Medical Specialties Commons^™

A Multiparous Woman With Lately Diagnosed Multilevel Left Ventricular Obstruction, Nasir Rahman, Ibrahim Gul, Amjad Nabi

Section of Cardiology

A 56-year hypertensive, multiparous woman presented to the cardiology unit with Canadian Cardiovascular Society (CCS) class-III angina and worsening dyspnea for the past few weeks. Her clinical examination showed high blood pressure and mid-systolic crescendo-decrescendo murmur radiating to carotids. However, there was no radio-femoral delay or significant blood pressure difference between her arms. Her transthoracic echocardiography (TTE) revealed moderate aortic stenosis (AS) and mid cavity left ventricular outflow (LVO) obstruction. Left heart catheterization (LHC) showed coarctation of aorta with extensive collaterals, mid cavity LVO obstruction, and moderate AS. Thus, she was diagnosed as a case of multi-level LVO obstruction including …

In Pursuit Of Quality Research: Editors' Perspective, Jamshed Akhtar, Saba Sohail

Department of Radiology

No abstract provided.

Posterior Knee Pain In A Teenage Soccer Player., Elan L. Goldwaser Do

Department of Family Medicine

No abstract provided.

“To Reduce Or Not Reduce: Is That A Question?”, Derek A. Woessner Md, Faafp, Christina Goral Ms, Atc

Department of Family Medicine

No abstract provided.

Treatment Of Hypertensive Emergencies, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Improving Heart Failure Education Prior To Discharge: An Emmi Implementation Project, Elizabeth Mccord

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Heart failure is one of the leading causes of hospitalizations and increased health care costs in the United States. Many patients are readmitted within 30 days of discharge, resulting in increased costs. Purpose of Capstone Project: The purpose of this capstone project was to improve heart failure education for patients admitted with heart failure to Mercy Medical Center by utilizing Emmi educational videos in order to decrease the risk of hospital readmissions, improve quality of life, and decrease costs. Methods: The project focused on educating nurses about the importance of utilizing the video. It was asked of the nurses …

Toxic And Essential Trace Element Content Of Commonly Administered Pediatric Oral Medications, Robert A. Yokel, Sarah E. Seger, Jason M. Unrine

Pharmaceutical Sciences Faculty Publications

OBJECTIVES: The aim of this study was to test the hypothesis that commonly administered pediatric oral medications are a significant source of toxic elements. The concentrations of 16 elements were determined in 14 frequently used pediatric oral medications.

METHODS: Samples were prepared for analysis by dilution or nitric acid microwave-assisted digestion and analyzed by inductively coupled plasma mass spectrometry. The intake of each element from administration for 1 week of the medication's maximum recommended daily dose to 6-month-olds was calculated and compared to an exposure guideline for that element. Exposure guidelines used for adverse effects were minimal risk levels, oral …

Humor In Medicine: A Literature Review Of Humor’S Potential Therapeutic Value In Health Care, Weston Michael Grant

Psychological Science Undergraduate Honors Theses

Using humor and laughter within the health care field has the potential to be relevant to patients during treatment, to the patient-caregiver relationship, to the subjective well-being of health care providers, and to the environments’ (e.g., work settings) impact on group relationships (e.g., colleagues). A review of the literature examines how the psychological and physiological effects of laughter and humor within the human body impact health and well-being, how humor and laughter improve the patient-practitioner relationship, and if humor and laughter can potentially impact physician burnout. Several possible implications for these findings are discussed, such as professional medical comedians, improvements …

Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication …

Oncolog, Volume 62, Number 05-06, May - June 2017, Joe Munch, Bryan Tutt, Kathryn Hale

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

• Chimeric Antigen Receptor-Directed Natural Killer Cells for B Cell Malignancies: New take on an experimental therapy holds promise for patients with acute lymphoblastic leukemia, chronic lymphocytic leukemia, other lymphoid cancers.
• Preoperative Exercise Program for Pancreatic Cancer Patients: Prehabilitation regimen to improve functional status during chemotherapy evaluated in clinical trials.
• Neoadjuvant Immunotherapy for Non-Small Cell Lung Cancer: Clinical Trial will evaluate immune checkpoint inhibitors in patients with operable early-stage disease.
• HOUSE CALL: Genetic Screening for Hereditary Cancer Syndromes: Genetic counseling, testing help people assess, manage cancer risk

