Medical Specialties Commons^™

Aggressive Diuresis And Severity-Adjusted Length Of Hospital Stay In Acute Congestive Heart Failure Patients, Muhammad U. Butt

Theses and Dissertations--Clinical Research Design

To see if aggressive diuresis in first twenty four hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. > 2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in …

Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis Associated With Zonisamide, Karina L. Vivar, Kimberly Mancl, Lucia Seminario-Vidal

Dermatology & Cutaneous Surgery Faculty Publications

No abstract provided.

2018 Peter Morgane Student Research Fellowship Recipients, University Of New England College Of Osteopathic Medicine

Peter Morgane Research Fellowships

2018 recipients of the University of New England College of Osteopathic Medicine's Peter Morgane Research Fellowship.

Prognostic Value Of 1p/19q Chromosomal Codeletion In Patients With Oligodendroglioma, Altaf Ali Laghari, Muhammad Usman Khalid, Namra Qadeer, Muhammad Shahzad Shamim

Section of Neurosurgery

Oligodendrogliomas are common intra-axial primary brain tumours, and carry special significance due to several key features, which when present provide better prognosis compared to other intra-axial tumours. One of these features is presence of 1p/19q chromosomal codeletion that seems to not only be a marker of better prognosis but also signifies better response to chemotherapy. Herein the authors review the literature for evidence of the prognostic value of 1p/19q codeletion in OD.

Spatial Distribution Of Road Traffic Crash Fatalities In Karachi: Perspective From 2008-2012, Rashid Jooma, Mir Shabbar Ali, Masood Ali Shaikh

Section of Neurosurgery

Road Traffic Crash (RTC) mortality and morbidity is one of the major public health problems in Karachi. In this study we used geographic information systems (GIS) to visualize and quantify the spatial distribution of RTC mortality and yearly trend from 2008 to 2012, for all 24 administrative subdivisions of Karachi, using Road Traffic Injury Research and Prevention Center's (RTIRPC) data. Cumulatively, 6040 deaths were recorded by RTIRPC, out of which we were able to map 4657 (77.1%) deaths based on location information available in the database. During the 5-year period, highest number of cumulative RTC fatalities were recorded for Kemari, …

The Top 50 Most-Cited Articles On Total Ankle Arthroplasty: A Bibliometric Analysis, Azeem Tariq Malik, Shahryar Noordin

Section of Orthopaedic Surgery

Total Ankle Arthroplasty (TAA) is a relatively new and evolving field in Foot and Ankle surgery. We conducted a citation analysis to identify the characteristics of the top 50 most cited articles on total ankle arthroplasty. Using the Web of Science database and the search strategy total ankle arthroplasty OR total ankle replacement, we identified 2445 articles. After filtering for relevant articles, the top 50 cited articles on total ankle arthroplasty were retrieved for descriptive and statistical analysis. The publication years ranged from 1979 to 2013. USA was the most productive country in terms of research output, followed by …

Homelessness Predicts Attrition But Not Alcohol Abstinence In Outpatients Experiencing Co-Occurring Alcohol Dependence And Serious Mental Illness., Emily Leickly, Jordan Skalisky, Oladunni Oluwoye, Sterling M Mcpherson, Debra Srebnik, John M Roll, Richard K Ries, Michael G Mcdonell

Articles, Abstracts, and Reports

BACKGROUND: Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk of poor mental health and treatment outcomes compared with stably housed adults with SMI. The additional issue of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, the authors investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI.

METHODS: The associations between housing status and attrition and alcohol abstinence during treatment, as assessed by ethyl glucuronide (EtG) urine tests, were evaluated in …

Teaching Children Road Safety Through Storybooks: An Approach To Child Health Literacy In Pakistan, Haris Ahmad, Rubaba Naeem, Nukhba Zia, Asher Feroze, Amarah Shakoor, Uzma R. Khan, Asad Mian

Department of Emergency Medicine

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.
Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a …

Peptide Density Targets And Impedes Triple Negative Breast Cancer Metastasis, Daxing Liu, Peng Guo, Craig Mccarthy, Biran Wang, Yu Tao, Debra Auguste

Publications and Research

The C-X-C chemokine receptor type 4 (CXCR4, CD184) pathway is a key regulator of cancer metastasis. Existing therapeutics that block CXCR4 signaling are dependent on single molecule-receptor interactions or silencing CXCR4 expression. CXCR4 localizes in lipid rafts and forms dimers therefore CXCR4 targeting and signaling may depend on ligand density. Herein, we report liposomes presenting a CXCR4 binding peptide (DV1) as a threedimensional molecular array, ranging from 9k to 74k molecules μm−2, target triple negative breast cancer (TNBC). TNBC cells exhibit a maxima in binding and uptake of DV1functionalized liposomes (L-DV1) in vitro at a specific density, which yields a …

