Medical Specialties Commons^™

Grant Application: Health Practitioners’ Perspective On Caring For Older Adults In Rural Maine – A Pilot Study, Jessica Harnisch, Allie Stanley, Amanda Langley, Jordan Beall

Health Practitioners' Perspective On Caring For Older Adults In Rural Maine

IPEC Mini-grant application for funding of UNE student project Health Practioners’ Perspective on Caring for Older Adults in Rural Maine. This pilot study was designed to identify challenges and determine potential solutions for Maine practitioners delivering health care to rural Maine’s aging population. UNE students from several healthcare professions partnered to interview physicians, physician assistants, nurse practitioners, social workers, occupational therapists, and physical therapists caring for community-dwelling older adults in Rural Maine. The student researchers then analyzed the interviews and identified themes.

More Illness In Offspring Of Bipolar Patients From The U.S. Compared To Europe., Robert M. Post, Lori L. Altshuler, Ralph Kupka, Susan L. Mcelroy, Mark A. Frye, Michael Rowe, Heinz Grunze, + 4 More

Psychiatry and Behavioral Sciences Faculty Publications

Background

Evidence suggests that patients with bipolar disorder from the United States have an earlier age of onset and a more difficult course of illness than those from Germany and the Netherlands. These characteristics were related to a greater family burden of psychiatric illness and the experience of more psychosocial adversity in childhood. We hypothesized that this greater illness burden would extend to the offspring of the US patients.

Methods

968 outpatients (average age 41) with bipolar illness gave informed consent for participation in a treatment outcome network and filled out a detailed questionnaire about their illness and family history …

Psychiatric Boarding In New Hampshire: Violation Of A Statutory Right To Treatment, James A. Mcclure

The University of New Hampshire Law Review

[Excerpt] "New Hampshire law provides for the involuntary commitment of a patient such as Jane when she is a danger to herself or others as a result of mental illness. The patient has a right to treatment under N.H. Rev. Stat. Ann. § 135-C:1, et seq. Specifically, the patient should receive "adequate and humane treatment" pursuant to an "individual service plan" and "in the least restrictive environment necessary." However, appropriate facilities often are not available for patients waiting in emergency rooms, and patients can become trapped for hours or even days. This phenomenon is called "psychiatric boarding."

New Hampshire is …

Adherence To Lifestyle Advice And Reatments In Pakistani Patients With Type 2 Diabetes Mellitus., Sarwar Malik, Rabia Basit, Sabahat Naz, Minaz Mawani, Qamar Masood, J. Akhter

Section of Diabetes, Endocrinology and Metabolism

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease that has become a major health care concern, especially in developing countries like Pakistan. Lifestyle modification and appropriate pharmacotherapy are shown to improve blood glucose levels, lipid abnormalities and blood pressure. It is not known how many patients adhere to advice and drugs prescribed. This study aimed to determine adherence to lifestyle and therapeutic advice. Methods: A cross sectional hospital based study was conducted among patients attending the diabetic clinic at the Aga Khan University Hospital, using a structured questionnaire. Adult patients with T2DM and with at least one year …

Spatially Selective 2d Rf Inner Field Of View (Ifov) Diffusion Kurtosis Imaging (Dki) Of The Pediatric Spinal Cord, Chris J. Conklin, Devon M. Middleton, Mehdi Alizadeh, Jürgen Finsterbusch, David L. Raunig, Scott H. Faro, Pallav N. Shah, Laura Krisa, Rebecca Sinko, Ms, Otr/L, Joan Z. Delalic, M. J. Mulcahey, Feroze B. Mohamed

Department of Physical Therapy Faculty Papers

No abstract provided.

Response To: Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Faizuddin Najmuddin, Mohammad Ali Alvi, Muhammad Ehsan Bari

Section of Neurosurgery

No abstract provided.

Factors Affecting Depression Among Married Women Living In Urban Squatter Settlements Of Karachi, Pakistan, Shireen Shehzad, Salima Farooq, Yasmin Parpio, Rozina Karmaliani Professor, Nargis Asad, Iqbal Azam Syed, Omrana Pasha

School of Nursing & Midwifery

Background: Depression is one of the growing public health concerns among women worldwide. This is one of the most under-recognized and under-treated mental illnesses worldwide. Women of developing countries are inexplicably affecting with depression. Purpose: The purpose of study is to assess the prevalence and associative factors of depression among women of aged 20 to 40 years living in urban squatter settlements of Karachi, Pakistan. The identification of all the potential determinants will potentially help in formulating preventive strategies in order to decline the prevalence of depression among women and improve the well being of women.
Methods: An analytical cross-sectional …