Phoenix Ink: Psychodynamic Motivations For Tattoo Attainment By Survivors Of Trauma, December Renee Maxwell

Graduate Theses and Dissertations

Tattoos adorn people from all over the world and date back as far as the Stone Age. Tattoos adorn people from all over the world and motivations for tattoo attainment have been studied recently. Still, there remains limited research on the potential therapeutic properties of tattoo attainment, particularly for survivors of sexual trauma. The purpose of this study was to investigate the experience of the tattoo process for survivors of sexual trauma and their motivations for tattoo attainment. This qualitative exploratory study interviewed both survivors of sexual trauma (N=10) and tattoo artists (N=7) to gain a wider perspective on the …

Dox Inducible Idh2 R140q Expression In Stem Cells Results In Cell Death, Opposite Of Cancerous Overgrowth, Reuben Hogan

Undergraduate Research Symposium Posters

Mutations in isocitrate dehydrogenase (IDH) 1 or 2 are found in about 23% of acute myeloid leukemia (AML) samples and about 90% of gliomas. Mutations result in neomorphic function of the IDH enzyme that yields the novel molecule 2-hydroxyglutarate (2HG) instead of alpha-ketoglutarate (aKG). 2HG is known to be associated with hypermethylation of DNA and histones, a phenotype seen in AML. Our lab intends to study the mechanism by which hypermethylation is achieved and how this mechanism relates to the onset of cancer. In this experiment, we utilized a line of H9 stem cells which we had developed. These cells …

Differences In Interlimb Performance During A Repetitive Step Test In Older Adults, Harold L. Merriman, Kurt Jackson, Wesley Horn, Jake Jones, Evan Price, Jill Spicer

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Each year, one out of three adults (younger than 65 years old) experiences a fall, resulting in fractures, head injuries, and even death. Falling is the leading cause of death from an injury and causes the greatest number of nonfatal injuries and hospital admissions for trauma. Since balance and muscle performance decrease as one ages, it is vitally important to assess these factors as part of a comprehensive strategy to monitor and predict fall risk. Previous data analysis of the Repetitive Step Test (RST) has shown that there is a correlation between subject performance and fall risk between non-fallers and …

A Comparison Of Arch Height Index Measures Between Collegiate Basketball And National Basketball Association Players, Philip Anloague, N Hess, L Barhorst, G Hock, A Iannarino, A Kelly, C Williams

University of Dayton Doctor of Physical Therapy Annual Research Symposium

The rate of game related basketball injuries is 2xs greater in professionals than collegiate players and the most common injuries occur in the lower extremity. Arch mechanics are often cited as a related factor and the Arch Height Index Measurement System (AHIMS) is a reliable and valid system for quantifying mobility. However, normative or comparative values for basketball athletes have not been reported.

The Effects Of Yoga On Balance, Strength, Flexibility, And Mindfulness In Typical Children Ages 4-9 Years, Betsy Donahoe Fillmore, Mary I. Fisher, Katie Lunsford, Justin Master, Sarahanne Pelkey, Emily Puthoff, Kristen Schulte, Brittany Snider, Jordan Villanueva

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Yoga improves a variety of impairments in typical pediatric populations: cardiovascular, neuromuscular, musculoskeletal, and pulmonary conditions, balance, strength, and flexibility. Yoga improves mindfulness in adult populations, and emerging evidence shows a similar effect among pediatric populations.

