Medical Specialties Commons^™

Divergent Pro-Leukemic Effects Of Myd88 And Ticam-1/Trif Mediated Toll-Like Receptor Signaling, Joseph Michael Cannova

Dissertations

The goal of this study is to determine the role of Toll-like receptor (TLR) signaling in acute myeloid leukemia (AML). AML is a hematopoietic malignancy that predominately affects the elderly. The median age of AML diagnosis is 67 years old. The standard of care of AML is treatment with cytotoxic chemotherapy, which elderly patients are often unable to tolerate. To identify novel pathways as potential targets for treatment, a microarray on AML primary patient samples was performed to determine the expression of key inflammatory genes. This microarray, and other published datasets, showed that TLR are overexpressed in myelomonocytic (M4) and …

Psychodynamic Psychiatrists' Experiences Of Being Stalked, Douglas Ingram

NYMC Faculty Publications

Despite the estimated 15% likelihood that a psychiatrist will become the victim of stalking, there is little formal recognition of its prevalence or its impact on well-being. Through narrative accounts, ten psychiatrists with psychodynamic orientations speak of their experiences including how each managed the anxieties consequent to stalking. These include a variety of adaptive psychic operations as well as concrete actions to curtail stalking.

Modeling Safe Sleep Practices For The Newborn In The Hospital: Is It Happening?, Marietta Sperry, Kimberly Kohlieber

Books, Presentations, Posters, Etc.

Background: Nurses have been noted to model unsafe sleep practices for the newborn in the hospital, despite having been extensively trained. Parents report they repeat this behavior at home. There is a reluctance of nurses to comply, notwithstanding implementation of Back to Sleep programs and documentation of parents being taught safe sleep practices, causing a plateau in the reduction sudden infant death syndrome (SIDS).

Methods: Systematic review of literature from CINHAL, Indiana State University Library, Google Scholar, and PubMed from last five years.

Results: Nurses were found to agree with many guidelines. Personal bias, or habit influenced poor implementation. Although …

A Standardized Comparison Of Peri-Operative Complications After Minimally Invasive Esophagectomy: Ivor Lewis Versus Mckeown., Andrew M. Brown, Michael J. Pucci, Adam C. Berger, Talar Tatarian, Nathaniel R. Evans Iii, Ernest L. Rosato, Francesco Palazzo

Department of Surgery Faculty Papers

BACKGROUND: While our institutional approach to esophageal resection for cancer has traditionally favored a minimally invasive (MI) 3-hole, McKeown esophagectomy (MIE 3-hole) during the last five years several factors has determined a shift in our practice with an increasing number of minimally invasive Ivor Lewis (MIE IL) resections being performed. We compared peri-operative outcomes of the two procedures, hypothesizing that MIE IL would be less morbid in the peri-operative setting compared to MIE 3-hole.

METHODS: Our institution's IRB-approved esophageal database was queried to identify all patients who underwent totally MI esophagectomy (MIE IL vs. MIE 3-hole) from June 2011 to …

Dosimetric Comparison Between Using Daily Cone Beam Ct And Planning Ct In Volumetric Modulated Arc Therapy Technique For Prostate Cancer Therapy, Julaluck Chanayota

Chulalongkorn University Theses and Dissertations (Chula ETD)

The variations of shape and size of organs inside, especially bladder and rectum, in prostate cancer patient are mainly factors of external beam radiation therapy that may impact to disease control and normal tissue toxicity. The purpose of this study was to investigate the dosimetric comparison between using daily CBCT and planning CT in Volumetric modulated arc therapy (VMAT) technique for prostate cancer therapy. The HU and electron density between CBCT and planning CT were verified by using Catphan® 600 phantom. Treatment planning system was verified by dose distribution comparison between plans on CBCT and planning CT images of Anthropomorphic …

The Measurement Of Transverse Relaxation Time (T2) Using Histogram From Roi Setting In Muscle Activity Study At 1.5 Tesla Mri, Kannikar Kanyakham

Chulalongkorn University Theses and Dissertations (Chula ETD)

