Medical Specialties Commons^™

Cell Free Dna As A Marker Of Training Status In Weightlifters, Jeremy A. Gentles, William G. Hornsby, Christine L. Coniglio, Andy R. Dotterweich, Jon A. Miller, Charles A. Stuart, Michael H. Stone

ETSU Faculty Works

The purpose of this investigation was to elucidate the changes in cf-DNA as it relates to fluctuations in resistance training workloads and intensities. The relationship between cell free DNA (cf-DNA), C-reactive protein (CRP), creatine kinase (CK), testosterone (T), cortisol (C), testosterone-cortisol ratio (T:C), body mass and body composition were also examined. Eight weightlifters (5 males and 3 females, age = 25 ± 3.5 yr, body mass = 88.3 ± 22.7 kg, height = 173.8 ±8.4 cm) volunteered to participate in this study. Venous blood samples, body mass and body composition were taken six times, each corresponding to the end of …

Assessing Survival And Grading The Severity Of Complications In Octogenarians Undergoing Pulmonary Lobectomy., Andrew Feczko, Elizabeth Mckeown, Jennifer L Wilson, Brian E Louie, Ralph W Aye, Jed A Gorden, Eric Vallières, Alexander S Farivar

Articles, Abstracts, and Reports

No abstract provided.

Histopathology And Enhanced Detection Of Tumor Invasion Of Peritoneal Membranes., Jey-Hsin Chen, Melissa Borges

Articles, Abstracts, and Reports

Tumor invasion of the peritoneal membrane may have an adverse prognostic significance, but its histopathologic features can be diagnostically difficult to recognize. We observed that local peritoneal injury associated with tumor invasion is characterized by activation and proliferation of serosal stromal cells that express cytokeratin, a characteristic property of injured serosal membranes that may have diagnostic utility. To explore this, we examined 120 primary tumors of the gastrointestinal tract and pancreaticobiliary system using cytokeratin and elastic stains to assess for tumor invasion of peritoneal membranes. Peritoneal invasion by tumor was associated with retraction, splaying, and destruction of the elastic lamina …

Extracorporeal Membrane Oxygenation With Multiple-Organ Failure: Can Molecular Adsorbent Recirculating System Therapy Improve Survival?, Bailey E. Sparks, Nicholas C. Cavarocchi, Hitoshi Hirose

Department of Surgery Faculty Papers

BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO.

METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter). Of these patients, 14 underwent MARS treatment (Group M), and 14 were supported with …

Concussion Policy Development At The Ymca Of Missoula, Keith Forkin

Graduate Student Theses, Dissertations, & Professional Papers

This professional paper addresses the implementation of concussion policy for the YMCA of Missoula. Specifically, evaluating concussion policy throughout the United States and determining key aspects of implementation. Evaluating the role of all people who that are influenced by concussion policy is imperative to developing a sound policy. Athletes, parents, coaches and health care providers each play essential roles when considering the effectiveness of policy implementation. While exploring varying concussion policies and research, this professional paper recognizes each of these essential aspects and incorporates them into the final Concussion Policy by the YMCA of Missoula.

Predictors Of Modern Contraceptive Usage Among Women In Rural Pakistan: Physical Access To Services Stills A Major Barrier, Sumera Aziz Ali, Zafar Fatmi

Community Health Sciences

Background: The predictors of contraceptive use may vary in urban and rural areas. Studies have largely focused on the factors predicting contraceptive usage in urban areas. We studied the predictors of contraceptives in one of the rural districts of Pakistan.
Methods: A nested case-control design was used on The Global Network’s Maternal Newborn Health Registry (MNHR) in district Thatta Pakistan between June 2011 to July 2012. Pregnant women before their index pregnancy, who did not use (n = 200 cases) and those used any modern contraceptive method (n = 600 controls), were compared. Logistic regression was used to as certain …

New Leadership Model For Family Physicians In The Eastern Mediterranean Region: A Pilot Study Across Selected Countries, Salman Rawaf, Waris Qidwai, Tam Khoja, Kashmira Nanji, Ny Kurashi, F Alnasir, Ma Al Shafaee, M Al Shetti, M Bashir, Nes Saad, S Alkaisi, W Halasa, H Al-Duwaisan, A Al-Ali, Tm Farahat, M Tarawneh, A Khathami, A Abutiheen, Iqbal Azam Syed, A Swaka

Department of Family Medicine

Background: Family Medicine is growing rapidly across the Eastern Mediterranean Region. However, it needs support in terms of overall health system development. This will require strong leadership in family medicine to implement the change required to improve current conditions.

Objective: To collect data that will support the development of a leadership program for the future family physicians in the region.

