Medical Specialties Commons^™

The Role Of Noxa/Mcl-1 In Head And Neck Squamous Cell Carcinoma (Hnscc) Treatment, June Young Lee

Theses and Dissertations

Head and neck cancer is the sixth leading type of cancer with 90 percent of head and neck cancer arising from squamous cell lining on the epithelium of the oral and nasal cavity, pharynx, and salivary gland. Even with tremendous achievements on chemotherapeutic drugs and therapies, the long-term prognosis of patients with advanced head and neck squamous cell carcinoma (HNSCC) has shown little improvement over the last three decades. Cisplatin is one of widely used chemotherapeutic drugs for multiple

cancers, including head and neck cancer, but the prolonged use of this drug is limited by its toxicity and by the …

Application And Histology-Driven Refinement Of Active Contour Models To Functional Region And Nerve Delineation: Towards A Digital Brainstem Atlas, Nimal Patel, Sharmin Sultana, Tanweer Rashid, Dean Krusienski, Michel A. Audette

Electrical & Computer Engineering Faculty Publications

This paper presents a methodology for the digital formatting of a printed atlas of the brainstem and the delineation of cranial nerves from this digital atlas. It also describes on-going work on the 3D resampling and refinement of the 2D functional regions and nerve contours. In MRI-based anatomical modeling for neurosurgery planning and simulation, the complexity of the functional anatomy entails a digital atlas approach, rather than less descriptive voxel or surface-based approaches. However, there is an insufficiency of descriptive digital atlases, in particular of the brainstem. Our approach proceeds from a series of numbered, contour-based sketches coinciding with slices …

Evaluation Of Common Risk Factors For Breast Carcinoma In Females: A Hospital Based Study In Karachi, Pakistan, Saira Naz Sufian, Imrana Masroor, Waseem Mirza, Sehrish Butt, Shaista Afzal, Zafar Sajjad

Department of Radiology

Background: Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available.
Materials and methods: A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 …

Fibrodysplasia Ossificans Progressiva Misdiagnosed As Cervical Exostosis, Muhammad Awais, Abdul Rehman, Noor Ul-Ain Baloch

Department of Radiology

No abstract provided.

Pseudo-Thyroid Lobe: A Diagnostic Conundrum Caused By Ossified Anterior Longitudinal Ligament On Bone Scan, Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Unaiza Zaman, Areeba Zaman, Rabia Tahseen

Department of Radiology

Radionuclide bone imaging is one of the most commonly performed nuclear medicine procedure around the world and characterized by its high sensitivity and relatively low specificity. False positive findings on a bone scan are very common; however, dense uptake over unilateral ossified anterior longitudinal ligament appearing as single thyroid lobe on a bone scan has not been described in the literature.

Use Of Low-Dose Ketamine For Pain Management In An Emergency Department, Joseph Ladd, Winifred Pardo

All Publications

Background/Purpose: In the emergency department (ED), many barriers exist to pain management. Non-steroidal anti-inflammatory drugs and acetaminophen often cannot provide enough relief, while opioid analgesics are hindered by side effects, dependency, and tolerance. A non-competitive NMDA receptor antagonist, ketamine has historically been used for sedation and anesthesia in rural settings or in those with limited resources. Ketamine's unique safety profile and variety of dosage forms indicate its potential role in pain management. An evaluation was conducted of ketamine's use in low doses to treat pain in an emergency department with the third-greatest annual census in Miami-Dade county.

