Medical Specialties Commons^™

Gene Expression Profiling In An Alzheimer's Disease Mouse Model, Matthew R. Dalton

Senior Honors Theses

Explaining precisely how Alzheimer’s disease (AD)—the world’s most common form of dementia—materializes in the human brain has proven to be one of the most elusive ends in modern medicine. Progressive memory loss, neurodegeneration, and the presence of abnormal protein aggregates of amyloid-beta (Aβ) and neurofibrillary tangles (NFT) characterize this disease. Genome sequencing provides researchers with the ability to better identify disease-related changes in gene expression, some of which may play a role in the initiation and progression toward the AD-like state. Intimate interactions between tissues have been observed in many diseases, particularly between the brain and blood. This analysis seeks …

Imaging The Transgender Patient, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Within the health care system, lesbian, gay, bisexual, and transgender (LGBT) persons face many obstacles that lead to health disparities. These disparities include social stigma, lack of provider knowledge and training, lack of sufficient health insurance coverage, and layout of physician practice. As noted by the Joint Commission, federal law prohibits the discrimination of individuals based on race, color, national origin, age, disability, and sex within the health care system.1 It is essential for all health care providers to be educated on the best practices in regard to caring for the LGBT patient.

The focus of this exhibit is to …

Proceedings Of The Third Annual Deep Brain Stimulation Think Tank: A Review Of Emerging Issues And Technologies, P. Justin Rossi, Aysegul Gunduz, Jack Judy, Linda Wilson, Andre Machado, James J Giordano, W. Jeff Elias, Marvin A. Rossi, Christopher L. Butson, Michael D. Fox, Cameron C. Mcintyre, Nader Pouratian, Nicole C. Swann, Coralie De Hemptinne, Robert E. Gross, Howard J. Chizeck, Michele Tagliati, Andres M. Lozano, Wayne Goodman, Jean-Philippe Langevin, Ron L. Alterman, Umer Akbar, Greg A. Gerhardt, Warren M. Grill, Mark Hallett, Todd Herrington, Jeffrey Herron, Craig Van Horne, Brian H. Kopell, Anthony E. Lang

Neuroscience Faculty Publications

The proceedings of the 3rd Annual Deep Brain Stimulation Think Tank summarize the most contemporary clinical, electrophysiological, imaging, and computational work on DBS for the treatment of neurological and neuropsychiatric disease. Significant innovations of the past year are emphasized. The Think Tank's contributors represent a unique multidisciplinary ensemble of expert neurologists, neurosurgeons, neuropsychologists, psychiatrists, scientists, engineers, and members of industry. Presentations and discussions covered a broad range of topics, including policy and advocacy considerations for the future of DBS, connectomic approaches to DBS targeting, developments in electrophysiology and related strides toward responsive DBS systems, and recent developments in sensor and …

Enhancing Nurse-Physician Communication And Collaboration, Pamela D. Missi

Graduate Theses, Dissertations, and Capstones

In healthcare organizations today, creating a culture of safety is critically important. Communication failures among healthcare providers have been linked to 70% of annual sentinel events. Seventy-six percent of individuals experiencing a sentinel event die (Joint Commission, 2009). Lack of good communication behavior between nurses and physicians has been recognized as a cause of preventable harm to patients (Institute of Medicine, 2004; Zwarenstein & Reeves, 2006). In hospital settings, communication failures are linked to increases in length of stay, patient harm, resource utilization, more rapid turnover, and caregiver dissatisfaction (Dingley et al., 2008). Numerous national organizations and commissions have officially …

Emergency Medicine Resident On Shift Clinical Teaching Efficacy As Measured By Student Evaluation And Self-Reflection Using A Previously Validated Metric, Alan R. Cherney Md, Dawn M. Yenser, Amy B. Smith Phd, Kevin Weaver D.O.,Facoep, Charles C. Worrilow Md, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Dcc Mediates Functional Assembly Of Peripheral Auditory Circuits., Young J Kim, Sheng-Zhi Wang, Stephen Tymanskyj, Le Ma, Huizhong W Tao, Li I Zhang

Department of Neuroscience Faculty Papers

Proper structural organization of spiral ganglion (SG) innervation is crucial for normal hearing function. However, molecular mechanisms underlying the developmental formation of this precise organization remain not well understood. Here, we report in the developing mouse cochlea that deleted in colorectal cancer (Dcc) contributes to the proper organization of spiral ganglion neurons (SGNs) within the Rosenthal's canal and of SGN projections toward both the peripheral and central auditory targets. In Dcc mutant embryos, mispositioning of SGNs occurred along the peripheral auditory pathway with misrouted afferent fibers and reduced synaptic contacts with hair cells. The central auditory pathway simultaneously exhibited similar …

Utilizing Lean Methodologies To Automate The Oacc Medicare Cost Report, Cathyann Feher Rn,Msn, Patrick Kincaid Mba, Elyse Kernan, Denise Hill, Deb Bianco, Marybeth Mcmennamin Ba

Department of Surgery

No abstract provided.

