Medical Specialties Commons^™

Acute Care Surgical Service Experience With Ruptured Visceral Artery Aneurysms, Jayme D. Lieberman Md, Meghan L. Good Md, Rovinder S. Sandhu Md, Michael M. Badellino Md

Department of Surgery

No abstract provided.

Preop Evaluation/Post Operative Care (Nutrition, Pain Management), Malia Eischen Md, Meghan L. Good Md, Lung-Ching Lee Md

Department of Surgery

No abstract provided.

Indications For Warfarin In Trauma Patients, Victor V. Ha Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Comparison Of Wound Complications In Open Vs Closed Lateral Internal Sphincterotomy For Anal Fissure (Presentation), Gregg M. Baranski Md, Arthur Yushuva Md, John S. Park Md

Department of Surgery

No abstract provided.

Amyotrophic Lateral Sclerosis, The Primary Motor Neuron Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Amyotrophic lateral sclerosis is a degenerative neurological disease that damages nerve cells in the brain, in particular the neurons that are involved in voluntary muscle movements. Internationally the disorder is also known as Charcot’s disease and motor neuron disease. In the United States, amyotrophic lateral sclerosis is often referred to as Lou Gehrig’s disease, motor neuron disease, and more colloquially ALS. Amyotrophic Lateral Sclerosis is the most prominent of the five motor neuron diseases, distinguishing itself from the others through degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN) respectively. The “Father of neurology” Jean-Marie Charcot founded …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

Dementia In The Context Of Disability, Rosanne Dizazzo-Miller, Fredrick D. Pociask

Department of Health Care Sciences

Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed …

Prevalence Of Suspicious Ultrasound Findings In Patients With Mammographic Focal Asymmetry At Aga Khan University Hospital, Nairobi, Jacqueline Ndunge Mavuti

Master of Medicine in Imaging and Diagnostic Radiology

Background: Breast cancer has become the leading cancer in women in both economically developed and developing countries, accounting for 25% of all cancers diagnosed worldwide in 2012. The cornerstone of breast cancer control remains early detection in order to improve outcomes and survival. Thus far the only breast cancer screening method that has proved to be effective is mammography. Although mammography is the mainstay of early detection, a fundamental limitation is its low inherent contrast difference between the soft tissue structures in the breast. Mammographic specificity relies on the ability to distinguish benign from malignant breast lesions based on their …

Cardiovascular Disease Performance Measures In The Outpatient Setting In India: Insights From The American College Of Cardiology's Pinnacle India Quality Improvement Program (Piqip), Ankur Kalra, Yashashwi Pokharel, Ravi S. Hira, Samantha Risch, Veronique Vicera, Qiong Li, Ram N. Kalra, Prafulla G. Kerkar, Ganesh Kumar, Salim S. Virani

Office of the Provost

Background: India has a growing burden of cardiovascular disease (CVD), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology's PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP). PIQIP is India's first national outpatient CVD quality-improvement program.
Methods and results: In the PIQIP registry, we estimated the prevalence of CVD risk factors …

Comparison Of Quantitative Analysis To Qualitative Analysis For Interpretation Of Lower Limb Lymphoscintigraphy, Edward Chege Nganga

Master of Medicine in Imaging and Diagnostic Radiology

Background: Lymphoscintigraphy is now the primary imaging modality used in determining a diagnosis in patients with suspected extremity lymphedema. However, analysis is mainly by visual qualitative analysis which is subjective and has a wide inter-observer variability. Subtle differences in ilioinguinal uptake between normal and abnormal limbs may be missed with visual qualitative analysis. This study seeks to compare quantitative analysis to qualitative analysis by computing percentage ilioinguinal nodes uptake at 1.5 hours. Objectives: To compare quantitative analysis to qualitative analysis of lower limb lymphoscintigraphy in the diagnosis of lymphedema. To determine the diagnostic accuracy of quantitative lymphoscintigraphy analysis. Methodology: 52 …

Percutaneous Ultrasonic Debridement Of Tendinopathy—A Pilot Achilles Rabbit Model, Srinath Kamineni, Timothy Butterfield, Anthony Sinai

Orthopaedic Surgery and Sports Medicine Faculty Publications

BACKGROUND: Tendinopathy is a common clinical pathology, with mixed treatment results, especially when chronic. In this study, we examine the effects of an ultrasonic debridement modality in a rabbit tendinopathy model. We asked four questions: (1) Was it possible to create and visualize with ultrasound a tendinopathy lesion in a rabbit Achilles tendon? (2) Was it possible to guide a 19-gauge ultrasonic probe into the tendinopathy lesion? (3) Following ultrasonic treatment, was tendinopathy debris histologically present? and (4) Was the collagen profile qualitatively and quantitatively normalized following treatment?

