Medical Specialties Commons^™

Global Causes Of Maternal Death: A Who Systematic Analysis, Lale Say, Doris Chou, Alison Gemmill, Özge Tunçalp, Ann-Beth Moller, Jane Daniels, A Metin Gülmezoglu, Marleen Temmerman, Leontine Alkema

Obstetrics and Gynaecology, East Africa

Background: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analyzed global, regional, and sub-regional estimates of the causes of maternal death during 2003–09, with a novel method, updating the previous WHO systematic review.

Methods: We searched specialized and general bibliographic databases for articles published between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of pre-specified inclusion criteria, we analyzed causes of maternal death from datasets.

We aggregated country level estimates to …

The Potential Role Of Magnetic Resonance Spectroscopy In Image-Guided Radiotherapy., Mai Lin Nguyen, Brooke Willows, Rihan Khan, Alexander Chi, Lyndon Kim, Sherif G Nour, Thomas Sroka, Christine Kerr, Juan Godinez, Melissa Mills, Ulf Karlsson, Gabor Altdorfer, Nam Phong Nguyen, Gordon Jendrasiak

Department of Medical Oncology Faculty Papers

Magnetic resonance spectroscopy (MRS) is a non-invasive technique to detect metabolites within the normal and tumoral tissues. The ability of MRS to diagnose areas of high metabolic activity linked to tumor cell proliferation is particularly useful for radiotherapy treatment planning because of better gross tumor volume (GTV) delineation. The GTV may be targeted with higher radiation dose, potentially improving local control without excessive irradiation to the normal adjacent tissues. Prostate cancer and glioblastoma multiforme (GBM) are two tumor models that are associated with a heterogeneous tumor distribution. Preliminary studies suggest that the integration of MRS into radiotherapy planning for these …

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

The Anatomical And Functional Benefit Of Bevacizumab In The Treatment Of Macular Edema Associated With Purtscher-Like Retinopathy, B. Lw. Nesmith, Maya Bitar, S. Schaal

Ophthalmology

We read the article by Miguel et al1 regarding Purtscher’s and Purtscher-like retinopathies with great interest. As the authors well describe, ‘Purtscher-like retinopathy’ is diagnosed in patients with fundus findings similar to Purtscher’s retinopathy, without a history of trauma but with known systemic associations.¹ Current proposed mechanisms for the underlying pathogenesis include leukocyte aggregation by activated complement factor 5 (C5a).² As noted by the authors’ systematic review, there is currently no established treatment for Purtscher-like retinopathy, although the literature consists of several case reports of treatment with corticosteroids, without certainty as to effect on the clinical course.1 Herein, …

Novel Roles Of The Protein Tyrosine Phosphatase Shp2 In Non-Small Cell Lung Cancer, Valentina Schneeberger

USF Tampa Graduate Theses and Dissertations

The gene PTPN11 was identified in the early 1990s, and encodes the non-transmembrane protein tyrosine phosphatase SHP2. SHP2 is expressed ubiquitously in cells, and plays an important role in cancer. Unlike most phosphatases, SHP2 positively regulates several signaling pathways including the Ras/MAPK and Src signaling pathways and acts as a proto-oncogene. SHP2 is also a cancer essential gene in certain types of carcinomas, and promotes growth, survival, and epithelial to mesenchymal transformation. Gain of function (GOF) SHP2 mutations are known leukemic oncogenes, and have been identified to a smaller extent in solid tumors as well. Currently, the roles of SHP2 …

Medical Education Digest, Vol. 16 No. 3 (May/June 2014), Nova Southeastern University

Medical Education Digest

No abstract provided.

Reduction In Post-Botulinum Toxin Flu-Like Symptoms After Injection With Incobotulinum Toxin, Edwin George, Natalya Shneyder

Neurology Faculty Publications

OBJECTIVE: To determine if patients reporting flu-like symptoms (FLS) after botulinum toxin (BoNT) injections are less susceptible to this reaction after incobotulinum toxin.

