Medical Specialties Commons^™

Sonoelastography Of The Common Flexor Tendon Of The Elbow With Histologic Agreement: A Cadaveric Study., Andrea S Klauser, Mathias J Pamminger, Ethan J. Halpern, Mohamed M H Abd Ellah, Bernhard Moriggl, Mihra S Taljanovic, Christian Deml, Judith Sztankay, Guenter Klima, Leonhard Gruber, Werner R Jaschke

Department of Radiology Faculty Papers

Purpose To determine the correlation of the results of conventional B-mode ultrasonography (US) and compression sonoelastography with histologic results in common flexor tendons of the elbow in human cadavers. Materials and Methods Twenty-five common flexor tendons were evaluated in 16 fresh, unembalmed cadavers of 11 women with a median age of 85 years (range, 71-101 years) and five men with a median age of 78 years (range, 70-88 years). Informed consent was provided according to the last will of the donors. B-mode US results were classified as grade 1, normal tendon with homogeneous fibrillar pattern; grade 2, tendon thickening or …

Buspirone For The Treatment Of Dementia With Behavioral Disturbance, Maria R. Santa Cruz, Priscilla Hidalgo, Meredith Lee, Cornelius Thomas, Suzanne Holroyd

Psychiatry

Behavioral disturbances are common but serious symptoms in patients with dementia. Currently there are no FDA approved drugs for this purpose. There have been case reports and small case series of the use of buspirone. In this retrospective study, we review 179 patients prescribed buspirone for treatment of behavioral disturbance in dementia to better characterize the efficacy and potential side effects. All patients prescribed buspirone for behavioral disturbance due to dementia from a geropsychiatric outreach program were reviewed. Data was collected and analyzed using SPSS. One hundred-seventy-nine patients met criteria for the study with a mean age of 83.8 + …

Nature, Scope And Use Of Economic Evaluation Of Healthcare Programmes: With Special Reference To Pakistan., Muhammad Ashar Malik, Saleem Perwaiz Iqbal, Farina Abrejo

Community Health Sciences

Economic evaluation (EE)/cost effectiveness analysis(CEA) of healthcare programmes is an emerging area, yet the resource base to apprehend EE/CEA is very limited in Pakistan. This paper attempts to fill this gap by providing a basic text in the field of EE with special reference to Pakistan. We used four dimensional criteria (available, relevant, complete and accurate) for reviewing the EE contents in the locally available textbooks and reading material on public health. We find CEA as core competency and skill of medical doctors in undergraduate medical curricula yet we could not find EE contents in the recommended textbooks. We find …

Did Contracting Effect The Use Of Primary Health Care Units In Pakistan?, Ashar Muhammad Malik, Ellen Van De Poel, Eddy Van Doorslaer

Community Health Sciences

For many years, Pakistan has had a wide network of Basic Health Units spread across the country, but their utilization by the population in rural and peri-urban areas has remained low. As of 2004, in an attempt to improve the utilization and performance of these public primary healthcare facilities, the government has gradually started contracting-in intergovernmental organizations to manage these BHUs. Using five nationally representative household surveys conducted between 2001 and 2012, and exploiting the gradual roll-out of this reform to apply a difference-in-difference approach, we evaluate its impact on BHU utilization. We find that contracting of the BHU management …

Implementation Of Ventilator Bundle In Pediatric Intensive Care Unit Of A Developing Country, Anwar Ul Haque, Quratulain Riaz, Syed Asad Ali

Department of Paediatrics and Child Health

The aim of this study was to assess the frequency of VAP(ventilator associated pneumonia) after strict implementation of ventilator bundle in PICU. Medical records of all children (age 1 month - 16 years) were retrospectively reviewed, who were on mechanical ventilation (MV) for more than 48 hours and received all key components of "ventilator bundle" from January 2012 to December 2014. Out of 1050, 565 (54%) patients were enrolled. The mean age was 4.02 SD 4.29 years and 62 (69%) were male. The indications of MV were respiratory illness (54%), neurological illness (31%), shock (9%), and postoperative care (6%). The …

Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips), Naveed Ur Rehman Siddiqui, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer Amanullah, Amina Rehmat, Anwarul Haque