Teaching Third-Year Medical Students To Address Patients’ Spiritual Needs In The Surgery/Anesthesiology Clerkship, Holly G. Atkinson, David Fleenor, Susan M. Lerner, Edward Poliandro, Joseph Truglio

Publications and Research

Introduction: Despite many patients wanting physicians to inquire about their religious/spiritual beliefs, most physicians do not make such inquiries. Among physicians who do, surgeons are less likely than family and general practitioners and psychiatrists to do so.

Methods: To address this gap, we developed a 60-minute curriculum that follows the Kolb cycle of experiential learning for third-year medical students on their surgery/anesthesiology clerkship. The session includes definitions of religion/spirituality, an overview of the literature on spirituality in surgery, a review of the FICA Spiritual History Tool, discussion of the role of the chaplain and the process of initiating a chaplain …

Continuous Monitoring Devices And Seizure Patterns By Glucose, Time And Lateralized Seizure Onset., Katie M Kinnear, Nicole M Warner, Alan M Haltiner, Michael J Doherty

Articles, Abstracts, and Reports

Objectives: To investigate if glucose levels influence seizure patterns.

Materials and methods: In a patient with RNS/NeuroPace implanted bi-temporally and type 1 diabetes mellitus, seizure event times and onset locations were matched to continuous tissue glucose.

Results: Left focal seizure (LFS, n = 22) glucoses averaged 169 mg/dL, while right focal seizure (RFS, n = 23) glucoses averaged 131 mg/dL (p = 0.03). LFS occurred at mean time 17:02 while RFS occurred at 04:23. LFS spread to the contralateral side (n = 19) more than RFS (n = 2).

Conclusion: Seizure onset laterality and spread vary with glucose and time …

The Prevalence And Awareness Of Sleep Apnea In Patients Suffering Chronic Pain: An Assessment Using The Stop-Bang Sleep Apnea Questionnaire., Gregory S Tentindo, Scott M Fishman, Chin-Shang Li, Qinlu Wang, Steven D Brass

Articles, Abstracts, and Reports

Purpose: Some patient subsets are at higher risk of sleep apnea, including patients with chronic pain. However, it is unclear whether patients and their caregivers are aware of the possibly increased risk of sleep apnea in this population. Chronic pain is often treated with opioids which may decrease both the central respiratory drive and the patency of the upper airway, potentially contributing to this sleep disorder. Using a self-reporting questionnaire approach in the chronic pain population, this study surveyed patient and caregiver awareness surrounding the risk of sleep apnea. In addition, we looked at the influence of opioid therapy on …

Targeted Treatment Of Advanced Ovarian Cancer: Spotlight On Rucaparib., Diana C Pearre, Krishnansu S Tewari

Articles, Abstracts, and Reports

The last 2 years have ushered in a new era in ovarian cancer therapy with the US Food and Drug Administration's (FDA) approval of poly-ADP ribose polymerase (PARP) inhibitors (PARPi). One of the deadliest cancers that women experience, ovarian cancer, is most often diagnosed in advanced stages. Although cytoreductive surgery and (platinum/taxane-based) chemotherapy can place the majority of patients into remission, most will experience a relapse of their disease in their lifetime. This has led to studies exploring the benefits and efficacy of maintenance treatment. This review will briefly discuss the history of maintenance therapy as well as focus on …

Effectiveness Of Subcutaneously Administered Leuprolide Acetate To Achieve Low Nadir Testosterone In Prostate Cancer Patients., Christopher M Pieczonka, Przemyslaw Twardowski, Joseph Renzulli, Jason Hafron, Deborah M Boldt-Houle, Stuart Atkinson, Scott Eggener

Articles, Abstracts, and Reports

Evidence suggests lower nadir testosterone levels during the first year of androgen deprivation therapy improve advanced prostate cancer clinical outcomes. We evaluated pivotal trials for subcutaneously administered leuprolide acetate (1-, 3-, 4-, and 6-month doses) to determine nadir testosterone levels. Pooled analysis showed 99%, 97%, and 91% of patients reached nadir testosterone ≤20, ≤10, and ≤5 ng/dL respectively (median ≤3 ng/dL). Across all available categories, $88% of patients reached nadir testosterone ≤5 ng/dL, and

