Medical Specialties Commons^™

Pseudocholinesterase Deficiency, Ross Gerken

Nursing Student Class Projects (Formerly MSN)

Pseudocholinesterase deficiency is a rare genetic or acquired variation in the metabolism of choline esters such as the neuromuscular blockers succinylcholine, mivacurium, and ester local anesthetics. Pseudocholinesterase deficiency genetically is transmitted in an autosomal recessive pattern with the frequency of apnea from a genetic abnormality of pseudocholinesterase between 1:480 and 1:3200 people (Ok et al., 2013). An extended period of neuromuscular blockade results from these medications than what is clinically expected. The signs and symptoms which occur are apnea and paralysis hours longer. This condition is rare but must be known and understood by the clinician in order to provide …

Understanding The Mystery Of Brain Death, Natalie A. Felter

Nursing Student Class Projects (Formerly MSN)

Lack of understanding of brain death has contributed to recent controversial cases (Copnell, 2014). The cases of Jahi McMath and Marlise Munoz were the focus of national news, causing an intense debate among the public and healthcare professionals (Copnell, 2014). The concept of brain death is a mystery to the public (Powell, 2014). Copnell (2014) found that 60% of family members who had been told their loved one was brain dead believed that they were still alive. Health professionals not having a clear grasp of brain death’s definition and assessment can lead to increased confusion in family members (Powell, 2014).

Early-Onset Familial Alzheimer Disease, Laura J. Murphy

Nursing Student Class Projects (Formerly MSN)

An Alzheimer’s diagnosis is an overwhelming and devastating diagnosis for both patients and families. Now imagine if this diagnosis was made at age 55. Instead of looking forward to retirement and grandchildren, these people are preparing for a debilitating disease that will rob them of their memory, cognitive and functional abilities. Early-onset familial Alzheimer’s disease (EOFAD) affects people before the age of 65. Although extremely rare, some exhibit symptoms as early as in their 30s. One of the things most frustrating about this disease is so little is known about its cause. That and the fact there is no cure. …

Sports Related Traumatic Brain Injuries, Ky Parrott

Nursing Student Class Projects (Formerly MSN)

Traumatic Brain Injuries (TBI) are the leading cause of long-term disability and injury death in the United States of America (Dash, Oh, Santiago, & Wade, 2012, p. 108). It is estimated that approximately 75% of all TBI’s are sports related. Recently, sports related TBI’s have received increased awareness due to the $765 million settlement between 18,000 retired football players who suffer from long-term concussive injuries and the National Football Association (NFL) (Mason, 2013, p. 267). Education regarding the pathophysiology of TBI’s is beneficial to understanding what changes the brain is enduring and why it is important to protect the brain, …

Tension Pneumocephalus, Nicole Liebner

Nursing Student Class Projects (Formerly MSN)

Pneumocephalus is defined as the presence of air within the cranial vault; tension pneumocephalus occurs when air within the cranial vault becomes trapped and causes a mass effect or increased pressure, damaging the brain (Patel, Idicula, Carrau, & Prevedello, 2013). Small amounts of air within the cranial vault can be reabsorbed or metabolized by the body over a few days without causing symptoms, however, in tension pneumocephalus the air cannot escape, causing extensive neurological symptoms (Webber-Jones ,2005). Thus, asymptomatic pneumocephalus can be a common finding following a cranial surgery, where as tension pneumocephalus is extremely rare (Webber-Jones, 2005). Markam (1967) …

Neglected Or Non-Compliant? Assessing The Difficulties Of Tuberculosis Patients In Salvador-Ba, Brazil, Erin Slatery

Independent Study Project (ISP) Collection

Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, …

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Miranda Carlson, Nicole Christine, Charles Dowd, Cassandra Dawley, Irina Fedulow, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Angela Serrani

Disease Prevention and Health Promotion Papers

The first section of this report addresses the evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment. The second section investigates the evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment. The third section discusses the underlying behavioral change theory for incorporation of our Cancer Survivorship Rehabilitation Algorithm (Appendix 1), which details our proposed use of rehabilitation and wellness services in the continuum of cancer care and includes an outline for a survivorship care plan. This section also discusses …

Improving On Time Starts For Procedures, Diane Rydzy Rn, Stuart Zarich

Posters

Patient satisfaction is clearly linked to how long a patient waits for their procedure. In order to positively impact patient satisfaction we evaluated start times for our non-invasive cardiology procedures. According to Press Ganey Associates when time spent waiting is 0-20 minutes, overall patient satisfaction ranges from 89.8 to 95.4%.