Uchunguzi (Journal Watch/Montre De Journal) March 2016, Benjamin Wachira

Emergency Medicine, East Africa

Increasing demand on emergency healthcare systems throughout Africa means there is a need to develop and harmonise standards of emergency care for the benefit of African populations. This can potentially be achieved by developing guidelines for appropriate and high quality education to prepare future generations of emergency healthcare providers for their role in all regions of Africa. With this in mind, the African Emergency Nursing Curriculum was developed by emergency nurses, academics and researchers from Africa and the rest of the world to provide a consensus document to guide the development of harmonised standards of emergency nursing theory and practice …

Oncolog, Volume 61, Number 02, February 2016, Joe Munch, Bryan Tutt, C Graber

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

• Overcoming Challenges in Cutaneous T Cell Lymphomas: Cutaneous T Cell lymphomas (CTCLs) not only are largely incurable but also make patients miserable with itching, burning skin and unsightly lesions. Because CTCL can resemble various benign skin conditions, many patients are diagnosed at an advanced and difficult-to-treat stage. But ongoing clinical trials may offer patients with CTCL improved treatments and better quality of life.
• Swallowing Therapy Improves Function and Quality of Life for Patients with Head and Neck Cancer: In patients with head and neck cancer, loss of swallowing function may result from radiation therapy, surgery, or the cancer itself and …

Optimal Unified Combination Rule In Application Of Dempster-Shafer Theory To Lung Cancer Radiotherapy Dose Response Outcome Analysis, Yanyan He, M. Yousuff Hussaini, Yutao U T Gong, Ying Xiao

Department of Radiation Oncology Faculty Papers

No abstract provided.

Elevated Transpulmonary Gradient And Cardiac Magnetic Resonance-Derived Right Ventricular Remodeling Predict Poor Outcomes In Sickle Cell Disease, Kim-Lien Nguyen, Xin Tian, Shoaib Alam, Alem Mehari, Steve W. Leung, Catherine Seamon, Darlene Allen, Caterina P. Minniti, Vandana Sachdev, Andrew E. Arai, Gregory J. Kato

Saha Cardiovascular Research Center Faculty Publications

No abstract provided.

To Asses Inter- And Intra-Observer Variability For Breast Density And Birads Assessment Categories In Mammographic Reporting, Imrana Masroor, Mahreen Rasoor, Shaista Afzal Saeed, Saba Sohail

Department of Radiology

Objective: To evaluate the inter- and intra-observer variability among radiologists in the characterisation of mammograms according to Breast Imaging Reporting and Data System assessment and breast density categories.
Methods: The descriptive cross-sectional study was conducted at Aga Khan University Hospital, Karachi, from January 2014 to June 2014. Using non-probability purposive sampling, all mammograms in the study were interpreted by three radiologists on the basis of Breast Imaging Reporting and Data System categories and by assessing the breast density composition. The inter-observer variability was recorded by comparing the difference in the interpretation and categorisation of each case. Intra-observer variability was noted …

Pitfalls Of Practicing Cancer Epidemiology In Resource-Limited Settings: The Case Of Survival And Loss To Follow-Up After A Diagnosis Of Kaposi’S Sarcoma In Five Countries Across Sub-Saharan Africa, Esther Freeman, Aggrey Semeere, Megan Wenger, Mwebesa B. Bwana, F. Chite Asirwa, Naftali Busakhala, Emmanuel Oga, Elima Jedy-Agba, Vivian Kwaghe, Kenneth Iregbu, Antoine Jaquet, Francois Dabis, Habakkuk Azinyui Yumo, Jean Claude Dusingize, David Bangsberg, Kathryn Anastos, Sam Phiri, Julia Bohlius, Matthias Egger, Constantin T. Yiannoutsos, Kara Wools-Kaloustian, Jeffrey Martin

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Survival after diagnosis is a fundamental concern in cancer epidemiology. In resource-rich settings, ambient clinical databases, municipal data and cancer registries make survival estimation in real-world populations relatively straightforward. In resource-poor settings, given the deficiencies in a variety of health-related data systems, it is less clear how well we can determine cancer survival from ambient data.

