Medical Specialties Commons^™

Methods And Systems For Prognosis And Diagnosis Of Brain Damage, Mark A. Lovell, Bert C. Lynn, Melissa A. Bradley-Whitman

Sanders-Brown Center on Aging Faculty Patents

The presently-disclosed subject matter includes methods and devices for diagnosing, prognosing, and treating brain damage in a subject, including brain damage caused by stroke or a traumatic brain injury (TBI). The methods can comprise providing a sample obtained from the subject, exposing the sample to an antibody selective for a visinin-like protein, detecting the presence of a complex that includes the antibody and the visinin-like protein, and diagnosing and/or prognosing the subject as having brain damage if there is the presence of the complex. Embodied methods can also comprise administering a treatment for brain damage if the subject includes the …

Standardization Of Postoperative Transitions Of Care To The Pediatric Intensive Care Unit Enhances Efficiency And Handover Comprehensiveness, Anthony Sochet, Ashley Simms, Grace Ye, Nihal Godiwala, Lauren Hebert, Christine O. Corriveau

Pediatrics Faculty Publications

Introduction: To determine the impact of standardization of postoperative transitions of care to the pediatric intensive care unit on handover efficiency and the quality of healthcare data exchange.

Methods: This was a prospective, pre–post observational study after standardization of postoperative transitions in a 44-bed pediatric intensive care unit in a 313-bed tertiary care pediatric hospital from April to July 2015. Standardization was completed using a multidisciplinary handover checklist. Primary outcomes were efficiency expressed as mean handover duration and the comprehensiveness of healthcare data exchange.

Results: Forty-seven postoperative transitions were observed of which 23 were preintervention and 24 were postintervention. After …

Improving Standards Of Care In Obstructed Labour: A Criteria-Based Audit At A Referral Hospital In A Low-Resource Setting In Tanzania, Andrew H. Mgaya, Hussein Kidanto, Lennarth Nystrom, Birgitta Essén

Faculty of Health Sciences, East Africa

Objective In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting.

Methods A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases …

Breech Delivery At A University Hospital In Tanzania, Ulf Högberg, Catrin Claeson, Lone Krebs, Agneta Skoog Svanberg, Hussein Kidanto

Faculty of Health Sciences, East Africa

Background There is a global increase in rates of Cesarean delivery (CD). A minor factor in this increase is a shift towards CD for breech presentation. The aim of this study was to analyze breech births by mode of delivery and investigate short-term fetal and maternal outcomes in a low-income setting.

Methods The study design was cross-sectional and the setting was Muhimbili National Hospital (MNH), Dar-es-Salaam, Tanzania. Subjects were drawn from a clinical database (1999–2010) using the following inclusion criteria: breech presentation, birth weight ≥ 2,500 g, single pregnancy, fetal heart sound at admission, and absence of pregnancy-related complication as …

Criteria-Based Audit To Improve Quality Of Care Of Foetal Distress: Standardising Obstetric Care At A National Referral Hospital In A Low Resource Setting, Tanzania, Andrew H. Mgaya, Helena Litorp, Hussein Kidanto, Lennarth Nyström, Birgitta Essén

Faculty of Health Sciences, East Africa

Background In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting.

Methods During 2013–2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for …

Mahaim Tachycardia Induced Cardiomyopathy, Ibrahim Gul, Qamaruddin Roziman, Aamir Hameed Khan

Section of Cardiology

We present the case report of a 22-year man, with incessant palpitations, chest pain, shortness of breath, and pulsations in his neck for the past 7 months. He was referred to the cardiology unit for workup of wide complex tachycardia (WCT). His echocardiography, 6 months earlier, had demonstrated severe left ventricular (LV) systolic dysfunction, severe global hypokinesia, mild tricuspid regurgitation (TR), and mild mitral regurgitation (MR) which resolved with medical therapy including beta-blockers. He underwent electrophysiological study, which revealed a decremental right sided atriofascicular pathway causing a WCT with left bundle branch block (LBBB) morphology and left axis deviation (LAD, …

Remembering Dr. Henry W. Gray (1827-1861) And His Timeless Contribution To Modern Medical Education., Niti Shahi, Abigail L. Brooks, Charles J. Yeo, Scott W. Cowan, Gerald A. Isenberg

Department of Surgery Gibbon Society Historical Profiles

No abstract provided.