BACKGROUND: Approximately 10% of patients injected with BoNT in our clinic complain of FLS, primarily malaise, myalgias and rhinorrhea, beginning a few days to one week after injection and lasting one week or less. A review by Baizabal-Carvallo et al. (Toxicon, 2011, 58:1-7) found rates of FLS between 1.7 and 20% in patients after various preparations of botulinum toxin A, and a subsequent study showed increased cytokines in patients with FLS (Neurotoxicity Research, …

Manganese-Containing Prussian Blue Nanoparticles For Imaging Of Pediatric Brain Tumors, Matthieu F. Dumont, Sridevi Yadavilli, Raymond Sze, Javad Nazarian, Rohan Fernandes

Radiology Faculty Publications

Pediatric brain tumors (PBTs) are a leading cause of death in children. For an improved prognosis in patients with PBTs, there is a critical need to develop molecularly-specific imaging agents to monitor disease progression and response to treatment. In this paper, we describe manganese-containing Prussian blue nanoparticles as agents for molecular magnetic resonance imaging (MRI) and fluorescence-based imaging of PBTs. Our core-shell nanoparticles consist of a core lattice structure that incorporates and retains paramagnetic Mn²⁺ ions, and generates MRI contrast (both negative and positive). The biofunctionalized shell is comprised of fluorescent avidin, which serves the dual purpose of enabling …

Patient Reported Barriers And Limitations To Attending Diabetes Group Visits (Poster), Beth Careyva Md, Melanie B. Johnson Mpa, Kyle Shaak Bs, Brian Stello Md

Department of Family Medicine

No abstract provided.

"Can’T Touch This": Empowering Children With Severe Food Allergy In The Residential Camp Setting 2014, Alexsandra Dubin

Master's Theses

The purpose of this project was to create an empowerment program for children with severe food allergy (SFA) in a residential camp setting. Despite recent advancements in research, there is no cure for SFA, thus there is a need for programs to help children manage their allergies and cope with the ramifications of their condition. Quality of life is a major concern for children with SFA, as the constant fear of exposure to an allergen can lead to high levels of anxiety. This is particularly noteworthy because, barring exposure to an allergen, these children are otherwise healthy and symptom free. …

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

Department of Surgery Updates

A five page newsletter created by the Department of Surgery documenting changes to the department. This issue contains news about students and faculty, a list of important dates, committee meetings, scholarly activity and more.

Safety Of Infliximab In Children With Ibd: The Experience Of An Academic Center In Wv, Michael Northcutt Md, Awni Al-Subu Md, Brooke Bella Rn, Yoram Elitsur Md

Biochemistry and Microbiology

BACKGROUND: The immune-modulating drug, infliximab, is approved for Inflammatory Bowel Disease (IBD) treatment in children. Chronic therapy with infliximab is associated with the development of early and delayed infusion reactions. We reviewed our experience with infliximab treatment and its side effects in a cohort of children diagnosed with IBD who were treated in our clinic.

METHODS: A retrospective analysis of all IBD children treated with infliximab in our center from 2006-2011 was performed. The demographic, chronological and clinical data were recorded. The infliximab infusion was given at 5mg/ kg according to a standard protocol after pre-treatment with low dose …

Preventing Falls With Vitamin D, Franklin D. Shuler Md, Phd, Thomas Schlierf, Matthew Wingate

Orthopaedics

Falls are the number one cause for injury-related morbidity and mortality in West Virginia’s seniors. Multiple independent variables contribute to the risk of a fall: previous falls, alterations in balance and vision, impairments in gait and strength, and medications most highly correlate with the risk for a fall. Vitamin D supplementation is emerging as an easy, safe and well-tolerated fall reduction/prevention strategy due to the beneficial effects on the musculoskeletal system with improvements in strength, function and navigational abilities. From meta-analysis data, maximal fall reduction benefit in seniors is achieved when correcting vitamin D deficiency and when using adjunctive calcium …

Compassion In Medicine, Lawrence M. Wyner M.D.