Department of Paediatrics and Child Health

Objectives: The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia.
Trial design: The EIPS trial is designed as a randomised, equivalence trial between two treatment arms.
Study setting: The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi.
Participants: 41 patients (aged 1 month to 15years) who were admitted to PCICU post cardiac surgery were recruited (23 IVPR arm and 18 …

Improved Survival After Acute Graft-Versus-Host Disease Diagnosis In The Modern Era, H Khoury, T Wang, Michael T. Hemmer, D Couriel, A Alousi, Mitchell Cairo, J Pidala

NYMC Faculty Publications

Acute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic …

Hepatitis C Virus And Nonliver Solid Cancers: Is There An Association Between Hcv And Cancers Of The Pancreas, Thyroid, Kidney, Oral Cavity, Breast, Lung, And Gastrointestinal Tract?, S Qadwai, T Rehman, Jonathan Barsa, Z Solangi, Edward Lebovics

NYMC Faculty Publications

Hepatitis C virus (HCV) is known for its oncogenic potential and has been found to be associated with hepatocellular carcinoma (HCC) and non-Hodgkin lymphoma. It has also been postulated that HCV may play a role in the development of other extrahepatic solid tumors of other organs of the body since it has been isolated from the vessel wall, kidney, and oral mucosa. In this article, we have reviewed epidemiological studies that have been done to look into the relationship of HCV with nonliver solid cancers of the pancreas, thyroid, renal, oral cavity, breast, and lung and nonpancreatic gastrointestinal cancers. Based …

Hyper Ige Syndrome And Renal Cell Carcinoma, N Patel, Mark J. Ferretti, John L. Phillips

NYMC Faculty Publications

Hyper IgE Syndrome (HIES) is an immunodeficiency disorder characterized by increased serum levels of IgE, eczema, and recurrent cutaneous and pulmonary infections. In this report, we present, to our knowledge, the first documented case of renal cell carcinoma (RCC) found in a patient with HIES. The patient received infectious disease clearance prior to obtaining a partial nephrectomy which revealed clear cell histology. Both HIES and RCC have an immunological basis for their pathophysiology and may involve common pathways. Further studies may provide insight into any possible link and clinicians should be mindful of immunocompromised patients who present with risk factors …

Trends Of Revascularization In Acute Myocardial Infarction Patients With Coronary Artery Anomalies: A Nationwide Analysis Of 8,131 Patients., Neeraj Shah Md, Vratika Agarwal Md, Nainesh C. Patel Md

Department of Medicine

No abstract provided.

Thrombotic Microangiopathy Associated With Synthetic Cannabinoid Receptor Agonists, Michael Karass, Savneek Chugh, Gabriela Andries, A Mamorska-Dyga, John C. Nelson, Praveen Chander

NYMC Faculty Publications

Marijuana is one of the most commonly used recreational drugs in the United States. As marijuana is illegal in the majority of countries, the use of readily available and unregulated synthetic cannabinoids (SCBs) has increased. Little is known about the potential adverse effects of SCBs especially in regards to their nephrotoxicity. Case reports of acute kidney injury (AKI) from acute tubular injury secondary to their use have been reported. However, the exact pathology, mechanism, and extent of renal injury remain unknown. We report the first case of biopsy proven thrombotic microangiopathy (TMA) associated with SCBs resulting in AKI. The patient …

Fatal Flaw - Driveline Fracture As A Rare But Serious Complication Of Mechanical Circulatory Support With Left Ventricular Assist Devices, Yuri Boyechko, Thomas Tribble, Maya Guglin

The VAD Journal

Background: Patients with advanced heart failure have seen decreased mortality and improved quality of life due to mechanical circulatory support with left ventricular assist devices (LVAD). Regardless of such outcomes, many complications still exist and remain a significant cause of morbidity and mortality. Our purpose is to study the prevalence, clinical course, and outcomes specifically of patients with LVAD driveline (DL) fractures.

Methods: This single-center, retrospective review included all patients at our institution who had continuous flow LVADs and experienced DL fracture/injury from January 2012 - December 2015.

