Medical Specialties Commons^™

Incidence, Outcome And Risk Factors For Sepsis- A Two Year Retrospective Study At Surgical Intensive Care Unit Of A Teaching Hospital In Pakistan, Ali Asghar, Madiha Hashmi, Saima Rashid, Fazal Hameed Khan

Department of Anaesthesia

Background: Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scarse. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan.
Methods: Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013.
Results: Two hundred and twenty-nine patients met the inclusion criteria. Average age of the …

Impact Of Home- And Hospital-Based Exercise In Cardiac Rehabilitation On Hopelessness In Patients With Coronary Heart Disease, Susan L. Dunn, L. Maureen Dunn, Nicole P. Rieth, Grace B. Olamijulo, Lien L. Swieringa, Theresa P. Holden, Jacob A. Clark, Holli A. Devon, Nathan L. Tintle

Faculty Work Comprehensive List

Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). The purpose of this research was to examine the effect of regular home- and hospital-based cardiac rehabilitation (CR) exercise on hopelessness levels in patients with CHD, hypothesizing that increased exercise in either setting would lead to decreased state hopelessness.

Association Of Caregiver Quality Of Care With Neurocognitive Outcomes In Hiv-Affected Children Aged 2–5 Years In Uganda, Judith Bass, Noeline Nakasujja, Itziar Familiar-Lopez, Alla Sikorskii, Sarah Murray, Robert Opoka, Jura Augustinavicius, Michael Boivin

Paediatrics and Child Health, East Africa

Abstract: Children affected by HIV are at increased risk of developmental and neuropsychological disturbances due to direct effects of HIV on the brain and direct effects associated with living in poverty. Caregivers can play an important role, through quality caregiving, in mitigating the negative effect of these stressors. This study used baseline data from an ongoing caregiver training intervention trial to evaluate the association between quality of caregiver-child interactions and neurocognitive outcomes in rural HIV-infected and HIV-exposed but uninfected children in Uganda. We also assessed the extent to which caregiver distress moderated this relationship. Data on 329 caregiver-child dyads were …

Endometrial Tuberculosis Compounding Polycystic Ovary Syndrome In A Subfertile Woman: A Case Report, Charles Mariara, Angela Koech, P. Waweru, Alfred Murage

Obstetrics and Gynaecology, East Africa

Background: Asymptomatic female genital tuberculosis can impair tubal and endometrial function and later present as subfertility. A majority of the patients with genital tuberculosis in endemic regions present with subfertility and the delay in presentation, coupled with the potential the disease has in mimicking other gynecological conditions, renders it elusive. In addition to the challenge of diagnosing genital tuberculosis, fertility outcomes after treatment are not impressive. This is particularly so in the background of another confounding subfertility factor to which interventional efforts may initially be directed, at the expense of undiagnosed genital tuberculosis. We therefore present a case of subfertility …

Use Of Continuous Renal Replacement Therapy For Removal Of Dabigatran In A Patient In Need Of Emergent Surgery, Sara E. Parli, Melissa L. Thompson Bastin, Daniel A. Lewis

Pharmacy Practice and Science Faculty Publications

Purpose. To report the ability to remove serum dabigatran using continuous renal replacement therapy (CRRT) in a patient with life-threatening bleeding. Summary. A 77-year-old female with history of atrial fibrillation who takes dabigatran for stroke prevention presented with abdominal pain. Patient was found to have bleeding and possible mesenteric ischemia and was taken to the operating room and had continued bleeding postoperatively. CRRT was initiated for the removal of any remaining dabigatran, with serum dabigatran levels collected to evaluate removal of dabigatran with CRRT. This patient had an increased dabigatran level prior to intervention, which decreased to an …

Who Statement On Caesarean Section Rates, A. P. Betran, M. R. Torloni, J. J. Zhang, A. M. Gulmezoglu, Marleen Temmerman, Who Working Group On Caesarean Section

