Medical Specialties Commons^™

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Vitamin D Supplementation: Preventing Fractures, Courtney L. Carn, Michael S. Doherty

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the ability of vitamin D supplementation in preventing musculoskeletal fractures. Methods: Systematic literature review using Google Scholar search terms “vitamin D supplementation” and “preventing hip fractures” from 2006-2015. Only RCTs, meta-analysis, and clinical guidelines were included. Results: Our search resulted in one meta-analysis and two randomized controlled trials. Conclusion: The summation of our investigation into vitamin D deficiency and the presence of musculoskeletal fractures has proven to be relatively inconclusive. The resulting data from our three studies did not provide any definitive proof that improved vitamin D levels correlates with better bone health.

The Effect Of Acute Aerobic Exercise On Hemostasis In Obstructive Sleep Apnea Patients, Ryan A. Martin

Masters Theses, 2010-2019

Purpose: To determine the hemostatic response after acute aerobic exercise in Obstructive Sleep Apnea (OSA). Methods: Eighteen males were recruited from the university and local community. Individuals who presented evidence of cardiovascular, pulmonary, or metabolic disease were excluded. Apnea-Hypopnea Index (AHI) > 5 was criteria for OSA. Subjects performed a treadmill exercise test at 35% and 70% predicted VO₂reserve during the morning hours. Pre exercise blood samples were obtained after 15 minutes supine rest and within two minutes following exercise. Repeated Measures ANOVA were performed for Factor VIII antigen, tPA antigen, tPA activity, and PAI-1 activity across two time …

Want To Lose Weight? Commercial Weight Loss Programs Vs. Primary Care, Jessica Jacobson, Katherine Chui

Physician Assistant Capstones, 2016 to 2019

Context Overweight and obesity rates are on a continuous incline in the United States leading to increased rates of diabetes, cardiovascular disease and death. Much of the healthcare costs are going into treating this disease; therefore, it is vital to find effective weight loss treatments in both the primary care and community settings to reduce the prevalence of overweight and obesity and subsequent healthcare costs.

Objective To assess whether primary care-based therapy or commercial weight loss programs help overweight and obese patients lose 5% of their weight from baseline.

Design, Setting and Participants A systematic review of four randomized control …

Orthotopic Heart Transplant Following Implantation Of A Systemic Ventricular Assist Device In A Patient With Congenitally Corrected Transposition Of The Great Arteries And Dextrocardia Situs Inversus Totalis, Bree Ann C. Young, Zachariah B. Nealy, Michael F. Mcgrath, John M. Herre

The VAD Journal

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart disease that commonly results in congestive heart failure due to exposure of the anatomic right ventricle to systemic pressures. Additional anatomic abnormalities, such as situs inversus, in which the viscera are mirror images of normal anatomy, or dextrocardia in which the heart apex is located on the patient’s right, once were contraindications to transplant in the treatment of advanced heart failure. However, recent advancements now allow for the management of heart failure through mechanical circulatory support and subsequent transplant. This case presents a 52 year-old man with …

Amyloidosis Masquerading As Suspected Angioedema: Delay In Diagnosis, Grace Berlin Do, Marie S. O’Brien Do

Department of Medicine

No abstract provided.

Va-Ecmo In Cardiogenic Shock In Adults: Indications And Outcomes, Maya Guglin, Andrew Burchett

The VAD Journal

Background

Use of veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) has become increasingly common as a means of providing hemodynamic support for patients in cardiogenic shock. Data regarding the efficacy of VA-ECMO are provided almost exclusively by single-center, retrospective analyses. These retrospective analyses vary significantly with regards to documentation of the underlying pathophysiologic process resulting in cardiogenic shock.