Methodology: A retroactive …

A Microsurgical Anterior Cervical Approach And The Immediate Impact Of Mechanical Retractors: A Case Control Study, Rodrigo Ramos-Zúñiga, Laura Rocio Díaz-Guzmán, Shannen Velasquez, Ana Magdelena Macías-Ornelas, Martín Rodríguez-Vázquez

Faculty Publications

Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF) is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, …

A Narrative Inquiry: Case Leaders' Perspectives On Resilience In Hospice Care, Gail Renee Ahern

Antioch University Dissertations & Theses

This study is a qualitative inquiry examining the perspective of team leaders within hospice organizations on resilience. The goal of this study was to examine how hospice leaders build resilience for themselves and within the interdisciplinary teams they lead. A framework of three key theories of leadership—servant, spiritual and authentic—was used to help in understanding the similarities and differences of the interviewed leaders and their key themes and practices. The eight leaders interviewed were from a range of hospices in diverse settings and all were directly responsible for leading interdisciplinary teams. In-depth phenomenological interviewing was undertaken until the study reached …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

Analyzing The Effect Of Complaints, Investigation Of Allegations, And Deficiency Citations On The Quality Of Care In United States Nursing Homes (2007 – 2012), Kevin E. Hansen

USF Tampa Graduate Theses and Dissertations

The quality of care in nursing homes has been evaluated from many varying perspectives, but few studies have analyzed quality in light of complaints made to state survey agencies by residents, their family members, or other individuals interacting with the nursing home. This study analyzed complaints, investigation of complaint allegations, and complaint-related deficiency citations to determine their effect, if any, on the quality of care in nationwide nursing homes. Using the Online Survey Certification and Reporting (OSCAR) survey dataset for facility characteristics and the complaint investigation dataset for outcomes of complaint investigation, analyses conducted included descriptives, correlations, conceptual mapping for …

The Effect Of Multidisciplinary Rehabilitation On Brain Structure And Cognition In Huntington's Disease: An Exploratory Study, Travis M. Cruickshank, Jennifer A. Thompson, Juan F. Dominguez D, Alvaro P. Reyes, Mike Bynevelt, Nellie Georgiou-Karistianis, Roger A. Barker, Mel R. Ziman

Research outputs 2014 to 2021

Background: There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD. Methods: Fifteen participants who …

Infant Feeding Practices Of Emirati Women In The Rapidly Developing City Of Abu Dhabi, United Arab Emirates, Hazel Gardner, Katherine Green, Andrew Gardner

Research outputs 2014 to 2021

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, …

Saccharomyces Boulardii And Bismuth Subsalicylate As Low-Cost Interventions To Reduce The Duration And Severity Of Cholera, Johnathan Sheele, Jessica Cartowski, Angela Dart, Arjun Poddar, Shikha Gupta, Ajay Gupta

Computer Science Faculty Publications

We conducted a randomised single-blinded clinical trial of 100 cholera patients in Port-au-Prince, Haiti to determine if the probiotic Saccharomyces cerevisiae var. boulardii and the anti-diarrhoeal drug bismuth subsalicylate (BS) were able to reduce the duration and severity of cholera. Subjects received either: S. boulardii 250 mg, S. boulardii 250 mg capsule plus BS 524 mg tablet, BS 524 mg, or two placebo capsules every 6 hours alongside standard treatment for cholera. The length of hospitalisation plus the number and volume of emesis, stool and urine were recorded every 6 hours until the study subject was discharged (n=83), left against …

Alzheimer's Disease Cerebrospinal Fluid Biomarkers Are Not Influenced By Gravity Drip Or Aspiration Extraction Methodology, Alan Rembach, Lisbeth A. Evered, Qiao-Xin Li, Tabitha Nash, Lesley Vidaurre, Christopher J. Fowler, Kelly K. Pertile, Rebecca L. Rumble, Brett O. Trounson, Sarah Maher, Francis Mooney, Maree Farrow, Kevin Taddei, Stephanie Rainey-Smith, Simon Laws, S. Lance Macaulay, William Wilson, David G. Darby, Ralph N. Martins, David Ames, Steven Collins, Brendon Silbert, Colin L. Masters, James D. Doecke

Research outputs 2014 to 2021

Introduction Cerebrospinal fluid (CSF) biomarkers, although of established utility in the diagnostic evaluation of Alzheimer’s disease (AD), are known to be sensitive to variation based on pre-analytical sample processing. We assessed whether gravity droplet collection versus syringe aspiration was another factor influencing CSF biomarker analyte concentrations and reproducibility. Methods Standardized lumbar puncture using small calibre atraumatic spinal needles and CSF collection using gravity fed collection followed by syringe aspirated extraction was performed in a sample of elderly individuals participating in a large long-term observational research trial. Analyte assay concentrations were compared. Results For the 44 total paired samples of gravity …