Methods: We addressed this issue in sub-Saharan Africa for Kaposi’s sarcoma (KS), a cancer for which incidence has exploded with the HIV epidemic but for which survival in the region may be changing with the recent advent of antiretroviral therapy (ART). From 33 …

Pulmonary Scedosporiosis Mimicking Aspergilloma In An Immunocompetent Host: A Case Report And Review Of The Literature, Fasih Ur Rahman, Muhammad Irfan Ul Haq, Naima Fasih, Kauser Jabeen

Department of Surgery Docs

Abstract

A case of localized lung scedosporiosis is reported here that mimicked aspergilloma in an immunocompetent host. Through this case the importance of considering Scedosporium spp. in differential diagnosis of locally invasive lung infections and fungal ball is highlighted. As it is difficult to differentiate Scedosporium from Aspergillus on clinical grounds, microscopy, radiology and histopathology, this case is further emphasizing the significance of the definitive etiological characterization of Scedosporium through culture or molecular diagnostic tools. Accurate identification of Scedosporium, surgical resection and high-dose voriconazole has been associated with favorable outcome in most reported cases of scedosporiosis.

Evaluation Of A Pacap Peptide Analogue Labeled With (68)Ga Using Two Different Chelating Agents., Pardeep Kumar, Sushil Kumar Tripathi, Chang-Po Chen, Neil Mehta, Bishnuhari Paudyal, Eric Wickstrom, Mathew L. Thakur

Department of Radiology Faculty Papers

OBJECTIVE: The authors have conjugated chelating agents (DOTA and NODAGA) with a peptide (pituitary adenylate cyclase-activating peptide [PACAP] analogue) that has a high affinity for VPAC1 receptors expressed on cancer cells. To determine a suitable chelating agent for labeling with (68)Ga, they have compared the labeling kinetics and stability of these peptide conjugates.

METHODS: For labeling, (68)GaCl3 was eluted in 0.1 M HCl from a [(68)Ge-(68)Ga] generator. The influences of peptide concentration, pH, and temperature on the radiolabeling efficiency were studied. The stability was evaluated in saline, human serum, DTPA, transferrin, and metallic ions (FeCl3, CaCl2, and ZnCl2). Cell binding …

Ncrp Program Area Committee 7: Radiation Education, Risk Communication, Outreach, And Policy, S. M. Becker, P. A. Locke

Community & Environmental Health Faculty Publications

Recognizing the central importance of effective communication, education, and policy across all of the domains of radiation safety and radiation protection, the National Council on Radiation Protection and Measurements (NCRP) established a new committee in 2013. Program Area Committee 7 (PAC 7) was created to develop projects and provide guidance on Radiation Education, Risk Communication, Outreach, and Policy. After identifying individuals with relevant expertise who were willing to serve, the Committee held its inaugural meeting in 2014. In 2015, the Committee increased its membership and began carrying out an expanded program of activities. One area of activity has involved providing …

Malt Lymphoma Of The Base Of The Tongue: A Rare Case Entity, Haissan Iftikhar, Moghira Siddiqui, Khurram Minhas

Department of Surgery Docs

Abstract

Lymphoma is a malignant tumour arising from lymphoid tissue, with the majority of cases being in the lymph nodes, however, in 1/4th of cases, these tumours are found in extralymphoid tissue. Lymphoid tissue is also found in organs having mucosa, such as the digestive tract, salivary gland and in tracheal tissue. This collection of lymphoid tissue is known as mucosa-associated lymphoid tissue (MALT), and non-Hodgkin lymphoma involving this extralymphoidal lymph tissue is known as MALT lymphoma. It was first reported by Isaacson and Wright in 1983, however, it was not included as a working diagnosis in clinical use until …

Theory-Driven Longitudinal Study Exploring Indoor Tanning Initiation In Teens Using A Person-Centered Approach, Joel J. Hillhouse, Rob Turrisi, Michael J. Cleveland, Nichole M. Scaglione, Katie Baker, L. Carter Florence

ETSU Faculty Works

Background

Younger indoor tanning initiation leads to greater melanoma risk due to more frequent and persistent behavior. Despite this, there are no published studies exploring the predictors of indoor tanning initiation in teen populations.

Purpose

This longitudinal study uses latent profile analysis to examine indoor tanning initiation in indoor tanning risk subgroups from a national sample of female adolescents.

Methods

Latent profile analysis used indoor tanning beliefs and perceptions to identify indoor tanning initiation risk subgroups. The teens in each subgroup were reassessed on indoor tanning initiation after a year.

