Medical Specialties Commons^™

Certain General Anesthetics Used In Pediatrics Hinder Neurological Development In Infants, Michael R. Hirschi

Selected Honors Theses

General anesthetics act by either blocking N-methyl-d-aspartate (NMDA) receptors or over stimulating γ-aminobutyric acid (GABA) receptors.^1–3 The actions of these receptors are responsible for the anesthetized state and are also crucial in the neurological development of infants.^2,4–8 Animal studies, although limited, provide vital information about general anesthesia’s neurotoxicity its hindrance of neurological development. Exposure to general anesthesia can severely hinder proper neuronal migration, synaptogenesis, and can drastically increase neuronal apoptosis in infant animals.^9–16 General anesthetics are more neurotoxic to infant animals in combination compared to individually.^10,16,17 Additionally, multiple exposures to general anesthesia tend to have compounding …

The Therapeutic Role Of Turmeric In Treatment And Prevention Of Alzheimer’S Disease, Rylan M. Mcquade

Selected Honors Theses

As a devastating neurological condition that expends millions of lives each year, Alzheimer’s disease (AD) is a subject of intense investigation.¹ Although AD has been known for over a century, the precise mechanisms that underlie AD pathogenesis and development are still poorly understood. The Alzheimer phenotype is typified by extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), causing researchers to notice several key enzymes implicated in this process.¹ Most notable are β and γ secretases (which drive Aβ plaque production) and phospholipase

A₂ (which stimulates major cascade activation through the specific cleavage of fatty acyl esters). …

A Six-Week Home Exercise Program Improves Endothelial Function And Cd34+ Circulating Progenitor Cells In Patients With Pre-Diabetes, Sabyasachi Sen, Sarah Witkowski, Ann Lagoy, Ashequl Islam

Medicine Faculty Publications

Background: Pre-diabetes is associated with endothelial dysfunction and affects endothelium-associated stem cells. Lifestyle modification has been shown to prevent the progression from pre-diabetes to overt type 2 diabetes; however, the effect of such interventions on CD34⁺ progenitor cells in pre-diabetes participants has not been tested. The purpose of this study was to determine whether a home-based 6-week exercise intervention improved vascular function, circulating number, function, and gene expression of circulating CD34⁺progenitor cells in patients with pre-diabetes.

Methods: Patients (40 - 70 years, BMI of 25 - 39.9, n = 11) were enrolled in a 16-week randomized crossover …

Laparoscopic Surgery For Patients With Severe Chronic Obstructive Lung Disease, Talal S. Alzahrani, Victor S. Saxena, Alexander Cho, Guillermo Gutierrez

GW Research Days 2015

Introduction: Laparoscopy is a minimally invasive procedure that associated with decreased morbidity and hospital stays. There are over two million laparoscopic surgeries performed annually in the US. Several studies have shown that patients with mild (Stage I) to moderate (Stage II) Chronic Obstructive Pulmonary Disease (COPD) develop hypercapnia during laparoscopy procedures. However, hypercapnia in this population did not affect the rate of complication or prolonged hospital stay. We report a case of very severe (Stage IV) COPD, who developed an acute respiratory failure with an increase in hospital stay during a laparoscopic procedure. We write this to bring awareness to …

C-Anca Positive Necrotizing Crescentic Glomerulonephritis With Linear Immunoglobulin Staining, Akshita Mehta

GW Research Days 2015

Necrotizing crescentic glomerulonephritis is found in anti-glomerular basement membrane (GBM) disease (Type 1), immune complex (Type 2) deposition and anti-neutrophil cytoplasmic (ANCA)-related disease (Type 3).

ANCA positive glomerulonephritis is typically characterized on renal biopsy as pauci-immune, with mild or absent glomerular staining for immunoglobulin, or complement staining by immunofluorescence.

Rare cases of concomitant p-ANCA plus linear immunofluorescence pattern staining have been discussed, however none with prior association with c-ANCA.

We report a case of systemic c-ANCA pulmonary-renal syndrome with anti-GBM-disease-typical linear staining on renal biopsy immunofluorescence.

