Medical Specialties Commons^™

Hour Prediction Rule - Letter To The Editor., Andrew L. Koons Do, Robert D. Cannon Do, Facmt, Gillian A. Beauchamp Md, Kenneth D. Katz Md, Matthew D. Cook Do, Ryan M. Surmaitis Do

Department of Emergency Medicine

In a recent issue of Academic Emergency Medicine, we read with interest the article titled: Hospital Observation Upon Reversal (HOUR) with Naloxone: A Prospective Clinical Prediction Rule Validation Study by Clemency et al. In order to avoid over-reliance on this decision rule and possible untoward effects of early discharge, we feel that there are some key points worth considering in this regard. It is important to note that the average dose of prehospital naloxone was 3.1mg, which was administered intranasally (IN) in 85% of the patients. This fact was briefly discussed in the paper in terms of area under the …

Feasibility Of Implementation Of An Emergency Department Discharge Opioid Taper Protocol, Gillian A. Beauchamp Md, Joshua Rosentel Bsn, Rn, Erin Farber Do, Joseph Levi Do, Dpt, Lexis Laubach Bs, Lauren Crowley Ba, Richard S. Mackenzie Md, Mboe, David M. Richardson Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Do Female Residents Actually Demonstrate Better Levels Of Empathy, Emotional Intelligence And Burnout Than Their Male Counterparts?, Jeanne L. Jacoby Md, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Robert D. Barraco Md, Mph, Elaine A. Donoghue Md, Kevin Weaver D.O.,Facoep, Jennifer E. Macfarlan Mph, Alexander M. Rosenau Do, Joann F. Quinn Phd, Amy B. Smith Phd

Department of Emergency Medicine

No abstract provided.

Routine Late Trimester Ultrasound For The Detection Ofsmall-For-Gestational-Age And Growth-Restricted Fetus Inlow-Risk Pregnancy: A Randomised Controlled Trial, Sikolia Wanyonyi, Doreen Osoro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. …

Decreasing Time To Initiation Of Chemotherapy For Patients Electively Admitted To A Hematologic Malignancy Service., Jose N Galeas, Stuart Packer, Roy Browne, Susan Sakalian, Adam F. Binder

Department of Medical Oncology Faculty Papers

Background: Delays in initiating elective inpatient chemotherapy can decrease patient satisfaction and increase length of stay. At our institution, we observed that 86% of patients admitted for elective chemotherapy experienced a delay (greater than 6 hours) with a median time to chemotherapy of 18.9 hours. We developed a process improvement initiative to improve time to chemotherapy for elective chemotherapy admissions.

Methods: Our outcome measure was time from admission to chemotherapy administration in patients admitted for elective chemotherapy. Process measures were identified and monitored. We collected baseline data and utilized performance improvement tools to identify key drivers. We focused on these …

Teaching An Old Pain Medicine Society New Tweets: Integrating Social Media Into Continuing Medical Education., Kellie M Jaremko, Eric S Schwenk, Amy C S Pearson, Jonathan Hagedorn, Ankeet D Udani, Gary Schwartz, Nabil M Elkassabany, Anne Snively, Edward R Mariano

Department of Anesthesiology Faculty Papers

No abstract.

Eyelid Chalazion Or Not?, Jerry A. Shields, Sara E. Lally, Tatyana Milman, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Vascular Perfusion In Persistent Pupillary Membrane Of The Iris., Michael Chang, David Ancona-Lezama, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Overcoming Brick And Mortar: Feasibility Of Implementation Of A Mat And Linkage To Treatment Program By Leveraging Community Partnerships, Gillian A. Beauchamp Md, Priyanka Lauber Do, Jamie Allen Do, Nathan Boateng Ba, Samantha A. Shaak Phd, Paige Roth Msw, Lsw, Crs, Lexis Laubach Bs, Lauren M. Crowley Ba, David B. Burmeister Do, Facep, Cpe, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Do Incoming Residents Vary In Measures Of Emotional Status Even Prior To Residency Training?, Jeanne L. Jacoby Md, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Robert D. Barraco Md, Mph, Elaine A. Donoghue Md, Kevin Weaver D.O.,Facoep, Jennifer E. Macfarlan Mph, Alexander M. Rosenau Do, Joann F. Quinn Phd, Amy B. Smith Phd

Department of Emergency Medicine

No abstract provided.