Amyloid-Related Memory Decline In Preclinical Alzheimer's Disease In Dependent On Apoe Ε4 And Is Detectable Over 18-Months, Christine Thai, Yen Ying Lim, Victor L. Villemagne, Simon Laws, David Ames, Kathryn A. Ellis, Stephanie Rainey-Smith, Ralph Martins, Colin L. Masters, Christopher C. Rowe, Paul Maruff, Australian Imaging, Biomarkers And Lifestyle (Aibl) Research Group

Research outputs 2014 to 2021

High levels of β-amyloid (Aβ) in the brain and carriage of the APOE ε4 allele have each been linked to cognitive impairment in cognitively normal (CN) older adults. The aim of this study was to investigate the relationship between cerebral Aβ level, APOE ε4 carrier status, and cognitive decline over 18 monthes, in 317 cognitively healthy (CN) older adults (47% males, 52.4% females) aged between 60 and 89 years (Mean = 69.9, SC = 6.8). Cognition was assessed using the Cogstate Brief Battery (CBB) and the California Verbal Learning Test, Second Edition (CVLT-II). Planned comparisons indicated that CN older adults …

Association Between Ideal Cardiovascular Health Metrics And Depression In Chinese Population : A Cross-Sectional Study, Zhikun Li, Xin Yang, Anxin Wan, Jing Qui, Wei Wang, Qiaofeng Song, Xizhu Wang

Research outputs 2014 to 2021

The study aimed to examine the association between ideal cardiovascular health (CVH) metrics and depression. We conducted a population-based, cross-sectional study of 6,851 participants aged 20 years or older (3,525 men and 3,326 women) living in Tangshan City, China. Information on the seven CVH metrics (including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose) was collected via questionnaires, physical examination and laboratory test. Depression status was assessed using the Epidemiologic Studies Depression Scale (CES-D) and a score of 16 or above was considered depression. The relationship between CVH metrics and depression was …

Inflamation And Oxidative Stress : The Molecular Connectivity Between Insulin Resistance, Obesity And Alzheimer's Disease, Guiseppe Verdile, Kevin N. Keane, Vinicius F. Cruzat, Sandra Medic, Miheer Sabale, Joanne Rowles, Nadeeja Wijesekara, Ralph Martins, Paul E. Fraser, Philip Newsholme

Research outputs 2014 to 2021

Type 2 diabetes (T 2 DM), Alzheimer’s disease (AD), and insulin resistance are age-related conditions and increased prevalence is of public concern. Recent research has provided evidence that insulin resistance and impaired insulin signalling may be a contributory factor to the progression of diabetes, dementia, and other neurological disorders. Alzheimer’s disease (AD) is the most common subtype of dementia. Reduced release (for T 2 DM) and decreased action of insulin are central to the development and progression of both T 2 DM and AD. A literature search was conducted to identify molecular commonalities between obesity, diabetes, and AD. Insulin resistance …

Prostate Cancer Support Groups: Canada-Based Specialists' Perspectives, John L. Oliffe, Suzanne K. Chambers, Bernie Garrett, Joan L. Bottorff, Michael Mckenzie, Christina S. Han, John S. Ogrodniszuk

Research outputs 2014 to 2021

To understand prostate cancer (PCa) specialists’ views about prostate cancer support groups (PCSGs), a volunteer sample of Canada-based PCa specialists ( n = 150), including urologists ( n = 100), radiation oncologists ( n = 40), and medical oncologists ( n = 10) were surveyed. The 56-item questionnaire used in this study included six sets of attitudinal items to measure prostate cancer specialists’ beliefs about positive and negative influences of PCSGs, reasons for attending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs. In addition, an open-ended question was included to invite additional input from …

