Medical Specialties Commons^™

Test-Retest Reliability And Minimum Detectable Change For Various Frontal Plane Projection Angles During Dynamic Tasks, David M. Werner, Stephanie Di Stasi, Cara L. Lewis, Joaquin Alberto Barrios

Physical Therapy Faculty Publications

Objective: Establish between-day test-retest reliability metrics for 2-dimensional frontal plane projection angles (FPPAs) during the lateral step-down (LSD), single-limb squat (SLS), single-limb landing (SLL), and drop vertical jump (DVJ).

Design: Test-retest reliability study

Setting: University laboratory

Participants: 20 healthy adults (12 female, age = 23.60±1.93 years old, body mass index = 24.26±2.54 kg/m²) were tested on 2 separate occasions 7-14 days apart.

Main Outcome Measures: Intraclass correlation coefficients (ICC), standard errors of the measurement (SEM), and minimal detectable change (MDC) values across the LSD, SLS, SLL, and DVJ for the following body region variables: trunk, trunk on pelvis, …

Safe And Effective Use Of A Hands-Free Intracorporeal Retractor For Suture-Based Liver Retraction During Minimally Invasive Bariatric Procedures: Results Of A Large Case Series, Roger De La Torre, Matthew Sappington, Tom Smith, Jeremy Bryner, David Mantilla, J Stephen Scott

General Surgery

Background

Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate operative view and working space. Conventional approaches utilize a mechanical retractor that requires a dedicated incision, may cause liver damage, and often requires an assistant. This study evaluated the safety and efficacy of hands-free intracorporeal retractors in a large series of subjects undergoing laparoscopic bariatric surgery. This method eliminates the need for a subxiphoid incision, enables full surgeon autonomy, and allows for adjustments throughout the procedure.

Methods

Retrospective chart review identified all subjects at a single hospital undergoing bariatric surgery between September 2017-March 2019 …

Creating An Interprofessional Collaborative Research Opportunity For Physical And Occupational Therapy Students, Anne Fleischer, Mary Insana Fisher, Shirley P. O'Brien

Physical Therapy Faculty Publications

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional …

Microbial Profile And Antibiotic Susceptibility Trend In Postoperative Endophthalmitis: A 12-Year Review, Rashid Baig, Pushpa Bhawan Mal, Khabir Ahmed, Salman Naveed Sadiq, Sidra Zafar, Ghazala Jabeen, Saajan Kukreja

Section of Ophthalmology

Objective: To identify the microbial profile and susceptibility pattern of pathogens responsible for culture-proven postoperative endophthalmitis, and to investigate possible trends in both pathogens and antibiotic sensitivities.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised record of ophthalmology patients from January 1, 2005, to December 31, 2016. Culture and sensitivity reports of vitreous and aqueous humor samples from all the patients were retrieved from the medical record section of the hospital. SPSS 19 was used for data analysis.
Results: Of the samples of 202 patients with a mean age of 58.2±15.8 years, 106(52.5%) were …

Use Of Befasstt Acronym To Improve Brainstem Stroke Recognition - A Case Study, Marietta Sperry, Amber Wilson

Articles, Abstracts, and Reports

Purpose: To increase recognition of lower brain stem strokes through the use of the BeFASSTT acronym to improve patient outcomes.

Impact Of Integrating A Neonatal Early-Onset Sepsis Risk Calculator Into The Electronic Health Record., Nyles T Fowler, Michael Garcia, Cynthia Hankins

Articles, Abstracts, and Reports

Investigators from Kaiser Permanente developed a risk-assessment calculator as a tool for evaluation of early-onset sepsis (EOS) to narrow antibiotic use for the treatment of EOS. The integration of the EOS risk calculator into an electronic health record will minimize manual calculations and data entry and improve compliance and accuracy through automation.