Assessing Cognitive Abilities In High-Performing Cochlear Implant Users., Jake Hillyer, Elizabeth Elkins, Chantel Hazlewood, Stacey D Watson, Julie G Arenberg, Alexandra Parbery-Clark

Articles, Abstracts, and Reports

Despite being considered one of the most successful neural prostheses, cochlear implants (CIs) provide recipients with a wide range of speech perception performance. While some CI users can understand speech in the absence of visual cues, other recipients exhibit more limited speech perception. Cognitive skills have been documented as a contributor to complex auditory processing, such as language understanding; however, there are no normative data for existing standardized clinical tests assessing cognitive abilities in CI users. Here, we assess the impact of modality of presentation (i.e., auditory-visual versus visual) for the administration of working memory tests in high-performing CI users …

Classification And Outcome Measures For Psoriatic Arthritis., Ying Ying Leung, Alexis Ogdie, Ana-Maria Orbai, William Tillett, Laura C Coates, Vibeke Strand, Philip Mease, Dafna D Gladman

Articles, Abstracts, and Reports

Psoriatic arthritis (PsA) is an inflammatory arthritis with multiple manifestations: peripheral/axial arthritis, enthesitis, dactylitis, psoriasis, and nail involvement. From having an agreed upon classification criteria in 2006, the assessment of PsA has advanced from uncertainties to development and validation of numerous specific outcome measures. The Group for Research and Assessment of Psoriasis and Psoriatic arthritis (GRAPPA) has spearheaded the development of a core domain set and is now working on a core outcome measurement set to standardize outcome measures for PsA, that will provide guidance for use of instruments in randomized controlled trials (RCTs) and longitudinal observational studies (LOS). This …

Persistent Sex Disparities In Clinical Outcomes With Percutaneous Coronary Intervention: Insights From 6.6 Million Pci Procedures In The United States., Jessica Potts, Alex Sirker, Sara C Martinez, Martha Gulati, Mirvat Alasnag, Muhammad Rashid, Chun Shing Kwok, Joie Ensor, Danielle L Burke, Richard D Riley, Lene Holmvang, Mamas A Mamas

Articles, Abstracts, and Reports

BACKGROUND: Prior studies have reported inconsistencies in the baseline risk profile, comorbidity burden and their association with clinical outcomes in women compared to men. More importantly, there is limited data around the sex differences and how these have changed over time in contemporary percutaneous coronary intervention (PCI) practice.

METHODS AND RESULTS: We used the Nationwide Inpatient Sample to identify all PCI procedures based on ICD-9 procedure codes in the United States between 2004-2014 in adult patients. Descriptive statistics were used to describe sex-based differences in baseline characteristics and comorbidity burden of patients. Multivariable logistic regressions were used to investigate the …

Myxopapillary Ependymoma With Anaplastic Features: A Case Report With Review Of The Literature., Tridu R Huynh, Conrad Lu, Doniel Drazin, Gregory Lekovic

Articles, Abstracts, and Reports

Background: Myxopapillary ependymoma (MPE) with anaplastic features is extremely rare, with only three case reports in the literature.

Case Description: We report the case of a MPE with anaplastic features in a 24-year-old female who presented with a dominant lumbar mass along with intracranial and sacral metastases. Upon gross total resection of the dominant tumor located at L2-L3, it appeared to arise from the filum terminale, and had a solid component in addition to soft or necrotic areas. Histologically, the tumor was composed of the two classic components of MPE: (1) low-grade ependymal cells surrounding blood vessels, producing the papillary …

Earle A. Chiles Research Institute 2017 Year In Review, Earle A. Chiles Research Institute

Articles, Abstracts, and Reports

2017 Year in Review for the Earle A. Chiles Research Institute, a division of Providence Cancer Institute at the Robert W. Franz Cancer Center. Year in Review is published annually and highlights translational immunotherapy research from the Earle A. Chiles Research Institute.

A leader in cancer immunotherapy research and innovation since 1993, the Earle A. Chiles Research Institute is a world-class research facility, and home to a team of internationally known scientists and physicians.

