Medical Specialties Commons^™

A Systematic Review - The Effect Of Hospice And Palliative Care, Justin M. Brown, David J. Havener, Jeffrey T. Byrne

Williams Honors College, Honors Research Projects

Many older adults nearing death experience unnecessarily invasive and costly healthcare treatments, often causing more harm than good. Hospice and palliative care interventions offer a possible solution to this problem by prioritizing high-quality and cost-effective care with a strong focus on comfort and satisfaction. The authors of this paper seek to answer the following question: Do hospice and palliative care interventions directed toward older adults at the end of life improve quality of life, cost of care, and satisfaction? This paper thoroughly reviews and critically appraises existing research related to the effect of hospice and palliative care directed toward older …

Forget-Me-Not, Daniel Barber-Cironi, Shawn Nicholson, Jake Kruse, Nicole Dent

Williams Honors College, Honors Research Projects

The purpose of Forget-Me-Not is to provide another level of care and comfort to those suffering from mild dementia, as well as provide further assistance for a friend, family member, or caretaker who may look after them. Research shows that timely reminders and persistent information can greatly improve the quality of life for those afflicted with mild dementia (Mokhtari et al.). Forget-Me-Not’s persistent display and wearable smart-bracelet offer a customizable and well connected system to provide these reminders. For the caretaker, a mobile application is provided in order to maintain the display and notify them of emergencies or critical events …

A Comparison Of Changes In Women's Cardiovascular Fitness And Body Composition After Performance In Zumba, Tabata, And Cycling, Kristi N. Kester

Williams Honors College, Honors Research Projects

Aerobic group exercise is important to prevent against cardiovascular, pulmonary, and metabolic diseases. Regular exercise can help to reduce the risk of these diseases and premature death. Group exercise classes have shown to be effective in reducing weight, blood pressure, and body composition Further research is necessary to evaluate the effectiveness of these aerobic group exercise classes to one another. PURPOSE: To evaluate and compare the potential health benefits that may occur for women who participate in regular group exercise classes at the Kohl Family YMCA. METHODS: A surrey and body measurements were taken of females enrolled an eight-week aerobic …

Mechanisms Of Hormonal Regulation Of Invasiveness And Metastasis Of Luminal Breast Cancer, Thomas Mcfall

Wayne State University Dissertations

ABSTRACT

MECHANISMS OF HORMONAL REGULATION OF INVASIVENESS AND METASTASIS OF LUMINAL BREAST CANCER

By

THOMAS MCFALL

December 2017

Advisor: Dr. Manohar Ratnam

Major: Cancer Biology

Degree: Doctor of Philosophy

Over 20% of breast cancer cases present with distal metastasis and they are predominantly of luminal subtypes. As luminal breast cancer is relatively indolent, it is believed that progression to metastasis must occur over many years, generally well into post-menopausal years. Unfortunately, very little is known about the mechanisms by which these hormone receptor positive tumors metastasize, likely in part due to their slow metastatic rates in animal model systems as …

Functional Analysis Of Rad6 In Brca1 Wild Type And Brca1 Mutant Triple Negative Breast Cancer Drug Response, Brittany Haynes

Wayne State University Dissertations

TNBCs account for 15-20% of all breast and are unsuitable for common targeted therapies as they lack expression of estrogen, progesterone, and Her2/neu receptors. Cisplatin, a DNA damaging agent, is currently under clinical investigation for treatment of TNBCs and paclitaxel, a mitotic spindle poison, is a first-line treatment option for this disease. While both agents elicit therapeutic benefit BRCA1 mutation status, toxicity, and resistance are limiting factors. Rad6 functions as an E2 ubiquitin conjugating protein and its enzymatic activity is critical for its cellular function. Rad6 is known to play a critical role in the translesion synthesis (TLS) damage response …

Introduction Of Peanuts To The Pediatric Patient, Leslee Graff

Physician Assistant Scholarly Project Posters

Peanut allergies have been diagnosed exponentially over the last ten-years and are more severe now than ever before. (DuToit et al. 2106) Some of the latest statistics are citing more than double the amount of peanut allergies diagnosed in the last few years. Guidelines set forth in 2010, by the American Academy of Allergy, Asthma, and Immunology stated that peanut, milk, soy, wheat, egg, and other tree nuts were to be avoided until three years of age, unless these patients have other chronic illnesses such as asthma or other atopic conditions. If so, the patient is to abstain from these …

Use Of Mesenchymal Stem Cells For The Treatment Of Osteoarthritis, Dennis W. Stewart

Physician Assistant Scholarly Project Posters

• Healthy articular cartilage protects and provides smooth functioning of the joint. The deterioration of the articular cartilage leads to the crippling disease known as osteoarthritis (OA).