METHODS: Skeletally mature female New Zealand white rabbits (n = 12) …

Aquaporin 1 And 5 Expression Decreases During Human Intervertebral Disc Degeneration: Novel Hif-1-Mediated Regulation Of Aquaporins In Np Cells., Zariel I Johnson, Shilpa S Gogate, Rebecca Day, Abbie Binch, Dessislava Z Markova, Neil Chiverton, Ashley Cole, Matt Conner, Irving Shapiro, Christine L Le Maitre, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

Objectives of this study were to investigate whether AQP1 and AQP5 expression is altered during intervertebral disc degeneration and if hypoxia and HIF-1 regulate their expression in NP cells. AQP expression was measured in human tissues from different degenerative grades; regulation by hypoxia and HIF-1 was studied using promoter analysis and gain- and loss-of-function experiments. We show that both AQPs are expressed in the disc and that mRNA and protein levels decline with human disease severity. Bioinformatic analyses of AQP promoters showed multiple evolutionarily conserved HREs. Surprisingly, hypoxia failed to induce promoter activity or expression of either AQP. While genomic …

Endoscopic Mucosal Resection And Radiofrequency Ablation For Intramucosal Adenocarcinoma In The Background Of Barrett’S Esophagus: A Case Series, Bonnie Patek Do, Patrick Hickey Do, Hiral N. Shah Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Undifferentiated Carcinoma With Osteoclast-Like Giant Cells Of The Pancreatic Tail, Patrick Hickey Do, Ranjit R. Nair Md, Victoria A. Loven Md, Jeffrey Brodsky Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Ferritin Levels In The Cerebrospinal Fluid Predict Alzheimer's Disease Outcomes And Are Regulated By Apoe, Scott Ayton, Noel G. Faux, Ashley I. Bush, Charles D. Smith, Greg A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad, Alzheimer's Disease Neuroimaging Initiative

Neurology Faculty Publications

Brain iron elevation is implicated in Alzheimer's disease (AD) pathogenesis, but the impact of iron on disease outcomes has not been previously explored in a longitudinal study. Ferritin is the major iron storage protein of the body; by using cerebrospinal fluid (CSF) levels of ferritin as an index, we explored whether brain iron status impacts longitudinal outcomes in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. We show that baseline CSF ferritin levels were negatively associated with cognitive performance over 7 years in 91 cognitively normal, 144 mild cognitive impairment (MCI) and 67 AD subjects, and predicted MCI conversion to AD. …

Genetic Polymorphisms And Antidepressant Adverse Effects, Rajnish Mago, S. Gupta, Kelly Huhn, R. Shah

Department of Psychiatry and Human Behavior Faculty Papers

Abstract

Background

Aim: to assess whether pharmacogenetic polymorphisms are associated with increased adverse effects or non-response with certain antidepressants whose metabolism is highly dependent on specific CYP450 isoenzymes. This is interim analysis of an ongoing study

Methods

We used a Case Control design comparing patients with major depressive disorder or generalized anxiety disorder who had had increased adverse effects from specified antidepressants (Cases) to patients who were poor responders to an antidepressant but without significant adverse effects (Controls) Genecept Assay™ (battery of pharmacogenetic tests relevant to psychiatry) was obtained using saliva or cheek swab

Results

Importantly, 57.1% of Cases were …

Idiopathic Pulmonary Hemosiderosis: A Rare Cause Of Hemoptysis In Adults, Michael Kalil Do, B Miller Do, Ryan Rogers Do, Vanessa Ribaudo Kaufman Md

Department of Medicine

No abstract provided.

Quantification Of Atrial Dynamics Using Cardiovascular Magnetic Resonance: Inter-Study Reproducibility., Johannes T. Kowallick, Geraint Morton, Pablo Lamata, Roy Jogiya, Shelby Kutty, Gerd Hasenfuß, Joachim Lotz, Eike Nagel, Amedeo Chiribiri, Andreas Schuster

Journal Articles: Cardiology

BACKGROUND: Cardiovascular magnetic resonance (CMR) offers quantification of phasic atrial functions based on volumetric assessment and more recently, on CMR feature tracking (CMR-FT) quantitative strain and strain rate (SR) deformation imaging. Inter-study reproducibility is a key requirement for longitudinal studies but has not been defined for CMR-based quantification of left atrial (LA) and right atrial (RA) dynamics.