4-Year Results From The Rapid-Psa Phase 3 Randomised Placebo-Controlled Trial Of Certolizumab Pegol In Psoriatic Arthritis., Désirée Van Der Heijde, Atul Deodhar, Oliver Fitzgerald, Roy Fleischmann, Dafna Gladman, Alice B Gottlieb, Bengt Hoepken, Lars Bauer, Oscar Irvin-Sellers, Majed Khraishi, Luke Peterson, Anthony Turkiewicz, Jürgen Wollenhaupt, Philip Mease

Articles, Abstracts, and Reports

Objective: To report the efficacy, patient-reported, radiographic and safety outcomes of 4 years' certolizumab pegol (CZP) treatment in patients with psoriatic arthritis (PsA).

Methods: RAPID-PsA (NCT01087788) was double-blind and placebo-controlled to Week 24, dose-blind to Week 48 and open-label (OL) to Week 216. Patients were randomised 1:1:1 to either placebo or CZP 200 mg every 2 weeks (Q2W) or 400 mg every 4 weeks (Q4W) (following 400 mg at Weeks 0/2/4). Patients randomised to CZP continued their assigned dose in the OL period. Patients randomised to placebo were re-randomised to CZP 200 mg Q2W or 400 mg Q4W (post-loading dose) …

Readability Of Prostate Cancer Information Online: A Cross-Sectional Study, Corey H. Basch, Danna Ethan, Sarah A. Maclean, Joseph Fera, Phillip Garcia, Charles E. Basch

Publications and Research

Reading and understanding health information, both components of health literacy, can influence patient decisions related to disease management. Older adults, the population of males at greatest risk for prostate cancer, may have compromised capacity to understand and use health information. The purpose of this study was to determine the readability of prostate cancer materials on the Internet using five recommended readability tests. Using a cleared Internet browser, a search was conducted for “prostate cancer.” The URLs of the first 100 websites in English were recorded to create the sample. The readability scores for each website were determined using an online, …

Intracorporeal Versus Extracorporeal Anastomosis For Minimally Invasive Right Colectomy: A Multi-Center Propensity Score-Matched Comparison Of Outcomes., Robert K Cleary, Andrew Kassir, Craig S Johnson, Amir L Bastawrous, Mark K Soliman, Daryl S Marx, Luca Giordano, Tobi J Reidy, Eduardo Parra-Davila, Vincent J Obias, Joseph C Carmichael, Darren Pollock, Alessio Pigazzi

Articles, Abstracts, and Reports

BACKGROUND: The primary objective of this study was to retrospectively compare short-term outcomes of intracorporeal versus extracorporeal anastomosis for minimally invasive laparoscopic and robotic-assisted right colectomies for benign and malignant disease. Recent studies suggest potential short-term outcomes advantages for the intracorporeal anastomosis technique.

METHODS: This is a multicenter retrospective propensity score-matched comparison of intracorporeal and extracorporeal anastomosis techniques for laparoscopic and robotic-assisted right colectomy between January 11, 2010, and July 21, 2016.

RESULTS: After propensity score-matching, there were a total of 1029 minimal invasive surgery cases for analysis-379 right colectomies (335 robotic-assisted and 44 laparoscopic) done with an intracorporeal anastomosis …

Tumor Mutational Burden Is A Determinant Of Immune-Mediated Survival In Breast Cancer., Alexandra Thomas, Eric D Routh, Ashok Pullikuth, Guangxu Jin, Jing Su, Jeff W Chou, Katherine A Hoadley, Cristin Print, Nick Knowlton, Michael A Black, Sandra Demaria, Ena Wang, Davide Bedognetti, Wendell D Jones, Gaurav A Mehta, Michael L Gatza, Charles M Perou, David B Page, Pierre Triozzi, Lance D Miller

Articles, Abstracts, and Reports

Mounting evidence supports a role for the immune system in breast cancer outcomes. The ability to distinguish highly immunogenic tumors susceptible to anti-tumor immunity from weakly immunogenic or inherently immune-resistant tumors would guide development of therapeutic strategies in breast cancer. Genomic, transcriptomic and clinical data from The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) breast cancer cohorts were used to examine statistical associations between tumor mutational burden (TMB) and the survival of patients whose tumors were assigned to previously-described prognostic immune subclasses reflecting favorable, weak or poor immune-infiltrate dispositions (FID, WID or PID, respectively). …

Evaluating State Mental Health And Addiction Parity Statutes: A Technical Report, Megan Douglas, Glenda Wrenn, Samantha Bent-Weber, Lauren Tonti, Garry Carneal, Torie Keeton, Jessica Grillo, Sharon Rachel, David Lloyd, Eve Byrd, Benjamin F. Miller, Albert Lang, Ron Manderscheid, Joe Parks

Articles, Abstracts, and Reports

At an event recognizing the 10th anniversary of the Mental Health Parity and Addiction Equity Act (MHPAEA), the Kennedy-Satcher Center for Mental Health Equity in the Satcher Health Leadership Institute at Morehouse School of Medicine, The Kennedy Forum, The Carter Center, and Well Being Trust (WBT) jointly released “Evaluating State Mental Health and Addiction Parity Statutes,” with 32 states receiving a failing grade for statues designed to ensure equal access to mental health and addiction treatment.