Results

Three subgroups were identified: a low risk, anti-tanning subgroup …

A Nursing Approach To Self-Management Education For Individuals With Mental Illness And Diabetes, Edna Fuentes-Casiano, Martha Sajatovic

Faculty Scholarship

Patients with serious mental illness (SMI) and diabetes often seek care in primary care settings and have worse health outcomes than patients who have either illness alone. Individual, provider, and system-level barriers present challenges to addressing both psychiatric and medical comorbidities. This article describes the feasibility, acceptability, and implementation of Targeted Training and Illness Management (TTIM), a self-management intervention delivered by trained nurse educators and peer educators to groups of individuals with SMI and diabetes to improve self-management of both diseases. TTIM is intended to be delivered in a primary care setting. Findings are intended to support the future development …

Tough Decisions For Premature Triplets., Ashley Hurst, Scott And Emily (Parents), Brooke D. Vergales, Alix Paget-Brown, Mark Mercurio, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When infants are born at the borderline of viability, doctors and parents have to make tough decisions about whether to institute intensive care or provide only palliative care. Often, these decisions are made in moments of profound emotional turmoil, and parents receive different information from different health professionals. Communication can become garbled. It may be difficult to tell when and whether the patient's clinical condition has changed enough so that certain choices that had once been permissible become impermissible. In this "Ethics Rounds," we present a case of triplets born at the borderline of viability. We sought comments from the …

Physical Examination Findings Among Children And Adolescents With Obesity: An Evidence-Based Review., Sarah Armstrong, Suzanne Lazorick, Sarah Hampl, Joseph A. Skelton, Charles Wood, David Collier, Eliana M. Perrin

Manuscripts, Articles, Book Chapters and Other Papers

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. …

A Quality Improvement Collaborative To Improve Pediatric Primary Care Genetic Services., Michael L. Rinke, Amy Driscoll, Natalie Mikat-Stevens, Jill Healy, Elizabeth Colantuoni, Abdallah F. Elias, Beth A. Pletcher, Ruth S. Gubernick, Ingrid Larson, Wendy K. Chung, Beth A. Tarini

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To investigate if a national pediatric primary care quality improvement collaborative (QIC) could improve and sustain adherence with process measures related to diagnosis and management of children with genetic disorders.

METHODS: Thirteen practices in 11 states from the American Academy of Pediatrics' Quality Improvement Innovation Networks participated in a 6-month QIC that included regular educational opportunities, access to genetic professionals, and performance feedback. The QIC identified 11 aims related to improving diagnosis and management of children with genetic disorders. The practices evaluated adherence by reviewing patient records at baseline, monthly for 6 months (active improvement period), and then once …

Safety And Immunogenicity Of Sequential Rotavirus Vaccine Schedules., Romina Libster, Monica Mcneal, Emmanuel B. Walter, Andi L. Shane, Patricia Winokur, Gretchen Cress, Andrea A. Berry, Karen L. Kotloff, Kwabena Sarpong, Christine B. Turley, Christopher J. Harrison, Barbara A. Pahud, Jyothi Marbin, John Dunn, Jill El-Khorazaty, Jill Barrett, Kathryn M. Edwards, Vteu Rotavirus Vaccine Study Work Group

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Although both licensed rotavirus vaccines are safe and effective, it is often not possible to complete the schedule by using the same vaccine formulation. The goal of this study was to investigate the noninferiority of the immune responses to the 2 licensed rotavirus vaccines when administered as a mixed schedule compared with administering a single vaccine formulation alone.

METHODS: Randomized, multicenter, open-label study. Healthy infants (6-14 weeks of age) were randomized to receive rotavirus vaccines in 1 of 5 different schedules (2 using a single vaccine for all doses, and 3 using mixed schedules). The group receiving …

The Effects Of Acidified Pepsin On Porcine Vocal Fold Tissue: Developing A Porcine Model Of Laryngopharyngeal Reflux Disease, Abigail Cox Durkes

Open Access Dissertations

Approximately 7.5 million Americans are affected by a voice disorder. In the last year, 7.2% of people missed one or more days of work due to a voice problem. For professional voice users, such as teachers, the rate increases to 20% and an annual cost of $2.5 billion. Voice disorders are complex and multi-faceted, as well as difficult to diagnose and treat. Prospective animal studies are necessary to study the pathophysiology of voice disorders, optimize our understanding of laryngeal pathology, and improve treatment outcomes. The pig provides a unique opportunity to test hypotheses relating to laryngeal disease because porcine vocal …

Primary Angiosarcoma Of Breast, Saroona Haroon, Naveen Faridi, Faisal Rashid Lodhi

Department of Pathology and Laboratory Medicine

Primary breast sarcomas, except for phyllodes tumour, are very rare entities, accounting for < 0.1% of all malignant neoplasms. Angiosarcoma of breast is infrequent malignancy and differential diagnosis from other sarcomatous and angiomatous breast tumours holds importance. Two cases of primary angiosarcoma of breast were encountered. One involved a 32 years lady who was treated by wide local excision and six cycles of chemotherapy. The other occurred in a 54 years old lady who was treated with mastectomy, did not receive any radiation or chemotherapy and was later lost to follow-up. Neither of the patient had history of previous breast surgery, chemotherapy or radiotherapy.