Neonatal Nmda Receptor Blockade Disrupts Spike Timing And Glutamatergic Synapses In Fast Spiking Interneurons In A Nmda Receptor Hypofunction Model Of Schizophrenia, Kevin S. Jones, Joshua G. Corbin, Molly M. Huntsman

Pediatrics Faculty Publications

The dysfunction of parvalbumin-positive, fast-spiking interneurons (FSI) is considered a primary contributor to the pathophysiology of schizophrenia (SZ), but deficits in FSI physiology have not been explicitly characterized. We show for the first time, that a widely-employed model of schizophrenia minimizes first spike latency and increases GluN2B-mediated current in neocortical FSIs. The reduction in FSI first-spike latency coincides with reduced expression of the Kv1.1 potassium channel subunit which provides a biophysical explanation for the abnormal spiking behavior. Similarly, the increase in NMDA current coincides with enhanced expression of the GluN2B NMDA receptor subunit, specifically in FSIs. In this study mice …

Effect Of Age On Uterine And Ovarian Morphology With Polycystic Ovaries, Ambreen Usmani, Rehana Rehman, Aisha Qamar

Department of Biological & Biomedical Sciences

Abstract

Objective: To measure the outcome of age on ovarian and uterine morphology in primary infertile women with

polycystic ovaries.

Methods: The observational cross-sectional study was conducted from January 2009 to March 2010, and the

subjects were recruited from Ziauddin Hospital, Nazimabad, Karachi. The primary infertile subjects with polycystic

ovaries were subdivided into two age groups:20-30 years (group I), and 31-40 years (group II). Both groups had equal

number of subjects. The ovarian volume, follicles count and size, uterine area and endometrial thickness were

determined by transabdominal and transvaginal scans. Shapiro-Wilk's test and Mann-Whitney test were applied,

with p<0.05 being significant.

Results: …

Medical Education Practice-Based Research Networks: Facilitating Collaborative Research, Alan Schwartz, Robin Young, Patricia J. Hicks, Ann Burke, Hilary M. Haftel, R. Mcgregor, L. Degnon, Carol Carraccio

Pediatrics Faculty Publications

Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging.Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research …

When Exercise Is A Pain In The Head, Rebecca D. Granger

Nursing Student Class Projects (Formerly MSN)

Headache is one of the five most common chief complaints in the US, resulting in nearly 5 million visits to the ED (Lange, 2011). With great variance in quality, etiology, pathophysiology, and as a potential indicator of a serious underlying problem, it is critical that these headaches be accurately diagnosed, primarily for rapid identification of life threatening factors, but also to offer treatment and education specific to the particular type of headache the patient is experiencing. This will result in better outcomes for the patient through better control and will subsequently save health care dollars by reducing ED visits and …

Magnetic Resonance Spectroscopy Of Enhancing Cerebral Lesions: Analysis Of 78 Histopathology Proven Cases, Muhammad Shahbaz Alam, Humera Ahsan, Zafar Sajjad, Madiha Beg, Umer Bhatti, Ather Enam, Mohammad Wasay

Department of Radiology

Objectives: To investigate the efficacy of magnetic resonance spectroscopy in differentiating various types of neoplastic and non-neoplastic enhancing cerebral lesions.
Methods: The prospective study was conducted from January 2007 to December 2009 at the Department of Radiology, Aga Khan University Hospital, Karachi. All patients with enhancing brain lesions on magnetic resonance imaging who underwent magnetic resonance spectroscopy and a biopsy with histopathological analysis were included in study. The lesions were categorised into neoplastic and non-neoplastic lesions on the basis of spectroscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of magnetic resonance spectroscopy were calculated. …