Muscle functional MRI (mfMRI) is the method to evaluate the muscle activity before and immediately after the muscle exercise by the magnetic resonance images. Exercise of skeletal muscles enhances image contrast in T2-weighted magnetic resonance (MR) images. In previous studies, the exercised physiology used multiple-spin-echo (MSE) sequences for calculating transverse relaxation time (T2) with several small regions of interest (ROI) within the target tissue. Such a method may not represent all properties of the target tissue. The purpose of this study is to measure T2 in rest and exercise muscle at 1.5 Tesla MRI using average mode values in histogram …

Eye Lens Dose Measurement In Patients During Brain Arteriovenous Malformation Interventional Neuro-Radiology Procedure, Rasalin Thana

Chulalongkorn University Theses and Dissertations (Chula ETD)

Brain arteriovenous malformation (AVM) interventional neuroradiology (INR) is a complicated procedure which the patients may receive the high radiation dose exceeding the threshold level for detectable eye lens opacities and cataracts (ICRP, 2012). The objectives of this study are to measure the patient eye lens dose using optically stimulated luminescence dosimeter, OSLD, during AVM INR procedure at Interventional Radiology Unit, Department of Radiology, King Chulalongkorn Memorial Hospital (KCMH) and to study the factors affecting the patient eye lens dose. NanoDot OSLDs were attached on the transparent radiation thin film eyewear and closed to the patient eyelids during the procedure. Philips …

Investigation Of Parameters For Metallic Artifact Reduction Using 3-D Space In Mr Lumbar Spine At 1.5 Tesla: A Phantom Study, Thanatchaya Lowong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Metallic artifact reduction in magnetic resonance imaging (MRI) has increasingly interested especially metal implant postoperative in lumbar spine. Recently, the new pulse sequence based on true isotropic 3D voxel with high resolution namely Sampling Perfection with Application Optimized Contrasts using Different Flip Angle Evolutions (SPACE) was introduced. This study aimed to determine the appropriate 3D T2-SPACE parameters for reducing the metallic artifact in MR lumbar spine 1.5 Tesla. Cylindrical phantom filled with 3.3 g/L, NiCl2-6H2O and 2.4 g/L NaCl solution, and two commonly used metal implants (stainless steel and titanium) for lumbar spine were acquired using turbo spin echo (TSE) …

The Pharmacokinetic Model Of 18f-Fdopa In Pet Brain Imaging For Early Parkinson’S Disease, Wirunpatch Buratachwatanasiri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Parkinson’s disease (PD) symptom usually appears when over half of all dopaminergic neurons have died. Early detection and treatment approach are; therefore, very important. The 18F-FDOPA PET scan is extensively examined to differentiate the normal and pathological dopamine metabolism in the human brain. The purpose of this study was to investigate the transfer rate constants of 18F-FDOPA in PET brain imaging based on compartmental model in early Parkinson’s disease. The retrospective data from five early PD patients who underwent 18F-FDOPA PET brain scan at King Chulalongkorn Memorial Hospital (KCMH) were collected. After 18F-FDOPA was administered intravenously, PET images were acquired …

ผลการเปลี่ยนแปลงของค่าคะแนนอาการปวดเข่าลูกสะบ้าและค่าผลลัพธ์การทำงานของข้อต่อลูกสะบ้าหลังได้รับโปรแกรมการออกกำลังกายที่บ้านในนักวิ่งสมัครเล่นเพศชายและเพศหญิงที่มีอาการปวดเข่าลูกสะบ้า, กิตตินัฐ นวลใย

Chulalongkorn University Theses and Dissertations (Chula ETD)