A Rare Case Of Non-Cardiogenic Pulmonary Edema, Talal Alzahrani, Kelly Zhang, Angela Ryan, Yasir Alfi, Jeffrey Zweig

GW Research Days 2015

INTRODUCTION:

Nephrotic syndrome is identified by a significant proteinuria more than 3.5 g/day, hypoalbuminemia less than 3.5 g/dl, and peripheral edema. It associated with risks of thrombosis, infection, and hyperlipidemia due to loss of plasma protein. Several studies have shown patients with nephrotic syndrome do not develop non-cardiogenic pulmonary edema. However, we report a case of nephrotic syndrome caused by diabetic nephropathy and presented with non-cariogenic pulmonary edema.

CASE REPORT:

A 37-year old man with a past medical history of diabetes mellitus, hypertension, dyslipidemia, Charcot foot, who presented with dyspnea, orthopnea, and non-productive cough for two days. He had been …

Ubiquitous L1 Mosaicism In Hippocampal Neurons., Kyle R. Upton, Daniel J. Gerhardt, J. Samuel Jesuadian, Sandra R. Richardson, Francisco J. Sánchez-Luque, Gabriela O. Bodea, Adam D. Ewing, Carmen Salvador-Palomeque, Marjo S. Van Der Knaap, Paul M. Brennan, Adeline Vanderver, Geoffrey J. Faulkner

Neurology Faculty Publications

Somatic LINE-1 (L1) retrotransposition during neurogenesis is a potential source of genotypic variation among neurons. As a neurogenic niche, the hippocampus supports pronounced L1 activity. However, the basal parameters and biological impact of L1-driven mosaicism remain unclear. Here, we performed single-cell retrotransposon capture sequencing (RC-seq) on individual human hippocampal neurons and glia, as well as cortical neurons. An estimated 13.7 somatic L1 insertions occurred per hippocampal neuron and carried the sequence hallmarks of target-primed reverse transcription. Notably, hippocampal neuron L1 insertions were specifically enriched in transcribed neuronal stem cell enhancers and hippocampus genes, increasing their probability of functional relevance. In …

Providence Ed Guide Program - Analysis Of Program Impacts; The Center For Outcomes Research & Education (Core); Providence Health & Services, Bill J. Wright

Articles, Abstracts, and Reports

No abstract provided.

Mindfulness: Being Present In The Moment, Stephanie Ann Stathas, Christine Frazer

Walden Faculty and Staff Publications

This article serves to enlighten childbirth educators’ knowledge about mindfulness and the mother-baby benefits associated with incorporating mindfulness- based interventions into practice. Jon Kabat-Zinn, who developed the Mindfulness Based Stress Reduction program, brought the concept of mindfulness into the world of healthcare and mainstream society. Mindfulness is the practice of bringing awareness to the here and now using a variety of methods. Nancy Bardacke has taken the practice of mindfulness further and developed a program for expecting mothers, known as Mindfulness Based Childbirth and Parenting. This program has been shown to reduce stress responses that may be harmful to a …

The Role Of Ultrasound In The Lebanese Outreach Setting, Reem Abu-Rustum, Fouad M. Ziade, Hadi Danawi

Walden Faculty and Staff Publications

A cross-sectional study was carried out on 669 patients to assess the role of introducing ultrasound into obstetrical outreach in Lebanon. Data were collected, and descriptive statistics were performed. Sonographic findings were compared using Chi-square tests between underserved Lebanese and Syrian refugee mothers. Ultrasound plays a significant role in properly dating pregnancies in addition to identifying at-risk fetuses and detecting placental abnormalities. Medical providers need to make sonographic evaluation in the Lebanese outreach obstetrical setting more available and more systematic in order to secure a safe outcome for underserved Lebanese and Syrian refugee mothers and offspring.

Smokeless Tobacco Use Among Pakistani Women: A Missed Opportunity For Tobacco Control, Tanzil Jamali, Sana Tanzil

Community Health Sciences

No abstract provided.

Attitudes Of Paramedic Students Towards Specific Medical Conditions: A Four-Year Study, Brett A. Williams, Malcolm J. Boyle, Stuart Howard

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine the attitude of first year students entering a paramedic course over 4 consecutive yearly intakes toward patients with intellectual disability, substance abuse, attempted suicide, and acute mental illness. Method: The students’ attitude towards four medical conditions commonly encountered in the out-of-hospital setting was assessed using the Medical Condition Regard Scale (MCRS). The MCRS score ranges from 11 to 66. Results: 230 students in Victoria, Australia, participated in the study; 66% were female, and 76% of all students < 21 years of age. Students showed the most negative attitudes towards substance abuse, mean 35(SD+6.6), and the most positive attitude toward intellectual disability, mean 38.2(SD+6.3). Students in 2008 cohort displayed significantly higher regard for all medical conditions (pConclusions: The study findings suggest that these students in Victoria, Australia, entering an undergraduate paramedic or paramedic/nursing course have a relatively poor attitude towards the four reviewed medical conditions, particularly substance abuse.