Methods: A cross-sectional study was conducted from July 2016 to September 2016 in eight countries of the Eastern Mediterranean Region, (Bahrain, Egypt, Iraq, Jordan, Kuwait, Qatar, Pakistan, and Saudi Arabia). These countries were selected to obtain perceptions …

Role Of Assessment For Retreatment With Transarterial Chemoembolization Score In Decision Of Retreatment With Trans-Arterial Chemo-Embolization Sessions In Patients With Hepatocellular Carcinoma, Anwar Hussain Abbasi, Shahab Abid, Tanveer Ul Haq, Safia Awan

Department of Family Medicine

Background: The objective behind this study was to determine that Assessment for Retreatment with Transarterial chemoembolization (ART) score is really applicable in patients with hepatocellular carcinoma.
Methods: A cross sectional observational study was conducted on all patients with hepatocellular carcinoma of intermediate stage and undergone ≥2 Transarterial chemoembolization. ART score was assessed before and after each session of Transarterial chemoembolization. Multi-logistic regression analysis was performed to compare the final outcome of patients with ART score of ≥2.5 into groups with two and more than two Trans-arterial chemo-embolization sessions.
Results: A total of 100 HCC patients were recruited for final analysis. …

The Impact Of Sglt2 Inhibitors, Compared With Insulin, On Diabetic Bone Disease In A Mouse Model Of Type 1 Diabetes, Kathryn M. Thrailkill, Jeffry S. Nyman, R. Clay Bunn, Sasidhar Uppuganti, Katherine L. Thompson, Charles K. Lumpkin, Evangelia Kalaitzoglou, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Skeletal co-morbidities in type 1 diabetes include an increased risk for fracture and delayed fracture healing, which are intertwined with disease duration and the presence of other diabetic complications. As such, chronic hyperglycemia is undoubtedly a major contributor to these outcomes, despite standard insulin-replacement therapy. Therefore, using the streptozotocin (STZ)-induced model of hypoinsulinemic hyperglycemia in DBA/2J male mice, we compared the effects of two glucose lowering therapies on the fracture resistance of bone and markers of bone turnover. Twelve week-old diabetic (DM) mice were treated for 9 weeks with: 1) oral canagliflozin (CANA, dose range ~10-16 mg/kg/day), an inhibitor of …

Anti-Proliferative Role Of Recombinant Lethal Toxin Of Bacillus Anthracis On Primary Mammary Ductal Carcinoma Cells Revealing Its Therapeutic Potential, Rekha Khandia, Bramhadev Pattnaik, Katherikamem Rajukumar, Atul Pateriya, Sandeep Bhatia, Harshad Murugkar, Anil Prakash, Hare Krishna Pradhan, Kildeep Dhama, Ashol Munjal, Sunil K. Joshi

Bioelectrics Publications

Bacillus anthracis secretes three secretary proteins; lethal factor (LF), protective antigen (PA) and edema factor (EF). The LF has ability to check proliferation of mammary tumors, chiefly depending on mitogen activated protein kinase (MAPK) signaling pathway. Evaluation of therapeutic potential of recombinant LF (rLF), recombinant PA (rPA) and lethal toxin (rLF + rPA = LeTx) on the primary mammary ductal carcinoma cells revealed significant (p < 0.01) reduction in proliferation of tumor cells with mean inhibition indices of 28.0 ±1.37% and 19.6 ± 1.47% respectively. However, treatment with rPA alone had no significant anti-proliferative effect as evident by low mean inhibition index of 3.4 ± 3.87%. The higher inhibition index observed for rLF alone as compared to LeTx is contrary to the existing knowledge on LF, which explains the requirement of PA dependent endocytosis for its enzymatic activity. Therefore, the plausible existence of PA independent mode of action of LF including direct receptor mediated endocytosis or modulation of signal transduction cascade via unknown means is hypothesized. In silico protein docking analysis of other cellular receptors for any plausibility to play the role of receptor for LF revealed c-Met receptor showing strongest affinity for LF (H bond = 19; Free energy = …

Teaching The Emergency Department Patient Experience: Needs Assessment From The Cord-Em Task Force., Kory S. London, Jeffrey Druck, Matthew Silver, Douglas Finefrock

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Since the creation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction (PS) scores, patient experience (PE) has become a metric that can profoundly affect the fiscal balance of hospital systems, reputation of entire departments and welfare of individual physicians. While government and hospital mandates demonstrate the prominence of PE as a quality measure, no such mandate exists for its education. The objective of this study was to determine the education and evaluation landscape for PE in categorical emergency medicine (EM) residencies.