Obstetrics and Gynaecology, East Africa

In 1985 when a group of experts convened by the World Health Organization in Fortaleza, Brazil, met to discuss the appropriate technology for birth, they echoed what at that moment was considered an unjustified and remarkable increase of caesarean section (CS) rates worldwide.1 Based on the evidence available at that time, the experts in Fortaleza concluded: ‘there is no justification for any region to have a caesarean section rate higher than 10–15%’.1 Over the years, this quote has become ubiquitous in scientific literature, being interpreted as the ideal CS rate. Although this reference range was intended for ‘populations’, which are …

Preparation And Biological Activity Of The Monoclonal Antibody Against The Second Extracellular Loop Of The Angiotensin Ii Type 1 Receptor, Mingming Wei, Chengrui Zhao, Suli Zhang, Li Wang, Huirong Liu, Xin-Liang Ma

Department of Medicine Faculty Papers

No abstract provided.

Do Pressure Requirements Change Over Time With Auto Titrating Positive Airway Pressure Therapy For Obstructive Sleep Apnea?, Anupama Tiwari, Md, Karl Doghramji, Md, Ritu Grewal, Md

Department of Sleep Medicine Faculty Papers

Study Objective:

Prior studies have demonstrated reduced inflammation after chronic use of CPAP therapy. This may lead to reduced pressures over time as the upper airway becomes more compliant. We sought to determine if there was a reduction in 90th percentile pressure requirements in patients on Auto PAP for OSA.

Methods:

A retrospective chart review of 988 patients who underwent a sleep study at our sleep center was performed. Those with moderate to severe sleep apnea who were prescribed and compliant with Respironics Auto PAP were included, yielding a total of 46 patients for analysis. All statistical analysis analyses were …

A Dramaturgical Analysis Of The Miracle Worker, Abby Butzer

All Graduate Theses, Dissertations, and Other Capstone Projects

This document is a thesis submitted in partial fulfillment of the Master of Arts degree in theatre. It is a dramaturgical analysis for William Gibson's play The Miracle Worker, providing a reference for directors and actors. The thesis explores the play's medical and pedagogical history in six chapters: the physiology and psychology of language acquisition as it pertains to sight and/or hearing impaired children, a pedagogical comparison of Samuel G. Howe and Annie Sullivan, a modern diagnosis of the fever that destroyed Helen Keller's vision and hearing, the 19th century pathology and treatment options for the disease of the eye …

Addressing Racial Disparities In Breast Cancer Treatment Delays: An Application Of Group Model Building (Gmb), Faustine Williams, Nancy Zoellner, Maisha Flannel, L. Noel, J. Habif, P. Hovmand, Sarah Gehlert

ETSU Faculty Works

No abstract provided.

Salvage Brachytherapy For Biochemically Recurrent Prostate Cancer Following Primary Brachytherapy, John M. Lacy, William A. Wilson, Raevti Bole, Li Chen, Ali S. Meigooni, Randall G. Rowland, William H. St. Clair

Urology Faculty Publications

Purpose. In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure. Methods and Materials. From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases. Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation. Results. The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41–1.68). Mean follow-up was 61 months. At last follow-up after reseeding, …

The Role Of Capillaries In The Lesser Ailments Of Old Age And In Alzheimer's Disease And Vascular Dementia: The Potential Of Pro-Therapeutic Angiogenesis, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Apart from chronic diseases (arthritis, diabetes, etc.), old age is generally characterized by three lesser ailments: muscle weakness, minor memory lapses, and cold intolerance. This trio of complaints may have a common, underlying cause, namely, the age-associated reduced microcirculation in muscles, brain, skin, and elsewhere in the body. The Angiogenesis Hypothesis proposes that old age is in part a deficiency disease due to the decline in angiogenic (AG) factors, resulting in a reduced capillary density (CD) throughout the body. Over fifty published papers document waning levels of AG factors and/or decreased CD in various organ systems of aged animals and …