Exosome-Mediated Transfer Of Αvβ3 Integrin From Tumorigenic To Nontumorigenic Cells Promotes A Migratory Phenotype., Amrita Singh, Carmine Fedele, Huimin Lu, Marja T. Nevalainen, James H. Keen, Lucia R. Languino

Department of Cancer Biology Faculty Papers

The αvβ3 integrin is known to be highly upregulated during cancer progression and promotes a migratory and metastatic phenotype in many types of tumors. We hypothesized that the αvβ3 integrin is transferred through exosomes and, upon transfer, has the ability to support functional aberrations in recipient cells. Here, for the first time, it is demonstrated that αvβ3 is present in exosomes released from metastatic PC3 and CWR22Pc prostate cancer cells. Exosomal β3 is transferred as a protein from donor to nontumorigenic and tumorigenic cells as β3 protein or mRNA levels remain unaffected upon transcription or translation inhibition in recipient cells. …

Getting Started: Identifying Funding Opportunities With Jefferson Resources, Molly Gerber, Avp, Gary Kaplan, Dana Marcus

Department of Surgery, Faculty Development Sessions

Section 1: Philanthropy Basics

Section 2: Fundraising for Research

Section 3: Information Resources

36 PowerPoint slides

Obstetric Patients In Intensive Care Unit: Perspective From A Teaching Hospital In Pakistan, Rahat Qureshi, Sheikh Irfan Ahmed, Amir Raza, Ayesha Khurshid, Uzma Chishti

Department of Obstetrics & Gynaecology

Objective: Review of obstetric cases admitted to the intensive care unit.
Design: Ten year retrospective review of individual patients' medical records.
Participants: Records of obstetric patients admitted from 2005-2014.
Setting: Aga Khan University Hospital Karachi.
Main outcome Measures: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality.
Findings: A total of 194 obstetric patients were admitted out of which 86.2% of patients had ventilator support. Mortality was not seen to be significantly associated with parity and antenatal/postnatal status. The median age of patients was 34 years, minimum length of stay …

Comments On The Editorial On Ild Published In The September 2016 Issue Of Jpma, Ali Bin Sarwar Zubairi

Department of Medicine

No abstract provided.

Clinical Outcomes Of Pneumocystis Pneumonia From A Tertiary Care Centre In Pakistan., Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar

Department of Medicine

Objective: To assess the predisposing immunocompromised states, administration of pneumocystis jirovecii pneumonia prophylaxis, the disease course and outcomes of patients with pneumocystis jirovecii pneumonia.

Methods: The retrospective study was conducted at the Aga Khan University Hospital in Karachi. The medical records of patients diagnosed with pneumocystis jirovecii pneumonia from January 1995 to October 2015 were retrieved. Baseline characteristics, clinical course, treatment, and mortality rates were noted. SPSS 19 was used for data analysis.

Results: Of the 37 patients, 24(64.9%) were men and 13(35.1%) were women. The overall mean presenting age was 47.08±16.21 years(range: 19-83 years). Ten (27%) patients were positive …

Cardiac Consequences Of The Heroin Epidemic: Loperamide Causing Torsades De Pointes, Justin L. Guthier Do, Apurva Vyas Md

Department of Medicine

No abstract provided.

Tct-353 Underweight Status, Platelet Reactivity, And 2-Year Clinical Outcomes In Patients Undergoing Pci With Des: An Adapt-Des Study Analysis., Puja B. Parikh Md, Ajay J. Kirtane Md, Giora Weisz Md, Thomas D. Stuckey Md, M Ozgu Ozan Ms, Bernhard Witzenbichler Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Bruce R. Brodie Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

The relationships between underweight status, platelet reactivity, and clinical outcomes after PCI with DES are not well understood.

Methods

ADAPT-DES was a prospective, multicenter study of 8582 pts treated with aspirin and clopidogrel in whom routine measurement of P2Y12 reaction units (PRU) by VerifyNow testing was performed following successful DES implantation. Pts were classified according to the following body mass index (BMI) groups: Underweight (BMI/m2), normal weight (20 kg/m2 ≤ BMI/m2), overweight (25 kg/m2 ≤ BMI/m2), and obese (BMI ≥30 kg/m2).

Results

Underweight pts were more often female, smokers, had higher rates of peripheral arterial disease and renal insufficiency, …

Tct-352 Proportion Of Ischemic Risk After Pci Mediated By High Platelet Reactivity On Clopidogrel: Analysis From The Adapt-Des Study., Björn Redfors, Ori Ben-Yehuda Md, Sheng-Hsuan Lin, Ariel Furer, Ajay J. Kirtane Md, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Akiko Maehara Md, Philippe Généreux Md, Gennaro Giustino Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Girma M. Ayele, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Tct-237 Outcomes After Successful Pci Of Severely Calcified Lesions Using Rotational Atherectomy, Cutting Balloon, Or Balloon Angioplasty Only Before Second-Generation Drug-Eluting Stent Implantation., Björn Redfors, Philippe Généreux Md, Akiko Maehara Md, Ajay J. Kirtane Md, Rushad Dordi, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Claire Litherland Ms, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Prevalence Of Homelessness Or At-Risk For Homelessness In The Ed Setting, Marna R. Greenberg Do, Mph, Facep, Brett Feldman Pa-C, Osman Z. Abbasi Do, Joshua Enyart Do, Yasir Abunamous Ba, Timothy Batchelor, Emily L. Bennett Bs, Cristina G. Calogero Bs, Kareem S. Elsayed, Rachel F. Ledyard Bs, Mikdat Ulas Bs, Alexis M. Begliomini Ba, Zachary J. Ezrow Bs, Timothy J. Friel Md

Department of Emergency Medicine

No abstract provided.

