …

Progressive Ataxia In An Aids Patient On Antiretroviral Therapy, Misbahuddin Syed Md

Department of Medicine

No abstract provided.

Microscopic Polyangiitis Presenting With A Pure Sensory Peripheral Symmetric Polyneuropathy, Matthew Sullivan Do, Craig A. Mackaness Do, James Ross Md, Facp

Department of Medicine

No abstract provided.

Chasing The Dragon: A Case Of Inhaled Heroin Overdose Resulting In Stunned Myocardium, Neiman Ramjattan Do

Department of Medicine

No abstract provided.

Adenomyomatous Hyperplasia Of The Ampulla Of Vater Masquerading As Malignancy: A Case Series, Patrick Hickey Do, Saba Ahmad Md, Matthew Sullivan Do, Miriam L. Enriquez Md, Jeffrey Brodsky Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Recurrent Biliary Obstruction Overcome With Metal Biliary Stent Placement In The Surgically Altered Down Syndrome Patient For Congenital Duodenal Atresia, Patrick Hickey Do, Matthew Sullivan Do, Saba Ahmad Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Experimental Study Of Needle-Tissue Interaction Forces: Effect Of Needle Geometries, Insertion Methods And Tissue Characteristics., Shan Jiang, Pan Li, Yan Yu, Jun Liu, Zhiyong Yang

Department of Radiation Oncology Faculty Papers

A thorough understanding of needle-tissue interaction mechanics is necessary to optimize needle design, achieve robotically needle steering, and establish surgical simulation system. It is obvious that the interaction is influenced by numerous variable parameters, which are divided into three categories: needle geometries, insertion methods, and tissue characteristics. A series of experiments are performed to explore the effect of influence factors (material samples n=5 for each factor) on the insertion force. Data were collected from different biological tissues and a special tissue-equivalent phantom with similar mechanical properties, using a 1-DOF mechanical testing system instrumented with a 6-DOF force/torque (F/T) sensor. The …