งานวิจัยนี้ศึกษาการเปลี่ยนแปลงของค่าคะแนนอาการปวดเข่าลูกสะบ้า (Kujala Score), Pain Scale, ค่า Single Leg Hop Test (SLHT), ค่า Step Down Test (SDT) และค่าอัตราส่วนแบบทำงานของความแข็งแรงกล้ามเนื้อเหยียดเข่าต่อกล้ามเนื้องอเข่า (Functional Qecc/Hcon ratio) หลังได้รับโปรแกรมการออกกำลังกายที่บ้าน 24 สัปดาห์ ในนักวิ่งสมัครเล่นเพศชายและเพศหญิงที่มีอาการปวดเข่าลูกสะบ้า จำนวน 59 คน เป็นเพศชาย 30 คน เพศหญิง 29 คน วัดค่า Kujala Score, Pain Scale, SLHT, SDT และค่า Functional Qecc/Hcon ratio ก่อนเริ่มต้นการออกกำลังกาย (T0) ครบ 8 สัปดาห์ (T8) ครบ 16 สัปดาห์ (T16) และเมื่อสิ้นสุด 24 สัปดาห์ (T24) ผลการศึกษาพบว่า ผู้เข้าร่วมวิจัยทั้งหมดมีค่า Kujala Score เพิ่มขึ้น จากที่ T0 มีค่า 78.95 ± 9.42 และที่ T24 มีค่าเป็น 99.50 ± 0.82, ค่า Pain Scale ที่ T0 มีค่า 5.61±1.43 ที่ T24 มีค่า 0.03±0.18, ค่า SLHT และค่า SDT มีค่าผลลัพธ์เปลี่ยนแปลงดีขึ้น ค่า Functional Qecc/Hcon ratio ที่ T0 มีค่า 1.34 ± …

การศึกษาผลของการฝึกเกร็งกล้ามเนื้อหน้าท้องต่ออัตราการตอบสนองในการหดตัวขณะที่กล้ามเนื้อเหยียดยาวออกของกล้ามเนื้อที่ใช้ในการเหยียดหลังและการเปลี่ยนแปลงมุมการเคลื่อนไหวของกระดูกสันหลังระดับเอวในอาสาสมัครที่มีอาการปวดเอว, ปรารถนา เนมีย์

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยโดยการทดลองในครั้งนี้ มีวัตถุประสงค์ เพื่อศึกษาผลของโปรแกรมการฝึกเกร็งกล้ามเนื้อหน้าท้องต่ออัตราการตอบสนองของกล้ามเนื้อที่ใช้ในการเหยียดหลังขณะยืนก้มลำตัวในอาสาสมัครที่มีอาการปวดเอวที่มีอายุระหว่าง 20-40 ปี จำนวน 44 คน โดยถูกสุ่มออกเป็น 2 กลุ่ม คือกลุ่มทดลอง (N=22) และกลุ่มควบคุม (N=22) ซึ่งกลุ่มทดลองได้รับโปรแกรมการฝึกออกกำลังกายจำนวน 3 ครั้งต่อสัปดาห์ เป็นระยะเวลา 4 สัปดาห์ สำหรับกลุ่มควบคุมได้รับคู่มือเกี่ยวกับอาการปวดหลัง ผลการศึกษาพบว่าหลังจากการทดลองกลุ่มที่ได้รับโปรแกรมการออกกำลังกาย มีความแตกต่างกันอย่างมีนัยสำคัญทางสถิติระหว่างก่อนและหลังการทดลอง ของเปอร์เซ็นต์ของอัตราการตอบสนองของกล้ามเนื้อที่ใช้ในการเหยียดหลังเท่ากับ 42.52±25.32 และ 29.08±14.21 ตามลำดับ (P=0.015) มุมการเคลื่อนไหวของกระดูกสันหลังระดับเอวเท่ากับ 44.95±9.78 และ 37.28±8.66 องศา (P=0.017) มุมการเคลื่อนของข้อสะโพกเท่ากับ 42.17±17.62 และ 54.81±19.26 องศา (P=0.001) ค่าดัชนีชี้วัดระดับความสามารถในการทำกิจวัตรประจำวันเท่ากับ 16.89±2.16 และ 3.91±1.06 (P<0.05) และระดับความปวดระหว่างทำกิจกรรม 5.32±1.67 และ 2.26±1.76 (P<0.05) สำหรับกลุ่มควบคุมดังนั้นผลการศึกษานี้แสดงให้เห็นว่าโปรแกรมการฝึกเกร็งกล้ามเนื้อหน้าท้องส่งผลต่อการลดลงของอัตราการตอบสนองของกล้ามเนื้อที่ใช้ในการเหยียดหลังขณะก้มลำตัวในระยะสุดท้าย มีองศาการเคลื่อนไหวของกระดูกสันหลังระดับเอวลดลงและข้อสะโพกเพิ่มขึ้น การจำกัดการใช้ชีวิตประจำวันเนื่องจากอาการปวดน้อยลงและระดับปวดบริเวณเอวลดลง โดยโปรแกรมการออกกำลังกายนี้สามารถใช้เป็นทางเลือกในการรักษาและให้คำแนะนำสำหรับผู้ป่วยที่มีอาการปวดเอว