• OA is a leading cause of disability in the United States. Although some of the current treatment modalities, along with pharmacological treatment, may offer short term improvement with pain and function, they do not offer long term relief, and are ineffective in preventing the progression of OA.

• In advanced stages, surgery in the form of total knee arthroplasty (TKA), is sometimes needed. This is an invasive procedure and typically requires hospitalization. …

Effectiveness Of Different Styles Of Diabetic Education On Outcomes Of The Type Ii Diabetic Patient, Emil Trutwin

Physician Assistant Scholarly Project Posters

•The purpose of this project is to determine if there is a significant advantage to certain diabetic education strategies that yield better outcomes in regards to control of diabetes.

Prenatal Screening For Aneuploidy: Should Cfdna Replace Traditional Methods?, Rachel Watson

Physician Assistant Scholarly Project Posters

In 2011, advances in research in medical genetics led to the advent of prenatal cell-free DNA (cfDNA) or also known simply as non-invasive prenatal screening or testing (NIPS). This screen consists of analyzation of placental DNA circulating in maternal blood. NIPS has had a major impact on prenatal screening for aneuploidy. Mixed opinions and data exist as to whom this test is most appropriate for. The sensitivity and specificity of this screen in detecting common fetal aneuploidies has been well documented as superior to other screens in high-risk populations, but less so in low-risk obstetric populations. This paper will compare …

Identifying Cognitive And Postural Deficits Through Re-Baseline Evaluations, Brian J. Mizeski

College of Graduate Studies: Theses & Dissertations

Introduction: Baseline evaluations provide vital information for clinicians, as they are a representation of an athlete’s healthy clinical state. It has been recommended when an athlete sustain a concussion, they be administered a re-baseline evaluation, as the effects of a single concussion are not well documented. Limited literature was found which examines re-baseline examinations following a concussion. Purpose: The purpose of this study was to evaluate cognitive and postural deficits, in athletes who sustained a concussion, at the conclusion of the athletic season. Methods: 38 concussed athletes (CONC) were matched on sport and gender with 38 healthy …

Student-Athletes' Knowledge Of Athletic Trainers' Scope Of Practice, Jessica Pearson

College of Graduate Studies: Theses & Dissertations

Context: As a member of the sports medicine team, athletic trainers serve athletes through injury prevention, evaluation, and rehabilitation. While it is imperative for members of the sports medicine team to have knowledge of scope of practice of athletic trainers, it may also be important for athletes as well, so that the athletic trainers can be properly utilized by all parties. Although previous research has been completed on how athletes’ sport profile and satisfaction of care relate, no previous studies were identified that assessed athletes’ knowledge of athletic trainers’ scope of practice.

Objective: Determine student-athletes’ knowledge of athletic …

Type 2 Immune Responses In The Context Of Helminth Infection, Asthma, Dendritic Cells, And Myeloid Derived Suppressor Cell Function, Sheela Ruby Damle

Theses and Dissertations

Type 2 (T_H2) immune responses evolved to respond to helminth parasite infections by the production of T_H2 cytokines, which stimulate anti-helminth immunity. Macrophage migration inhibitor factor (MIF) is a pleiotropic cytokine, which is produced by many cell types. We demonstrate that mice deficient in MIF have enhanced clearance of a helminth parasite. MIF deficiency in CD4⁺ T cells was found to be the most important for mediating parasite clearance. We mimicked MIF deficiency by administering an inhibitor of the MIF tautomerase activity, sulforaphane, and this also increased parasite clearance (Section I).

