Medical Specialties Commons^™

Esophageal Diagnosis Of A Malignant Aspergilloma, Muneer Al Zoby, Nancy Munn,, Yousef Shweihat

Internal Medicine

A 59-year-old male patient developed a new 4 cm × 6 cm cavitary left upper lung lesion over a 2 months period. The patient had a prior history of a surgically resected Stage IA non-small cell lung cancer in the right upper lobe 3 years prior. He was treated for possible infection with radiographic improvement on subsequent imaging. Further imaging after 3 months revealed an oval soft tissue density within the cavity with air crescent sign. Bronchoscopy with transbronchial biopsies showed an acute and chronic granulomatous inflammation. Aspergillus fumigatus was noted on culture and voriconazole was initiated. Subsequent imaging showed …

The Impact Of Alzheimer’S Disease In An Aging Rural Population, Lynne J. Goebel, Vivian M. Minkemeyer, Courtney Wellman

Internal Medicine

West Virginia already has a large elderly population, and it is expected to increase along with the elderly population of the nation as a whole. Since the most important risk factor for Alzheimer’s disease is older age, it is not surprising that the prevalence of Alzheimer’s disease is projected to increase significantly over the next thirty-five years. This paper discusses the prevalence of Alzheimer’s disease in West Virginia, programs available to assist people and caregivers affected by the disease, and the associated economic burden of the disease.

Rural Disparities In Cancer Care: A Review Of Its Implications And Possible Interventions, Raj Singh, Lynne J. Goebel Md

Internal Medicine

Cancer care has greatly improved in the last few decades, as evidenced by a 22% decline in the overall cancer-related death rate in the United States since 1991. However, the question presents itself whether rural residents, for whom the latest advancements are not as accessible, are also realizing these benefits as much as their urban counterparts. The aim of this study is to provide are view of the literature regarding the disparities in cancer care facing rural Appalachia and specifically West Virginia (WV) as well as possible solutions towards bridging this gap. We find that WV has a higher cancer …

Behavioral Interventions In Six Dimensions Of Wellness That Protect The Cognitive Health Of Community-Dwelling Older Adults: A Systematic Review, Kelley A. Strout, Daniel J. David, Elizabeth J. Dyer, Roberta C. Gray, Regula H. Robnett, Elizabeth P. Howard

Library Services Faculty Publications

OBJECTIVES: To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community-dwelling older adults using a holistic wellness framework. DESIGN: Systematic review of randomized controlled trials that tested the effectiveness of behavioral interventions within each of the six dimensions of wellness: occupational, social, intellectual, physical, emotional and spiritual. Databases searched included PubMed MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, ALOIS, and The Grey Literature Report through July 1, 2014. SETTING: Community. PARTICIPANTS: Individuals aged 60 and older (N = 6,254). MEASUREMENTS: Consolidated Standards of Reporting Trials Checklist. RESULTS: Eighteen studies met the inclusion criteria. …

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …

Improving Rural Bone Health And Minimizing Fracture Risk In West Virginia: Validation Of The World Health Organization Frax® Assessment Tool As A Phone Survey For Osteoporosis Detection, Franklin D. Shuler Md, Phd, Kelly Scott Md, Mph, Timothy Wilson-Byrne Md, Miranda R. Morgan, Linda Morgan

Orthopaedics

West Virginia ranks second nationally in population ≥ 65 years old placing our state at greater risk for osteoporosis and fracture. The gold standard for detecting osteoporosis is dual X-ray absorptiometry (DXA), yet over half of West Virginia’s counties do not have this machine. Due to access barriers, a validated phone-administered fracture prediction tool would be beneficial for osteoporosis screening. The World Health Organization’s FRAX® fracture prediction tool was administered as a phone survey to 45 patients; these results were compared to DXA bone mineral density determination. Results confirmed that the FRAX® phone survey is as reliable as DXA in …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

Aquagenic Palmoplantar Keratoderma With Dorsal Hand Involvement In An Adolescent Female, Divya Angra, Kunal Angra, Ife J. Rodney

Dermatology Faculty Publications

Aquagenic palmoplantar keratoderma (APK) is a rare, acquired condition that presents as papules on the palms, and rarely the soles, upon immersion in water. We describe a patient who presented with the unusual finding of dorsal involvement of the hands.