Vitamin E Status Is Inversely Associated With Risk Of Incident Tuberculosis Disease Among Household Contacts, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression.

OBJECTIVE: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on …

Motion-Induced Artifact Mitigation And Image Enhancement Strategies For Four-Dimensional Fan-Beam And Cone-Beam Computed Tomography, Matthew J. Riblett

Theses and Dissertations

Four dimensional imaging has become part of the standard of care for diagnosing and treating non-small cell lung cancer. In radiotherapy applications 4D fan-beam computed tomography (4D-CT) and 4D cone-beam computed tomography (4D-CBCT) are two advanced imaging modalities that afford clinical practitioners knowledge of the underlying kinematics and structural dynamics of diseased tissues and provide insight into the effects of regular organ motion and the nature of tissue deformation over time. While these imaging techniques can facilitate the use of more targeted radiotherapies, issues surrounding image quality and accuracy currently limit the utility of these images clinically.

The purpose of …

Economic Burden Of Renal Cell Carcinoma (Rcc) And Treatment Patterns, Overall Survival And Healthcare Costs Among Older Metastatic Rcc Patients, Hrishikesh P. Kale

Theses and Dissertations

Background

Renal cell carcinoma (RCC) is the most common type of kidney cancer. Patients diagnosed with metastatic RCC (mRCC) have shorter overall survival compared to those diagnosed at earlier stages. Several targeted therapies, which cost from $7,000 - $16,000 per month have been approved since 2005 to treat mRCC. In addition, there is a growing interest in the use of cytoreductive nephrectomy (CN) with targeted therapies among mRCC patients. However, little is known regarding the economic burden of RCC and role of CN and prescribing patterns of targeted therapies among older mRCC patients.

Objectives

1) To assess the economic burden …

Reducing Uncertainty In Head And Neck Radiotherapy With Plastic Robotics, Mark R. Ostyn

Theses and Dissertations

One of the greatest challenges in achieving accurate positioning in head and neck radiotherapy is that the anatomy at and above the cervical spine does not act as a single, mechanically rigid body. Current immobilization techniques contain residual uncertainties that are especially present in the lower neck that cannot be reduced by setting up to any single landmark. The work presented describes the development of a radiotherapy friendly mostly-plastic 6D robotic platform for positioning independent landmarks, (i.e., allowing remote, independent positioning of the skull relative to landmarks in the thorax), including analysis of kinematics, stress, radiographic compatibility, trajectory planning, physical …

Evaluation And Adaptation Of Live-Cell Interferometry For Applications In Basic, Translational, And Clinical Research, Kevin A. Leslie

Theses and Dissertations

Cell mass is an important indicator of cell health and status. A diverse set of techniques have been developed to precisely measure the masses of single cells, with varying degrees of technical complexity and throughput. Here, the development of a non-invasive, label-free optical technique, termed Live-Cell Interferometry (LCI), is described. Several applications are presented, including an evaluation of LCI’s utility for assessing drug response heterogeneity in patient-derived melanoma lines and the measurement of CD3+ T cell kinetics during hematopoietic stem cell transplantation. The characterization of mast cells during degranulation, the measurement of viral reactivation kinetics in Kaposi’s Sarcoma, and drug …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

Influence Of Muscle Strength On Mobility In Critically Ill Adult Patients On Mechanical Ventilation, Audrey R. Roberson

Theses and Dissertations

Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence …

Relationship Between Patient-Health Coach Interactions And Changes In Markers Of Glucose Homeostasis, Jason P. Nagy

Theses and Dissertations

Diabetes and insulin resistance are on the rise in the United States. Early detection and deployment of therapies has allowed for the reversal of pancreatic beta cell damage. Unfortunately, not all providers can offer the support to facilitating the required life style modifications. The introduction of clinical health consultants (CHC) as supplemental care has improved patient health for a variety of chronic diseases. Missing in the literature are studies investigating the correlation between the number of CHC interactions and improvement in biomarkers.