Police Use Of Naloxone After Statewide Legislation Enabling First-Responder Administration, John F. Mccarthy Do, Kathryn A. Henry Do, Lauren Crowley Ba, David M. Sassa Aas, Kira D. Weaver Do, Robert D. Cannon Do, Tara K. Henry-Morrow Emt-P, Jennifer E. Macfarlan Mph, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

A Study Of Scars: Narratives Of Unintentional Childhood Injuries In Cato Manor, Carolyn Fox

Independent Study Project (ISP) Collection

The purpose of this study is to identify the specific types of injuries children experience growing up in Cato Manor, specifically, KwaMasxha, to understand how community members process and make meaning of their injuries over time, and to analyze the social determinants of health in Cato Manor that have been conducive to these injuries.

In order to learn about experiences of unintentional childhood injuries in Cato Manor, data was collected using a qualitative, narrative-based approach. I conducted interviews with young adult community members aged 19 to 27 years, asking about their personal experiences with childhood injuries as someone who grew …

Herbal Medicine And Pediatric Massage: Interning At A Tcm Pediatric Clinic, Yvette Way

Independent Study Project (ISP) Collection

Before entering this program my knowledge of TCM was practically nonexistent. However even from a young age, I had an interest in learning about the healing properties of plants and herbs but, I had no way of exploring this interest of mine. After entering this program, I have learned more about TCM and herbal medicine. Because of the lessons that we have taken in class, it made me want to have a deeper understanding of TCM because of this, I decided to do an internship that would involve TCM. My time at Yang Zhen Er Kang clinic has taught me …

The Hapless State Of Amyotrophic Lateral Sclerosis In India: A Comprehensive Look At Life And Medical Services For Als Patients In Rural Himachal Pradesh, Carson J. Bergström

Independent Study Project (ISP) Collection

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a neurodegenerative disorder that leads to paralysis. The disease requires a high amount of medical intervention and interdisciplinary focus to achieve quality of life for patients. This study looks at ALS patient’s lifestyles, their access to these medical devices, Indian therapeutic approaches and policy that impacts patients in Shimla, Himachal Pradesh. As caretakers have a critical part in the care for this disease, their lives were also considered in the case studies. It was found that ALS patients are not experiencing access to medical devices necessary for life because of physical …

Perceptions Of Rural Birthing Practices: A Glimpse Into Maternal And Child Health For Women In Kangra District, Himachal Pradesh, Mackenzie Burke

Independent Study Project (ISP) Collection

Over the past two decades birthing practices within India have drastically changed. This change is most visible in the shift from homebirths to hospital births following the implementation of the National Rural Health Mission. This study aims to understand and give voice to women’s perceptions of birthing practices in the rural villages of Kangra District of Himachal Pradesh. A total of ten interviews were conducted with both mothers and healthcare practitioners in the surrounding villages of Kangra District in order to gain a thorough, qualitative understanding of birthing practices in the local communities. The healthcare practitioners’ responses were divided according …

La Ciudad Versus El Campo: La Calidad De Vida De Los Adultos Mayores Aymara Entre Arica Y Putre, Clare Rogowski

Independent Study Project (ISP) Collection

The elderly population in Chile is increasing rapidly. In indigenous villages in the interior of Chile, like Putre, the younger generation is leaving to pursue education and employment opportunities in cities, in this case Arica. In many cases no one stays to take care of the elders. As the elderly begin to grow older and require greater support, the younger generation seeks to move their family members to the city so that they can care for them. While this provides for greater connection to family and access to medical care for the elderly relatives, the elderly loses their connection to …

Oral Delivery Of Xenon For Cardiovascular Protection, Xing Yin, Melanie R Moody, Valeria Hebert, Melvin E Klegerman, Yong-Jian Geng, Tammy R Dugas, David D Mcpherson, Hyunggun Kim, Shao-Ling Huang