Quality Assurance Guidelines For Superficial Hyperthermia Clinical Trials : Ii. Technical Requirements For Heating Devices., Hana Dobšíček Trefná, Johannes Crezee, Manfred Schmidt, Dietmar Marder, Ulf Lamprecht, Michael Ehmann, Jacek Nadobny, Josefin Hartmann, Nicolleta Lomax, Sultan Abdel-Rahman, Sergio Curto, Akke Bakker, Mark D. Hurwitz, Chris J. Diederich, Paul R. Stauffer, Gerard C. Van Rhoon

Department of Radiation Oncology Faculty Papers

Quality assurance (QA) guidelines are essential to provide uniform execution of clinical trials with uniform quality hyperthermia treatments. This document outlines the requirements for appropriate QA of all current superficial heating equipment including electromagnetic (radiative and capacitive), ultrasound, and infrared heating techniques. Detailed instructions are provided how to characterize and document the performance of these hyperthermia applicators in order to apply reproducible hyperthermia treatments of uniform high quality. Earlier documents used specific absorption rate (SAR) to define and characterize applicator performance. In these QA guidelines, temperature rise is the leading parameter for characterization of applicator performance. The intention of this …

Emergency Preparedness Competencies Among Nurses In Northwest Arkansas, Taylor A. Matlock

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Despite years of training and experience, evidence suggests nurses report wide gaps in emergency competencies and disaster preparedness. Further, nurses report low levels of familiarity in competencies related to planning for disasters, implementing disaster guidelines, and assessing patients exposed to biological and chemical agents. This research sought to establish the self-reported level of emergency preparedness competencies of nurses in Northwest Arkansas, an area that faces a diverse set of potential disasters ranging from nuclear accidents to pandemic disease. Additionally, differences between of the level of preparedness by education level or work specialty were studied. The results are alarming in that …

Interdependency Of Egf And Glp-2 Signaling In Attenuating Mucosal Atrophy In A Mouse Model Of Parenteral Nutrition, Yongjia Feng, Farok R. Demehri, Weidong Xiao, Yu-Hwai Tsai, Jennifer C. Jones, Constance D. Brindley, David W. Threadgill, Jens J. Holst, Bolette Hartmann, Terrence A. Barrett, Daniel H. Teitelbaum, Peter J. Dempsey

Internal Medicine Faculty Publications

BACKGROUND & AIMS: Total parenteral nutrition (TPN), a crucial treatment for patients who cannot receive enteral nutrition, is associated with mucosal atrophy, barrier dysfunction, and infectious complications. Glucagon-like peptide-2 (GLP-2) and epidermal growth factor (EGF) improve intestinal epithelial cell (IEC) responses and attenuate mucosal atrophy in several TPN models. However, it remains unclear whether these 2 factors use distinct or overlapping signaling pathways to improve IEC responses. We investigated the interaction of GLP-2 and EGF signaling in a mouse TPN model and in patients deprived of enteral nutrition.

METHODS: Adult C57BL/6J, IEC-Egfr^{knock out (KO)} and IEC-pik3r1^KO mice receiving …

Rising Thyroid Cancer Incidence In Southern India: An Epidemic Of Overdiagnosis?, Indu Elizabeth Mathew, Aju Mathew

Internal Medicine Faculty Publications

Background: Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis.

Objective: We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease.

Design: Population-based study using data from the National Cancer Registry Program.

Participants: We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai. We used data for three reporting periods from 2005 to 2014 (represented as 2006, 2009, and 2012). …

Demographics, Patterns Of Care, And Survival In Pediatric Medulloblastoma, Emily V. Dressler, Therese A. Dolecek, Meng Liu, John L. Villano

Internal Medicine Faculty Publications

We evaluated the American College of Surgeon’s National Cancer Data Base (NCDB) to describe current hospital-based epidemiologic frequency, survival, and patterns of care of pediatric medulloblastoma. We analyzed NCDB 1998–2011 data on medulloblastoma for children ages 0–19 years using logistic and poisson regression, Kaplan–Meier survival estimates, and Cox proportional hazards models. 3647 cases of medulloblastoma in those aged 0–19 years were identified. Chemotherapy was received by 79 and 74% received radiation, with 65% receiving both therapies. Those who received radiation were more likely to be older than four, while those who received chemotherapy were more likely to be age four …