Role Of Prophylactic Magnesium Supplementation In Prevention Of Postoperative Atrial Fibrillation In Patients Undergoing Coronary Artery Bypass Grafting: A Meta-Analysis Of 23 Randomized Controlled Trials (Poster)., Jalaj Garg Md, Rahul Chaudhary Md, Parasuram Krishnamoorthy Md, Neeraj Shah Md, Babak Bozorgnia Md

Department of Medicine

No abstract provided.

Transcatheter Aortic Valve Replacement Is Associated With A Higher Rate Of Permanent Pacemaker Implantation Compared To Surgical Aortic Valve Replacement: A Propensity Matched Analysis (Poster)., Neeraj Shah Md, Achint Patel Mbbs, Nileshkumar Patel Md, Vratika Agarwal Md, Jalaj Garg Md, Nainesh C. Patel Md, Facc, David A. Cox Md, Facc, Fscai

Department of Medicine

Contraception, Abortion And Assisted Fertility Among Muslim Women A Look At Islamic Culture And Policy In Iran And Afghanistan, Hayley Jacobsen

What All Americans Should Know About Women in the Muslim World

Discourse on women's reproductive rights through the lens of Muslim culture. The use of contraception, assisted fertility and abortion, are analyzed in Iran and Afghanistan. The culture surrounding family planning is detailed through a woman’s community, family, religion and the laws that govern the society they live in, which all influence her decision making in these matters. This piece stands as a cultural analysis of women's agency specifically in Middle Eastern Muslim culture, as it stands as a part of a global women's rights movement.

Com Outlook Spring 2016, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

The Effect Of Tommy John (Ucl) Reconstructive Surgery On A Pitcher’S Arm And Career Progression, Jack Grant

Honors Projects in Mathematics

Injuries have plagued professional athletes since their sports have been in existence. The examination of how teams can diminish the side effects of the injuries en route to a speedy recovery remains an evolving process and a topic of concern for all. Injury preventative tactics have been implemented by coaching staffs and various training personnel. Major League Baseball (MLB) pitchers are noticing an increase in the number of surgeries performed each year. The tearing of the ulnar collateral ligament (UCL) in the elbow has become a predominant injury among pitchers in the MLB. Reconstructive surgery, also known as Tommy John …

Inadequate Sensitivity Of Laboratory Risk Indicator To Rule Out Necrotizing Fasciitis In The Emergency Department, Elizabeth Burner, Sean Henderson, Guenevere Burke, Jeffrey Nakashioya, Jerome R. Hoffman

Emergency Medicine Faculty Publications

Introduction: Necrotizing fasciitis (NF) is a life-threatening illness, particularly when surgical debridement is delayed. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was developed to identify patients at higher risk for NF. Despite limited information in this regard, the LRINEC score is often used to "rule out" NF if negative. We describe the sensitivity of the LRINEC score in emergency department (ED) patients for the diagnosis of NF.

Methods: We conducted a chart review of ED patients in whom coding of hospital discharge diagnoses included NF. We employed standard methods to minimize bias. We used laboratory data to …

How Complicated Can It Be? The Link Between Apol1 Risk Variants And Lipoprotein Heterogeneity In Kidney And Cardiovascular Diseases., Chien-An A Hu, Patricio E Ray

Pediatrics Faculty Publications

The beginning of human apolipoprotein L1 study (gene: APOL1; protein: ApoL1) originated from the identification of circulating ApoL1 as an interacting protein of ApoA1 and a minor component of high-density lipoprotein subfraction 3 (HDL3) in 1997 [1]. In the past 18 years, ApoL1 has been investigated in the context of complex human diseases such as African sleeping sickness, schizophrenia, host innate immunity, cancer, hyperlipidemia, cardiovascular diseases, stroke and type 2 diabetes [2–10]. A major breakthrough, however, was the documentation of two haplotypes of APOL1, harboring three coding-sequence mutations as risk variants associated with non-diabetic …

Time Of Year Affects Surgical Outcome Of Pediatric Congenital Heart Disease, Krystin Sinclair

Honors Projects in Science and Technology

Approximately 35,000 children are born in the US each year with Congenital Heart Disease (CHD). Surgical timing for many of these conditions is elective, and the distribution of surgical cases, therefore, varies with time of year. The hypothesis of this project is that time of the year for surgery is associated with mortality, length of hospital stay (LOS), and total hospital costs. A retrospective, cohort study was performed, using the Pediatric Health Information Systems (PHIS) Database to investigate these relationships.