Faculty, Staff and Student Publications

Cardiac hypertrophy often causes impairment of cardiac function. Xenon (Xe), a naturally occurring noble gas, is known to provide neurological and myocardial protection without side effects. The conventional method of Xe delivery by inhalation is not feasible on a chronic basis. We have developed an orally deliverable, effective Xe formulation for long-term administration. We employed 2-hydroxypropyl)-β-cyclodextrin (HPCD), which was dissolved in water to increase the Xe concentration in solution. The beneficial effects of long-term oral administration of Xe-enriched solutions on cardiovascular function were evaluated in vivo. HPCD increased Xe solubility from 0.22 mM to 0.67 mM (3.8-fold). Aged ApoE knockout …

End Tidal Carbon Dioxide Monitoring (Capnography) In The Cardiac Intensive Care Unit, Madeline Elaine Huff, Kenneth T. Shelton

School of Medicine Publications

Background: Carbon dioxide levels can be monitored throughout the respiratory cycle via capnography. In this way, capnography allows healthcare professionals to follow several respiratory factors in real-time, including respiratory depression, apnea, and hypercapnia. Postoperative patients are subjected to significant harm while receiving sedating medications without appropriate monitoring and intervention. Earlier detection of alterations to ventilation status will better enable providers to more accurately dose medications during procedures, especially in high-risk patient populations.

Methods: Patient selection included post-operative patients in the intensive care unit that were receiving sedation/analgesia, high dose or high frequency opioids, epidural or intrathecal pain management, patients that …

Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang

Independent Study Project (ISP) Collection

Background: Schistosomiasis is considered one of the most prevalent neglected tropical diseases in the world. According to the World Health Organization (WHO), the most effective strategy for schistosomiasis control is through preventive chemotherapy with praziquantel (PZQ). In order to successfully control morbidity rates, the WHO recommends mass treatment targeting high risk groups, such as school-age children and adults considered to be at risk.

Methods: This cross-sectional study examined the effects of the National School-Based Deworming Programme (NSBDP) on knowledge of schistosomiasis and subsequent prevalence rates and intensity. A total of 43 residents in Luanda K’Otieno were interviewed, and 34 of …

Longitudinally Extensive Transverse Myelitis With Seropositive Chikungunya, Sajid Hameed, Mubashar Memon, Hina Imtiaz, Dureshahwar Kanwar

Section of Neurology

Chikungunya viral (CHIKV) fever is often a self-limiting febrile illness associated with severe debilitating arthralgia. Neurological complications associated with CHIKV, although rare, have been reported in literature; however, longitudinally extensive transverse myelitis (LTEM) is rarely associated with it. We present a case of a middle-aged man with a 1-week history of low-grade fever and arthralgia followed by urinary retention and quadriplegia. A sensory level was noted at T2. On subsequent investigations, he was diagnosed with LETM. Although LETM is commonly seen in patients with neuromyelitis optica, the other possible etiologies are inflammatory and parainfectious. To date, only two cases of …

Complications Of Ultrasound-Guided Liver Biopsy At A Tertiary Care Hospital In Pakistan: An Audit, Basit Salam, Fatima Mubarak, Yusra Waheed, Noman Khan

Department of Radiology

Introduction: Liver diseases account for two million deaths per year worldwide, half of which are attributed to complications of cirrhosis. Liver conditions have wide-ranging serological findings and imaging appearances and may require biopsy for a definitive diagnosis. Despite ultrasound (US) guidance, liver biopsy is an invasive procedure and the expected benefit must outweigh risks involved.
Objective: The purpose of the audit was to calculate complication rates of US-guided liver biopsy and summarize institutional data pertaining to the procedure.
Materials and Methods: The audit was performed at Aga Khan University Hospital, Karachi, Pakistan. All consecutive patients undergoing liver biopsy from February …

Daily Technology Interruptions And Emotional And Relational Well-Being., Brandon T. Mcdaniel Phd, Michelle Drouin