Renal Stress Testing In The Assessment Of Kidney Disease, Lakhmir S. Chawla, Claudio Ronco

Anesthesiology and Critical Care Medicine Faculty Publications

As part of human evolutionary development, many human organ systems have innate mechanisms to adapt to increased “work demand” or stress. This reserve capacity can be informative and is used commonly in cardiology to assess cardiac function (e.g., treadmill test). Similarly, the kidney possesses reserve capacity, which can be demonstrated in at least 2 of the following renal domains: glomerular and tubular. When appropriate stimulants are used, healthy patients with intact kidneys can significantly increase their glomerular filtration rate and their tubular secretion. This approach has been used to develop diagnostics for the assessment of renal function. This article reviews …

Expert Opinion Regarding Invasive Monitoring: From Surface To Depth, Mohamad Z. Koubeissi

Neurology Faculty Publications

No abstract provided.

Mr Imaging Findings In Xp21.2 Duplication Syndrome, Matthew T. Whitehead, Guy Helman, Andrea L. Gropman

Radiology Faculty Publications

Xp21.2 duplication syndrome is a rare genetic disorder of undetermined prevalence and clinical relevance. As the use of chromosomal microarray has become first line for the work-up of childhood developmental delay, more gene deletions and duplications have been recognized. To the best of our knowledge, the imaging findings of Xp21.2 duplication syndrome have not been reported. We report a case of a 33 month-old male referred for developmental delay that was found to have an Xp21.2 duplication containing IL1RAPL1 and multiple midline brain malformations.

Interrupted Aortic Arch Complicated With Takotsubo Cardiomyopathy Mimicking Aortic Dissection, Farhala Mari Baloch, Javed Majid Tai, Aamir Hameed, Abdul Baqi

Section of Cardiology

A 50-year-old man presented to the emergency department with interscapular pain, diaphoresis and restlessness. Initial examination raised the possibility of aortic dissection; however, the CT scan did not concur with the diagnosis. An ECG showed ST segment elevation in leads V1-V6 and echocardiography showed severe left ventricular systolic dysfunction. Coronary angiography through the right femoral artery was attempted but the diagnostic catheter could not be advanced to the ascending aorta. Radiocontrast injection showed complete obstruction of the descending aorta. Coronary angiography through right radial approach showed mild left anterior descending disease. The aortogram showed complete interruption of the ascending aorta …

An Epidemiological Look At Injuries Among High School Athletes Participating In A Variety Of Sports For Both Sexes, Emily H. Wills

Undergraduate Honors Theses

Physical activity is part of a healthy lifestyle, but participating in athletic activities like team sports can lead to injury. This study was designed to find the differences in types of high school sports injuries and how frequently these injuries occur among different sports and between males and females. A survey was given to members of the football, boys’ basketball, girls’ basketball, baseball, softball, and volleyball teams of a central Appalachian high school. The highest rate of injury was found in girls’ basketball at 86.7%, followed by football at 85.2%, boys’ basketball at 70.6%, softball and volleyball each at 69.2%, …

Improving Access To Care For Arkansas Youth Athletes With Sport-Related Concussion: Establishing “Teleconcussion” In Arkansas, Kristin Maxey

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Proper management of sport-related concussion (SRC) is critical for improved recovery outcomes in youth athletes. Several barriers exist to improving the standard of care for youth athletes with SRC. Many rural areas lack medical professionals with specialized training in SRC. Innovative methods for providing specialized healthcare to youth athletes with SRC are needed. Telehealth may be an effective means of providing specialized care for youth athletes with SRC located in underserved areas that have a shortage of healthcare providers specializing in SRC.