Methods

Relevant published studies were identified by using a comprehensive search of English-language MEDLINE from 1966 to November 2015. Relevant references found cited in these studies were also analyzed. These studies were analyzed with regard to the indications the authors used for initiation of …

The Tnfα-Transgenic Rat: Hippocampal Synaptic Integrity, Cognition, Function, And Post-Ischemic Cell Loss, L. Creed Pettigrew, Richard J. Kryscio, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

The cytokine, tumor necrosis factor α (TNFα), is a key regulator of neuroinflammation linked to numerous neurodegenerative conditions and diseases. The present study used transgenic rats that overexpress a murine TNFα gene, under the control of its own promoter, to investigate the impact of chronically elevated TNFα on hippocampal synaptic function. Neuronal viability and cognitive recovery in TNFα Tg rats were also determined following an ischemic insult arising from reversible middle cerebral artery occlusion (MCAO). Basal CA3-CA1 synaptic strength, recorded in acute brain slices, was not significantly different between eight-week-old TNFα Tg rats and non-Tg rats. In contrast, slices from …

Effect Of A 72 Hour Stroke Care Bundle On Early Outcomes After Acute Stroke: A Non Randomised Controlled Study, Martha Sajatovic, Anthony J. Furlan

Faculty Scholarship

Background Integrated care pathways (ICP) in stroke management are increasingly being implemented to improve outcomes of acute stroke patients. We evaluated the effect of implementing a 72 hour stroke care bundle on early outcomes among patients admitted within seven days post stroke to the national referral hospital in Uganda. Methods In a one year non-randomised controlled study, 127 stroke patients who had ‘usual care’ (control group) were compared to 127 stroke patients who received selected elements from an ICP (intervention group). Patients were consecutively enrolled (controls first, intervention group second) into each group over 5 month periods and followed to …

Establishing The Feasibility Of The Dosimetric Compliance Criteria Of Rtog 1308: Phase Iii Randomized Trial Comparing Overall Survival After Photon Versus Proton Radiochemotherapy For Inoperable Stage Ii-Iiib Nsclc., Tawfik Giaddui, Wenzhou Chen, Jialu Yu, Liyong Lin, Charles B. Simone, Lulin Yuan, Yutao U.T. Gong, Q. Jackie Wu, Radhe Mohan, Xiaodong Zhang, Jaques B. Bluett, Michael Gillin, Kevin Moore, Elizabeth O'Meara, Jennifer Presley, Jeffrey D Bradley, Zhongxing Liao, James Galvin, Ying Xiao

Department of Radiation Oncology Faculty Papers

BACKGROUND: To establish the feasibility of the dosimetric compliance criteria of the RTOG 1308 trial through testing against Intensity Modulation Radiation Therapy (IMRT) and Passive Scattering Proton Therapy (PSPT) plans.

METHODS: Twenty-six lung IMRT and 26 proton PSPT plans were included in the study. Dose Volume Histograms (DVHs) for targets and normal structures were analyzed. The quality of IMRT plans was assessed using a knowledge-based engineering tool.

RESULTS: Most of the RTOG 1308 dosimetric criteria were achieved. The deviation unacceptable rates were less than 10 % for most criteria; however, a deviation unacceptable rate of more than 20 % was …

Reciprocity: Caring For America's Caregivers, Courtney Dunn

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

Should families be forced to choose between the health of a caregiver and patient? Through the eyes of a woman caring for her husband with Alzheimer's disease, we see that family caregivers suffer tremendous amounts of stress while caring for the patient. Despite the time and efforts required to care for someone with Alzheimer's disease, people every day choose this as an alternative to out-of-home care. This often leads to depression, anxiety, and physical stress which can result in series medical issues. Considering the increase of people with Alzheimer's disease in the United States, this article argues that support programs …

Thyroid Cancer And Tumor Collaborative Registry (Tccr)., Oleg Shats, Whitney Goldner, Jianmin Feng, Alexander Sherman, Russell B. Smith, Simon Sherman

Journal Articles: Eppley Institute

A multicenter, web-based Thyroid Cancer and Tumor Collaborative Registry (TCCR, http://tccr.unmc.edu) allows for the collection and management of various data on thyroid cancer (TC) and thyroid nodule (TN) patients. The TCCR is coupled with OpenSpecimen, an open-source biobank management system, to annotate biospecimens obtained from the TCCR subjects. The demographic, lifestyle, physical activity, dietary habits, family history, medical history, and quality of life data are provided and may be entered into the registry by subjects. Information on diagnosis, treatment, and outcome is entered by the clinical personnel. The TCCR uses advanced technical and organizational practices, such as (i) metadata-driven software …