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

African Immigrant Parents' Understanding Of Their Teenager's Newly Diagnosed Diabetes Status In Western Australia, Annette S. Hart, Sara J. Bayes, S Geraghty

Research outputs 2014 to 2021

Background: Recently Western Australia has seen a rise in African population due to both economic and refugee migration. Concurrently, a rise in the numbers of teenagers of African origin diagnosed with both type 1 and type 2 diabetes and associated complications has been noticeable. Different ethnic background is a known risk factor for poor metabolic control; this trend is reflected in studies wherein people of African origin have been found to have a high risk of developing diabetes. What is evident from health promotion literature is that parents of teenagers with a chronic health condition, when they are well informed …

Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, Irene M. Ngune, Moyez Jiwa, Alexandra Mcmanus, Jeff Hughes

Research outputs 2014 to 2021

Background: Alongside specialist cancer clinics, general practitioners have an important role in cancer patients ’ follow-up care, yet no literature summarises the nature, extent and impact of their involvement. This paper addresses this issue through a review of the literature. Methods: Studies were sourced from six academic databases - AustHealth ( n = 202), CINAHL ( n = 500), the Cochrane Library (reviews and trials; n = 200), Embase ( n = 368), PHCRIS ( n = 132) and PubMed/Medline ( n = 410). Studies that focused on interventions designed for patients receiving follow-up care and reported cancer care provided …

Surveys Of Cancer Patients And Cancer Health Care Providers Regarding Complementary Therapy Use, Communication, And Information Needs, Ngaire King, Lynda G. Balneaves, Gregory T. Levin, Thao Nguyen, Jill G. Nation, Cynthia Card, Tracy Truant, Linda E. Carlson

Research outputs 2014 to 2021

Background. Complementary therapies (CTs) are increasingly utilized by cancer patients. Nonetheless, patients report insufficient support from health care practitioners (HCPs) and there is a general lack of patient-practitioner communication about CT use. Best care practices suggest that HCPs should address the needs of patients, including CT use. This study examined current practices of patients and HCPs as well as their interactions relating to CTs. Methods. A total of 481 cancer outpatients and 100 HCPs completed questionnaires. Patient questions addressed CT use and information needs; HCP questions addressed knowledge, opinions and beliefs about complementary and alternative medicine. Patient-practitioner communication around CT …

Quantification Of Opportunities For Early-Stage Paramedicine Students To Practice Clinical Skills During Clinical Placements Compared With An Equal Dose Of Simulation-Based Workshops, Brennen W. Mills, Owen B. Carter, Cobie Rudd, Jodie Mills, Nathan Ross, Joanne D. Ruck

Research outputs 2014 to 2021

Introduction A reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.

Methods N=37 first-year paramedicine students completed activity diaries during 3 days of CP …

Reduced Cardiovascular Capacity And Resting Metabolic Rate In Men With Prostate Cancer Undergoing Androgen Deprivation: A Comprehensive Cross-Sectional Investigation, Bradley Wall, Daniel A. Galvao, Naeem Fatehee, Dennis Taaffe, Nigel Spry, David Joseph, Robert Newton

Research outputs 2014 to 2021

Objectives. To investigate if androgen deprivation therapy exposure is associated with additional risk factors for cardiovascular disease and metabolic treatment-related toxicities. Methods. One hundred and seven men (42-89 years) with prostate cancer undergoing androgen deprivation therapy completed a maximal graded objective exercise test to determine maximal oxygen uptake, assessments for resting metabolic rate, body composition, blood pressure and arterial stiffness, and blood biomarker analysis. A cross-sectional analysis was undertaken to investigate the potential impact of therapy exposure with participants stratified into two groups according to duration of androgen deprivation therapy (≥3 months). Results. Maximal oxygen uptake (26.1 ± 6.0 mL/kg/min …

Circulating Tumor Dna To Monitor Treatment Response And Detect Acquired Resistance In Patients With Metastatic Melanoma, Elin S. Gray, Helen Rizos, Anna L. Reid, Suzanah Boyd, Michelle Pereira, Johnny Lo, Varsha Tembe, James Freeman, Jenny Lee, Richard Scolyer, Kelvin Siew, Chris Lomma, Adam Cooper, Muhammad Khattak, Tarek Meniawy, Georgina Long, Matteo Carlino, Michael Millward, Mel R. Ziman