Analysis Of Candidate Genes Has Proposed The Role Of Y Chromosome In Human Prostate Cancer, Pegah Khosravi, Javad Zahiri, Vahid H. Gazestani, Samira Mirkhalaf, Mohammad Akbarzadeh, Mehdi Sadeghi, Bahram Goliaei

Publications and Research

Background: Prostate cancer, a serious genetic disease, has known as the first widespread cancer in men, but the molecular changes required for the cancer progression has not fully understood. Availability of high-throughput gene expression data has led to the development of various computational methods, for identification of the critical genes, have involved in the cancer. Methods: In this paper, we have shown the construction of co-expression networks, which have been using Y-chromosome genes, provided an alternative strategy for detecting of new candidate, might involve in prostate cancer. In our approach, we have constructed independent co-expression networks from normal and cancerous …

The Denali Trial: An Interim Analysis Of A Prospective, Multicenter Study Of The Denali Retrievable Inferior Vena Cava Filter., S William Stavropoulos, Ronald F Sing, Fakhir Elmasri, Mitchell J Silver, Alex Powell, Frank C Lynch, Ahmed Kamel Abdel Aal, Alexandra J Lansky, Richard A Settlage, Bart E Muhs, Denali Trial Investigators

Heart and Vascular Articles

Purpose: To assess safety and effectiveness of a nitinol retrievable inferior vena cava (IVC) filter in patients who require caval interruption to protect against pulmonary embolism (PE).

Materials and methods: Two hundred patients with temporary indications for an IVC filter were enrolled in this prospective, multicenter clinical study. Patients undergoing filter implantation were to be followed for 2 years or for 30 days after filter retrieval. At the time of the present interim report, all 200 patients had been enrolled in the study, and 160 had undergone a retrieval attempt or been followed to 6 months with their filter in …

Systematic Review Of Potential Health Risks Posed By Pharmaceutical, Occupational And Consumer Exposures To Metallic And Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide And Its Soluble Salts, Calvin C. Willhite, Nataliya A. Karyakina, Robert A. Yokel, Nagarajkumar Yenugadhati, Thomas M. Wisniewski, Ian M. F. Arnold, Franco Momoli, Daniel Krewski

Pharmaceutical Sciences Faculty Publications

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007).

Challenges encountered in carrying out the present review reflected the experimental use of different physical …

Detection Of Bacterial Antigens And Alzheimer's Disease-Like Pathology In The Central Nervous System Of Balb/C Mice Following Intranasal Infection With A Laboratory Isolate Of Chlamydia Pneumoniae, C. Scott Little Phd, Timothy A. Joyce, Christine Hammond, Hazem Matta, David Cahn, Denah Appelt, Brian J. Balin Phd

PCOM Scholarly Works

Pathology consistent with that observed in Alzheimer’s disease (AD) has previously been documented following intranasal infection of normal wild-type mice with Chlamydia pneumoniae (Cpn) isolated from an AD brain (96-41). In the current study, BALB/c mice were intranasally infected with a laboratory strain of Cpn, AR-39, and brain and olfactory bulbs were obtained at 1-4 months post-infection (pi). Immunohistochemistry for amyloid beta or Cpn antigens was performed on sections from brains of infected or mock-infected mice. Chlamydia-specific immunolabeling was identified in olfactory bulb tissues and in cerebrum of AR-39 infected mice. The Cpn specific labeling was most prominent at 1 …

Oncolog, Volume 59, Number 10, October 2014, Sarah Bronson, Kathryn L. Hale, Roberto Molar-Candanosa, K. Stuyck

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

• New Drugs for Myeloproliferative Neoplasms Ease Suffering and Extend Life: A new class of drugs has redefined treatment for patients with myeloproliferative neoplasms by easing their symptom burden while extending their lives
• Neoadjuvant Targeted Therapy May Offer Multiple Benefits for Patients with Locally Advanced Renal Cancer: Despite definitive treatment with nephrectomy, locally advanced renal cancer recurs in 20%-30% of patients, substantially reducing their chance for long-term survival. To prevent such recurrences and prolong survival, urologic oncologists are studying the integration of targeted molecular therapies with surgical treatments
• New Combination Therapy Offers Potential to Cure FLT3-ITD Acute Myelogenous Leukemia: A new …