Fbxo30 Regulates Mammopoiesis By Targeting The Bipolar Mitotic Kinesin Eg5., Yan Liu, Yin Wang, Zhanwen Du, Xiaoli Yan, Pan Zheng, Yang Liu

Pediatrics Faculty Publications

Fbxo30 is an orphan member of the F-box protein family with no known substrate or function. Here we report that, while Fbxo30^−/− mice exhibit normal development, growth, lifespan, and fertility, the females fail to nurture their offspring as a result of defective mammopoiesis. Mass spectrometry analysis of Fbxo30-associated proteins revealed that Fbxo30 specifically interacts with the bipolar spindle kinesin EG5 (encoded byKif11). As a result, Fbxo30 targets Eg5 for ubiquitinylation and controls its oscillation during the cell cycle. Correlated with EG5 dysregulation, Fbxo30^−/− mammary epithelial cells exhibit multiple defects in centrosome homeostasis, mitotic spindle …

Compositions And Methods For Treating Retinal Degradation, Jayakrishna Ambati, Benjamin J. Fowler

Ophthalmology and Visual Science Faculty Patents

The present disclosure relates to compositions and methods for treating retinal damage and/or retinal degradation. More specifically, this disclosure relates to methods for treating degradation of the retinal pigment epithelium by administering compositions comprising a nucleoside and/or a nucleoside or nucleotide reverse transcriptase inhibitor.

Integrating Pediatric Burn Patients, Less Than 12 Years Old, Into An Adult Burn Icu Setting, Jennifer A. Nagle Rn, Jessica Ayers Rn, Nancy Humes Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Utilization Of Hiv-1 Envelope V3 To Identify X4- And R5-Specific Tat And Ltr Sequence Signatures., Gregory C Antell, Will Dampier, Benjamas Aiamkitsumrit, Michael R Nonnemacher, Jeffrey M Jacobson, Vanessa Pirrone, Wen Zhong, Katherine Kercher, Shendra Passic, Jean W Williams, Gregory Schwartz, Uri Hershberg, Fred C Krebs, Brian Wigdahl

Department of Medicine Faculty Papers

BACKGROUND: HIV-1 entry is a receptor-mediated process directed by the interaction of the viral envelope with the host cell CD4 molecule and one of two co-receptors, CCR5 or CXCR4. The amino acid sequence of the third variable (V3) loop of the HIV-1 envelope is highly predictive of co-receptor utilization preference during entry, and machine learning predictive algorithms have been developed to characterize sequences as CCR5-utilizing (R5) or CXCR4-utilizing (X4). It was hypothesized that while the V3 loop is predominantly responsible for determining co-receptor binding, additional components of the HIV-1 genome may contribute to overall viral tropism and display sequence signatures …

The Global Strategy For Women's, Children's And Adolescents' Health (2016-2030): A Roadmap Based On Evidence And Country Experience., Shyama Kuruvilla, Flavia Bustreo, Taona Kuo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The Global strategy for women’s, children’s and adolescents’ health (2016–2030) provides a roadmap for ending preventable deaths of women, children and adolescents by 2030 and helping them achieve their potential for and rights to health and well-being in all settings.1 The global strategy has three objectives: survive (end preventable deaths); thrive (ensure health and well-being); and transform (expand enabling environments). These objectives are aligned with 17 targets within nine of the sustainable development goals (SDGs),2 including SDG 3 on health and other SDGs related to the political, social, economic and environmental determinants of health and sustainable development.