Research outputs 2014 to 2021

Repeat tumor biopsies to study genomic changes during therapy are difficult, invasive and data are confounded by tumoral heterogeneity. The analysis of circulating tumor DNA (ctDNA) can provide a non-invasive approach to assess prognosis and the genetic evolution of tumors in response to therapy. Mutation-specific droplet digital PCR was used to measure plasma concentrations of oncogenic BRAF and NRAS variants in 48 patients with advanced metastatic melanoma prior to treatment with targeted therapies (vemurafenib, dabrafenib or dabrafenib/trametinib combination) or immunotherapies (ipilimumab, nivolumab or pembrolizumab). Baseline ctDNA levels were evaluated relative to treatment response and progression-free survival (PFS). Tumor-associated ctDNA was …

Maternal Fish Oil Supplementation In Pregnancy: A 12 Year Follow-Up Of A Randomised Controlled Test, Suzanne Meldrum, Janet A. Dunstan, Jonathon K. Foster, Karen Simmer, Susan L. Prescott

Research outputs 2014 to 2021

A number of trials have been undertaken to assess whether the intake of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) during pregnancy can influence the neurological development of the offspring, yet no consensus from these trials has been reached. We aimed to investigate the long-term effects (12 years) of fish oil supplementation in pregnancy on neurodevelopment, including cognition, language and fine motor skills. In a follow up of a previously published randomised controlled trial of 98 pregnant women, their children were assessed at 12 years of age using a battery of neurodevelopmental assessments. Fifty participants were assessed at 12 years, …

Strategy For Improvement Of Maternal Health In Nepal, Gehendra Mahara, Xiuhua Gua, Wei Wang

Research outputs 2014 to 2021

Maternal death is a public health problem in like Nepal. Still women have been facing the pregnancy related problems due to inaccessible and poor quality health service as well as a less available health service from skilled health workers. This is due to lack of essential knowledge about pregnancy and its complications. The main aim of this article is to evaluate and synthesize the current public health issues of maternal health of women in Nepal. Syntheses the problems, challenges and issues regarding maternal health and what can be done for the improvement of those problems with the evidence base practice. …

Patient- And Family-Centered Care Of Children In The Emergency Department., Nanette Dudley, Alice Ackerman, Kathleen M. Brown, Sally K. Snow, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee., Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.

Can Routine Screening And Iron Supplementation For Iron Deficiency Anemia In Nonsymptomatic Pregnant Women Improve Maternal And Infant Health Outcomes?, Anoosh Moin, Zohra S. Lassi

Department of Paediatrics and Child Health

Pregnant women have an increased need for iron that might not be met with diet alone. Due to physiologic anemia and population differences, no set criteria for defining iron deficiency anemia (IDA) are available globally. Serum ferritin and transferrin levels are often used to guide therapy by clinicians. Studies have reported an association between poor iron status and negative health outcomes such as low birth weight, premature birth, and perinatal death for women and their infants, although the evidence is weak.

Optimum Number Of Procedures Required To Achieve Procedural Skills Competency In Internal Medicine Residents, M. Tariq, Nizar Bhulani, Asif Jafferani, Quratulain Naeem, Syed Ahsan Ali, Afaq Motiwala, Jan Van Dalen, Saeed Hamid

Section of Internal Medicine

Background: Procedural skills training forms an essential, yet difficult to assess, component of an Internal Medicine Residency Program. We report the development of process of documentation and assessment of procedural skills training.
Method: An explanatory sequential mixed methods design was adopted where both quantitative and qualitative information was collected sequentially. A survey was conducted within the Department of Internal Medicine at The Aga Khan University Hospital, Karachi, Pakistan to determine the optimum number of procedures needed to be performed by residents at each year of residency. Respondents included both faculty and the residents in the Department. Thereafter, all responses …