T_H2 immune …

Posthurricane Environment's Impact On Childhood Cancer Rates In Louisiana, 2004-2010, Lenora M. Robinson

Walden Dissertations and Doctoral Studies

Childhood cancer is the second leading cause of death in children aged 0-19 years. Research efforts to identify factors associated with or influencing this growing health problem are limited. The purpose of this research study was to examine, in reference to Louisiana during the period 2004-2010, the annual number of children diagnosed with cancer; the types of cancers; the possible effects of the environmental aftermath resulting from Hurricanes Katrina, Rita, and Gustav; and any correlation between environmental contaminants following these hurricanes with the number of children diagnosed with cancer. This study employed correlational quantitative methodology using archival data from the …

Eeg Slow Waves In Traumatic Brain Injury: Convergent Findings In Mouse And Man, Mo H. Modarres, Nicholas N. Kuzma, Tracy Kretzmer, Allan I. Pack, Miranda M. Lim

Physics Faculty Publications and Presentations

OBJECTIVE: Evidence from previous studies suggests that greater sleep pressure, in the form of EEG-based slow waves, accumulates in specific brain regions that are more active during prior waking experience. We sought to quantify the number and coherence of EEG slow waves in subjects with mild traumatic brain injury (mTBI).

METHODS: We developed a method to automatically detect individual slow waves in each EEG channel, and validated this method using simulated EEG data. We then used this method to quantify EEG-based slow waves during sleep and wake states in both mouse and human subjects with mTBI. A modified coherence index …

Measuring The Effects Of Therapeutic Listening - Quickshifts, Hannah Tashjian, Phoebe Taasan, Donielle Hair

Student Research Posters

This study examines a structured protocol to measure the effects of daily individualized use of Therapeutic Listening - Quickshifts (TL-Q) used to improve occupational performance in children with learning and developmental disabilities. The study identifies a standardized practice-based evidence procedure to measure the outcomes of implementing TL-Q within traditional OT practice. OTs worldwide are using sound-based therapies (SBTs) despite limited supporting evidence available regarding the productivity of these interventions. Even fewer studies have been published on the effects of Therapeutic Listening (TL), a novel intervention shown to increase personal and interpersonal skills including sensory processing skills, visual motor integration, and …

Healthy Aging Website: Providing Online Occupation Based Information, Haley Caruthers, Samantha Talavera, Stephanie Vera, Jackeline Ulloa

Student Research Posters

Older adults (OAs) over the age of 65 are the fastest growing age group in the United States. They are also the fastest growing population of Internet users as they use the Internet to access health information related to optimizing independence, productivity, and social engagement. Although there is an abundant amount of information available that is devoted to healthy aging, the validity of the information can be questionable and the information may be confusing.

Dominican University of California’s (DUC) Healthy Aging website contains relevant and evidence-based research, including activities and local community based programs that promote healthy aging. To expand …

Journey From Black To Pink Gums: Management Of Melanin Induced Physiological Gingival Hyper Pigmentation, Huma Farid, Muhammad Saad Shinwari, Farhan Raza Khan, Farzin Tanwir

Department of Surgery Docs

Abstract

Smile is an expression of happiness, self-confidence, kindness and beauty. Along with teeth and lips, gingiva is also a vital component of smile. Melanin induced gingival hyper pigmentation may appear un-aesthetic especially when it is associated with high smile line, upper anterior labial segment and is uneven in appearance. It affects individuals from all races. Generally, it is believed that melanin induced gingival hyper pigmentation is confined to individuals from dark races. But studies have shown that Iranian, Indian, Italian, Arabian, Greek. German, French, Japanese, Chinese, Jewish, Thai, Malaysian and other ethnic groups also display clinical gingival pigmentation.1 Gingival …

Readiness For Antimicrobial Resistance (Amr) Surveillance In Pakistan; A Model For Laboratory Strengthening, Dania Khalid Saeed, Rumina Hasan, Mahwish Naim, Afia Zafar, Erum Khan, Kauser Jabeen, Seema Irfan, Imran Ahmed Haq, Mohammad Zeeshan, Zabin Wajidali, Joveria Farooqi, Sadia Shakoor, Abdul Chagla, Jason Roy

Department of Pathology and Laboratory Medicine

Background: Limited capacity of laboratories for antimicrobial susceptibility testing (AST) presents a critical diagnostic bottleneck in resource limited countries. This paper aims to identify such gaps and to explore whether laboratory networks could contribute towards improving AST in low resource settings.
Methods: A self-assessment tool to assess antimicrobial susceptibility testing capacity was administered as a pre-workshop activity to participants from 30 microbiology laboratories in 3 cities in Pakistan. Data from public and private laboratories was analyzed and capacity of each scored in percentage terms. Laboratories from Karachi were invited to join a support network. A cohort of five laboratories that …