Purpose: The purpose of this study was to compare patient, caregiver, and provider ratings of the therapeutic …

Impact Of Delay In Admission On The Outcome Of Critically Ill Patients Presenting To The Emergency Department Of A Tertiary Care Hospital From Low Income Country, Badar Afzal Khan, Nishi Shakeel, Emad Uddin Siddiqui, Ghazala Kazi, Irum Qamar Khan, Munawer Khursheed, Asher Feroze, Kiran Ejaz, Sumaiya Tauseeq Khan, Hatem Adel

Department of Emergency Medicine

Objective: To assess the impact of admission delay on the outcome of critical patients.Methods: The retrospective chart review was done at Aga Khan University Hospital, Karachi, and comprised adult patients visiting the Emergency Department during 2010. Outcome measures assessed were total hospital length of stay, total cost of the visit and in-hospital mortality. Patients admitted within 6 hours of presentation at Emergency Department were defined as non-delayed. Data was analysed using SPSS 19.Results: Of the 49,532 patients reporting at the Emergency Department during the study period, 17,968 (36.3%) were admitted. Of them 2356(13%) were admitted to special or intensive care …

University Of New England’S College Of Osteopathic Medicine 2016 Peter Morgane Research Fellowship Recipients, University Of New England College Of Osteopathic Medicine

Peter Morgane Research Fellowships

2016 recipients of the University of New England College of Osteopathic Medicine's Peter Morgane Research Fellowship.

Changes In Physical Functioning And Muscle Strength In Men Receiving Androgen Deprivation Therapy For Prostate Cancer: A Controlled Comparison, Brian D. Gonzalex, Heather S. L. Jim, Brent J. Small, Mayer N. Fishman, Babu Zachariah, Randy V. Heysek, Paul B. Jacobsen

Aging Studies Faculty Publications

Purpose: The purpose of the study is to examine changes in muscle strength and self-reported physical functioning in men receiving androgen deprivation therapy (ADT) for prostate cancer compared to matched controls.

Methods: Prostate cancer patients scheduled to begin ADT (n = 62) were assessed within 20 days of starting ADT and 6 and 12 months later. Age and geographically matched prostate cancer controls treated with prostatectomy only (n = 86) were assessed at similar time intervals. Grip strength measured upper body strength, the Chair Rise Test measured lower body strength, and the SF-12 Physical Functioning scale measured self-reported physical functioning. …

The Effect Of Sleep Quality And High Intensity Physical Activity On Inflammation And Cardiovascular Disease Risk Factors In College Students, Catherine Abraham

Honors Scholar Theses

Background: Inflammation is the common denominator in chronic conditions such as obesity, diabetes, and depression. While adequate physical activity and optimal sleep quality may help maintain normal inflammation levels, evidence is somewhat conflicting. Aim: This cross-sectional observational study aimed to assess how sleep quality and high intensity physical activity associated with cardiovascular disease (CVD) risk factors and inflammatory biomarkers in a sample of young adults (n=106, ages 18-25 years). Methods: Laboratory-based assessments included lifestyle behaviors (sleep quality, Pittsburgh Sleep Quality Index; self-reported frequency/intensity of physical activity; Healthy Behavior Index derived from reported preference for diet and physical activity), CVD risk …

Association Of Self-Care Confidence And Hospital Readmission Following Student Nurse Led Congestive Heart Failure Transitional Care Project, Peyton A. Phelps

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Over 5 million Americans have been diagnosed with heart failure, and that number is growing. This disease is burdensome to the patient as it lessens their quality of life and to the healthcare system due to costliness and frequent readmissions. This study aims to evaluate if a student nurse led transitional care program can increase patient self-care confidence, in turn reducing 30 day hospital readmission rates. Twenty patients completed the Self Care of Heart Failure Index before and after a 14-week transitional care program. These reported data were compared using a paired samples t-test. There was not a …

Intimate Partner Violence In Early Adolescence: The Role Of Gender, Socioeconomic Factors And The School, A. J. Mason-Jones, P De Koker, S. M. Eggers, Marleen Temmerman, E. Leye, P. J De Vries, H De Vries

Obstetrics and Gynaecology, East Africa

Background: Intimate partner violence (IPV) among adolescents is common worldwide, but our understanding of perpetration, gender differences and the role of social-ecological factors remains limited.