Surgery

“Doctor, you know this patient’s HIV-positive.” The scrub nurse’s words hit me like a ton of bricks. I had been called into the operating room to assist one of my colleagues, a good friend and a good surgeon, who had requested my help after he had inadvertently gotten into the bladder during a hernia repair. I scrubbed in and took a look – the bladder neck was almost completely detached from the bladder. A small papillary tumor was visible just lateral to the left ureteral orifice. I snipped off the tumor with the Metzenbaum scissors, fulgurated its base, and proceeded …

Three Dimensional Dual Labelled Dna Fluorescent In Situ Hybridization Analysis In Fixed Tissue Sections, Kristin D Kernohan, Nathalie G. Bérubé

Paediatrics Publications

Emerging studies demonstrate that three-dimensional organization of chromatin in the nucleus plays a vital role in regulating the genome. DNA fluorescent in situ hybridization (FISH) is a common molecular technique used to visualize the location of DNA sequences. The vast majority of DNA FISH studies are conducted on cultured cells due to the technical difficulties encountered using fixed tissue sections. However, the use of cultured cells poses important limitations that could yield misleading results, making in vivo analysis a far superior approach. Here we present a protocol for multiplexed three dimensional DNA FISH in mouse brain sections, which is also …

Fact Sheet #2: How Do Mainecare Providers Perform On Childhood Screening And Prevention?, Jean A. Talbot Phd, Mary Lindsey Smith Phd, Msw, Kimberley S. Fox Mpa

Population Health & Health Policy

The annual Survey of Children Served by MaineCare, which collects a wealth of data on the experiences of MaineCare families, examines the extent to which MaineCare providers follow Bright Futures guidelines during well-child visits. This fact sheet presents findings on Bright Futures adherence from the 2013 survey.

Fact Sheet #1: How Family-Centered Is Mainecare?, Jean A. Talbot Phd, Mary Lindsey Smith Phd, Msw, Kimberley S. Fox Mpa

Population Health & Health Policy

Parent reports on family experiences of care can provide health plans, systems and providers with crucial information on their performance in the domain of family-centeredness. The Maine Department of Health and Human Services (DHHS) conducts an annual survey to gather this kind of information for MaineCare, the state of Maine’s Medicaid and Child Health Insurance (CHIP) program.

Modeling The Adaptive Immune Response To Mutation-Generated Antigens, Rory J. Geyer

University Scholar Projects

Somatic mutations may drive tumorigenesis or lead to new, immunogenic epitopes (neoantigens). The immune system is thought to represses neoplastic growths through the recognition of neoantigens presented only by tumor cells. To study mutations as well as the immune response to mutation-generated antigens, we have created a conditional knockin mouse line with a gene encoding, 5’ to 3’, yellow fluorescent protein (YFP), ovalbumin (which is processed to the immunologically recognizable peptide, SIINFEKL), and cyan fluorescent protein (CFP), or, YFP-ovalbumin-CFP. A frame shift mutation has been created at the 5’ end of the ovalbumin gene, hence YFP should always be expressed, …

Response To Androgen Therapy In Patients With Dyskeratosis Congenita, Payal P. Khincha, Ingrid M. Wentzensen, Neelam Giri, Blanche P. Alter, Sharon A. Savage

Pediatrics Faculty Publications

Dyskeratosis congenita (DC) is an inherited bone marrow failure syndrome and telomere biology disorder characterized by dysplastic nails, reticular skin pigmentation and oral leucoplakia. Androgens are a standard therapeutic option for bone marrow failure in those patients with DC who are unable to undergo haematopoietic stem cell transplantation, but there are no systematic data on its use in those patients. We evaluated haematological response and side effects of androgen therapy in 16 patients with DC in our observational cohort study. Untreated DC patients served as controls. Seventy percent of treated DC patients had a haematological response with red blood cell …