Phenotypic Low-Level Isoniazid Resistance As A Marker To Predict Ethionamide Resistance In Mycobacterium Tuberculosis, Salima Qamar, Joveria Q. Farooqi, Kausar Jabeen, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: Tuberculosis is one of the most prevalent diseases in Pakistan. Pakistan has the highest burden of MDR-TB in the Eastern Mediterranean region. Ethionamide is an anti-tuberculous drug frequently used to treat MDR-TB. Its drug susceptibility testing is not easily available in resource limited settings. Since it acts on the same target protein as isoniazid (inhA protein encoded by inhA gene), we sought to find out if phenotypic isoniazid resistance can be a marker of ethionamide resistance.
Materials and Methods: This was a retrospective observational study conducted at the Aga Khan University hospital section of microbiology. Data was retrieved between …

Utility Of Peripheral Film Findings And Its Correlation With Automated Analyzer - An Audit From Tertiary Care Hospital, Sidra Asad, Imran Ahmed, Natasha Ali

Department of Pathology and Laboratory Medicine

Background and Objective: With the advent of automated hematology analyzer, the use of traditional microscopy of blood film has become limited. The objective of our study was to determine the percentage of peripheral blood smear review in our institution in the era of automation and to identify reasons of manual review.
Materials and Methods: This was a prospective audit from January 1, 2015, to January 15, 2015. Consecutive complete blood count (CBC) samples and peripheral smear requests made up the sample size. All age groups and genders were included. CBCs were performed on Sysmex XE-5000. The variables to be analyzed …

Papillary Craniopharyngioma: A Clinicopathologic Study Of A Rare Entity From A Major Tertiary Care Center In Pakistan, Muhammad Usman Tariq, Nasir Ud Din, Zubair Ahmad, Wasim Memon

Department of Pathology and Laboratory Medicine

Background: Papillary craniopharyngioma (PCP) are uncommon variants of craniopharyngiomas (CP), which are benign epithelial neoplasms of the sellar and suprasellar region. Histologically, PCPs are typically composed of well-differentiated stratified squamous epithelium; however, focal variations are not uncommon. A distinction from other lesions of the region, despite being difficult to achieve due to the overlapping radiological and clinical features, is important for adequate treatment to be administered.
Objective: Our aim was to study the clinical and histological features of PCP with emphasis on features that are helpful in its distinction from other lesions that are similar in appearance.
Materials and Methods: …

Rapid Detection Of In Vitro Antituberculous Drug Resistance Among Smear-Positive Respiratory Samples Using Microcolony Detection-Based Direct Drug Susceptibility Testing Method, Irim Iftikhar, Seema Irfan, Joveria Farooqi, Zahida Azizullah, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: With the rise in multidrug-resistant tuberculosis, there is a search for newer techniques that will rapidly detect drug-resistant Mycobacterium tuberculosis. Although molecular techniques can detect resistance, culture is still considered gold standard, especially in resource-limited settings where quick, cheap, and easy techniques are needed. The aim of the study was to evaluate microcolony method thin layer agar (TLA) for quick detection of resistance against the first- and second-line antituberculous drugs in clinical isolates. This was a cross-sectional study performed at Aga Khan University Hospital.
Material and Methods: A total of 87 Z-N stain smear-positive pulmonary samples were received and …

Can Contrast Harmonic Endoscopic Ultrasonography Replace Endoscopic Ultrasonography-Guided Fine-Needle Aspiration In Patients With Solid Pancreatic Lesions? An American Perspective., Joseph Yoo, Linda H. Yan, Ali A. Siddiqui

Division of Internal Medicine Faculty Papers & Presentations

No abstract provided.

Properties And Optimization Of Respiratory Navigator Gating For Spiral Cine Dense Cardiac Mri, Sean Michael Hamlet

Theses and Dissertations--Electrical and Computer Engineering

Cardiac magnetic resonance (MR) imaging can non-invasively assess heart function. Displacement encoding with stimulated echoes (DENSE) is an advanced cardiac MR imaging technique that measures tissue displacement and can be used to quantify cardiac mechanics (e.g. strain and torsion). When combined with clinical risk factors, cardiac mechanics have been shown to be better predictors of mortality than traditional measures of heart function.