Health Services and Informatics Research

The current abundance of technology in daily life creates opportunities for interruptions in couple interactions, termed technoference or phubbing. The current study examined reports from both partners in 173 romantic relationships who completed daily surveys on technoference and relational well-being measures across 14 days. By using daily diary data, we were able to examine within-person associations and more closely approximate everyday life. Utilizing multilevel modeling, we found that on days when participants rated more technoference than usual, they felt worse about their relationship, perceived more conflict over technology use, rated their face-toface interactions as less positive, and experienced more negative …

Mortality Assessment Of Paclitaxel-Coated Balloons: Patient-Level Meta-Analysis Of The Illumenate Clinical Program At 3 Years., William A Gray, Michael R Jaff, Sahil A Parikh, Gary M Ansel, Marianne Brodmann, Prakash Krishnan, Mahmood K Razavi, Frank Vermassen, Thomas Zeller, Roseann White, Kenneth Ouriel, Mark A Adelman, Sean P Lyden

Heart and Vascular Articles

BACKGROUND: A recent summary-level meta-analysis comprising randomized, controlled trials (RCTs) of femoropopliteal paclitaxel-coated balloon and stent intervention identified excess late mortality in the paclitaxel-treated patients.

METHODS: We evaluated the safety of the Stellarex drug-coated balloon (DCB) for femoropopliteal artery disease with an independently performed meta-analysis of patient-level data from all patients in the Stellarex femoropopliteal clinical program. To compare mortality after DCB or uncoated percutaneous transluminal angioplasty (PTA), we aggregated data from 2 RCTs comprising 419 patients treated with DCB and 170 patients treated with PTA. In an additional analysis, data were aggregated from 6 poolable Stellarex DCB studies (2 …

Abdominal Tb, More To Abdominal Masses And Symptoms Than Meets The Eye, Johnathon Dallarosa Md, Breanna S. Goldner Do

Department of Medicine

No abstract provided.

Endoscopic Ultrasound-Guided Drainage Of Pancreatic Fluid Collections Using Axios™ Electrocautery Enhanced Delivery System: A Retrospective Experience At A Large Quaternary Care Center, Michal Kloska Md, Phd, Valery Hrad Md, Soorya N. Aggarwal Do, Shashin Shah Md, Zachary Zator Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Management Of Large Aspergilloma With Massive Hemoptysis Complicated By Adhesions From A Previous Partial Lobectomy, Johnathon Dallarosa Md, Nathan Brewster Do, Brian J. Holahan Do, Kareem Godil Md, Jaimin Patel Do, Jessica Boehmler Md

Department of Medicine

No abstract provided.

69-Year-Old Male After Gastric Bypass With Choledocholithiasis Treated With Edge Procedure Complicated By Lams Dislocation, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

A Rare Case Of Biliary Pancreatitis Caused By Ampullary Somatostatinoma In A 46-Year-Old Female, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Umbilical Hernia Rupture Complicated By Enterocutaneous Fistula In 63-Years-Old Female With Decompensated Nash Cirrhosis, Michal Kloska Md, Phd, Matthew J. Sullivan Do, Adam Peyton Do, Waqas Adeel

Department of Medicine

No abstract provided.

Use Of Machine Learning Algorithms For Prediction Of Fetal Risk Using Cardiotocographic Data, Zahra Hoodbhoy, Mohammad Noman, Ayesha Shafique, Ali Nasim, Devyani Chowdhury, Babar Hasan

Department of Paediatrics and Child Health

Background: A major contributor to under-five mortality is the death of children in the 1^st month of life. Intrapartum complications are one of the major causes of perinatal mortality. Fetal cardiotocograph (CTGs) can be used as a monitoring tool to identify high-risk women during labor.
Aim: The objective of this study was to study the precision of machine learning algorithm techniques on CTG data in identifying high-risk fetuses.
Methods: CTG data of 2126 pregnant women were obtained from the University of California Irvine Machine Learning Repository. Ten different machine learning classification models were trained using CTG data. Sensitivity, precision, …