The state-by-state report cards assess the strength of mental health and substance use disorder parity laws. Wyoming (F, 10), Arizona (F, 26), …

Impact Of Huddles On Provider’S Knowledge Of Medically Complex Patients, Irina G. Trifonova, Troy E. Richardson, Jessica L. Bettenhausen, Matthew B. Johnson

Posters

Background:
The increasing complexity of pediatric inpatients requires that all providers understand a comprehensive child’s medical and social needs. A survey administered to Children’s Mercy Hospital inpatient providers identified gaps in knowledge regarding the daily plan of care and discharge planning needs among Complex Chronic Care (CCC) patients. Multidisciplinary rounds (MDRs) create a shared decision model among all team members to ensure that all aspects of care for CCC patients are addressed.

Objectives:
To improve provider knowledge of the plan of care and discharge planning needs for CCC patients admitted to the Hospitalist service, from 40% to 75% of providers …

The Western Diet: A Smoking Gun For Chronic Obstructive Pulmonary Disease And Asthma?, Conor Kerley

Other resources

No abstract provided.

Evaluating The Needs Of Cancer Survivors Through Focus Groups And Surveillance Data, Maria George Mph, Taylor Seaton Ms, Diana Haggerty M.S., Debbie Webster Bsn, Rn, Lmsw

Michigan Journal of Public Health

Introduction

As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum.

Methods

Using data compiled from the Michigan cancer registry, the Michigan Behavioral Risk Factor Survey (MiBRFS), and focus groups, several areas of need amongst cancer survivors were identified. The cancer registry provides information on incidence and survival rates to help understand the burden of cancer; this Quantitative data from the Michigan cancer registry and MiBRFS can supplement the qualitative data gained from the focus groups. …

Standard Ablation Versus Magnetic Resonance Imaging-Guided Ablation In The Treatment Of Ventricular Tachycardia., Tarek Zghaib, Esra G Ipek, Rozann Hansford, Hiroshi Ashikaga, Ronald D Berger, Joseph E Marine, David D Spragg, Harikrishna Tandri, Stefan L Zimmerman, Henry Halperin, Scott Brancato, Hugh Calkins, Charles Henrikson, Saman Nazarian

Articles, Abstracts, and Reports

No abstract provided.

Congenital Ventricular Diverticulum Or Aneurysm: A Difficult Diagnosis To Make., Lloyd Halpern, Carl Garabedian, Neil K Worrall

Articles, Abstracts, and Reports

A pouch protruding from the free wall of the left ventricle may be either a congenital ventricular diverticulum (CVD) or aneurysm (CVA). Being aware of these rare congenital anomalies is critical in making the diagnosis. Differentiating the two is important for treatment decisions. We describe a patient with dextrocardia, Tetralogy of Fallot, and a congenital left ventricular apical diverticulum diagnosed following the induction of anesthesia. CVD and CVA may present in the antenatal period through late adulthood with differing morphology, location, and symptoms. Echocardiography is paramount in the diagnosis and characterization of these lesions. If this anomaly is encountered after …

Radiation Recall Myelitis Following Paclitaxel Chemotherapy: The First Reported Case., Shearwood Mcclelland, Paul H Cooper, Anupama K Acheson, Jeremy N Ciporen, Jerry J Jaboin, Timur Mitin

Articles, Abstracts, and Reports

Introduction: Stereotactic body radiotherapy (SBRT) of the spine has become an increasingly utilized modality in the United States, most commonly for metastatic disease (McClelland et al., 2017). Spinal SBRT in patients with spinal instrumentation has been sparsely examined. We report a patient who developed myelitis following spinal SBRT to a region with existing hardware.

Methods: A 55-year-old woman with Stage IV breast cancer developed a T4 vertebral body metastasis and underwent tumor debulking with posteriorly instrumented T3-T5 fusion. Postoperatively she proceeded with SBRT to the T3-T5 vertebral bodies, receiving 30 Gy in 6 Gy/fraction. Seven months later, she required paclitaxel …