Objectives: To explore the prevalence of physical and sexual IPV perpetration and victimisation by gender, and associated risk and protective factors.

Methods: Young adolescents (N=2 839) from 41 randomly selected public high schools in the Western Cape region of South Africa (SA), participating in the PREPARE study, completed a self-administered questionnaire.

Results: The participants’ mean age was 13.65 years (standard deviation 1.01), with 19.1% (541/2 839) reporting being victims/survivors of IPV and 13.0% (370/2 839) …

Immune Modulating Functions By Soypeptide Lunasin In Cancer Immunotherapy, Chun-Yu Tung

Open Access Dissertations

Chemotherapy is currently the mainstay of treatment for most cancer patients. Despite its efficacy in eliminating cancer cells, a high percentage of chemotherapy patients eventually relapse or suffer progression of the disease. Immunosurveillance is capable of recognizing and eliminating continuously arising transformed mutant cells, and thus cancer immunotherapy is one of the emerging therapeutic strategies that harnesses the power of the immune system to eradicate chemotherapy-resistant cancerous cells. However, the adverse side effects of chemotherapy impede the therapeutic effects of immunotherapy. Our previous studies demonstrate that lymphoma patients are refractory to clinical immunotherapy because of chemotherapy-induced immune dysfunction. In addition, …

Oncolog, Volume 61, Number 05, May 2016, Bryan Tutt, Katelyn Werner

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

• Intratumoral Therapies Offer Novel Cancer Treatment Approach: Injecting cancer treatments such as vaccines and genetically modified bacteria and viruses directly into tumors may shrink or destroy the tumors and stimulate an immune response that attacks tumor cells. These treatments have shown promise in clinical trials, and newer trials are exploring whether such treatments can augment the effectiveness of immunotherapy in patients with metastatic or inoperable disease.
• High-Risk Acute Lymphoblastic Leukemia Subtype Targeted in Upcoming Clinical Trial: Early T cell precursor acute lymphoblastic leukemia (ETP-ALL), an uncommon subtype of T cell acute lymphoblastic leukemia (T-ALL), carries a poor prognosis and low …

Rapid Step Test Based On Leg Length As A Novel Dynamic Standing Balance Test In The Geriatric Population: A Pilot Study, Harold L. Merriman, Kurt Jackson, E. Conkel, D Mcintyre, Q Rizvi, P Sharkey

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Each year, 1 out of 3 adults over age 65 experience a fall resulting in a traumatic injury or even mortality. Falls are the leading cause of death in the elderly population and cause the greatest number of hospital admissions from trauma. The Balance Evaluation Systems Test (BEST), Berg Balance Scale, and Tinetti are frequently used tests to determine fall risk. However, they can be complicated, time consuming, and exhibit a ceiling effect. This study employed the Rapid Step Test (RST) to examine the use and practicality of a new, portable and easy to administer test that may differentiate between …

Scapular Performance In Women With Breast Cancer Compared To Healthy Controls, Carlie S. Henzler, Mary I. Fisher, Lucinda A. Pfalzer, Ellen Levy, Shana E. Harrington, Naomi L. Gerber, Nicole L. Stout

University of Dayton Doctor of Physical Therapy Annual Research Symposium

The Scapular Flip Test is designed to recognize abnormal scapular position defined by winging/tipping of the scapula on resisted external rotation. Originally created to detect scapular dysfunction with spinal accessory nerve damage, the Scapular Flip Test may be a simple screening tool for any scapular dysfunction that results from breast cancer surgery and treatment to the shoulder and axillary region.