Results: Thirteen of 110 LVAD patients (11.8%) had DL fractures (Table 1). …

Improved Survival After Acute Graft-Versus-Host Disease Diagnosis In The Modern Era., Hanna J. Khoury, Tao Wang, Michael T. Hemmer, Daniel Couriel, Amin Alousi, Corey Cutler, Mahmoud Aljurf, Joseph H Antin, Mouhab Ayas, Minoo Battiwalla, Jean-Yves Cahn, Mitchell Cairo, Yi-Bin Chen, Robert Peter Gale, Shahrukh Hashmi, Robert J. Hayashi, Madan Jagasia, Mark Juckett, Rammurti T. Kamble, Mohamed Kharfan-Dabaja, Mark Litzow, Navneet Majhail, Alan Miller, Taiga Nishihori, Muna Qayed, Helene Schoemans, Harry C. Schouten, Gerard Socie, Jan Storek, Leo Verdonck, Ravi Vij, William A. Wood, Lolie Yu, Rodrigo Martino, Matthew Carabasi, Christopher Dandoy, Usama Gergis, Peiman Hematti, Melham Solh, Kareem Jamani, Leslie Lehmann, Bipin Savani, Kirk R. Schultz, Baldeep M. Wirk, Stephen Spellman, Mukta Arora, Joseph Pidala

Department of Medical Oncology Faculty Papers

A cute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received a sibling …

Cervical Ectropion May Be A Cause Of Desquamative Inflammatory Vaginitis., Leia Mitchell, Michelle King, Heather Brillhart, Andrew Goldstein

Obstetrics and Gynecology Faculty Publications

Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman …

A Comparative Analysis Of The West African Hemorrhagic Fevers Caused By The Lassa And Ebola Viruses, Emiene E. Amali-Adekwu

Selected Honors Theses

Lassa fever (LF) and Ebola Hemorrhagic Fever (EHF) are viral diseases endemic to West Africa.The etiological agent of Lassa fever is an enveloped virus from the Arenaviridae family and was first discovered in 1969 when two missionary nurses died of a mysterious illness in the town of Lassa in Borno state, Nigeria.1 This virus is animal-borne (zoonotic) and is carried by the animal vector Mastomys natalensis (multimammate rat). The Ebola virus is also zoonotic originating from fruit bats belonging to the Pteropodidae family.2 The first reported case of Ebola Virus Disease (EVD) was a principal who was believed to have …

Determining The Protective Effects Of Quercetin Against Cadmium Toxicity In Human Embryonic Kidney Cells, Caroline N. Smith

Undergraduate Theses

Cadmium is a toxic industrial and environmental pollutant found in groundwater, air, soils, food and cigarettes. Chronic intake of low levels of cadmium has been shown to result in renal dysfunction due to cell death which can occur via apoptosis as well as necrosis. Previous studies have shown that plant extracts containing quercetin, a flavonoid found in many fruits and vegetables, protect against cadmium toxicity in rat liver hepatocytes. To determine if quercetin may have a protective effect in a cadmium-treated human embryonic kidney cell line, HEK-293 cells were treated using concentrations of cadmium chloride from 10 to 50 μM …

The Effect Of Three Different Ankle Braces On Vertical Jump Performance In Female College Volleyball Players, Ashley M. Jefferson

Undergraduate Theses

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces.

Subjects: 31 female varsity/club college volleyball players >18 years of age.

Materials/Methods: Health History Assessment and a dynamic …

Ultrasound Monitoring Of Extant Adnexal Masses In The Era Of Type 1 And Type 2 Ovarian Cancers: Lessons Learned From Ovarian Cancer Screening Trials, Eleanor L. Ormsby, Edward J. Pavlik, John P. Mcgahan

Obstetrics and Gynecology Faculty Publications

Women that are positive for an ovarian abnormality in a clinical setting can have either a malignancy or a benign tumor with probability favoring the benign alternative. Accelerating the abnormality to surgery will result in a high number of unnecessary procedures that will place cost burdens on the individual and the health delivery system. Surveillance using serial ultrasonography is a reasonable alternative that can be used to discover if changes in the ovarian abnormality will occur that favor either a malignant or benign interpretation. Several ovarian cancer screening trials have had extensive experiences with changes in subclinical ovarian abnormalities in …

A Case Matched Study Examining The Reliability Of Using Impact To Assess Effects Of Multiple Concussions., Trevor Barker, Stephen A. Russo, Gaytri Barker, Mark A Rice, Mary G Jeffrey, Gordon Broderick, Travis J A Craddock

Department of Neurology Faculty Papers

BACKGROUND: Approximately 3.8 million sport and recreational concussions occur per year, creating a need for accurate diagnosis and management of concussions. Researchers and clinicians are exploring the potential dose-response cumulative effects of concussive injuries using computerized neuropsychological exams, however, results have been mixed and/or contradictory. This study starts with a large adolescent population and applies strict inclusion criteria to examine how previous mild traumatic brain injuries affect symptom reports and neurocognitive performance on the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) computerized tool.