The study utilized a non-experimental, retrospective study design to evaluate the relationship between the use between the use …

"To Conceive With Child Is The Earnest Desire If Not Of All, Yet Of Most Women": The Advancement Of Prenatal Care And Childbirth In Early Modern England: 1500-1770, Victoria E.C. Glover

Theses and Dissertations

This thesis analyzes medical manuals published in England between 1500 and 1770 to trace developing medical understandings and prescriptive approaches to conception, pregnancy, and childbirth. While there have been plenty of books written regarding social and religious changes in the reproductive process during the early modern era, there is a dearth of scholarly work focusing on the medical changes which took place in obstetrics over this period. Early modern England was a time of great change in the field of obstetrics as physicians incorporated newly-discovered knowledge about the male and female body, new fields and tools, and new or revived …

Estimating The Respiratory Lung Motion Model Using Tensor Decomposition On Displacement Vector Field, Kingston Kang

Theses and Dissertations

Modern big data often emerge as tensors. Standard statistical methods are inadequate to deal with datasets of large volume, high dimensionality, and complex structure. Therefore, it is important to develop algorithms such as low-rank tensor decomposition for data compression, dimensionality reduction, and approximation.

With the advancement in technology, high-dimensional images are becoming ubiquitous in the medical field. In lung radiation therapy, the respiratory motion of the lung introduces variabilities during treatment as the tumor inside the lung is moving, which brings challenges to the precise delivery of radiation to the tumor. Several approaches to quantifying this uncertainty propose using a …

Effects Of The Na-Cl Co-Transporter (Ncc) In Western Diet Induced Metabolic And Cardiac Dysfunction, Zachary S. Cutter

Theses and Dissertations

Interleukin-18 (IL-18) is a pro-inflammatory cytokine known to be involved in maintaining metabolic homeostasis; however, also capable of inducing cardiac dysfunction. Additionally, IL-18, has been shown to bind to a novel receptor, the Na-Cl Co-transporter (NCC). We hypothesized that NCC mediates IL-18 metabolic and cardiac signaling in mice. Using male C57BL/6J mice, we compared the metabolic and cardiac function changes after at least 8 weeks of high-saturated fat high sugar diet (Western Diet) in NCC knockout (NCCKO), IL-18 knockout (IL-18KO), and wild-type mice. We show that NCCKO mice have significantly increased body weight gain from baseline, no difference in fasting …

Advances In Dual-Energy Computed Tomography Imaging Of Radiological Properties, Dong Han

Theses and Dissertations

Dual-energy computed tomography (DECT) has shown great potential in the reduction of uncertainties of proton ranges and low energy photon cross section estimation used in radiation therapy planning. The work presented herein investigated three contributions for advancing DECT applications. 1) A linear and separable two-parameter DECT, the basis vector model (BVM) was used to estimate proton stopping power. Compared to other nonlinear two-parameter models in the literature, the BVM model shows a comparable accuracy achieved for typical human tissues. This model outperforms other nonlinear models in estimations of linear attenuation coefficients. This is the first study to clearly illustrate the …

Understanding The Role Of Phosphoinositide 3-Kinase And Its Function As A Driving Force Behind The Er Stress Response In Fibrostenotic Crohn’S Disease-Affected Ileal Smooth Muscle Cells, Prashant Yadav

Theses and Dissertations

Crohn’s disease (CD) affects about 780,000 people in the United States alone, and it is estimated that 6-15 per 100,000 persons will receive a diagnosis of this disease each year. There currently is no cure for Crohn’s disease, and available medical therapies simply serve to alleviate the inflammation. This does not help treat fibrostenosis that Crohn’s disease patients may develop, which can only be treated surgically. Finding alternatives to treat CD requires an understanding of mechanisms at the biochemical level. In this thesis, we attempted to gain a better understanding of certain pathways found to be active in Crohn’s disease-affected …