Sensitivity Of Diffuse Reflectance Spectroscopy To Dose- And Depth-Dependent Changes In Tumor Oxygenation After Radiation Therapy, Daria Semeniak

Graduate Theses and Dissertations

Along with chemotherapy, immunotherapy, and surgery, radiotherapy is one of the most common treatments used against cancer. Around 50% of all cancer patients undergo radiation therapy. While for some patients radiotherapy works efficiently and lead to a complete cancer disappearance, for others treatment outcome may be less favorable due to radioresistance processes happening within a tumor on the molecular level. Radioresistance remains a big challenge for modern oncology. The ability to identify radioresistance at the early stage of radiotherapy would help physicians to improve therapy efficiency. At the current moment, despite the rapid progress in cancer understanding and diagnostic modalities, …

Rct Testing Bystander Effectiveness To Reduce Violence, Ann L. Coker, Heather M. Bush, Patricia G. Cook-Craig, Sarah A. Degue, Emily R. Clear, Candace J. Brancato, Bonnie S. Fisher, Eileen A. Recktenwald

Obstetrics and Gynecology Faculty Publications

Introduction: Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years.

Design: A cluster RCT was conducted.

Setting/participants: Kentucky high schools were randomized to intervention or control (wait list) conditions.

Intervention: Green Dot−trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1.

Main outcome measures: The primary outcome was sexual …

Cyclin B1 Mediates The Effect Of Uchl1 In Promoting Cell Cycle Progression In Uterine Papillary Serous Carcinoma, Suet Ying Kwan

Dissertations and Theses (Open Access)

Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer with poor survival rates and a high risk of recurrence. The rarity of UPSC poses challenges to the discovery of novel targeted therapies. Therefore, the purpose of this dissertation was to identify novel therapeutic targets that could aid in the management of UPSC. To do so, we began with the relatively large cohort of UPSC cases in the TCGA data set, which was used to identify differentially expressed genes between UPSC and low-grade endometrioid endometrial carcinoma (EEC) and normal tissue.

We identified Ubiquitin Carboxyl-Terminal Hydrolase L1 (UCHL1 …

A Phase Ib/Ii Study Of Cabozantinib (Xl184) With Or Without Erlotinib In Patients With Non-Small Cell Lung Cancer., Heather A Wakelee, Scott Gettinger, Jeffrey Engelman, Pasi A Jänne, Howard J. West, Deepa S Subramaniam, Joseph Leach, Michael Wax, Yifah Yaron, Dale R Miles, Primo N Lara

Articles, Abstracts, and Reports

PURPOSE: Cabozantinib is a multi-kinase inhibitor that targets MET, AXL, and VEGFR2, and may synergize with EGFR inhibition in NSCLC. Cabozantinib was assessed alone or in combination with erlotinib in patients with progressive NSCLC and EGFR mutations who had previously received erlotinib.

METHODS: This was a phase Ib/II study (NCT00596648). The primary objectives of phase I were to assess the safety, pharmacokinetics, and pharmacodynamics and to determine maximum tolerated dose (MTD) of cabozantinib plus erlotinib in patients who failed prior erlotinib treatment. In phase II, patients with prior response or stable disease with erlotinib who progressed were randomized to single-agent …

Quality Of Life In Individuals Surgically Treated For Congenital Hydrocephalus During Infancy: A Single-Institution Experience, Saad Akhtar Khan, Muhammad Faheem Khan, Saqib Kamran Bakhshi, Omar Irfan, Hamza Abdur Rahim Khan, Asad Abbas, Safia Awan, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Congenital hydrocephalus (CH) is a frequently encountered birth anomaly that can hinder long-term neurologic maturity and social well-being of affected children. This study was undertaken to assess quality of life (QOL) 10-15 years after surgical treatment for primary CH during infancy at a tertiary care hospital in a developing country.
Methods: This retrospective cohort study included individuals who presented to Aga Khan University Hospital, Karachi, Pakistan, between 1995 and 2005 at QOL.
Results: Of 118 patients, 90 patients participated in the study. Mean age at first admission was 6.2 months. Mean length of follow-up was 5.4 years. Of these, …

