Medical Specialties Commons^™

Role Of Sex Chromosomes In Sexual Dimorphism Of Angii-Induced Abdominal Aortic Aneurysms, Yasir Alsiraj

Theses and Dissertations--Pharmacology and Nutritional Sciences

Abdominal aortic aneurysms (AAAs), a permanent dilation in the abdominal region of the aorta, is a highly sexually dimorphic disease. AAAs prevalence is ranging from 4-10 fold higher in males than females. Defining the mechanistic basis for reduced (in females) or increased (in males) AAA formation and progression may uncover potential therapeutic targets. The majority of studies examining sexual dimorphism focus on the role of sex hormones. However, genes residing on sex chromosomes, in addition to sex hormones, may contribute to sexual dimorphism of AAAs. For example, the X chromosome contains about 5% of the whole genome, but the role …

Healthcare Providers’ Perceptions Of Pregnant Women, Allison Goderwis

Theses and Dissertations--Family Sciences

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and …

Case Study Of The Four-Year Neuropsychological Changes In An Elderly Male With Possible Chronic Traumatic Encephalopathy, Patrick Martin

Antioch University Dissertations & Theses

Research demonstrates that the brain's response to Traumatic Brain Injury (TBI) is variable with age and the effects of TBI on the elderly are a critical and global public health concern, from both a medical and a neuropsychological perspective. Currently, there is scant research on the effects of TBI, including Chronic Traumatic Encephalopathy (CTE), on the elderly. Specifically, there is a paucity of literature regarding longitudinal neuropsychological changes in elderly post- TBI individuals. This dissertation will present a Single Case Research Design (SCRD) analysis of an elderly individual with possible Chronic Traumatic Encephalopathy and the associated neuropsychological changes over 49-months. …

Effects Of Cancer Staging On Maternal Coping And Mother-Child Communication Patterns Among Breast Cancer Survivors, Kevin Michael Lycke

Walden Dissertations and Doctoral Studies

Few researchers have examined the relationship between earlier stages of breast cancer and its effect on staging of the disease process and the co-occurring coping and communication patterns between mothers and their children. The purposes of this qualitative study with a multiple case study design were to examine (a) coping mechanisms that mothers used to manage the uncertainty of their breast cancer status and (b) the impact of early-stage breast cancer on communication patterns between mothers and their children. The Lazarus and Folkman theory of psychological coping and the McMaster family systems communication theory informed the conceptual framework for the …

Increasing Organ Donations In Maryland: An Interrupted Time Series Analysis, Laura A. Gerlach

Walden Dissertations and Doctoral Studies

The state of Maryland has been unsuccessful in achieving its goal of registering all of its population as organ donors. The purpose of this correlational study was to understand if allowing registered donors to remain anonymous would increase donor registration rates.

The theoretical foundation of this study was the theory of planned behavior. Data were collected from the Motor Vehicle Administration of Maryland and the Division of Motor Vehicle of Virginia. The data were analyzed using regression displacement, interrupted time series analysis, auto correlation analysis, and Arima Box Jenkins methodology. According to the study findings, offering the option to remain …

Impact Of Advanced Practice Providers (App) Care Models And Outcomes In Primary Care, Kathleen Exline

DNP Projects

Background: The Affordable Care Act, an aging population, and the increased burden of caring for the chronically ill are factors that have resulted in a significantly increased demand on primary care. This has prompted the strategy to utilize advanced practice providers (APPs) to supplement primary care physicians. Due to the inconsistency of a defined national model and measurement system, the impact of APP utilization in healthcare is not clear.

Purpose: The purpose of this project was to examine the use of APPs in primary care. The study involved a review of the current utilization of APPs, an evaluation of the …

Cesarean Births Rates After Implementation Of Labor Management Guidelines, Margie Allyn Bridges

Walden Dissertations and Doctoral Studies

Cesarean birth rates are associated with increased maternal morbidity. This project evaluated a quality improvement (QI) initiative implemented to reduce cesarean births among Nulliparous Term Singleton Vertex (NTSV) obstetric populations, the largest contributor to cesarean births. Variations in labor management practice contribute to cesarean birth rate; implementation of labor management bundles have been endorsed to influence practice- and system-level changes in the promotion of vaginal births. The problem addressed in this project was an organizational NTSV cesarean section rate of 30%. The purpose of the project was to use secondary data to evaluate a previously implemented labor management bundle at …

Maternal Anaemia And Folate Intake In Early Pregnancy, E.G. O'Malley, Shona Cawley, R.A.K. Kennedy, C.M.E. Reynolds, A. Molloy, M.J. Turner

Articles

The World Health Organization recommends that women take 400 µg of folate supplementation daily throughout pregnancy. We examined the relationship between total folate intake from the diet and supplements at the first prenatal visit and haematological indices at this visit and subsequently.