Obstetric Violence Within The Brazilian Healthcare System: A Critical Analysis Of The Childbirth Narratives Of Tupinambá Indigenous Women From The Olivença, Ilhéus Community, Cassandra Fareira

Independent Study Project (ISP) Collection

The objective of this research project is to hear the personal narratives of Tupinambá Indigenous Brazilian women living in the Olivença community in Ilheus, Bahia regarding their experiences giving birth in order to discern the prevalence of various forms of obstetric violence within their experiences. In the context of this study the term "obstetric violence," derived from an extensive literature review, encompasses 1) physical abuse, 2) the unethical imposition of medical interventions, 3) the denial or lack of privacy, 4) undignified care which includes verbal abuse, 5) discrimination, 6) abandonment, neglect or the refusal to grant assistance, 7) detention in …

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

Low Radiation Dose Calcium Scoring: Evidence And Techniques, Kaitlin B. Baron, Andrew D. Choi, Marcus Y. Chen

Medicine Faculty Publications

Coronary computed tomography (CT) allows for the acquisition of thin slices of the heart and coronary arteries, which can be used to detect and quantify coronary artery calcium (CAC), a marker of atherosclerotic cardiovascular disease. Despite the proven clinical value in cardiac risk prognostication, there remain concerns regarding radiation exposure from CAC CT scans. There have been several recent technical advancements that allow for significant radiation dose reduction in CAC scoring. This paper reviews the clinical utility and recent literature in low radiation dose CAC scoring.

Retrograde Epidural Catheter Relieves Intractable Sacral Pain, Ruchir Gupta, Shivam Shodhan, Amr Hosny

NYMC Student Publications

Pain caused by tumor infiltration of the sacral area remains a major clinical challenge. Patients with poor pain control despite comprehensive medical management may be treated with neuraxial techniques such as continuous epidural or spinal anesthetic. We report a case in which a patient with metastatic breast cancer experienced inadequate pain relief after multiple intravenous pain management regimens as well as intrathecal (IT) drug delivery. The concentration of local anesthetics delivered via the IT catheter was limited due to the patient's baseline motor weakness which would be exacerbated with higher concentrations of local anesthetics. Thus, a decision was made to …

A Comparative Study Of Women’S Health Care: Non-Syrian Refugee Women Living In Amman And Syrian Refugee Women Living In Refugee Camps, Megan Kerstein

Independent Study Project (ISP) Collection

The purpose of this study is to compare access and quality of women’s health care in Amman for non-Syrian refugee women and women’s health care in Syrian refugee camps. I also sought to understand how women’s health care could be improved in both Amman and in Syrian refugee camps. I hypothesized that Syrian refugee women in camps will have less access and lower quality women’s health care since refugee camps’ funding is limited, making medical equipment and women’s health care providers short. Since women in Amman often have more stable family situations and jobs, I thought they would have more …

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

Department of Surgery Updates

A three 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.

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Comparison Of Two Commercial Dna Extraction Kits For The Analysis Of Nasopharyngeal Bacterial Communities, Marcos Pérez-Losada, Keith Crandall, Robert J. Freishtat

Pediatrics Faculty Publications

Characterization of microbial communities via next-generation sequencing (NGS) requires an extraction ofmicrobial DNA. Methodological differences in DNA extraction protocols may bias results and complicate inter-study comparisons. Here we compare the effect of two commonly used commercial kits (Norgen and Qiagen)for the extraction of total DNA on estimatingnasopharyngeal microbiome diversity. The nasopharynxis a reservoir for pathogens associated with respiratory illnesses and a key player in understandingairway microbial dynamics.
Total DNA from nasal washes corresponding to 30 asthmatic children was extracted using theQiagenQIAamp DNA and NorgenRNA/DNA Purification kits and analyzed via IlluminaMiSeq16S rRNA V4 ampliconsequencing. The Norgen samples included more sequence reads …

Providing Care Beyond The Hospital: Perspective Of A Tertiary Care Hospital From A Developing Country, Saad Akhtar, Muhammad Waqas, Badar Uddin Ujjan, Adnan Salim, Gohar Javed, Syed Ijlal Ahmed, Malikah Surani, Marium Khan