Like the SDGs, …

Acth Prevents Deficits In Fear Extinction Associated With Early Life Seizures, Andrew T. Massey, David K. Lerner, Gregory L. Holmes, Rod C. Scott, Amanda Hernan

Dartmouth Scholarship

Objective: Early life seizures (ELS) are often associated with cognitive and psychiatric comorbidities that are detrimental to quality of life. In a rat model of ELS, we explored long-term cognitive outcomes in adult rats. Using ACTH, an endogeneous HPA-axis hormone given to children with severe epilepsy, we sought to prevent cognitive deficits. Through comparisons with dexamethasone, we sought to dissociate the corticosteroid effects of ACTH from other potential mechanisms of action.

Results: Although rats with a history of ELS were able to acquire a conditioned fear learning paradigm and controls, these rats had significant deficits in their ability to extinguish …

Lasers In Tattoo And Pigmentation Control: Role Of The Picosure(®) Laser System., Richard Torbeck, Richard Bankowski, Sarah Henize, Nazanin Saedi

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND AND OBJECTIVES: The use of picosecond lasers to remove tattoos has greatly improved due to the long-standing outcomes of nanosecond lasers, both clinically and histologically. The first aesthetic picosecond laser available for this use was the PicoSure(®) laser system (755/532 nm). Now that a vast amount of research on its use has been conducted, we performed a comprehensive review of the literature to validate the continued application of the PicoSure(®) laser system for tattoo removal.

STUDY DESIGN AND METHODS: A PubMed search was conducted using the term "picosecond" combined with "laser", "dermatology", and "laser tattoo removal".

RESULTS: A total …

Pessary Versus Cerclage Versus Expectant Management For Cervical Dilation With Visible Membranes In The Second Trimester., Alexis C. Gimovsky, Anju Suhag, Amanda Roman, Burton L. Rochelson, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: We evaluated pessary for dilated cervix and exposed membranes for prolonging pregnancy compared to cerclage or expectant management.

METHODS: Multicenter retrospective cohort study of women, 15-24 weeks, singleton pregnancies, dilated cervix ≥2 cm and exposed membranes. Women received pessary, cerclage or expectant management. Primary outcome was gestational age (GA) at delivery. Secondary outcomes were time until delivery, preterm premature rupture of membranes (PPROM) and neonatal survival.

RESULTS: About 112 women met study criteria; 9 - pessary, 85 - cerclage and 18 - expectant management. Mean GA at delivery was 22.9 ± 4.5 weeks with pessary, 29.2 ± 7.5 weeks …

Calpain-5 Expression In The Retina Localizes To Photoreceptor Synapses, Kellie A. Schaefer, Marcus A. Toral, Gabriel Velez, Allison J. Cox, Sheila A. Baker, Nicholas C. Borcherding, Diana F. Colgan, Vimala Bondada, Charles B. Mashburn, Chen Guang Yu, James W. Geddes, Stephen H. Tsang, Alexander G. Bassuk, Vinit B. Mahajan

Spinal Cord and Brain Injury Research Center Faculty Publications

Purpose: We characterize calpain-5 (CAPN5) expression in retinal and neuronal subcellular compartments.

Methods: CAPN5 gene variants were classified using the exome variant server, and RNA-sequencing was used to compare expression of CAPN5 mRNA in the mouse and human retina and in retinoblastoma cells. Expression of CAPN5 protein was ascertained in humans and mice in silico, in mouse retina by immunohistochemistry, and in neuronal cancer cell lines and fractionated central nervous system tissue extracts by Western analysis with eight antibodies targeting different CAPN5 regions.

Results: Most CAPN5 genetic variation occurs outside its protease core; and searches …

Providing Pediatric Patients With A Voice : Understanding How Children Want To Live Before They Die, Nina Friedman

Graduate Student Independent Studies

This paper explores what quality of life is for pediatric patients and how health care professionals, a certified child life specialist in particular, can help the patient, family, and medical team to navigate treatment options and decisions regarding end-of-life.

Medical Education Digest, Vol. 18 No. 3 (May-June 2016) Final Issue, Nova Southeastern University

Medical Education Digest

No abstract provided.