First Trimester Serum Biomarkers To Predict Gestational Diabetes In A High-Risk Cohort: Striving For Clinically Useful Thresholds, Siobhan M. Corcoran, Natalie Achamallah, John O'Loughlan, Philip Stafford, Pat Dicker, Fergal D. Malone, Fionnuala Breathnach

Articles

Objectives: Screening and diagnosis of gestational diabetes (GDM) has been a source of controversy. The prevalence has increased in line with an obesity epidemic and a trend towards delayed child-bearing. Treatment of even modest glycaemic impairment in pregnancy has been shown to be beneficial in preventing its clinical sequalae. However the cumbersome nature and timing of the oral glucose tolerance test coupled with debate around universal versus risk factor based screening have been problematic. This group aimed to investigate a panel of biomarkers which have shown promise in the literature to predict GDM from the first trimester in a group …

Factors Associated With Maternal Wellbeing At Four Months Post-Partum In Ireland, Annemarie E. Bennett, John Kearney

Articles

This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p < 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p < 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49–20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20–12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02–1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29–6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland.

Recreational Soccer As Sport Medicine For Middle-Aged And Older Adults: A Systematic Review, Hao Luo, Robert U. Newton, Fadi Ma'ayah, Daniel A. Galvao, Dennis R. Taaffe

Research outputs 2014 to 2021

Background Strategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.

Objective To examine the health benefits of recreational soccer in middle-aged and older adults.

Design Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources All available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.

Eligibility criteria for selecting studies All randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) …

Education And Prevention Of Stress And Ptsd In Prehospital Care Providers, Adriana Goad

A with Honors Projects

The field of prehospital emergency care is one full of unpredictability, high physical demand, and mental stress. EMTs and Paramedics are called to the unknown to treat whatever they come upon with the limited supplies and equipment that can be found in their trauma bag and ambulances. Some calls may be rewarding as they save the life of a patient, or they can be run of the mill as they get a call for a person not feeling well. Some calls, though, do not end in a relaxed drop off at the ED and back to the station for the …

Down Syndrome, Beta-Amyloid And Neuroimaging, Elizabeth Head, Alex M. Helman, David K. Powell, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

This review focuses on the role of Aβ in AD pathogenesis in Down syndrome and current approaches for imaging Aβ in vivo. We will describe how Aβ deposits with age, the posttranslational modifications that can occur, and detection in biofluids. Three unique case studies describing partial trisomy 21 cases without APP triplication, and the occurrences of low level mosaic trisomy 21 in an early onset AD patient are presented. Brain imaging for Aβ includes those by positron emission tomography and ligands (Pittsburgh Compound B, Florbetapir, and FDDNP) that bind Aβ have been published and are summarized here. In combination, we …

Tumor Microvessel Density As A Prognostic Marker In High-Risk Renal Cell Carcinoma Patients Treated On Ecog-Acrin E2805, Lucia B. Jilaveanu, Maneka Puligandla, Sarah A. Weiss, Xin Victoria Wang, Christopher Zito, Keith T Flaherty, Marta Boeke, Veronique Neumeister, Robert L. Camp, Adebowale Adeniran, Michael Pins, Judith Manola, Robert S. Dipaola, Naomi B. Haas, Harriet M. Kluger

Internal Medicine Faculty Publications

Purpose—Increased vascularity is a hallmark of renal cell carcinoma (RCC). Microvessel density (MVD) is one measurement of tumor angiogenesis; however, its utility as a biomarker of outcome is unknown. ECOG-ACRIN 2805 (E2805) enrolled 1,943 resected high-risk RCC patients randomized to adjuvant sunitinib, sorafenib, or placebo. We aimed to determine the prognostic and predictive role of MVD in RCC.