Section of Neurosurgery

Background: Neurorehabilitation is an important aspect of continuing care for neurosurgical patients with functional disability. In developing countries, where formal home nursing frequently is unavailable, ensuring care after discharge is a difficult task. Training attendants to provide nursing care is an alternate option. In this study, we compared the outcomes of patients nursed by family members versus those looked after by a professional nurse.
Methods: This was a retrospective observational study conducted at the Aga Khan University Hospital Karachi. The study consisted of 2 groups. Group 1 (consisting of patients cared for by a professional nurse) included 94 patients and …

Long-Tunneled Versus Short-Tunneled External Ventricular Drainage: Prospective Experience From A Developing Country, Muhammad Zubair Tahir, Zain A. Sobani, Muhammed Murtaza, Ather Enam

Section of Neurosurgery

Background: External ventricular drains (EVD) are commonly utilized for temporary diversion of cerebrospinal fluid (CSF). Many neurosurgeons prefer long-tunneled EVDs in their routine practice. However, it is still unclear whether this extended tunneling helps in reducing CSF infection. Keeping this in mind, we decided to compare infection rates in long-tunneled versus short-tunneled EVDs in the setting of a developing country.
Materials and methods: A prospective study of 60 patients was conducted. Consenting patients who underwent short-tunneled (Group A) or long-tunneled (Group B) EVDs between January 2008 and June 2009 were followed during the course of their inpatient care. All operational …

Interactive Spaced Online Education In Pediatric Trauma, Rohit Shenoi, Daniel Rubalcava, Bindi Naik-Mathuria, Harold A. Sloas, David Delemos, Linzhi Xu, Donna Mendez

Emergency Medicine Faculty Publications

Pediatric resident trauma education is suboptimal due to lack of a curriculum and limited trauma experience and education resources. The objective of the study was to test knowledge retention and acceptability of interactive spaced education (ISE) in pediatric trauma. Prospective, randomized trial involving 40 physicians in a pediatric emergency department was used. Instrument was comprised of 48 multiple-choice questions (evaluative component) and answer critiques (educational component) on pediatric trauma divided into two modules. The instrument was assessed for test–retest reliability, item difficulty, and construct validity. Intervention consisted of online administration of each module as eight spaced emails (3 questions each) …

Segmental Excision Versus Intralesional Curettage With Adjuvant Therapy For Giant Cell Tumour Of Bone, Omar Yacob, Masood Umer, Marrium Gul, Irfan Qadir

Department of Radiology

Abstract

PURPOSE:

To review the functional outcome and local recurrence rate of 29 patients who underwent segmental excision or intralesionalcurettage with adjuvant therapy for giant cell tumour (GCT) of bone.

METHODS:

Records of 17 men and 12 women (mean age, 30.17 years) who underwent segmental excision (n=18) or intralesional curettage followed by adjuvant therapy (n=11) for GCT of the femur (n=13), tibia (n=8), radius (n=6), or ulna (n=2) were reviewed. Nine of the patients had recurrent GCT of bone and had undergone segmental excision (n=6) or intralesional curettage (n=3) elsewhere. Functional outcome was evaluated using the Musculoskeletal Tumour Society (MSTS) …

Hypertensive Disorders Of Pregnancy In Rural Maharashtra: A Preventative Approach To Risk Factor Reduction Through Lifestyle Interventions, Jess Wiken

Independent Study Project (ISP) Collection

The primary purpose of this study is to assess the contribution and correlation between lifestyle behaviors and modifiable risk factors (MRF) established in adolescence and during pregnancy with development of hypertensive disorders of pregnancy (HDP) exclusive to preeclampsia (PE), eclampsia, and pregnancy induced hypertension (PIH). MRF include but are not exclusive to diet and nutrition, physical activity, and Mishri use. Associations of HDP with increased premature cardiovascular risk in the affected woman and child indicate the importance of healthy lifestyle modifications that promote cardiovascular health and longevity and reduction of risk factors through prevention. While cardiac conditions are primarily associated …

Is Preoperative Functional Status A Predictor Of Postoperative Mortality, Morbidity And Quality Of Life In Open Heart Patients?, A. Kate Macphedran

Dissertations

The very nature of mortality and morbidity surrounding cardiac surgery is complex with numerous risk factors involved and researchers have found functional status to be a stronger predictor of outcomes than the admitting diagnosis. Preoperative functional status, however, is not measured by any of the cardiac risk scores. Functional status can be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). In 3 studies, the impact and association of functional status changes over time was explored in patients who have undergone elective open heart surgery. Analyses in Study 1 demonstrated significantly improved functional status …

Perspectives On Pediatric Pain, Donald E. Greydanus, Dilip R. Patel, Colleen Dodich, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.