METHODS: This was a prospective survey analysis of the Council of Emergency Medicine Residency …

Design And Challenges Of A Randomized Clinical Trial Of Medical Expulsive Therapy (Tamsulosin) For Urolithiasis In The Emergency Department., Pamela K. Burrows, Judd E. Hollander, Allan B. Wolfson, Michael C. Kurz, Lorna Richards, Sara Difiore, Phillip Watts, Nivedita Patkar, Jeremy Brown, Stephen Jackman, Ziya Kirkali, John W. Kusek, Chloe Michel, Andrew C. Meltzer

Department of Emergency Medicine Faculty Papers

Urolithiasis or urinary stone disease has been estimated to affect about 1 in 11 Americans. Patients with urinary stone disease commonly present to the emergency department for management of their acute pain. In addition to providing analgesia, administration of drug (medical expulsive therapy) is often prescribed to assist passage of the urinary stone. In this methodology paper, we describe the design of a prospective, multi-center, randomized, double-blind placebo controlled clinical trial of the alpha-adrenergic blocker, tamsulosin, to evaluate its effectiveness as medical expulsive therapy. In addition, we describe the unique challenges of conducting a trial of this type within the …

Randomized Trial Of Two Doses Of Vitamin D3 In Preterm Infants <32 Weeks: Dose Impact On Achieving Desired Serum 25(Oh)D3 In A Nicu Population., Ann Anderson-Berry, Melissa Thoene, Julie Wagner, Elizabeth Lyden, Glenville Jones, Martin Kaufmann, Matthew Van Ormer, Corrine K. Hanson

Journal Articles: Pediatrics

BACKGROUND: Recommendations for vitamin D supplementation for preterm infants span a wide range of doses. Response to vitamin D supplementation and impact on outcomes in preterm infants is not well understood.

OBJECTIVE: Evaluate serum 25(OH)D3 concentration changes after 4 weeks in response to two different doses of vitamin D3 supplementation in a population of premature infants and quantify the impact on NICU outcomes.

DESIGN: 32 infants born at 24-32 weeks gestation were prospectively randomized to receive 400 or 800 IU/day vitamin D3 supplementation. Serum 25(OH)D3 levels were measured every 4 weeks. The Wilcoxon signed rank test was used to compare …

Practical Guide And Atlas For The Diagnosis Of Fungal Infections, Afia Zafar, Kauser Jabeen, Joveria Farooqi

Books

Laboratory diagnosis of fungal infections remains challenging in South East Asia as it is a neglected field in most diagnostic centres in the developing world. Initial microscopic examination of clinical specimens for the presence of fungal elements followed by growth and eventual identification of isolates up to genus and species levels are very basic and important services that must be provided by any clinical microbiology laboratory. These services have considerable impact on selection of appropriate antifungal therapy and ultimate reduction in morbidity and mortality. With the realisation of scarcity of this service and expertise in Pakistan, our group decided to …

A Comparison Of Sex Differences In Psychotropic Medication Use In Older People With Alzheimer's Disease In The Us And Finland, Daniela C. Moga, Heidi Taipale, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Qishan Wu, Gregory A. Jicha, Danijela Gnjidic

Pharmacy Practice and Science Faculty Publications

Aims—Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer’s disease (AD) living in the US and Finland.

Methods—We used data collected between 2005 and 2011 as part of the National Alzheimer’s Coordinating Center (NACC) in the US, and Medication use and Alzheimer’s disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable …

Association Between School Performance And Body Mass Index, Megan Rajagopal, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

The purpose of this paper is to determine the relationship between grade point average and other factors, including: body mass index, exercise habits, and weight perception. Data from School-Based Health Promotion Centers (SBHC) were used for this study. Students in sixth, seventh, and eighth grades were screened at the SBHC for a variety of behaviors and lifestyle characteristics using the Perkins Adolescent Risk Screen (PARS). Data from a total 579 students (281 males and 298 females; 278 sixth graders, 151 seventh graders, and 150 eight graders) were obtained. Of these students, 145 were underweight, with a BMI less than 18.5; …

Swaziland: A Journey Into Culture And Health Care, Claire Hickey

Posters

Describes a global health learning experience with Baylor International Pediatrics AIDS Initiative in Swaziland in 2017.

Sanibonani! A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Angie Schmidt

Posters

Describes a global health learning experience with the Baylor International Pediatric AIDS Initiative in Swaziland.

Unconditional Government Cash Transfer In Support Of Orphaned And Vulnerable Adolescents In Western Kenya: Is There An Association With Psychological Wellbeing?, Sylvia Shangani, Don Operario, Becky Genberg, Kipruto Kirwa, Miriam Midoun, Lukoye Atwoli, David Ayuku, Omar Galárraga, Paula Braitstein

Community & Environmental Health Faculty Publications

Background

Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA.

Objective

Among OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.

Methods

We examined the likelihood of depression, anxiety, post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 …

Concussion Knowledge Of Missoula Youth Hockey Participants And Their Parents, Samantha Riordan

Graduate Student Theses, Dissertations, & Professional Papers

Abstract:

Background: The Dylan Steigers Protection of Youth Athletes Act (DSPYAA) was passed by Montana legislature in 2013 which calls for mandatory concussion education of coaches, parents, and athletes. This law only applies to school sponsored sports, excluding those involved in youth sports organizations (YSO), such as youth hockey.