Experimental Design—We obtained pretreatment primary RCC nephrectomy tissues from 822 patients on E2805 and constructed tissue microarrays. Using quantitative immunofluorescence, we measured tumor MVD as the area of CD34-expressing cells. We determined the association with disease-free survival (DFS), overall survival …

Improvement In Diagnosis Of Histoplasma Meningitis By Combined Testing For Histoplasma Antigen And Immunoglobulin G And Immunoglobulin M Anti-Histoplasma Antibody In Cerebrospinal Fluid, Karen C. Bloch, Thein Myint, Luke Raymond-Guillen, Chadi A. Hage, Thomas E. Davis, Patty W. Wright, Felicia C. Chow, Laila Woc-Colburn, Raed N. Khairy, Alan C. Street, Tomotaka Yamamoto, Amanda Albers, L Joseph Wheat

Internal Medicine Faculty Publications

Background. Central nervous system (CNS) histoplasmosis is a life-threatening condition and represents a diagnostic and therapeutic challenge. Isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF) or brain tissue is diagnostic; however, culture is insensitive and slow growth may result in significant treatment delay. We performed a retrospective multicenter study to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis, the primary objective of the study. The secondary objective was to determine the effect of improvements in the Histoplasma galactomannan …

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Decreasing Cardiac Arrests In The Pediatric Intensive Care Unit, Jeremy Affolter, Kathlyn Baharaeen, Mari Hanson, Lisa Laddish, Amy Bohm, Lindsey Bradbury, Megan Mcghee, Anne Leroy, Hannah Cunningham, Michelle Waddell, Tiffany Mullen, Kimberly Lucas, William Douglas, Angel Pope, Marita Thompson, Paul N. Bauer, Erica Molitor-Kirsch, Tara Benton, Laura Miller-Smith

Posters

No abstract provided.

A Rare Case Of Presacral Epidermoid Cyst In An Adult Male: Emphasis On Diffusion Weighted Magnetic Resonance Sequences In Preoperative Imaging., Muhammad I. Alvi, Fatima Mubarak, Kumail Khandwala, Muhammad Nanish Barakzai, Aisha Memon

Department of Radiology

Epidermoid cyst of the presacral space is a rare congenital lesion of ectodermal origin. Presacral epidermoid cysts have been previously reported in women, however are extremely rare in males. We report a case of presacral epidermoid cyst in a 55-year-old male who presented to our emergency department with acute urinary retention and history of chronic constipation. A non-contrast computed tomography scan was performed with suspicion of urolithiasis, which revealed a well circumscribed low attenuation presacral mass. Magnetic resonance imaging (MRI) of the pelvis was subsequently performed to further characterize the lesion. The mass was returning hypointense T1 and hyperintense T2 …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Ebonyi, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Ebonyi …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Katsina, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Katsina …

A Rare Cause Of Recurrent Constipation With Abdominal Pain And Distension, Shahab Abid, Dawar Khan

Section of Gastroenterology

No abstract provided.

A Randomized Control Trial Comparing Train Of Four Ratio > 0.9 To Clinical Assessment Of Return Of Neuromuscular Function Before Endotracheal Extubation On Critical Respiratory Events In Adult Patients Undergoing Elective Surgery At A Tertiary Hospital In Nairobi, Isaac Adembesa, Vitalis Mung’Ayi, Zul Premji, Dorothy Kamya

Anaesthesiology, East Africa

Background: There is increasing evidence that the incidence of postoperative residual paresis after using neuromuscular blockers ranges from 24 to 50% in post anaesthesia care unit (PACU) and is associated with postoperative complications such as critical respiratory events as evidenced by hypoxia, hypoventilation and upper airway obstruction. Quantitative neuromuscular monitoring (such as the assessment of Train of four (TOF) ratio) and reversal of neuromuscular blockers has been shown to reduce postoperative residual paresis. There are very few outcome studies on effect of residual paresis in PACU. There is a paucity of published randomized controlled trials investigating whether using a TOF …

Brain-Derived Neurotrophic Factor As A Biomarker For Aging And Dementia, Krishna Lajwanti Bharani

MUSC Theses and Dissertations

The number of people with dementia due to Alzheimer’s disease (AD) is increasing worldwide. Although AD pathology begins well before clinical symptoms are apparent, identifying individuals at risk of developing AD to provide early interventions is still a challenge. Brain-derived neurotrophic factor (BDNF) is produced by neurons and glial cells and has complex interactions with AD pathology. BDNF also crosses the blood-brain barrier and can be measured in serum or plasma. In this dissertation, I investigated the biomarker potential of serum BDNF for AD using post mortem human samples, an aged rat model of cognitive impairment, and blood samples from …