Image Enhancement Of Cancerous Tissue In Mammography Images, Richard Thomas Richardson

CCAC Theses and Dissertations

This research presents a framework for enhancing and analyzing time-sequenced mammographic images for detection of cancerous tissue, specifically designed to assist radiologists and physicians with the detection of breast cancer. By using computer aided diagnosis (CAD) systems as a tool to help in the detection of breast cancer in computed tomography (CT) mammography images, previous CT mammography images will enhance the interpretation of the next series of images. The first stage of this dissertation applies image subtraction to images from the same patient over time. Image types are defined as temporal subtraction, dual-energy subtraction, and Digital Database for Screening Mammography …

Oncolog, Volume 60, Number 04, April 2015, Jill Delsigne, Joe Munch, Bryan Tutt, Sarah Bronson

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

• Multidisciplinary Globe-Sparing Treatment for Lacrimal Gland Carcinoma Preserves Vision and Minimizes Morbidity: Until recently, the treatment of lacrimal gland carcinoma almost always required removal of the eye. But for some patients with these tumors, globe-sparing surgery followed by radiation therapy can preserve vision and decrease ocular morbidity and facial disfigurement.
• Novel Trial Design Streamlines Development of Breast Cancer Therapies: Developing a cancer-fighting drug can take around a billion dollars and a dozen or more years. Even then, fail in clinical trials. To identify effective cancer therapies more quickly and efficiently, researchers have tuned to an innovative clinical model in which …

Transient Cardiovascular Hemodynamics In A Patient-Specific Arterial System, Jr Rodward Hewlin

Dissertations

The ultimate goal of the present study is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present study a full cardiovascular experimental phantom and digital phantom (CFD model) was fabricated to study: (1) the effects of local hemodynamics on global hemodynamics, (2) the effects of transition from bed-rest to upright position, and (3) transport of dye (drug delivery) in the arterial system. Computational three dimensional (3-D) models (designs A, B, and C) …

Evaluation And Nonsurgical Management Of Rotator Cuff Calcific Tendinopathy., Ari C. Greis, Stephen M. Derrington, Matthew Mcauliffe

Rothman Institute Papers

Rotator cuff calcific tendinopathy is a common finding that accounts for about 7% of patients with shoulder pain. There are numerous theories on the pathogenesis of rotator cuff calcific tendinopathy. The diagnosis is confirmed with radiography, MRI or ultrasound. There are numerous conservative treatment options available and most patients can be managed successfully without surgical intervention. Nonsteroidal anti-inflammatory drugs and multiple modalities are often used to manage pain and inflammation; physical therapy can help improve scapular mechanics and decrease dynamic impingement; ultrasound-guided needle aspiration and lavage techniques can provide long-term improvement in pain and function in these patients.

Knowledge And Attitude Towards Rape And Child Sexual Abuse – A Community-Based Cross-Sectional Study In Rural Tanzania, Muzdalifat Abeid, Projestine Muganyizi, Siriel Massawe, Rose Mpembeni, Elisabeth Darj, Pia Axemo

Obstetrics and Gynaecology, East Africa

Background, Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

Methods, A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18–49 years were eligible for the study. Through a three-stage …

Quality Of Life Among Women With Symptoms Of Gynecological Morbidities: Results Of A Cross‐Sectional Study In Karachi, Pakistan, Neelofar Sami, Tazeen Saeed Ali, Muhammad Osama

Community Health Sciences

AIMS:

A population-based cross-sectional study design was used to study the effects of symptoms of various gynecological morbidities (GM) on health-related quality of life (HRQoL) of women, residents of squatter settlements of Karachi, Pakistan.

MATERIAL AND METHODS:

This cross-sectional study was conducted in squatter settlements of Karachi from September 2012 to August 2013, with 1002 married, non-pregnant women. After obtaining written informed consent from every participant, a structured questionnaire was used to collect information about symptoms of GM and their effect on four domains of HRQoL (physical, social, functional and financial domains).