Re: "Job Strain And The Cortisol Diurnal Cycle In Mesa: Accounting For Between- And Within-Day Variability, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Rudolph et al. (2016) examined the association between job strain and cortisol profile. Several potential confounders were considered, including sociodemographic characteristics, income-wealth index, financial strain, physical health, physical activity, and medication use. No relationship between job strain and the cortisol awakening response was observed. We have 4 comments on the methods used in the study. First, although the authors related the modifications in cortisol profiles to job strain, they did not assess and statistically control for a number of nonoccupational strain factors (e.g., family- or couple-related chronic stress). Second, depressive symptoms and disorders were not considered in the study. Depression …

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and sociodemographic variables.The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited stigma scores signaling agreement with the proposed …

The Effect Of Thermacare Heat Wraps On Balance And Mobility In Seniors With Impaired Gait - A Cross Over Study, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed, Haneul Lee

College of Health & Human Services (TUN) Publications and Research

To examine if the use of heat at home can result in better quality and safer mobility in the elderly with gait and balance impairments.

Setting: Randomized longitudinal cross over study design in a clinical setting.

Methods: 20 people with impaired mobility (assessed as a score of more than 4 on the Stepping On questionnaire) were tested with a multi-camera gait analysis system, a treadmill with pressure sensors, a balance platform and the timed up and go and walking speed tests before and after using ThermaCare continuous heat wraps on their legs and knees for 6 days at 4 hours …

Oncolog, Volume 61, Number 01, January 2016, Sarah Bronson, Bryan Tutt, Bryan Tutt

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

• Proactive Management of Li-Fraumeni Syndrome Benefits Patients: Li-Fraumeni syndromes a hereditary disorder that confers an extremely high likelihood of developing cancer on affected individuals.
• Clinical Trial Tests High-Dose Radiation Therapy for Limited Stage Small Cell Lung Cancer: Small cell lung cancer carries a poor prognosis, even for patients without metastatic disease. But a phase III trial of high-dose daily or accelerated twice-daily thoracic radiation therapy for limited stage small cell kung cancer may lead to longer survival.
• Reducing Complications and Hospital Readmissions after Liver Surgery: Hepatectomy carries a risk of complications that can lead to hospital readmission and even death. …

Synapsis: Philadelphia Campus 2016, Philadelphia College Of Osteopathic Medicine

All Yearbooks

No abstract provided.

Recapitulating Cross-Species Transmission Of Sivcpz To Humans Using Humanized-Blt Mice, Zhe Yuan, Guobin Kang, Fangrui Ma, Wuxun Lu, Wenjin Fan, Christine M. Fennessey, Brandon F. Keele, Qingsheng Li

Nebraska Center for Virology: Faculty Publications

The origins of HIV-1 have been widely accepted to be the consequence of simian immunodeficiency viruses from wild chimpanzees (SIVcpz) crossing over to humans. However, there has not been any in vivo study of SIVcpz infection of humans. Also, it remains largely unknown why only specific SIVcpz strains have achieved cross-species transmission and what transmission risk might exist for those SIVcpz strains that have not been found to infect humans. Closing this knowledge gap is essential for better understanding cross-species transmission and predicting the likelihood of additional cross-species transmissions of SIV into humans. Here we show hu-BLT mice are susceptible …

High Glucose Induces Reactivation Of Latent Kaposi’S Sarcoma-Associated Herpesvirus, Fengchun Ye, Yan Zeng, Jingfeng Sha, Tiffany Jones, Kurt Kuhne, Charles Wood, Shou-Jiang Gao

Nebraska Center for Virology: Faculty Publications

High prevalence of Kaposi’s sarcoma (KS) is seen in diabetic patients. It is unknown if the physiological condition of diabetes contributes to KS development. We found elevated levels of viral lytic gene expression when Kaposi’s sarcoma-associated herpesvirus (KSHV) infected cells were cultured in high glucose medium. To demonstrate the association between high glucose and KSHV replication, we xeno29

grafted telomerase-immortalized human umbilical vein endothelial cells that are infected with KSHV (TIVE-KSHV) into hyperglycemic and normal nude mice. The injected cells expressed significantly higher levels of KSHV lytic genes in hyperglycemic mice than in normal mice. We further demonstrated that high …