End-expiratory breath-holds are typically used to minimize respiratory motion artifacts. Unfortunately, requiring subjects to breath-hold introduces limitations with the duration of image acquisition and quality of data acquired, especially in patients with limited ability to hold their breath. …

Ultrasound Shear Wave Elastography And Liver Fibrosis: A Prospective Multicenter Study, Joyce Sande, Suleman Verjee, Sudhir Vinayak, Farin Amersi, Munir Ghesani

Imaging & Diagnostic Radiology, East Africa

Aim: To assess the accuracy of shear wave elastography (SWE) alone and in combination with aminotransferase platelet ratio index (APRI) score in the staging of liver fibrosis.

Methods: A multicenter prospective study was conducted to assess the accuracy of SWE (medians) and APRI to predict biopsy results. The analysis focused on distinguishing the different stages of liver disease, namely, F0 from F1-4, F0-1 from F2-4, F0-2 from F3-4 and F0-3 from F4; F0-F1 from F2-F4 being of primary interest. The area under the receiver operating characteristic (AUROC) curve was computed using logistic regression model. The role of age, gender and …

Training Midwives To Perform Basic Obstetric Point-Of-Care Ultrasound In Rural Areas Using A Tablet Platform And Mobile Phone Transmission Technology—A Wfumb Coe Project, Sudhir Vinayak, Joyce Sande, Harvey Nisenbaum, Christian Pállson Nolsøe

Imaging & Diagnostic Radiology, East Africa

Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, …

Antenatal Umbilical Coiling Index And Newborn Outcomes: Cohort Study, Josephine Mwikali Ndolo, Sudhir Vinayak, Micah Ominde, William Stones

Imaging & Diagnostic Radiology, East Africa

Objectives: We aimed to test the predictive value of antenatal umbilical coiling index (aUCI) among a prospectively recruited cohort of antenatal women.

Methods: Women with singleton pregnancies were recruited at their second‑trimester scan. Images of the umbilical cord were used to calculate the aUCI. Pregnancy and birth outcomes were recorded and statistical associations between aUCI and small for gestational age (SGA) using international standard birth weight centiles and preterm birth were investigated (n = 430).

Results: aUCI results were consistent with the literature and showed good reproducibility between observers. Abnormal aUCI was not associated with SGA, but there was a …

Hematuria Without Microalbuminuria, Angela Ferguson, Vimal Chadha, Amy Wiebold, Uttam Garg

Posters

Background

Microabubiminuria is a condition in which small amounts of albumin are excreted in the urine without overt nephropathy. Based on the

American Diabetic Association classification, microalbuminuria is defined as urinary excretion of albumin of 30–300 mg per 24 hours or 20–200 mcg/min or 30–300 mcg/mg creatinine. Various conditions such as diabetes, hypertension, and impaired renal tubular reabsorption can lead to microalbuminuria. Microalbuminuria is an indicator and predictor of the development of overt nephropathy. If identified and treated early, overt nephropathy can be prevented and averted. Proteinuria and hematuria are the two most common urinary abnormalities encountered during routine urinalysis. …

Global Health Elective: Swaziland, Africa, Jane Duong

Posters

Describes her learning experience providing care with the Baylor International Pediatric AIDS Initiative (BIPAI) in September 2017.

Epidemiological Investigation Of Candida Species Causing Bloodstream Infection In Pediatric Small Bowel Transplant Recipients, Mallory J. Suhr, João Carlos Gomes-Neto, Nabaraj Banjara, Diana F. Florescu, David F. Mercer, Peter C. Iwen, Heather E. Hallen-Adams

Department of Food Science and Technology: Faculty Publications

Small bowel transplantation (SBT) can be a life-saving medical procedure. However, these recipients experience high risk of bloodstream infections caused by Candida. This research aims to characterize the SBT recipient gut microbiota over time following transplantation and investigate the epidemiology of candidemia in seven pediatric patients. Candida species from the recipients’ ileum and bloodstream were identified by internal transcribed spacer sequence and distinguished to strain by multilocus sequence typing and randomly amplified polymorphic DNA. Antifungal susceptibility of bloodstream isolates was determined against nine antifungals. Twenty-two ileostomy samples harbored at least one Candida species. Fungemia were caused by Candida parapsilosis …