A Conserved Dna Repeat Promotes Selection Of A Diverse Repertoire Of Trypanosoma Brucei Surface Antigens From The Genomic Archive., Galadriel Hovel-Miner, Monica R Mugnier, Benjamin Goldwater, George A M Cross, F Nina Papavasiliou

Microbiology, Immunology, and Tropical Medicine Faculty Publications

African trypanosomes are mammalian pathogens that must regularly change their protein coat to survive in the host bloodstream. Chronic trypanosome infections are potentiated by their ability to access a deep genomic repertoire of Variant Surface Glycoprotein (VSG) genes and switch from the expression of one VSG to another. Switching VSG expression is largely based in DNA recombination events that result in chromosome translocations between an acceptor site, which houses the actively transcribed VSG, and a donor gene, drawn from an archive of more than 2,000 silent VSGs. One element implicated in these duplicative gene conversion events is a DNA repeat …

A Single Exercise Bout Enhances The Manufacture Of Viral-Specific T-Cells From Healthy Donors: Implications For Allogeneic Adoptive Transfer Immunotherapy, Guillaume Spielmann, Catherine Bollard, Hawley Kunz, Patrick J. Hanley, Richard J. Simpson

Pediatrics Faculty Publications

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections remain a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). The adoptive transfer of donor-derived viral-specific cytotoxic T-cells (VSTs) is an effective treatment for controlling CMV and EBV infections after HSCT; however, new practical methods are required to augment the ex vivo manufacture of multi-VSTs from healthy donors. This study investigated the effects of a single exercise bout on the ex vivo manufacture of multi-VSTs. PBMCs isolated from healthy CMV/EBV seropositive participants before (PRE) and immediately after (POST) 30-minutes of cycling exercise were stimulated with CMV (pp65 and …

Career Services Focus: Surgery, Boonshoft School Of Medicine Career Services

Department of Surgery Faculty Publications

A seven page newsletter from the Boonshoft School of Medicine's Career Services highlighting interviews with Department of Surgery faculty and students.

Spinal Cord Compression Secondary To Extramedullary Hematopoiesis: Case Report And Review Of The Literature, Arthur Wang, Nathan Carberry, Elena Solli, John Gillick, Humayun Islam, Virany Hillard

NYMC Faculty Publications

Extramedullary hematopoiesis (EMH) is a rare cause of spinal cord compression (SCC). EMH represents the growth of blood cells outside of the bone marrow and occurs in a variety of hematologic illnesses, including various types of anemia and myeloproliferative disorders. Although EMH usually occurs in the liver, spleen, and lymph nodes, it may also occur within the spinal canal. When this occurs, the mass effect can compress the spinal cord, potentially leading to the development of neurological deficits. We present a case of SCC secondary to EMH. This report illustrates the importance of considering EMH in the differential diagnosis of …

Department Of Surgery Update, May 2016, Wright State University Department Of Surgery

Department of Surgery Updates

A four page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

A Medical Malpractice Trial Where The Residents And Faculty Are The Judge And The Jury, Kelly A. Rabah

Obstetrics and Gynecology Faculty Publications

At the conclusion of this session, the learner should be able to:

• Name 3- 5 of the most common reasons for a medical malpractice claim

• Describe and compare negligence, types of error, and recklessness

• Explain 3-5 steps that should be taken to minimize risk for a malpractice suit

• Discuss the emotional toll that litigation causes and the personal and professional risks that may result

Chronic Kidney Disease And Acute Myocardial Infarction: The Story After 1 Year, Paulette S. Wehner, William A. Nitardy

Internal Medicine

When chronic kidney disease (CKD) is part of the clinical history for a patient with acute myocardial infarction, the interventional cardiologist experiences an increased anxiety level. An acute myocardial infarction with renal disease requires more attention to dye load and fluid status, and general opinion exists regarding the negative outcomes of these “sicker” patients.

Mark Navarro and colleagues completed a thorough study from a different angle. We know the interventionalists’ concerns are justified acutely as these CKD patients have a higher level of inpatient complications, but these authors chose to look at the patients 1 year from their event to …