Persistent Low-Level Replication Of Sivδnef Drives Maturation Of Antibody And Cd8 T Cell Responses To Induce Protective Immunity Against Vaginal Siv Infection, Sama Adnan, R. Keith Reeves, Jacqueline Gillis, Fay E. Wong, Yi Yu, Jeremy V. Camp, Qingsheng Li, Michelle Connole, Yuan Li, Michael Piatak Jr., Jeffrey D. Lifson, Wenjun Li, Brandon F. Keele, Pamela A. Kozlowski, Ronald C. Desrosiers, Ashley T. Haase, R. Paul Johnson

Nebraska Center for Virology: Faculty Publications

Defining the correlates of immune protection conferred by SIVΔnef, the most effective vaccine against SIV challenge, could enable the design of a protective vaccine against HIV infection. Here we provide a comprehensive assessment of immune responses that protect against SIV infection through detailed analyses of cellular and humoral immune responses in the blood and tissues of rhesus macaques vaccinated with SIVΔnef and then vaginally challenged with wild-type SIV. Despite the presence of robust cellular immune responses, animals at 5 weeks after vaccination displayed only transient viral suppression of challenge virus, whereas all macaques challenged at weeks 20 and 40 post-SIVΔnef …

Characterization Of The Protective Role Of Regulatory T Cells In Experimental Periapical Lesions Development And Its Chemoattraction Manipulation As A Therapeutic Tool, Carolina Favaro Francisconi, Andreia Espindola Vieira, Cláudia Cristina Biguetti, Andrew J. Glowacki, Ana Paula Favaro Trombone, Ariadne Letra, Renato Menezes Silva, Charles S. Sfeir, Steven R. Little, Gustavo P. Garlet

School of Podiatric Medicine Publications

Introduction

The pathogenesis of periapical lesions is determined by the balance between host pro-inflammatory immune response and counteracting anti-inflammatory and reparative responses, which include regulatory T cells (Tregs) as potential immunoregulatory agents. In this study, we investigated (in a cause-and-effect manner) the involvement of CCL22-CCR4 axis in Tregs migration to the periapical area and the role of Tregs in the determination of outcomes in periapical lesions.

Methods

Periapical lesions were induced in C57Bl/6 (WT) and CCR4KO mice (pulp exposure and bacterial inoculation), and treated with anti-GITR to inhibit Tregs function or alternatively with CCL22-releasing, PLGA particles to induce site-specific migration …

Development Of A Financial Decision-Making Self-Efficacy Measure For Older Adults, Evan Gross

Wayne State University Theses

Financial decision-making is important for older adults, and many are at increased risk for elder financial exploitation due to a combination of biological, social, and psychological factors. The role of self-efficacy for financial decision-making in this population has received little attention from researchers, but evidence suggests it may be a critical aspect in motivating positive decisions and avoiding exploitation. This study developed the Financial Decision-Making Self-Efficacy Scale (FDMSES) for older adults. Participants (N = 200, mean age = 71.5) completed the Lichtenberg Financial Decision-Making Rating Scale (LFDRS) and a neuropsychological test battery. Items from the LFDRS related to financial decision-making …

Toward Magnetic Resonance Only Treatment Planning: Distortion Mitigation And Image-Guided Radiation Therapy Validation, Ryan Glen Price

Wayne State University Dissertations

While MR-only treatment planning has shown promise, there are still several well-known challenges that are currently limiting widespread clinical implementation.

Firstly, MR images are affected by both patient-induced and system-level geometric distortions that can significantly degrade treatment planning accuracy. . In addition, the availability of comprehensive distortion analysis software is currently limited. Also while many groups have been working toward a synthetic CT solution, further study is needed on the implementation of synCTs as the reference datasets for linac-based image-guided radiation therapy (IGRT) to help determine their robustness in an MR-only workflow.