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

Roscoe Reid Graham (1890 To 1948): A Canadian Pioneer In General Surgery., Christine C. Piper, Ba, Charles J. Yeo, Md, Scott W. Cowan, Md

Department of Surgery Gibbon Society Historical Profiles

Roscoe Reid Graham, a Canadian surgeon trained at the University of Toronto, was a true pioneer in the field of general surgery. Although he may be best known for his omental patch repair of perforated duodenal ulcers-often referred to as the "Graham patch"-he had a number of other significant accomplishments that decorated his surgical career. Dr. Graham is credited with being the first surgeon to successfully enucleate an insulinoma. He ventured to do an essentially brand new operation based solely on his patient's symptoms and physical findings, a courageous move that even some of the most talented surgeons would shy …

High-Dose Interleukin-2 Administration In The Oncology Medical-Surgical Setting – An Innovation To Impact Cost Efficiencies, Clinical Outcomes And The Ideal Patient Experience, Deidre L. Kutzler Rn, Megan L. Derr Rn

Patient Care Services / Nursing

No abstract provided.

Pharmacokinetics And Pharmacodynamics Of Antifungals In Children And Their Clinical Implications, Chris Stockmann, Jonathan E. Constance, Jessica K. Roberts, Jared Olson, Elizabeth H. Doby, Krow Ampofo, Justin Stiers, Michael G. Spigarelli, Catherine Mt Sherwin

Pediatrics Faculty Publications

Invasive fungal infections are a significant cause of morbidity and mortality in children. Successful management of these systemic infections requires identification of the causative pathogen, appropriate antifungal selection, and optimisation of its pharmacokinetic and pharmacodynamic properties to maximise its antifungal activity and minimise toxicity and the emergence of resistance. This review highlights salient scientific advancements in paediatric antifungal pharmacotherapies and focuses on pharmacokinetic and pharmacodynamic studies that underpin current clinical decision making. Four classes of drugs are widely used in the treatment of invasive fungal infections in children, including the polyenes, triazoles, pyrimidine analogues and echinocandins. Several lipidic formulations of …

Limited Association Between Perceived Control And Health-Related Quality Of Life In Patients With Heart Failure, Teesta Banerjee, Kyoung Suk Lee, Steven R. Browning, Claudia Hopenhayn, Susan C. Westneat, Martha J. Biddle, Cynthia Arslanian-Angoren, Jo-Ann Eastwood, Gia Mudd, Debra K. Moser

Epidemiology and Environmental Health Faculty Publications

Background: Perceived control has been suggested as a modifiable factor associated with health-related quality of life (HRQOL). However, the relationship between perceived control and HRQOL has not been evaluated in patients with heart failure (HF). The purpose of this study was to determine whether perceived control independently predicts HRQOL in HF patients. Methods: A total of 423 HF patients were included. Hierarchical linear regression was performed to determine the independent association of perceived control to HRQOL after controlling for covariates. Results: Higher levels of perceived control were associated with better HRQOL in univariate analysis. However, this relationship was strongly attenuated …

Oncolog, Volume 59, Number 05, May 2014, Bryan Tutt, Therese Bevers, Zach Bohannan

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

• New Treatments may Improve Outcomes for AL Amyloidosis Patients: AL amyloidosis-a rare, potentially fatal disease-has no approved treatments. The ''standard'' treatments are prescribed off-label, and few clinical trials have compared their effectiveness
• Dialog: Screening Mammography Reduces Breast Cancer-Related deaths
• 'Sleeping Beauty'' Technique Modifies T Cells to Treat B Cell Malignancies: A novel technique that helps the patient's own immune system find and destroy cancer cells could extend remission times for patients with B cell lymphomas and leukemias
• INBRIEF: Analysis Suggests Need to Revise Low-Grade Glioma Classification, Treatment/Combination of Antiangiogenic Drugs Shows Activity Against Solid Tumors/ Computed Tomography Predicts Chemotherapy Response …