Methods: We performed a retrospective chart review for neonates ≥34 weeks and 0 days gestational age. We collected data pre-integration and post-integration of the EOS risk calculator. The primary outcome measure is the accuracy of user input into the calculator. Secondary outcomes include compliance with using the EOS …

Precision Medicine In Pancreatic Disease-Knowledge Gaps And Research Opportunities: Summary Of A National Institute Of Diabetes And Digestive And Kidney Diseases Workshop., Mark E Lowe, Dana K Andersen, Richard M Caprioli, Jyoti Choudhary, Zobeida Cruz-Monserrate, Anil K Dasyam, Christopher E Forsmark, Fred S Gorelick, Joe W Gray, Mark Haupt, Kimberly A Kelly, Kenneth P Olive, Sylvia K Plevritis, Noa Rappaport, Holger R Roth, Hanno Steen, S Joshua Swamidass, Temel Tirkes, Aliye Uc, Kirill Veselkov, David C Whitcomb, Aida Habtezion

Articles, Abstracts, and Reports

A workshop on research gaps and opportunities for Precision Medicine in Pancreatic Disease was sponsored by the National Institute of Diabetes and Digestive Kidney Diseases on July 24, 2019, in Pittsburgh. The workshop included an overview lecture on precision medicine in cancer and 4 sessions: (1) general considerations for the application of bioinformatics and artificial intelligence; (2) omics, the combination of risk factors and biomarkers; (3) precision imaging; and (4) gaps, barriers, and needs to move from precision to personalized medicine for pancreatic disease. Current precision medicine approaches and tools were reviewed, and participants identified knowledge gaps and research needs …

Biological Intratumoral Therapy For The High-Grade Glioma Part I: Intratumoral Delivery And Immunotoxins., Joshua Loya, Charlie Zhang, Emily J Cox, Achal Singh Achrol, Santosh Kesari

Articles, Abstracts, and Reports

Management of high-grade gliomas remains a complex challenge. Standard of care consists of microsurgical resection, chemotherapy and radiation, but despite these aggressive multimodality therapies the overall prognosis remains poor. A major focus of ongoing translational research studies is to develop novel therapeutic strategies that can maximize tumor cell eradication while minimizing collateral side effects. Particularly, biological intratumoral therapies have been the focus of new translational research efforts due to their inherent potential to be both dynamically adaptive and target specific. This two-part review will provide an overview of biological intratumoral therapies and summarize key advances and remaining challenges in intratumoral …

Targeting Dna Repair In Metastatic Castration-Resistant Prostate Cancer (Mcrpc): Genomic Screening For A Clinical Trial Of Rucaparib, Alan Bryce, Mitchell E. Gross, Charles Redfern, Nicholas Vogelzang, Matthew Rettig, Thomas Stanton, Julie N. Graff, Sandhya Srinivas, Andrea Loehr, Wassim Abida

Articles, Abstracts, and Reports

Objectives: The high prevalence of men with mCRPC carrying pathogenic mutations in DNA damage repair (DDR) genes may have implications for clinical treatment, as poly(ADP-ribose) polymerase (PARP) inhibitors, such as rucaparib, have shown preliminary evidence of activity in these patients. The ongoing phase 2 TRITON2 study (NCT02952534) is evaluating rucaparib in mCRPC patients harboring a deleterious germline or somatic mutation in BRCA1, BRCA2, ATM, or other DDR gene. Here we present results from genomic screening of tissue and plasma samples from mCRPC patients.

Methods: Comprehensive genomic profiling was performed by Foundation Medicine, Inc., using FFPE tumor tissue …

Biological Intratumoral Therapy For The High-Grade Glioma Part Ii: Vector- And Cell-Based Therapies And Radioimmunotherapy., Joshua Loya, Charlie Zhang, Emily J Cox, Achal Singh Achrol, Santosh Kesari

Articles, Abstracts, and Reports

Management of high-grade gliomas (HGGs) remains a complex challenge with an overall poor prognosis despite aggressive multimodal treatment. New translational research has focused on maximizing tumor cell eradication through improved tumor cell targeting while minimizing collateral systemic side effects. In particular, biological intratumoral therapies have been the focus of novel translational research efforts due to their inherent potential to be both dynamically adaptive and target specific. This two part review will provide an overview of biological intratumoral therapies that have been evaluated in human clinical trials in HGGs, and summarize key advances and remaining challenges in the development of these …

Time To Adopt Developmental Origins Of Health And Disease (Dohad) Science In Pakistan, Rozina Nuruddin, Akbar Shoukat Ali, Nuruddin Badruddin Mohammed

Community Health Sciences

No abstract provided.

Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa

Department of Paediatrics and Child Health

No abstract provided.

Chronic Maternal Depressive Symptoms Are Associated With Reduced Socio-Emotional Development In Children At 2 Years Of Age: Analysis Of Data From An Intervention Cohort In Rural Pakistan, Clariana V R. De Oliveira, Muneera Rasheed, Aisha K. Yousafzai

Department of Paediatrics and Child Health

Background: Maternal depression affects a high proportion of women during the antenatal and postnatal period in low- and middle-income countries. While maternal depression is recognized as a significant risk for poor early child development that warrants interventions, the effects of chronic maternal depression on children's development are less understood.
Objective: To determine the association of chronicity of maternal depressive symptoms and early child development in a rural population in southern Pakistan.
Materials and Methods: This study employs data from the "Pakistan Early Child Development Scale-Up Trial," a randomized controlled study that evaluated the integration of responsive stimulation and nutrition interventions …

Evaluation Of A Maternal, Neonatal And Child Health Intervention Package In A Rural District Of Pakistan: A Quasi-Experimental Study, Atif Habib, Kirsten I. Black, Camille Raynes Greenow, Mushtaq Mirani, Sajid Muhammad, Fariha Shaheen, Monika Christofori Khadka, Annette Vondeling, Shabina Ariff, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Pakistan is among the countries which have the highest maternal, neonatal and child mortality rates. Immediate efforts are required to enable Pakistan to achieve the health related sustainable development goals. The continuum of care interventions can substantially reduce the mortality burden, however local evidence to implement them is lacking in Pakistan. We implemented the maternal, neonatal and child health intervention package comprised of health facility strengthening, capacity building, continuum of care interventions and community mobilization and evaluated its effectiveness on maternal, neonatal and child health care practices and neonatal mortality.
Methods: The intervention package was delivered through existing public …

Association Of Exposure To Civil Conflict With Maternal Resilience And Maternal And Child Health And Health System Performance In Afghanistan, Nadia Akseer, Arjumand Rizvi, Zaid Ahmad Bhatti, Jai K. Das, Karl Everett, Aneesa Arur, Mickey Chopra, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Current studies examining the effects of Afghanistan's conflict transition on the performance of health systems, health service delivery, and health outcomes are outdated and small in scale and do not span all essential reproductive, maternal, newborn, and child health interventions.
Objective: To evaluate associations of conflict severity with improvement of health system performance, use of health services, and child nutrition outcomes in Afghanistan during the 2003 to 2018 reconstruction period.
Design, setting, and participants: This population-based survey study included a sequential cross-sectional analysis of individual-level panel data across 2 periods (2003-2010 and 2010-2018) and a difference-in-differences design. Surveys included …

Estimation Of Infectious Intestinal Disease Burden And Description Of The Infectious Disease Surveillance System In Ras Al Khaimah, United Arab Emirates, Fatema Hamdan Saif Al Alkeem Al Zaabi

Dissertations

Introduction: Infectious disease (ID) is an ongoing problem worldwide. In order to manage this problem, it is important to have an integrated and effective surveillance system that can be used to estimate the burden of ID. There is a scarcity of studies published on the prevalence of IDs in the United Arab Emirates (UAE), both in hospital settings and in the community. Infectious Intestinal Disease (IIDs) have been one of the most commonest IDs that have been studied in the community around the world, there are no studies on the prevalence of IIDs in Ras Al Khaimah (RAK). Furthermore, while …

Effect Of Increasing Age On Percutaneous Coronary Intervention Vs Coronary Artery Bypass Grafting In Older Adults With Unprotected Left Main Coronary Artery Disease: A Meta-Analysis And Meta-Regression, Mahin R. Khan, Waleed T. Kayani, Waqas Ahmad, Malalai Manan, Ravi S. Hira, Ihab Hamzeh, Hani Jneid, Salim S. Virani, Neal Kleiman, Nasser Lakkis