Feasibility And Implementation Study Of Group Prenatal Care In An Fqhc And Residency Training Site, Autumn Kieber-Emmons Md, Mph, Linda Garufi, Hannah D. Paxton Rn, Mph, Ashwini Kamath Mulki, Christina Hernandez Bsn, Genay Jackson Mph

Department of Family Medicine

No abstract provided.

Exploring Health Beliefs Among Hispanic Adults With Prediabetes (Poster)., Kyle Shaak Bs, Beth Careyva M.D., Susan E. Hansen Ma, Melanie B. Johnson Mpa, Samantha A. Goodrich, Alicia Rivera, Liselly Diaz, Jessecae K. Marsh Phd, Clare Lenhart Phd, Brian Stello Md

Department of Family Medicine

No abstract provided.

Hispanic Patient Preference In Colorectal Cancer Screening: Factors In Decision-Making, Melanie B. Johnson Mpa, Beth Careyva M.D., Melissa Dicarlo Mph, Ms, Alicia Rivera, Anett Petrich Rn, Msn, Kyle Shaak Bs, Anna Quinn Mph, Ryt, Evelyn T. Gonzalez Ma, Liselly Diaz

Department of Family Medicine

No abstract provided.

Oncolog, Volume 61, Number 11-12, November - December 2016, Brandon C. Strubberg, Sarah Bronson, Stephanie Deming, E Nielsen

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

• Innovative Trial Investigates Molecular Drivers of Triple-Negative Breast Cancer: A new clinical trial focusing on molecular biomarkers of triple-negative breast cancer (TNBC) is attempting to advance targeted therapy against the deadly disease.
• Smac Mimetics Show Activity against Myelofibrosis: Not all cases of myelofibrosis respond well to ruxolitinib, the only drug approved for this disease. However, early studies indicate that a new class of drugs, Smac mimetics, can achieve a response in some patients with myelofibrosis.
• Urothelial Cancer Subtypes Predict Treatment Response: Subtypes of urothelial cancer identified through gene expression profiling predict which patients are most likely to respond to neoadjuvant …

Methemoglobin And Nitric Oxide Therapy In Ugandan Children Hospitalized For Febrile Illness: Results From A Prospective Cohort Study And Randomized Double-Blind Placebo-Controlled Trial, Andrea Conroy, Michael Hawkes, Kyla Hayford, Laura Hermann, Chloe Mcdonald, Suparna Sharma, Sophie Namasopo, Robert Opoka, Chandy John, Conrad Liles

Paediatrics and Child Health, East Africa

Background: Exposure of red blood cells to oxidants increases production of methemoglobin (MHb) resulting in impaired oxygen delivery to tissues. There are no reliable estimates of methemoglobinemia in low resource clinical settings. Our objectives were to: i) evaluate risk factors for methemoglobinemia in Ugandan children hospitalized with fever (study 1); and ii) investigate MHb responses in critically ill Ugandan children with severe malaria treated with inhaled nitric oxide (iNO), an oxidant that induces MHb in a dose-dependent manner (study 2).

Methods: Two prospective studies were conducted at Jinja Regional Referral Hospital in Uganda between 2011 and 2013. Study 1, a …

Changes In Serum Lipid Profile Among Patients Suffering From Chronic Liver Disease Secondary To Hepatitis C, Fakhar Qazi, Shameem Behram Khan, Anam Umar, Noor Ul Saba Shaikh, Fizza Choudhry

Section of Gastroenterology

Objective: To find out the changes in lipid metabolism among patients suffering from chronic liver disease secondary to hepatitis C.

Study Design: Hospital based observational study.

Setting: Medical Unit-I, Ward–5, Jinnah Postgraduate Medical Centre, Karachi.

Duration: July 2013 to December 2013.

Patients and Methods: About 110 patients admitted in Medical Unit-I with a diagnosis of chronic liver disease were included in the study. Patients suffering from DM, HTN, CKD were excluded from the study. Fasting lipid profile was done in all cases.