“In Light Of Real Alternatives”: Negotiations Of Fertility And Motherhood In Morocco And Oman, Victoria E. Mohr

Student Publications

Many states in the Arab world have undertaken wide-ranging family planning polices in the last two decades in an effort to curb high fertility rates. Oman and Morocco are two such countries, and their policies have had significantly different results. Morocco experienced a swift drop in fertility rates, whereas Oman’s fertility has declined much more slowly over several decades. Many point to the more conservative religious and cultural context of Oman for their high fertility rates, however economics and the state of biomedical health care often present a more compelling argument for the distinct differences between Omani and Moroccan family …

Agreement Between Serology And Histology For Detection Of Helicobacter Pylori Infection, Javed Yakoob, Zaigham Abbas

Section of Gastroenterology

No abstract provided.

Giving The Homeless Population A Chance To Become Healthier: An Initial Needs Assessment Of The Homeless Population Of Portland, Maine, Annarae Andresen, Oana Butnarasu, Jayme Keith, Sarah Kou, Dana Mccoy, Stephanie Sheehan, Jessica Takatsuki, Zoe Hull, Ian Imbert, Suzanne Dunn, Tara Lonneman, Marissa Prezanno, Catherine Bixby

Homeless Needs Assessment

Research poster stemming from IPEC mini-grant student project Homeless Needs Assessment. The project was designed to assess the greatest needs for people experiencing homelessness in Portland, Maine. UNE Students from several healthcare professions partnered together to provide a holistic approach to the community needs with hopes of developing and implementing intervention strategies. Goal was to conduct surveys of at least 100 homeless individuals.

Listing Practices For Morbidly Obese Patients At Liver Transplant Centers In The United States, Dina Halegoua-De Marzio, Md, She-Yan Wong, Md, Jonathan M. Fenkel, Md, Cataldo Doria, Md, Phd, David A. Sass, Md

Division of Gastroenterology and Hepatology Faculty Papers

Introduction

• Obesity affects more than one third of Americans.
• Morbid obesity (body mass index (BMI) >35 kg/m2) has been associated with multiple co-morbidities and perioperative complications.
• The effect of morbid obesity on liver transplant outcomes has yielded mixed results.

Treatment Of Duodenal Variceal Hemorrhage With Endoscopic Band Ligation, Tripti R. Chopade, Md, Jesse M. Civan, Md, Jonathan M. Fenkel, Md, Ali A. Siddiqui, Md, Ashish R. Gandhe, Md, Dina L. Halegoua-De Marzio, Md

Division of Gastroenterology and Hepatology Faculty Papers

Introduction

• Duodenal varices (DV) are a rare but potentially serious complication of portal hypertension and carry a high risk of massive gastrointestinal bleeding.

• This is a report of successful treatment of a massive DV hemorrhage with endoscopic band ligation.

Enteral Nutrition Support For A Sarcopenia In End-Stage Liver Disease, Dina Halegoua-De Marzio, Md, She-Yan Wong, Md, Flavius Guglielmo, Md, Jonathan M. Fenkel, Md

Division of Gastroenterology and Hepatology Faculty Papers

Introduction

• Weight loss with muscle wasting, also known as sarcopenia, commonly occurs in patients with end-stage liver disease (ESLD).
• A robust association between sarcopenia and mortality in cirrhotic and post-liver transplant patients has been reported.
• This is a report of a patient with severe sarcopenia and ESLD who was provided enteral nutrition using a Dobhoff tube (DHT) pre-liver transplant resulting in successful bridging to transplant.

Leishmania Donovani Bodies In Bone Marrow, Natasha Ali, Shabneez Hussain

Department of Pathology and Laboratory Medicine

We report a case of a 5-year-old female, resident of Afghanistan, who presented with fever and massive splenomegaly. Bone marrow revealed Leishmania donovani bodies (LD bodies) in macrophages characterized by a kinetoplast and characteristic double dot appearance. She was diagnosed as visceral leishmaniasis which is transmitted by sandflies (Phlebotomus).