Nanotechnology: Current Concepts In Orthopaedic Surgery And Future Directions., M P Sullivan, K J Mchale, Javad Parvizi Md, S Mehta

Rothman Institute Papers

Nanotechnology is the study, production and controlled manipulation of materials with a grain size < 100 nm. At this level, the laws of classical mechanics fall away and those of quantum mechanics take over, resulting in unique behaviour of matter in terms of melting point, conductivity and reactivity. Additionally, and likely more significant, as grain size decreases, the ratio of surface area to volume drastically increases, allowing for greater interaction between implants and the surrounding cellular environment. This favourable increase in surface area plays an important role in mesenchymal cell differentiation and ultimately bone-implant interactions. Basic science and translational research have revealed important potential applications for nanotechnology in orthopaedic surgery, particularly with regard to improving the interaction between implants and host bone. Nanophase materials more closely match the architecture of native trabecular bone, thereby greatly improving the osseo-integration of orthopaedic implants. Nanophase-coated prostheses can also reduce bacterial adhesion more than conventionally surfaced prostheses. Nanophase selenium has shown great promise when used for tumour reconstructions, as has nanophase silver in the management of traumatic wounds. Nanophase silver may significantly improve healing of peripheral nerve injuries, and nanophase gold has powerful anti-inflammatory effects on tendon inflammation. Considerable advances must be made in our understanding of the potential health risks of production, implantation and wear patterns of nanophase devices before they are approved for clinical use. Their potential, however, is considerable, and is likely to benefit us all in the future. Cite this article: Bone Joint J 2014; 96-B: 569-73.

The Role Of Amp-Activated Protein Kinase (Ampk) In Regulating The Early Stages Of Acute Pancreatitis, Mohamed Shitia

Honors Scholar Theses

Acute pancreatitis is an inflammatory disease that is initiated by the activation and retention of digestive zymogens inside pancreatic acinar cells (acini). It is proposed that adenosine monophosphate-activated protein kinase (AMPK) regulates early responses of acute pancreatitis in acini. A recent study shows that induction of experimental pancreatitis in isolated rat acini with supraphysiologic cerulein (orthologue of cholecystokinin) increases intracellular zymogen activation, but decreases AMPK levels. Furthermore, in vitro pharmacologic stimulation of AMPK reduces zymogen activation, having a protective effect. In this study, the effectiveness of two AMPK activators was examined in two separate in vivo pancreatitis models. In the …

Endoscopic Pancreatic Pseudo-Cyst Drainage, Judith Dorsam Rn

Patient Care Services / Nursing

No abstract provided.

Validity Of The Zephyr Bioharness For Vertical Power Output And Ground Reaction Forces, Fuad Haydar

Health, Human Performance and Recreation Undergraduate Honors Theses

Overtraining has become a major problem in college sports today and there is an increasing need for devices to track or measure the amount of stress is being put on the bodies of athletes. One such device is the ZephyrTM BioHarness, which is a puck-like device worn on the chest and is the centerpiece of this study. Researchers wanted to answer the question of whether the ZephyrTM was an effective and valid tool to measure the amount of force placed on the body during a single vertical jump. There were 20 male participants used in this study, 10 Division I …

Surgical Management Of Pheochromocytoma In A 13-Week Pregnant Woman, Mazhar Ali Memon, Wajahat Aziz, Farhat Abbas

Section of Urology

A 34-year-old 13-week pregnant woman presented with hypertension refractory to medical therapy and on workup was found to have a right adrenal mass. Due to her persistent increased blood pressure she was advised urinary vanillylmandelic acid (VMA) and its level was raised. MRI of the abdomen showed a well-circumcised lesion in the right adrenal of 3.0×2.5 cm suggestive of pheochromocytoma. The patient was started on antihypertensives including α-blockers and β-blockers and planned for right open adrenalectomy. Intraoperatively, blood pressure was raised up to 180/110 mm Hg on slight manipulation of adrenal gland which was controlled with glyceryl-trinitrate and volatile agents. …