Results and Observations: There were 44 (40%) male and 66 (60%) female patients. Mean age of the patients …

Head And Neck Manifestations Of Eosinophilic Granulomatosis With Polyangiitis: A Systematic Review., Jared M. Goldfarb, Mindy R. Rabinowitz, Shristi Basnyat, Gurston G. Nyquist, Marc R. Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist.

DATA SOURCES: PubMed, Cochrane Library, Scopus, and LILACS.

REVIEW METHODS: A systematic review of the aforementioned sources was conducted per the PRISMA guidelines.

RESULTS: From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group …

Clinical Influences In The Multidisciplinary Management Of Small Renal Masses At A Tertiary Referral Center, Costas D. Lallas, Kymora Scotland, Michael Zhang, Daisey Schaeffer, Anne Calvaresi, Leonard G. Gomella, Daniel Brown, Colette Shaw, Edouard J. Trabulsi

Department of Urology Faculty Papers

Introduction We designed a multidisciplinary Small Renal Mass Center to help patients decide among treatment options and individualize therapy for small renal masses. In this model physicians and support staff from multiple specialties work as a team to evaluate and devise a treatment plan for patients at the same organized visit. Methods We retrospectively reviewed the records of 263 patients seen from 2009 to 2014. Monitored patient characteristics included age, Charlson comorbidity index, body mass index, nephrometry score, tumor size and estimated glomerular filtration rate. Univariate and multivariate analyses were performed to identify patient characteristics associated with each treatment choice. …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

The Development Of A Universally Accepted Sacral Fracture Classification: A Survey Of Aospine And Aotrauma Members., Gregory D. Schroeder, Mark Kurd, Christopher K. Kepler, James C. Krieg, Jefferson R. Wilson, Conor P. Kleweno, Reza Firoozabadi, Carlo Bellabarba, Frank Kandizoria, Klause J. Schnake, S. Rajesekaran, Marcel F. Dvorak, Jens R. Chapman, Luiz R. Vialle, F. C. Oner, Alex R. Vaccaro

Rothman Institute Papers

Study Design Survey study. Objective To determine the global perspective on controversial aspects of sacral fracture classifications. Methods While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma. The survey asked four yes-or-no questions to help determine the best way to handle controversial aspects of sacral fractures in future classifications. Chi-square tests were initially used to compare surgeons' answers to the four key questions of the survey, and then the data was modeled through multivariable logistic regression analysis. Results A total of 474 surgeons answered all questions in the survey. Overall …

Implementation Of Technology-Based Patient Engagement Strategies Within Practice-Based Research Networks (Poster), Beth Careyva M.D., Kyle Shaak Bs, Geoffrey Mills Md, Phd, Melanie B. Johnson Mpa, Samantha A. Goodrich, Brian Stello Md, Lorraine S. Wallace Phd

Department of Family Medicine

Careyva, B. Shaak, K. Mills, G. Johnson, M. Goodrich, S. Stello, B. Wallace, L. (2016, Nov). Implementation of Technology-Based Patient Engagement Strategies within Practice-Based Research Networks. Poster Presented at: North American Primary Care Research Group, Colorado Springs, CO.

Descriptive Epidemiology Of Karachi Road Traffic Crash Mortality From 2007 To 2014, Rashid Jooma, Masood Ali Shaikh

Department of Surgery Docs

Abstract

According to World Health Organization's estimate for Pakistan, there were 25,781 (95% CI: 20,979-30582) Road Traffic Collision (RTC) fatalities in year 2013. The Road Traffic Injury Research and Prevention Center, collects RTC data on injuries and fatalities from five major public and private hospitals' emergency departments in Karachi. For the eight-year period, from 2007-2014, 9129 fatalities were recorded. Males accounted for 8008 (87.7%) all RTC fatalities. Highest number of fatalities were recorded in the 21-25 age group with 1329 (15.3%) fatalities, while fatalities in 16-30 years old, recorded 3446 (39.7%) of all fatalities out of the total 8684 records …

Catamenial Pneumothorax: A Case Report., Hina Inam, Sumera Inam,, Munaim Tahir

Department of Surgery Docs

Abstract

Catamenial pneumothorax (CP) is a rare and complex clinical condition caused by endometrial tissues, commonly found in reproductive women (age 15-49 years).Its diagnosis is often delayed or overlooked by clinicians, which may result in recurrent hospitalizations and other complications. A case of Catamenial pneumothorax is presented of a 38-year-old young married woman, admitted to hospital with signs and symptoms including chest pain and shortness of breath that started with her menstrual period. Right pneumothorax was observed in the Chest x-ray. Patient underwent Video-assisted thoracoscopic surgery (VATS). Patient was kept under observation, and was discharged when stable with no pain.Catamenial …