Identification And Characterization Of Protein Kinase C Substrates In Human Breast Cells, Xin Zhao

Dissertations, Theses, and Capstone Projects

Aberrations in PKC signaling can lead to the development of multiple human diseases and the most prominent association of PKC with disease has been in tumor growth and metastasis. PKC and its related pathways have been recognized as promising targets for blocking the malignancy of breast cancer cells. To better understand PKC-mediated pathway in breast cancer cells, it is important to identify the cellular substrates of PKC. The main focus of this work is to identify physiologically relevant cellular substrates of PKC in human breast cells and to characterize their roles in cancer-related phenotypes. The work to be described consists …

Evaluating Initial Spine Trauma Response: Injury Time To Trauma Center In Pa, Usa., James Harrop, Md, George M. Ghobrial, Md, Rohan Chitale, Md, Kelly Krespan, Laura Odorizzi, Tristan Fried, Mitchell Maltenfort, Phd, Murray Cohen, Md, Alex R. Vaccaro, Md

Department of Neurosurgery Faculty Papers

Historical perceptions regarding the severity of traumatic spinal cord injury has led to considerable disparity in triage to tertiary care centers. This article retrospectively reviews a large regional trauma database to analyze whether the diagnosis of spinal trauma affected patient transfer timing and patterns. The Pennsylvania Trauma database was retrospectively reviewed. All acute trauma patient entries for level I and II centers were categorized for diagnosis, mechanism, and location of injury, analyzing transportation modality and its influence on time of arrival. A total of 1162 trauma patients were identified (1014 blunt injuries, 135 penetrating injuries and 12 other) with a …

Contemporary Use Of Balloon Aortic Valvuloplasty In The Era Of Transcatheter Aortic Valve Implantation, Dawn S Hui, David M Shavelle, Mark J Cunningham, Ray V Matthews, Vaughn A Starnes

The Texas Heart Institute Journal

The development of transcatheter aortic valve implantation (TAVI) has increased the use of balloon aortic valvuloplasty (BAV) in treating aortic stenosis. We evaluated our use of BAV in an academic tertiary referral center with a developing TAVI program.

We reviewed 69 consecutive stand-alone BAV procedures that were performed in 62 patients (mean age, 77 ± 10 yr; 62% men; baseline mean New York Heart Association functional class, 3 ± 1) from January 2009 through December 2012. Enrollment for the CoreValve® clinical trial began in January 2011. We divided the study cohort into 2 distinct periods, defined as pre-TAVI (2009–2010) and …

Effect Of Electrocautery On Endothelial Integrity Of The Internal Thoracic Artery: Ultrastructural Analysis With Transmission Electron Microscopy, Burak Onan, Mehmet Yeniterzi, Ismihan Selen Onan, Burak Ersoy, Suheyla Gonca, Elif Gelenli, Seyhun Solakoglu, Ihsan Bakir

The Texas Heart Institute Journal

The internal thoracic artery (ITA) is typically harvested from the chest wall by means of conventional electrocautery. We investigated the effects of electrocautery on endothelial-cell and vessel-wall morphology at the ultrastructural level during ITA harvesting. Internal thoracic artery specimens from 20 patients who underwent elective coronary artery bypass grafting were investigated in 2 groups. The ITA grafts were sharply dissected with use of a scalpel and clips in the control group (n=10) and were harvested by means of electrocautery in the study group (n=10). Each sample was evaluated for intimal, elastic-tissue, muscular-layer, and adventitial changes. Free flow was measured intraoperatively. …

Off-Pump Myocardial Revascularization In A High-Risk Patient With Essential Thrombocythemia, Ahmad K Darwazah, Hamad Madi, Rami Zagha, Yahia Hawash

The Texas Heart Institute Journal

Essential thrombocythemia is a rare type of myeloproliferative disorder. Cerebral, myocardial, and peripheral thrombosis are all frequent complications of the disease.

A 71-year-old man presented with severe coronary artery disease, associated with cerebral vascular ischemic changes and erythromelalgia. His platelet count was 1,486 ×103/μL. The patient underwent successful myocardial revascularization by means of an off-pump technique after his platelet count had been reduced by hydroxycarbamide administration.

We conclude that the use of off-pump cardiopulmonary bypass in high-risk patients with essential thrombocythemia is safe. Reducing platelet count via the administration of hydroxycarbamide and the careful balancing of antiplatelets and anticoagulants is …