Office of the Provost

Background: Older adults (≥70-year-old) are under-represented in the published data pertaining to unprotected left main coronary artery disease (ULMCAD).
Hypothesis: Percutaneous coronary intervention (PCI) might be comparable to coronary artery bypass grafting (CABG) for revascularization of ULMCAD.
Methods: We compared PCI versus CABG in older adults with ULMCAD with an aggregate data meta-analyses (4880 patients) of clinical outcomes [all-cause mortality, myocardial infarction (MI), repeat revascularization, stroke and major adverse cardiac and cerebrovascular events(MACCE)] at 30 days, 12-24 months & ≥36 months in patients with mean age ≥70 years and ULMCAD. A meta-regression analysis evaluated the effect of age on mortality …

Association Of Female Sexual Dysfunction And Fertility: A Cross Sectional Study, Felix Oindi, Alfred Murage, Valentino Manase Lema, Abraham Mukaindo

Obstetrics and Gynaecology, East Africa

Background: Sexual function plays an essential role in the bio-psychosocial wellbeing and quality of life of women and disturbances in sexual functioning often result in significant distress. Female sexual dysfunction (FSD) and subfertility are common problems affecting approximately 43 and 20% of women respectively. However, despite the high prevalence of both conditions, little has been studied on the effects of subfertility on sexual functioning especially in sub-Saharan Africa. We set out to compare the prevalence of female sexual dysfunction in patients on assessment for sub-fertility and those either seeking or already on fertility control services at a private tertiary teaching …

Factors Related To Congenital Heart Disease In Offspring From Women With Rheumatic Heart Disease: Case Reports From Moi Teaching And Referral Hospital, Eldoret, Kenya, Philippe P. A, Elkanah Omenge, Barasa F. A

Obstetrics and Gynaecology, East Africa

Maternal exposure to environmental factors has been reported to be associated with birth defects. Congenital heart defects are the most common and are associated with high morbidity and mortality in offspring. However, the relation of maternal rheumatic heart disease to congenital heart defects in the offspring is a rare event not yet reported. The authors report 2 cases of infants with congenital heart defects born from mothers with rheumatic heart disease. This study highlights factors related to congenital heart defects in both newborns.

Is There Value To Sub-Specialty Training In Sub-Saharan Africa?, Elkanah Omenge, S. E. Sinasac, Peter Itsura, Philip Tonui, B. Rosen, A. Covens

Obstetrics and Gynaecology, East Africa

Over the past three decades, Africa has focused on combatting infectious diseases, such as tuberculosis, malaria, and HIV/ AIDS. As treatment strategies for infectious diseases have improved over time, life expectancy has increased, shifting the burden to chronic diseases, such as cancer. The WHO has now identified non-communicable diseases, including cancer, as the new epidemic in sub-Saharan Africa1. Cancer incidence and mortality are increasing rapidly in low and middle-income countries (LMIC) as compared to high-income countries. By 2020, it is predicted that 70% of all new cancers worldwide will occur in LMIC2. In 2012 850 000 new cancers were diagnosed …

Electrocardiographic Findings During Standard Hands Only Cpr And Hands Only Cpr Plus Pedal Cpr In Senior Rescuers, Laura Melany Yassa

Master's Theses

The standard first aid for a heart attack resulting in cardiopulmonary arrest is effective cardiopulmonary resuscitation (CPR). Chest compressions are most commonly performed on a flat surface with the rescuer kneeling next to the victim with one hand on top of the other on the sternum and elbows straight. This technique of being on the ground may be challenging for those without the mobility and strength to get up and down from the ground. In 2005, the American Heart Association (AHA) Guidelines listed “pedal”, or heel, compression as an acceptable alternative to standard chest compressions (Trenkamp & Perez, 2015). That …

Assessing The Adherence Of Obstetricians Towards Postpartum Diabetes Screening Guidelines: A Pre- And Post-Intervention Study At Secondary Care Hospital In Karachi, Pakistan, Sadiqa Munir Razzaqui, Neelofur Babar, Zaib Un Nisa Memon, Sarah Rafiq