METHODS: Long-axis 2- and 4-chamber cine images were acquired at 9:00 (Exam A), 9:30 (Exam B) and 14:00 (Exam C) in 16 healthy volunteers. LA and RA reservoir, conduit and contractile booster pump functions were quantified by volumetric indexes as derived from fractional …

Spiritual Perspective, Mindfulness, And Spiritual Care Practices Of Hospice And Palliative Care Nurses, Patricia Ricci-Allegra

Seton Hall University Dissertations and Theses (ETDs)

Spiritual care is an ethical obligation of the nursing profession and an essential component of palliative care, but is often misunderstood. Lack of conceptual clarity is problematic, for each nurse will provide spiritual care based on his or her understanding of what this care should include.

Regardless of how a nurse defines spiritual care, an important element of spiritual care is what nurses bring of themselves to the patient encounter. Findings from several studies have shown a positive relationship between a nurse’s spiritual perspective and spiritual care practices. Spiritual perspective has increased as a result of participating in programs designed …

The Relationships Between Patients’ Perceptions Of Nurse Caring Behaviors, Nurses’ Perceptions Of Nurse Caring Behaviors And Patient Satisfaction In The Emergency Department, Theresa Bucco

Seton Hall University Dissertations and Theses (ETDs)

Background: Approximately 100 million people seek care in Emergency Departments yearly, which can be overwhelming for many Emergency Department (ED) nurses. Thus, caring for these patients and meeting their needs is challenging for ED nurses. It is the patients’ perceptions of the first caring encounters in the ED that can have a significant impact on patient satisfaction.

Objective: The purpose of the study was to examine the relationships between patients’ perceptions of nurse caring behaviors, nurses’ perceptions of nurse caring behaviors, and patient satisfaction in the ED.

Methods: This was a descriptive cross-sectional study that examined the …

Accuracy Of Melena Identification On Physical Exam In Post Graduate Training – Implications Of Level Of Training, Medical Specialty, Rectal Exam Concordance And Appropriateness Of Therapy, Richard M. Wu, Md, Mph, Eugene Han, Md, Andrew Dargan, Md, Cecilia Kelly, Md, Mitchell Conn, Md, Mba

Division of Gastroenterology and Hepatology Faculty Papers

Introduction

Melena is commonly misidentified by young resident physicians.

The magnitude of this inaccurate physical exam has not been quantified.

Precise identification of melena may have important diagnostic and therapeutic implications.

Is It Time To Replace Propranolol With Carvedilol For Portal Hypertension?, Shahab Abid, Saadat Ali, Muhammad Asif Baig, Anam Akbar Waheed

Section of Gastroenterology

Beta-adrenergic receptor antagonists (beta-blockers) have been well established for use in portal hypertension for more than three decades. Different Non-selective beta-blockers like propranolol, nadolol, timolol, atenolol, metoprolol and carvedilol have been in clinical practice in patients with cirrhosis. Carvedilol has proven 2-4 times more potent than propranolol as a beta-receptor blocker in trials conducted testing its efficacy for heart failure. Whether the same effect extends to its potency in the reduction of portal venous pressures is a topic of on-going debate. The aim of this review is to compare the hemodynamic and clinical effects of carvedilol with propranolol, and attempt …

End-Of-Life Care: Crossing The Bridge From Treatment To Support, Martha C. Romney Bsn, Ms, Jd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Systematic Review And Mixed Treatment Comparison Of Intravitreal Aflibercept With Other Therapies For Diabetic Macular Edema (Dme)., Jean-Francois Korobelnik, Jos Kleijnen, Shona H. Lang, Richard Birnie, Regina M. Leadley, Kate Misso, Gill Worthy, Dominic Muston, Diana V. Do

Journal Articles: Ophthalmology

BACKGROUND: This was an indirect comparison of the effectiveness of intravitreal aflibercept (IVT-AFL) 2 mg every 8 weeks after 5 initial monthly doses (or if different periods, after an initial monthly dosing period) (2q8) and other diabetic macular edema (DME) therapies at doses licensed outside the USA.

METHODS: A comprehensive search was undertaken to source relevant studies. Feasibility networks were prepared to identify viable comparisons of 12-month outcomes between IVT-AFL 2q8 and therapies licensed outside the USA, which were assessed for clinical and statistical homogeneity. Pooled effect sizes (mean difference [MD] and relative risk/risk ratio [RR]) were calculated using fixed- …

The Endogenous Cell-Fate Factor Dachshund Restrains Prostate Epithelial Cell Migration Via Repression Of Cytokine Secretion Via A Cxcl Signaling Module., Ke Chen, Kongming Wu, Xuanmao Jiao, Liping Wang, Xiaoming Ju, Min Wang, Gabriele Disante, Shaohua Xu, Qiong Wang, Kevin Li, Xin Sun, Chongwen Xu, Zhiping Li, Mathew C. Casimiro, Adam Ertel, Sankar Addya, Peter Mccue, Michael P. Lisanti, Chenguang Wang, Richard J. Davis, Graeme Mardon, Richard Pestell