Hypothesis: Participating youth athletes and parents will not be able to identify signs and symptoms of a concussion and will not be able to identify future consequences of a poorly managed concussion.

Study Design: Cross sectional survey. Level of Evidence: Level 4

Methods: A descriptive questionnaire, Concussion Knowledge in Youth Sports …

Comparison Of A Head Mounted Impact Measurement Device To The Hybrid Iii Anthropomorphic Testing Device In A Controlled Laboratory Setting, Eric Schussler, David Stark, John H. Bolte, Yun Seok Kang, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete’s helmet or directly on the athlete’s head.

Purpose: The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by …

Successful Resection Of Lymphangioma Of The Neck And Mediastinum Presenting As Stridor In A 12 Year Old Child, Babar Irfan, Maha Tahir, Omar Irfan, Hamza Abdur Rahim Khan, Saulat H. Fatimi

Department of Surgery Docs

Lymphangiomas are congenital malformations of lymphatic tissue. This benign condition is generally found in the neck region and is discovered by 2 years of age. Here we report the case of a 12 year old child who presented with a cervical and mediastinal cystic hygroma that had progressed to such a space occupying nature as to cause the shifting of the trachea. The entire mass was successfully resected with a lower neck incision. Our case suggests the necessity of considering cystic lymphangioma in the differential diagnosis of lateral neck masses and use of adequate imaging to substantiate the preoperative diagnosis.

Fellows And Chiefs, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Residents, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Letter From The Chief Of The Division Of Physical Therapy, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Elbow Injuries In The Throwing Athlete: A Review, Drew K. Newhoff

UNM Orthopaedic Research Journal

Overhand-throwing motions can create supraphysiologic stresses on the elbow. Repeated stresses often result in overuse injuries affecting the elbow, which are commonly seen in throwing athletes. Noted problems include medial epicondylitis, valgus extension overload, olecranon stress fractures, ulnar neuritis, and damage to the ulnar collateral ligament. Symptoms of pain or numbness at presentation vary in location depending on the injury. Successful diagnosis is typically made using results of physical examinations of elbow, wrist, and arm extensions; results of tests for valgus instability; and findings radiographs can all help indicate the problem. However, pathological features of these injuries are not always …

Current Issues In Treatment Of Anterior Shoulder Instability: A Review, Ian Power

UNM Orthopaedic Research Journal

Anterior shoulder instability can be problematic in the young, active population, particularly in athletes and military personnel. The shoulder joint is the most frequently dislocated joint, and there is a high rate of dislocation recurrence in younger patients. The stability of the glenohumeral joint is conferred through the bony anatomy and the static and dynamic stabilizers. Recognizing pathological features, identifying glenoid bone loss, and detecting Bankart and Hill-Sachs lesions are key to formulating an appropriate treatment strategy and improving surgical outcomes. Furthermore, the concept of critical bone loss has been refined by looking at subcritical loss. Recent evidence has shown …

Understanding Radiocarpal Rotation Through In Vivo Pronation And Supination Of The Hand: A Single Case Study, Jorge L. Orbay, Joshua M. Romero, Neal Wostbrock, Deana M. Mercer

UNM Orthopaedic Research Journal

Background: Studies have not clearly defined the motion of the distal radius in relation to the carpus in vivo. We hypothesized that 1) with the hand fixed by grasping a handle to prevent hand and wrist motion, the resulting load in torsion generated by extrinsic muscle in vivo would create motion at the radiocarpal joint; and 2) the motion measured will be between the distal radius and the proximal row of the carpus.

Methods: The data was acquired from the senior author external to our institution; in the current study, we quantify the resulting radiocarpal motion. A K-wire was placed …

Transhumeral Amputation For Treating Necrotizing Fasciitis Infection Of The Upper Extremity: Report Of Two Cases, Drew K. Newhoff, Amber L. Price, Christina Salas, Deana M. Mercer

UNM Orthopaedic Research Journal

Necrotizing fasciitis, an infection of the skin and subcutaneous tissue, can spread rapidly. Studies have emphasized the importance of prompt surgical intervention with aggressive debridement of diseased tissue; however, mortality rates are high despite immediate treatment. We describe two men, aged 44 years (case 1) and 74 years (case 2), presenting with necrotizing fasciitis who underwent aggressive surgical intervention, multiple debridements, and eventual transhumeral amputation of the upper extremity. In each case, the patients were discharged from the hospital to their homes on amoxicillin-clavulanate at postoperative days 15 (case 1) and 32 (case 2). Findings of laboratory studies had normalized. …