Department of Obstetrics & Gynaecology

Objective: To assess the adherence level of obstetricians towards postpartum diabetes screening guidelines.
Methods: The quasi-experimental pre- and post-intervention study was conducted from May 2014 to April 2015 at Aga Khan Hospital for Women-Karimabad, Karachi, and comprised all obstetricians practicing at the time. All the booked women with gestational diabetes delivered in the 6 months before refresher lecture (group 1) and those delivering in the 6 months following the intervention (group 2) were included. Data was analysed using SPSS 19.
Results: Of the 550 cases, 275(50%) each were in groups 1 and 2. All pregnant women had live-birth. The intervention …

Prevalence Of Malaria Reported During Summer And Winter At A Tertiary Care Hospital In Karachi, Pakistan, Fazal M. Arain, Aisha Memon, Roohi Jamal, Ahmed Raheem Buksh, Mohammad Asim Beg

Department of Biological & Biomedical Sciences

This study was designed to determine the prevalence and type of malaria cases that presented throughout the year 2014 in a tertiary care hospital in Karachi, Pakistan. A total of 1099 cases, (377 females, 722 males) were reported. Plasmodium vivax (P. vivax) was discovered in 93.7% cases compared to 6.3% Plasmodium falciparum (P. falciparum). Based on the highest and lowest weather temperatures, in summer (June, July and August) and in winter (December, January and February) were differentiated. The number of cases were greater during summer months compared to winter. Interestingly, the ratio of P. falciparum to P. vivax during winter …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

Creation Of Radiocephalic Arteriovenous Fistula In A Patient With Failed Brachiocephalic Arteriovenous Fistula, Zia Ur Rehman

Department of Surgery Docs

Abstract are not provided by the author/publisher

Plasma Cysteine/Cystine And Glutathione/Glutathione Disulfide Redox Potentials In Hiv And Copd Patients., Walter H. Watson, Jeffrey D. Ritzenthaler, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Tom J. Burke, Yuxuan Zheng, Julio A. Ramirez, Jesse Roman

Faculty and Staff Scholarship

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at the University of Louisville in the following groups: HIV-infected (n = 36), COPD (n = 32), HIV and COPD (n = 28), and uninfected controls with normal lung function (n = 34). HIV infection was assessed by viral load and CD4 cell counts. Pulmonary function was determined by spirometry …

Screening And Treating Hyperlipidemia In Patients On Tofacitinib, Tocilizumab, Sarilumab, And Baricitinib, William Torelli Do, Thomas A. Quinn Do, Kourtney Erickson Do, Andrea M. Soliman Do, Attiya Harit Ms, James Ross Md, Facp

Department of Medicine

No abstract provided.

Characterization And Longitudinal Assessment Of Daily Quality Assurance For An Mr-Guided Radiotherapy (Mrgrt) Linac, Kathryn Mittauer

All Publications

No abstract provided.

Preoperative Factors Related To Delayed Discharge After Total Knee Arthroplasty Removal From Inpatient-Only List, Juan Carlos Suarez, William Arguelles, Priscilla Rivera, Yvette Hernandez, Don Parris

All Publications

No abstract provided.

Standardizing Aminoglycoside Induced Ototoxicity Monitoring, Claire Elson, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier

Posters

Aminoglycoside (AG) antibiotics are essential for the treatment of cystic fibrosis (CF) lung infections. Pseudomonas aeruginosa. Nontuberculous mycobacteria. Monitoring is critical secondary to potential nephrotoxicity and ototoxicity. Children’s Mercy Kansas City (CMKC), standardized nephrotoxicity monitoring in 2016. Observed variable ototoxicity monitoring practices. Prevalence of ototoxicity, 2016 CFF Patient Registry, 1.1% in pediatric patients (less than or equal to 18 years). 2.2% in pediatric and adult population. National Institute of Deafness and Other Communication Disorders, 13% in US population equal to or less than 12 years old. A standardized AG induced ototoxicity monitoring algorithm (AIOA) was developed and implemented at CMKC …