RESULTS:

Of 1002 women who participated in the …

Frequency Of Electrolyte Derangement After Transurethral Resection Of Prostate: Need For Postoperative Electrolyte Monitoring, Wajahat Aziz, Hammad Ather

Department of Surgery Docs

Abstract

Objective. To determine the electrolyte derangement following transurethral resection of prostate (TURP). Methods. All patients undergoing TURP from June 2012 to April 2013 were included. Preoperative electrolytes were performed within a week of procedures. Monopolar TURP using 1.5% glycine was performed. Serum Na(+) and K(+) were assessed within 1 hour postoperatively and subsequently if clinically indicated. Results. The study included 280 patients. Sixty-six patients (23.6%) had electrolyte derangement after TURP. Patients with deranged electrolytes were older (mean age of 73.41 ± 4.08 yrs. versus 68.93 yrs. ± 10.34) and had a longer mean resection time (42.5 ± 20.04 min …

Air Displacement Plethysmography And Resistance Exercise, Joan Cebrick Grossman, Ronald W. Deitrick

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to examine the effect of resistance exercise (RE) on body composition using air-displacement plethysmography (ADP) within 2 hours of completing RE. Methods: Thirteen university students (9 males and 4 females; 18.8±0.5 yrs; mean ± SD) volunteered for this study. The RE program (55.4±8.7 min) consisted of a combination of upper- and lower-body extremity exercises and abdominal exercises for a total of nine different exercises. Relative body fat (BF) was assessed (1.76+0.4 hr) using ADP before and after the RE along with skinfold (SF) measures, body mass (BM) and respiratory quotient. Results …

Salvage Of Infected Non-Union Of The Tibia With An Ilizarov Ring Fixator, Muhammad Shahid Khan, Haroon Rashid, Masood Umer, Irfan Qadir, Kamran Hafeez, Arshad Iqbal

Department of Surgery Docs

Purpose: To review outcomes of 24 patients who underwent Ilizarov ring fixation for infected nonunion of the tibia.
Methods: Medical records of 21 men and 3 women aged 13 to 74 (mean, 38) years who underwent Ilizarov ring fixation for infected non-union of the tibia were reviewed. The mean bone defect was 3.3 (range, 2-5) cm. The mean time from injury to presentation was 11.9 (range, 1-36) months. The mean number of previous surgeries was 2 (range, 0-14). A local flap was used in 2 patients and a free flap was used in one patient. Nine of the patients underwent …

Eradication Of Advanced Pelvic Hydatid Bone Disease After Limb Salvage Surgery - 5-Year Follow-Up: A Case Report, Muhammad Shahid Khan, Pervaiz Hashmi, Dawar Khan

Department of Surgery Docs

Abstract

INTRODUCTION:

Echinococcosis is produced by the larval stage of Echinococcus granulosus; it is a parasitic disease which is seen rarely in humans and has adverse outcomes. We report a case of advanced pelvic hydatid bone disease with successful limb salvage surgery. Our patient had a 5-year follow-up without recurrence which is a rarity as per the literature. Early diagnosis and prompt medical therapy are necessary for effective management whereas delayed diagnosis is always fraught with the risk of recurrence and sepsis.

CASE PRESENTATION:

In 2009, a 30-year-old woman, native of Karachi (Sindhi ethnicity), presented at our clinic with history …

Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem, Wasiq Faraz Rawasia

Department of Surgery Docs

Abstract

Endocarditis is characterized by vegetations, which is a mass of platelets, fibrin, micro-colonies of micro-organisms, and inflammatory cells, in the endocardium. Over the past three decades, the incidence of right-sided endocarditis has risen dramatically in Pakistan. We report a 36-year woman with a history of repeated intravenous analgesic injections for low back pain, presenting with high grade fever, sepsis and a white cell count of 44,000 with 90% neutrophils. Echocardiography showed large mobile vegetations on TricuspidValve (TV). Tricuspid Valve Endocarditis (TVE) is generally responsive to medical treatment; however, about 25% of TVE patients require surgical intervention. Long-term survival of …

Salvage Of Infected Non-Union Of The Tibia With An Ilizarov Ring Fixator, Muhammad Shahid Khan, Haroon Rashid, Masood Umer, Irfan Qadir, Kamran Hafeez, Arshad Iqbal