METHODS: After applying exclusion criteria and case matching, 204 male and 99 female participants remained. These participants …

Low Molecular-Weight Heparin Is Better Than Warfarin For Prevention Of Recurrent Venous Thromboembolism In Cancer Patients, Sarah Choi

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lee AYY, Levin MN, Bake RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003;349:146-153. doi: 10.1056/NEJMoa025313

Systematic Analysis Of Whole Exome Sequencing Determines Ret G691s Polymorphism As Germline Variant In Melanoma, Brent J. Smith Jr, Jennifer D. Hintzsche, Carol M. Amato, Aik-Choon Tan, Keith R. Wells, Allison J. Applegate, Rita T. Gonzalez, Jodie R. Barr, William A. Robinson

Marshall Journal of Medicine

Abstract

The RET proto-oncogene encodes a receptor tyrosine kinase that is activated by glial cell derived neutrotrophic factor (GDNF). Previous studies have found that a single nucleotide polymorphism (SNP), RETp (G691S), in the juxtamembrane domain enhances the signaling pathway and promotes tumor growth by GDNF in pancreatic and thyroid cancer in addition to melanoma. It is uncertain however whether this SNP is a germline variant or somatic mutation. A prior study reported that the RETp variant was a germline SNP in desmoplastic and non-desmoplastic melanomas. In the present study, we examined both melanoma tissue samples and matching peripheral blood DNA …

Hpv Vaccination Among Females With Mental And Physical Limitation, Melissa Rowe, Audra L. Pritt, Amanda J. Stratton, Jennie L. Yoost

Marshall Journal of Medicine

Introduction

Adolescent HPV vaccination rates lag behind other vaccinations, partly due to missed opportunities for vaccination and lack of provider recommendation. This study evaluated the rates of HPV vaccination among adolescents with physical and mental limitation and controls, and evaluated differences in parental knowledge and reasons for nonvaccination between groups.

Materials and Methods

A retrospective chart review was performed on female patients age 12-18 presenting to pediatric or gynecology clinics in 2012. Those subjects with a diagnosis of mental or physical limitation were classified as “affected”. HPV vaccination rates were compared between affected and control groups. Parents of affected subjects …

Angiosarcoma Of The Lower Extremity Presenting As Bilateral Pneumothoraces, Mark H. Cooper

Marshall Journal of Medicine

Abstract

Spontaneous pneumothorax usually presents as unilateral disease. Bilateral spontaneous pneumothoraces are less common and are more likely to be secondary than primary. We describe a case of bilateral spontaneous pneumothoraces that were resistant to conventional treatment, and found ultimately to be secondary to angiosarcoma of the lower extremity. A previously well 49 year old white female was referred to our institution in London with bilateral pneumothoraces. A left video assisted thoracoscopic procedure was undertaken, and the wedge resection of the lung specimen contained an area of metastatic tumor. Talc was placed into the left pleural cavity; talc was also …

Dislodging Anchored Diagnoses: An Unusual Presentation Of Acute Appendicitis, Talal Asif, Ravali Gummi, Zara Wadood, Kristy E. Steigerwalt, Rebecca R. Pauly

Marshall Journal of Medicine

Cognitive errors are the most common cause of diagnostic errors in the process of clinical decision making. Recently, there has been an immense focus on the new science of error prevention in health care. Anchored thinking or heuristics is a form of cognitive error that portrays shortcuts or abbreviated thinking in the light of diagnostic uncertainty. The risk is of comfort in a typical scenario and not being able to adapt to a new situation. Here we present an intriguing case of acute appendicitis in a patient who was initially admitted and treated for hypothermia and alcohol withdrawal. As the …