Accelerating Kenya’S Progress To 2030: Understanding The Determinants Of Under-Five Mortality From 1990 To 2015, Emily C. Keats, William Macharia, Neha S. Singh, Nadia Akseer, Nirmala Ravishankar, Anthony Ngugi, Arjumand Rizvi, Emma Nelima Khaemba, John Tole, Zulfiqar Ahmed Bhutta

Paediatrics and Child Health, East Africa

Introduction: Despite recent gains, Kenya did not achieve its Millennium Development Goal (MDG) target for reducing under-five mortality. To accelerate progress to 2030, we must understand what impacted mortality throughout the MDG period.

Methods: Trends in the under-five mortality rate (U5MR) were analysed using data from nationally representative Demographic and Health Surveys (1989–2014). Comprehensive, mixed-methods analyses of health policies and systems, workforce and health financing were conducted using relevant surveys, government documents and key informant interviews with country experts. A hierarchical multivariable linear regression analysis was undertaken to better understand the proximal determinants of change in U5MR over the MDG …

A Systematic Review Of Non-Pharmacological Interventions To Improve Nighttime Sleep Among Residents Of Long-Term Care Settings, Elizabeth Capezuti, Rana Sagha Zadeh, Kevin Pain, Aleksa Basara, Nancy Ziyan Jiang, Ana C. Krieger

Publications and Research

Background: Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents.

Methods: The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome. We categorized each intervention …

Non-Ionic Iodinated Contrast-Induced Sialadenitis With Parotid Gland Sparing In Patient Of Hepatocellular Carcinoma, Muhammad Azeemuddin, Mustafa Belal Hafeez Chaudhry, Jehanzeb Shahid, Sarosh Zafar Belal

Department of Radiology

61-years-old male patient presented with complain of neck swelling and soreness following contrast-enhanced (CE) CT examination with resolution of symptoms in 36-48 hours. He is diagnosed with hepatitis C virus and hepatocellular carcinoma (HCC); already treated with radiofrequency ablation for HCC. He had already undergone two CECT examinations before he was referred to our institution for disease staging/treatment. He also underwent three triphasic CT scan examinations at our institution during the course of treatment for treatment response and staging. Patient remained undiagnosed up to his fourth CT scan due to inability to relate symptoms with contrast administration. The patient was …

Central Hypoventilation: A Rare Complication Of Wallenberg Syndrome, Keithan Sivakumar Md, Mba, Manveer Garcha, Dev Mehta, Megan Leary Md, Hussam A. Yacoub Md

Department of Medicine

Central alveolar hypoventilation disorders denote conditions resulting from underlying neurologic disorders affecting the sensors, the central controller, or the integration of those signals leading to insufficient ventilation and reduction in partial pressures of oxygen. We report a patient who presented with a left lateral medullary ischemic stroke after aneurysm repair who subsequently developed a rare complication of CAH. Increased awareness of this condition’s clinical manifestations is crucial to make an accurate diagnosis and understand its complications and prognosis.

Just Another Fever And Rash? A Broad Differential Leading To A Relatively Uncommon Condition In Adult Still's Disease., Nathan Brewster Do, Jaimin Patel Do, Rachel Kinney Do

Department of Medicine

No abstract provided.

Blunted Serum 25(Oh)D Response To Vitamin D3 Supplementation In Children With Autism, Conor Kerley, Basil Elnazir, Peter Greally, David Coghlan

Articles

Introduction: Data suggest a potential role for vitamin D in autism spectrum disorder (ASD) prevention and treatment. It is likely that the serum response to vitamin D supplementation contributes to its effectiveness. Multiple factors affect serum vitamin D 25(OH)D response to supplementation.

Methods: We conducted post-hoc analysis of two double-blind, randomized, placebo-controlled trials (RCT) of vitamin D3 supplementation, one RCT involving children with ASD and another involving children with asthma. Both trials were conducted in the same geographic location (Dublin, Ireland, 53°N), conducted over Winter season and utilized the same vitamin D3 dose (2000 IU/day).

Results: We …