Department of Cancer Biology Faculty Papers

Prostate cancer is the second leading form of cancer-related death in men. In a subset of prostate cancer patients, increased chemokine signaling IL8 and IL6 correlates with castrate-resistant prostate cancer (CRPC). IL8 and IL6 are produced by prostate epithelial cells and promote prostate cancer cell invasion; however, the mechanisms restraining prostate epithelial cell cytokine secretion are poorly understood. Herein, the cell-fate determinant factor DACH1 inhibited CRPC tumor growth in mice. Using Dach1(fl/fl)/Probasin-Cre bitransgenic mice, we show IL8 and IL6 secretion was altered by approximately 1,000-fold by endogenous Dach1. Endogenous Dach1 is shown to serve as a key endogenous restraint to …

Prospective Study Of Recovery From Copperhead Snake Envenomation: An Observational Study, Eric J. Lavonas, Charles J. Gerardo, Rebecca C. Bowers, Joann Short, Copperhead Snakebite Recovery Outcome Group

Emergency Medicine Faculty Publications

BACKGROUND: Although much is known about signs, symptoms, and management in the acute phase of crotaline snake envenomation, little is known about signs, symptoms, function, and quality of life during the recovery phase. The purpose of this observational pilot investigation is to evaluate the utility of several clinical outcome instruments in the setting of copperhead snakebite, and to characterize the clinical course of recovery.

METHODS: This is a multi-center prospective, open-label, observational study of patients envenomated by copperhead snakes. We administered the Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), Patient-Specific Functional Scale …

Treatment Plan Adherence To Guidelines In Senior Adult Oncology Patients, Amy R. Mackenzie, Md, Andrea M. Barsevick, Phd, Ronald Myers, Phd, Ludmila De Oliveira Koch, Md, Scott W. Keith, Phd, Thomas Wolf, Ma, James Cocroft, Ma, Joshua Schoppe, Mph, Ulysses Williams Iii, Andrew Chapman, Do

Department of Medical Oncology Faculty Papers

Materials & Methods:

• Review of 287 records
• Patients ≥ 65 years old with new diagnosis of cancer
• Seen by 6, dual-boarded hematologists/ oncologists practicing in an urban academic cancer center
• Treatment plans compared to national guidelines to determine plan adherence status
• Patients were recommended:

Adherent plan (AP) or Non-adherent plan (N-AP)

Characterization Of The Older Adult Refugee Population At Thomas Jefferson University’S Center For Refugee Health (Crh), Kathryn Beldowski, Md, Neesha Patel, Md, Brooke Salzman, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Background

• Established in 2007, the CRH has served over 1,000 refugees of all ages as they resettle in Philadelphia, PA.
• Research about refugee populations generally focuses on infectious disease, women’s health, pediatrics and mental health, with minimal research on the older adult refugee population.
• The objective of this study was to describe the characteristics of the older refugee population served by the CRH, focusing on chronic disease, smoking status, immunization and cancer screening rates, and presence of geriatric syndromes.

Draft Genome Sequences Of Six Different Staphylococcus Epidermidis Clones, Isolated Individually From Preterm Neonates Presenting With Sepsis At Edinburgh's Royal Infirmary, Paul Walsh, M. Bekaert, J. Carroll, T. Manning, B. Kelly, A. O'Driscoll, X. Lu, C. Smith, P. Dickinson, K. Templeton, P. Ghazal, Roy D. Sleator

Department of Biological Sciences Publications

Herein, we report the draft genome sequences of six individual Staphylococcus epidermidis clones, cultivated from blood taken from different preterm neonatal sepsis patients at the Royal Infirmary, Edinburgh, Scotland, United Kingdom.

Clinical Applications Of A Combination Chemotherapy Using 8-Chloro Camp And 8-Chloro Adenosine, Erik Munoz, Andrea Saich, Andrew Cox, Yu-An Peter Chang

Student Scholar Symposium Abstracts and Posters

Dr. Cho-Chung from the NIH first thought to use halogenated cAMP derivatives as competitive inhibitors of cAMP to slow down cancer cell mitosis. While the iodine and bromine substituted versions showed very little therapeutic actions, 8-Chloro cAMP has been shown to have strong anti-cancer effects. This has been shown in the phase II clinical trials this drug has undergone. However, these trials have had issues with solubility and toxicity. The drug is similar to vitamin C and is excreted quickly. Scientists tried to overcome this by using a peristaltic pump to give patients a continuous dosage, but this proved too …