Abms Board Certification: Improving Continuous Specialty Certification, Lois Margaret Nora

Marshall Journal of Medicine

For almost 100 years, the American Board of Medical Specialties (ABMS) and its 24 Member Boards have been entrusted with the responsibility of overseeing the process by which physicians become Board Certified and continue their certification across their careers. Continuing certification provides a framework that helps physicians keep up to date with the myriad of medical advances, to continually improve, and to objectively demonstrate their commitment to maintaining knowledge and skills to the patients, families, and communities who depend upon them. A robust and rigorous certification system is important to the profession, to individual physicians, and to patients and other …

Interprofessional Collaboration To Prevent Hospital-Acquired Pneumonia (Hap), Jessica Cooper, Amber Manning, Morgan Miller, Megan Mustard, Haleigh Pike, Suzi White

Celebration of Student Scholarship Poster Sessions Archive

No abstract provided.

Manual Trans-Tracheal High Frequency Positive Pressure Ventilation For Left Main Bronchus And Carinal Mass Surgical Resection In A Child, Mohammad Irfan Akhtar, Faisal Junejo, Hamid Iqil Naqvi, Mohammad Hamid

Department of Anaesthesia

Inflammatory myofibroblastic tumor (IMT), also called pseudo-tumor, is a very rare condition and accounts for less than 1% of primary lung tumor. It is most common benign tumor of lung in children. This case is reported with the objective of highlighting the role of manual trans-tracheal high frequency positive pressure ventilation (HFPPV) in facilitating surgical resection with maintenance of adequate oxygenation and a little compromised ventilation. A 9-year boy, weighing 21 kg, was diagnosed as a case of IMT of left main bronchus on biopsy and was successfully treated by surgical excision through left thoracotomy. HFPPV through improvised technique was …

Determinants Of Modern Contraceptive Use Among Sexually Active Men In Kenya, Rhoune Ochako, Marleen Temmerman, Mwende Mbondo, Ian Askew

Obstetrics and Gynaecology, East Africa

Background: Research in Kenya has focussed on family planning from women’s perspectives, with the aim of helping reduce the burden of unintended pregnancies. As such, the determinants of modern contraceptive use among sexually active women are well documented. However, the perspectives of men should be considered not only as women’s partners, but also as individuals with distinct reproductive histories and desires of their own. This study seeks to understand the determinants of modern contraceptive use among sexually active men, by exploring factors that are correlated with modern contraceptive use.

Methods: The data source is the nationally representative 2014 Kenya Demographic …

Decreased Body Mass Index In The Preclinical Stage Of Autosomal Dominant Alzheimer's Disease, Stephan A. Müller, Oliver Preische, Hamid R. Sohrabi, Susanne Gräber, Mathias Jucker, Janko Dietzsch, John M. Ringman, Ralph Martins, Eric M. Mcdade, Peter R. Schofield, Bernardino F. Ghetti, Martin N. Rossor, Neill R. Graff-Radford, Johannes Levin, Douglas R. Galasko, Kimberly A. Quaid, Stephen P. Salloway, Chengjie Xiong, Tammie L. Benzinger, Virginia D. Buckles, C. L. Masters, Reisa A. Sperling, Randall J. Bateman, John C. Morria, Christoph Laske

Research outputs 2014 to 2021

The relationship between body-mass index (BMI) and Alzheimeŕs disease (AD) has been extensively investigated. However, BMI alterations in preclinical individuals with autosomal dominant AD (ADAD) have not yet been investigated. We analyzed cross-sectional data from 230 asymptomatic members of families with ADAD participating in the Dominantly Inherited Alzheimer Network (DIAN) study including 120 preclinical mutation carriers (MCs) and 110 asymptomatic non-carriers (NCs). Differences in BMI and their relation with cerebral amyloid load and episodic memory as a function of estimated years to symptom onset (EYO) were analyzed. Preclinical MCs showed significantly lower BMIs compared to NCs, starting 11.2 years before …

A Ruptured Basilar Aneurysm Resulting In Takotsubo Cardiomyopathy., Ryan Murphy Do, Apurva Vyas Md, Megan Leary Md

Department of Medicine

No abstract provided.