A 36×43×2 cm3 phantom with 255 known landmarks …

Editorial Comment: Laparoscopic Single Port Cystolithotomy Using Pneumovesicum, Trushar Patel

Urology Faculty Publications

No abstract provided.

A Rare Case Of The Simultaneous, Multifocal, Metastatic Renal Cell Carcinoma To The Ipsilateral Left Testes, Bladder, And Stomach, Michael Kongnyuy, Samuel Lawindy, Daniel Martinez, Mary Hall

Urology Faculty Publications

We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC …

Retroperitoneoscopic Pyelolithotomy: A Good Alternative Treatment For Renal Pelvic Calculi In Children, Lucas Wiegand

Urology Faculty Publications

No abstract provided.

Is Therapeutic Play Effective At Reducing Preoperative Anxiety In Children Age 4 Through 12?, Samantha L. Mclaughlin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not therapeutic play is effective at reducing preoperative anxiety in children age 4 through 12.

STUDY DESIGN: Three single blind, randomized controlled trials that were published between 2008 and 2010 and published in the English language.

DATA SOURCES: Each of the three studies that evaluate the effectiveness of therapeutic play in pediatric populations were found using the PubMed database based on their relevance to the clinical question and their inclusion of patient oriented outcomes.

OUTCOMES MEASURED: These three articles compared anxiety and stress levels in preoperative therapeutic …

Non-Nad-Like Poly(Adp-Ribose) Polymerase-1 Inhibitors Effectively Eliminate Cancer In Vivo, Colin Thomas, Yingbiao Ji, Niraj Lodhi, Elena Kotova, Aaron Dan Pinnola, Konstantin Golovine, Peter Makhov, Kate Pechenkina, Vladimir Kolenko, Alexei V. Tulin

Publications and Research

The clinical potential of PARP-1 inhibitors has been recognized N10 years ago, prompting intensive research on their pharmacological application in several branches of medicine, particularly in oncology. However, natural or acquired resistance of tumors to known PARP-1 inhibitors poses a serious problemfor their clinical implementation. Present study aims to reignite clinical interest to PARP-1 inhibitors by introducing a new method of identifying highly potent inhibitors and presenting the largest known collection of structurally diverse inhibitors. The majority of PARP-1 inhibitors known to date have been developed as NAD competitors. NAD is utilized by many enzymes other than PARP-1, resulting in …

Patient-Reported Variables Associated With The Success Of Behavioral Intervention For Patients With Chronic Cough, Bridget Loomis

Graduate Student Theses, Dissertations, & Professional Papers

Purpose: To determine if patient-related variables exist that can potentially discriminate patients with refractory chronic cough (RCC) that are reasonable candidates for behavioral cough therapy (BCT). This study is a small sub-set of a larger, ongoing study, which aims to create and validate a screening tool that primary care physicians can use in order to refer patients early and appropriately for medical or behavioral intervention.

Methods: In this prospective, exploratory study, 20 adult participants, aged 29-68 years of age, answered a bank of questions developed by an expert panel, and the Leicester Cough Questionnaire (LCQ), before and after BCT. Questions …

The Role Of Notch Signaling On Heart Rate And Atrial Conduction, Somya Bhatnagar

Undergraduate Research Symposium Posters

Heart disease is the leading cause of death worldwide and can result in arrhythmias, or dysregulation in the electrical activation of the heart. Sick Sinus Syndrome (SSS) is characterized by sinus bradycardia (slowed heart rate, HR), slowed conduction through atrial myocardium, and can predispose to the development of atrial fibrillation. A developmental signaling pathway, Notch, regulates cellular identity through differentiation of cardiomyocytes (CMs) into cardiac conduction system-like cells. Previous data show that Notch electrically remodels the right atrium, causing slowed conduction velocity (CV) and hallmarks of SSS including sinus pauses, sinus bradycardia and a predisposition to atrial fibrillation. However, the …