The Effect Of Dna Methylation On Tp73 Expression In Tumorgenesis, Nujuma A. Moussa

Undergraduate Research Posters

Abstract: The Effect of DNA Methylation on TP73 Expression in Tumorgenesis

Nujuma Moussa, Zhixing Yao, Zaki A. Sherif

Department of Biochemistry & Molecular Biology, Howard University College of Medicine

TP73 is a member of the TP53 family of proteins that acts as a transcription factor to help regulate cellular distress. This tumor protein may play a dual role as a tumor suppressor and tumor promoter. The TP73 gene is mapped to chromosome 1p36, a frequently deleted region in neuroblastoma and other types of tumors. While mutations in the TP53 gene are commonly known to cause noxious cancers, 30% of cancers …

Financial Stewardship Through Appropriate Critical Care Documentation, Shobhit Jain, Nirav Shastri, Gregory P. Conners, Irene Walsh

Posters

No abstract provided.

Atrioventricular Junctional Tachycardia With Exit Block In An Adolescent, Nicholas M. Cundiff, Jeffrey A. Robinson, Bryan C. Cannon, Christopher S. Snyder

Journal Articles: Pediatrics

No abstract provided.

Depressed Left And Right Ventricular Cardiac Output In Fetuses Of Diabetic Mothers, Jennifer Winter, Aparna Kulkarni, Mary Craft, Ling Li, Lisa K. Hornberger, David A. Danford, Shelby Kutty

Journal Articles: Pediatrics

INTRODUCTION: We compared right and left ventricular cardiac output (RVCO and LVCO) in fetuses of diabetic mothers (FDM) to a large normal cohort.

METHODS: We prospectively enrolled 264 normal fetuses and 30 FDM. Fetal CO parameters: semilunar valve velocity time integrals (AVVTI, PVVTI), ventricular outflow diameters (LVOTD, RVOTD), stroke volumes (AVSV, PVSV) were measured, and LVCO and RVCO calculated. These were normalized using nonlinear regression to estimated fetal weight (EFW) to provide means and standard deviations. Among FDMs, mean Z-scores and 95% confidence limits (CL) were calculated, and compared to zero.

RESULTS: LVCO, RVCO, and parameters they were calculated from, …

Selective Infarct Zone Imaging With Intravenous Acoustically Activated Droplets, Songita A. Choudhury, Feng Xie, Shelby Kutty, John Lof, Elizabeth Stolze, Thomas R. Porter

Journal Articles: Pediatrics

BACKGROUND: Microbubbles (MB) can be compressed to nanometer-sized droplets and reactivated with diagnostic ultrasound; these reactivated MB possess unique imaging characteristics.

OBJECTIVE: We hypothesized that droplets formed from compressing Definity MB may be used for infarct-enhancement imaging.

METHODS: Fourteen rats underwent ligation of their left anterior descending (LAD) artery, and five pigs underwent 90 minute balloon occlusions of their mid LAD. At 48 hours in rats, transthoracic ultrasound was performed at two and four minutes following 200 μL intravenous injections (IVI) of Definity droplets (DD), at which point the MI was increased from 0.5 to 1.5 to assess for a …

Atrioventricular Junctional Tachycardia With Exit Block In An Adolescent, Nicholas M. Cundiff, Jeffrey A. Robinson, Bryan C. Cannon, Christopher S. Snyder

Journal Articles: Pediatrics

No abstract provided.

Ecg Findings In Pediatric Patients Under The Influence Of Marijuana, Jeffrey A. Robinson, Sahana Somasegar, Jill K. Shivapour, Christopher S. Snyder

Journal Articles: Pediatrics

Background: The effects of marijuana on the cardiac conduction system are ill defined. The purpose of this study is to describe the association between electrocardiogram (ECG) findings and positive urine drug screening (+UDS) for marijuana in the pediatric population. Methods: A retrospective review was conducted through the electronic medical record from Emergency Department (ED) visits dated 10/13- 11/14 of patients ≤ 18 years of age who tested positive for marijuana exposure by +UDS in the ED. Inclusion criteria included: 1) +UDS for marijuana performed in the ED and 2) electrocardiogram (ECG) performed on same day as +UDS. Each ECG was …