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Differences And Similarities In The Clinicopathological Features Of Pancreatic Neuroendocrine Tumors In China And The United States: A Multicenter Study, Li-Ming Zhu, Laura Tang, Xin-Wei Qiao, Edward M. Wolin, Nicholas N. Nissen, Deepti Dhall, Jie Chen, Lin Shen, Yihebali Chi, Yao-Zong Yuan, Qi-Wen Ben, Bin Lv, Ya-Ru Zhou, Chun-Mei Bai, Jie Chen, Yu-Li Song, Tian-Tian Song, Chong-Mei Lu, Run Yu, Yuan-Jia Chen

Markey Cancer Center Faculty Publications

The presentation, pathology, and prognosis of pancreatic neuroendocrine tumors (PNETs) in Asian patients have not been studied in large cohorts. We hypothesized that the clinicopathological features of PNETs of Chinese patients might be different from those of US patients. The objectives of this study were to address whether PNETs in Chinese patients exhibit unique clinicopathological features and natural history, and can be graded and staged using the WHO/ENETS criteria.

This is a retrospective review of medical records of patients with PNETs in multiple academic medical centers in China (7) and the United States (2). Tumor grading and staging were based …

Safety And Efficacy Of Blood Exchange Transfusion For Priapism Complicating Sickle Cell Disease., Samir K. Ballas, David Lyon

Cardeza Foundation for Hematologic Research

BACKGROUND: Priapism is unwanted painful penile erection that affects about 36% of boys and men with sickle cell disease (SCD) most of whom have sickle cell anemia. Clinically, priapism could be stuttering, minor, or major. The first two types are mild, last < 4 h, are usually treated at home, have good prognosis with normal sexual function. The major type of priapism lasts >4 h, associated with severe pain, requires hospitalization; often does not respond to medical treatment and may require shunt surgery. Untreated major priapism and surgical intervention often cause impotence. In this study, we report our 15-year experience in treating adult patients with SCD and major priapism with blood exchange transfusion after being refractory to other medical therapies.

METHODS: …

Initial Benchmarking Of The Quality Of Medical Care In Childhood-Onset Systemic Lupus Erythematosus., Rina Mina, Julia G. Harris, Marisa S. Klein-Gitelman, Simone Appenzeller, Maraisa Centeville, Diane Eskra, Jennifer L. Huggins, Anne L. Johnson, Raju Khubchandani, Prachi Khandekar, Jiha Lee, Hai Mei Liu, Joshua D. Pendl, Clovis A. Silva, Marco F. Silva, Ahmad I. Zaal, Esi Morgan Dewitt, Stacy P. Ardoin, Hermine I. Brunner

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To assess the quality of medical care in childhood-onset systemic lupus erythematosus (SLE) at tertiary pediatric rheumatology centers as measured by observance of SLE quality indicators (SLE-QIs).

METHODS: International consensus has been achieved for childhood-onset SLE-QIs capturing medical care provision in 9 domains: diagnostic testing, education of cardiovascular (CV) risk and lifestyles, lupus nephritis (LN), medication management, bone health, ophthalmologic surveillance, transition, pregnancy, and vaccination. Using medical record information, the level of performance of these childhood-onset SLE-QIs was assessed in childhood-onset SLE populations treated at 4 tertiary pediatric rheumatology centers in the US, 2 in Brazil, and 1 center …

Fracture Burden And Risk Factors In Childhood Ckd: Results From The Ckid Cohort Study., Michelle R. Denburg, Juhi Kumar, Thomas Jemielita, Ellen R. Brooks, Amy Skversky, Anthony A. Portale, Isidro B. Salusky, Bradley A. Warady, Susan L. Furth, Mary B. Leonard

Manuscripts, Articles, Book Chapters and Other Papers

Childhood chronic kidney disease (CHD) poses multiple threats to bone accrual; however, the associated fracture risk is not well characterized. This prospective cohort study included 537 CKD in Children (CKiD) participants. Fracture histories were obtained at baseline, at years 1, 3, and 5 through November 1, 2009, and annually thereafter. We used Cox regression analysis of first incident fracture to evaluate potential correlates of fracture risk. At enrollment, median age was 11 years, and 16% of patients reported a prior fracture. Over a median of 3.9 years, 43 males and 24 females sustained incident fractures, corresponding to 395 (95% confidence …