Redesigning Gfp Reporter System For Utilization In Clostridium Difficile, Laura E. Fitzgerald

Biological Sciences Undergraduate Honors Theses

Clostridium difficile (C. difficile) is a gram-positive bacterium that comprises part of the healthy human gut microbiome. When it gains sufficient access to peptides, C. difficile flourishes and releases tissue-damaging toxins, which cause inflammation of the colon that can develop into a Clostridium difficile Infection (CDI).¹⁰ The Ivey Laboratory believes that the best tactic in preventing CDIs is stopping peptide ingestion, which theoretically could be accomplished by manipulating the oligopeptide permease (App) system.⁷ In order to verify that altering the App system would successfully impede peptide uptake, first the expression of the app Promoter Region ( …

Micellular Electrokinetic Chromatography For Studying Amyloid Beta Oligomer Membrane Affinity, Andrew Bryson

Biomedical Engineering Undergraduate Honors Theses

Amyloid Beta (Aβ) was the major focus of this study. It is a peptide that is present in the brain with a high tendency to self-aggregate. When this protein aggregates, it forms oligomers and protofibrils which in turn are deposited as senile plaques in the brain. The reason for the concern with these plaques is their association with the neurological disorder Alzheimer’s disease. It has been found that the most dangerous oligomers are formed in a portion of the plasma membrane known as lipid rafts. The purpose of this study was to understand how micelles affect the aggregation properties of …

The Effects Of Pulmonary Hypertension In Diabetic Zucker Rats On Pulmonary Vascular Contraction And Right Ventricular Size, Michael Franzetti

Biological Sciences Undergraduate Honors Theses

Pulmonary hypertension is a life-threatening disease that is identified by a resting mean pulmonary arterial pressure over 25 mmHg and established by right heart catheterization (Saglam et al., 2015). The symptoms commonly associated with pulmonary hypertension include fatigue, dyspnea, syncope, and chest pain, which severely limit quality of life in diagnosed patients (Saglam et al., 2015). According to recent studies in patients with pulmonary hypertension, the one, three and five year mortality rates are 8%, 25%, and 34%, respectively (Burudpakdee, Shah, Joish, Divers, & Yaldo, 2014). Although some advances have been made in therapies for pulmonary hypertension, the prognosis is …

A Comprehensive Study Of The Effects Of Chemotherapy On Friction Ridge Detail, M Mariel Lowe

Honors Theses

Past research and case studies have shown that chemotherapy drugs appear to lessen the quality of friction ridge skin, thereby impacting cancer patients who are already experiencing a number of unpleasant side effects. Palmar-plantar erythrodysaesthesia, more commonly referred to as Hand-Foot Syndrome (HFS), is a common side effect of many chemotherapy agents and includes redness, swelling, and peeling of the skin of the hands and feet. This syndrome has been linked to a number of cases involving fingerprint loss, including a prior longitudinal study that evidenced degradation in response to capecitabine, a common chemotherapy agent. This research builds upon the …

Effect Of Body Mass Index On Outcome Of Labour Induction, Farheen Yousuf, Tahira Naru, Sana Sheikh

Department of Obstetrics & Gynaecology

The retrospective study to explore the adverse effect of obesity on pregnancy and labour was conducted at Aga Khan University Hospital, Karachi, Pakistan, and comprised data of all patients booked between 12-14 weeks and required induction of labour from January 1 to December 31, 2012. Women were grouped into two body mass index categories: normal weight (23 kg/m2). Obesity increased the risk of development of gestational hypertension and diabetes. Therefore obese women were more likely to be induced due to medical indication whether primiparous or multiparous adjusted odds ratio =2.89(95% confidence interval 1.29-6.48) and 2.77 (95% confidence interval 1.07-7.19) respectively. …

Modulation Of Cardiac Kv Currents By Kvbeta2 And Pyridine Nucleotides., Peter Joseph Kilfoil

Electronic Theses and Dissertations

Myocardial voltage-gated potassium (Kv) channels regulate the resting membrane potential and the repolarization phase of the action potential. Members of the Kv1 and Kv4 family associate with ancillary subunits, such as the Kvβ proteins, that modify channel kinetics, gating and trafficking. Previous investigation into the function of cardiac β subunits demonstrated that Kvβ1 regulates I_to and I_K,slow currents in the heart, but the role of Kvβ2 in the myocardium remains unknown. In heterologous expression systems, Kvβ2 increases surface expression of Kv1 channels, shifts the activation potential of Kv1 channels to more polarized voltages, and increases the inactivation of …