A Description Of The Methods Of The Aspirin Supplementation For Pregnancy Indicated Risk Reduction In Nulliparas (Aspirin) Study, Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Norman Goco, Marion Koso-Thomas, Menachem Miodovnik, Elizabeth M. Mcclure, Dennis D. Wallace, Jennifer J. Emingway-Foday, Antoinette Tshefu, Adrien Lokangaka, Carl L. Bose, Elwyn Chomba, Musaku Mwenechanya, Waldemar A. Carlo, Ana Garces, Nancy F. Krebs, K. Michael Hambidge, Sarah Saleem, Robert L. Goldenberg, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Robert Silver, Richard J. Derman

Community Health Sciences

Background: Preterm birth (PTB) remains the leading cause of neonatal mortality and long term disability throughout the world. Though complex in its origins, a growing body of evidence suggests that first trimester administration of low dose aspirin (LDA) may substantially reduce the rate of PTB.
Methods: Hypothesis: LDA initiated in the first trimester reduces the risk of preterm birth. Study Design Type: Prospective randomized, placebo-controlled, double-blinded multi-national clinical trial conducted in seven low and middle income countries. Trial will be individually randomized with one-to-one ratio (intervention/control) Population: Nulliparous women between the ages of 14 and 40, with a …

Eliminating Wrong Blood Transfusions - Recent Advances, Farheen Karim, Salman Naseem Adil

Department of Pathology and Laboratory Medicine

No abstract provided.

Spinal Cord Injury Induced Cardiac Decline And The Limitations Of Exercise., Kathryn Michele Deveau

Electronic Theses and Dissertations

There is a general consensus that the level and the severity of spinal cord injury (SCI) impacts chronic cardiac abnormalities such that high thoracic and cervical SCI are the most severely affected. Furthermore, the extreme degree of immobility/inactivity experienced by the persons with SCI has implications on cardiac decline. Yet it has been difficult to separate the relative contributions of the decentralized autonomic nervous system (ANS) and the immediate and profound inactivity to chronic cardiac abnormalities. As such, this body of work sought to characterize a contusion SCI that results in persistent CV dysfunction. Echocardiography, Dobutamine stress echocardiography and pressure …

Targeting The Glucose Metabolism Of Myeloid-Derived Suppressor Cells (Mdscs) To Stimulate Cancer Immunity., Jaspreet Grewal

Electronic Theses and Dissertations

Myeloid derived suppressor cells (MDSCs) are a heterogeneous group of immature myeloid cells that are significantly increased in cancer patients and correlate with higher stage and poor prognosis. MDSCs negatively modulate anti-tumor immunity, suppress T cell activity, promote angiogenesis and increase the risk of metastasis. In this study, we report that monocytic-MDSCs (M-MDSCs) but polymorphonuclear-MDSCs (PMN-MDSCs) over-express 6-phosphofructo-2-kinase/fructose-2, 6-bisphosphatases 3 (PFKFB3), an important regulator of glycolysis. Furthermore in the melanoma model, M-MDSCs but not PMN-MDSCs suppressed T cell function which correlated with PFKFB3 over-expression and increased rate of glycolysis. PFKFB3 inhibition with the first-in-class small molecule inhibitor, PFK-158 reversed M-MDSC …

Enhancing Cell Therapy For Ischemic Cardiomyopathy., Michael J. Book

Electronic Theses and Dissertations

Cardiac cell therapy using cardiac mesenchymal cells (CMC) significantly reduces ventricular dysfunction in patients with ischemic cardiomyopathy. Despite the improvement in function, a modest number of CMCs survive in the heart post-transplantation. In this study, we sought to improve the survival and retention of transplanted CMCs to prolong the therapeutic benefits afforded by cardiac cell therapy. To do this, we targeted the enzyme telomerase (TERT), known to be active in some highly proliferating cells (e.g. germ, stem). TERT is responsible for preventing telomere attrition, thereby allowing continued proliferation. TERT has also been shown to be protective, improve cell migration and …