Department of Surgery Docs

Purpose: To review outcomes of 24 patients who underwent Ilizarov ring fixation for infected nonunion of the tibia.
Methods: Medical records of 21 men and 3 women aged 13 to 74 (mean, 38) years who underwent Ilizarov ring fixation for infected non-union of the tibia were reviewed. The mean bone defect was 3.3 (range, 2-5) cm. The mean time from injury to presentation was 11.9 (range, 1-36) months. The mean number of previous surgeries was 2 (range, 0-14). A local flap was used in 2 patients and a free flap was used in one patient. Nine of the patients underwent …

Point-Of-Care Ultrasonography By Pediatric Emergency Medicine Physicians., Jennifer R. Marin, Resa E. Lewiss, American Academy Of Pediatrics, Committee On Pediatric Emergency Medicine, Society For Academic Emergency Medicine, Academy Of Emergency Ultrasound, American College Of Emergency Physicians, Pediatric Emergency Medicine Committee, World Interactive Network Focused On Critical Ultrasound, Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Emergency physicians have used point-of-care ultrasonography since the 1990 s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing …

Point-Of-Care Ultrasonography By Pediatric Emergency Medicine Physicians, American Academy Of Pediatrics, Committee On Pediatric Emergency Medicine, Society For Academic Emergency Medicine,Academy Of Emergency Ultrasound, American College Of Emergency Physicians, Pediatric Emergency Medicine Committee, World Interactive Network Focused On Critical Ultrasound, Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Point-of-care ultrasonography is increasingly being used to facilitate accurate abstract and timely diagnoses and to guide procedures. It is important for pediatric emergency medicine (PEM) physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. PEM fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital …

Categorizing Fetal Heart Rate Variability With And Without Visual Aids, Amanda Jane Ashdown

Psychology Theses & Dissertations

This present study examined the ability of clinicians and novices to correctly categorize fetal heart rate (FHR) variability with and without the use of exemplars. Clinicians and undergraduate students were asked to inspect FHR images and determine into which of four categories they belonged. Each participant took part in three conditions: one in which they were provided exemplars of prototypical FHR variability to use during their categorization task, another in which they were provided exemplars of nonprototypical FHR variability to use in their task, and a control condition in which no exemplars were available. The results showed that experts were …

Assessing The Effectiveness Of An Interval Estimation And A Visual-Spatial Secondary Task As Measures Of Mental Workload During Laparoscopy, Levi Parker Warvel

Psychology Theses & Dissertations

The goal of the present study was to compare two secondary workload tasks, specifically a time interval estimation and visual-spatial task, to determine which of these is most appropriate for the assessment of laparoscopic mental workload. Participants performed a peg transfer task in two conditions: a normal camera angle and a 90° camera angle intended to increase mental workload. Based on multiple resource theory, it was predicted the visual-spatial task would be more sensitive to the workload manipulation than the time estimation task because it draws upon the specific, as opposed to more general, attentional resources required by laparoscopy. Primary …

Physical Actvity In Pregnant Rat Dams Reduces Mammary Tumor Formation In Offspring, Leon Clah

Open Access Theses

Breast cancer is the most frequently diagnosed cancer and a leading cause of cancer death among women. Lifestyle factors such as physical activity and diet play a role in attenuating the incidence of breast cancer. Current research is beginning to show that exercise during pregnancy can convey long term health benefits to offspring. In light of these studies, the goal of this project was to determine if maternal physical activity during pregnancy could lead to reduced mammary tumor development in female offspring. Towards this goal, female Sprague Dawley rats were divided into two groups, sedentary and exercise, with the exercise …

Attitudes Toward A Cancer Coalition: Implications For Coalition Health Communication, Chervin Lam Shih Kian

Open Access Theses

A cancer coalition is a communication hub for cancer patients that may help address cancer by promoting health and mitigating health issues. Attitudes toward a cancer coalition may be important in determining whether or not patients participate or utilize a coalition. However, little is known about the attitudes of cancer patients toward a cancer coalition, its services, and toward participation. This study addresses this gap by investigating these attitudes. The results encourage the development of a cancer coalition in states that do not yet have a coalition. Effective coalition health communication was found to be a pivotal service that cancer …