Medical Specialties Commons^™

Management Of Type 1 Diabetes: A Family Affair, Emily Grubbs

Southeastern Council on Family Relations Conference [2018-2020]

People who live with Type 1 diabetes (T1D) have to carefully self-administer insulin to keep blood glucose levels in a safe healthy range – a complex and demanding task (WHO, 2016). Social support has been found to alleviate diabetes-stress and increase management behaviors (Mackey et al., 2016). Social support from family members is especially advantageous, however currently no single family-based intervention has been established to show reliable improvements in T1D outcomes (Rosland et al., 2010). A review of the literature reveals that social support promoting autonomy is associated with the best T1D outcomes; social support that undermines autonomy is associated …

“Children Are A Blessing From God” – A Qualitative Study Exploring The Socio-Cultural Factors Influencing Contraceptive Use In Two Muslim Communities In Kenya, Batula Abdi, Jerry Okal, Gamal Serour, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Family planning (FP) is one of the high impact public health interventions with huge potential to enhance the health and wellbeing of women and children. Yet, despite the steady progress made towards expanding access to family planning, major disparities across different regions exist in Kenya. This study explored the socio cultural factors influencing FP use among two Muslim communities in Kenya.

Methods: A qualitative study involving Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) was conducted (from July to October 2018) in two predominant Muslim communities of Lamu and Wajir counties. Open ended questions explore key thematic areas around …

Novel Coronavirus (2019-Ncov) In Disguise, Qian Zhang, Annyella Douglas, Zain U. Abideen, Shristi Khanal, Stephanie Tzarnas

Abington Jefferson Health Papers

Novel coronavirus (2019-nCoV) pandemic is currently one of the most influential topics as it not only impacts the field of medicine but most importantly, it affects the lives of many individuals throughout the world. We report an interesting 2019-nCoV case in a tertiary community hospital with the initial concern of acute pyelonephritis without respiratory symptoms that ultimately led to the quarantine of a number of healthcare providers. This case emphasizes the importance of radiological evidence in diagnosing 2019-nCoV in the setting of an initial atypical presentation. It also serves as an example of how healthcare providers may need to increase …

Spider Venom Administration Impairs Glioblastoma Growth And Modulates Immune Response In A Non-Clinical Model., Amanda Pires Bonfanti, Natália Barreto, Jaqueline Munhoz, Marcus Caballero, Gabriel Cordeiro, Thomaz Rocha-E-Silva, Rafael Sutti, Fernanda Moura, Sérgio Brunetto, Celso Dario Ramos, Rodolfo Thome, Liana Verinaud, Catarina Rapôso

Department of Neurology Faculty Papers

Molecules from animal venoms are promising candidates for the development of new drugs. Previous in vitro studies have shown that the venom of the spider Phoneutria nigriventer (PnV) is a potential source of antineoplastic components with activity in glioblastoma (GB) cell lines. In the present work, the effects of PnV on tumor development were established in vivo using a xenogeneic model. Human GB (NG97, the most responsive line in the previous study) cells were inoculated (s.c.) on the back of RAG-/- mice. PnV (100 µg/Kg) was administrated every 48 h (i.p.) for 14 days and several endpoints were evaluated: tumor …

Physician Directed Smoking Cessation In The Ed: Do Patients Opt-Out?, Ali S. Aziz Bs, Natalie M. Greco Md, Timothy J. Batchelor Md, Andrew H F Miller Do, Theodore Doherty Do, Robert Kruklitis Md, Phd, Lauren Crowley Ba, Edward W. Casey Rph, Mba, Elizabeth A. Maclean Pharmd, Phd, Joann B. Trainer Pharmd, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

De Novo Frameshift Variants In The Neuronal Splicing Factor Nova2 Result In A Common C-Terminal Extension And Cause A Severe Form Of Neurodevelopmental Disorder, Francesca Mattioli, Gaelle Hayot, Nathalie Drouot, Bertrand Isidor, Jérémie Courraud, Maria-Victoria Hinckelmann, Frederic Tran Mau-Them, Chantal Sellier, Alica Goldman, Aida Telegrafi, Alicia Boughton, Candace Gamble, Sebastien Moutton, Angélique Quartier, Nolwenn Jean, Paul Van Ness, Sarah Grotto, Sophie Nambot, Ganka Douglas, Yue Cindy Si, Jamel Chelly, Zohra Shad, Elisabeth Kaplan, Richard Dineen, Christelle Golzio, Nicolas Charlet-Berguerand, Jean-Louis Mandel, Amélie Piton

Faculty, Staff and Students Publications

The neuro-oncological ventral antigen 2 (NOVA2) protein is a major factor regulating neuron-specific alternative splicing (AS), previously associated with an acquired neurologic condition, the paraneoplastic opsoclonus-myoclonus ataxia (POMA). We report here six individuals with de novo frameshift variants in NOVA2 affected with a severe neurodevelopmental disorder characterized by intellectual disability (ID), motor and speech delay, autistic features, hypotonia, feeding difficulties, spasticity or ataxic gait, and abnormal brain MRI. The six variants lead to the same reading frame, adding a common proline rich C-terminal part instead of the last KH RNA binding domain. We detected 41 genes differentially spliced after NOVA2 …

Phosphoinositides In Retinal Function And Disease, Theodore G Wensel

Faculty, Staff and Students Publications

Phosphatidylinositol and its phosphorylated derivatives, the phosphoinositides, play many important roles in all eukaryotic cells. These include modulation of physical properties of membranes, activation or inhibition of membrane-associated proteins, recruitment of peripheral membrane proteins that act as effectors, and control of membrane trafficking. They also serve as precursors for important second messengers, inositol (1,4,5) trisphosphate and diacylglycerol. Animal models and human diseases involving defects in phosphoinositide regulatory pathways have revealed their importance for function in the mammalian retina and retinal pigmented epithelium. New technologies for localizing, measuring and genetically manipulating them are revealing new information about their importance for the …

Fatigue In Primary Care: Doctor, Why Am I So Tired?, Nina Mingioni, Md

Clinical Education Teaching Tools

Learning Objectives:

1. Identify top causes of fatigue in women
2. Develop an evidence-based approach to assessing a patient with fatigue
3. Reflect on the evidence for available screening tools for fatigue

Implementation Of A Chemotherapy Guideline: A Quality Improvement Project To Standardize The Chemotherapy Delivery Process, Sara Maciej

Nursing Posters

Adjusting chemotherapy rates is one gap in chemotherapy practice that evokes inconsistency. The purpose of this project was to implement a standardized guideline for staff to utilize in adjusting rates of chemotherapy medications.

Coronavirus Disease 2019 (Covid-19), Matthew Dunbar

Pharmacy Student Scholarship

No abstract provided.

Reaching The Peak, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Is Physical Activity During Late Pregnancy Related To Infant Body Composition At Birth?, Brenna Menke

Masters Theses & Specialist Projects

Exercise is typically regarded as having a positive impact on maternal and infant health. However, the relationship between maternal physical activity and infant body composition is unclear. The aim of this project was to determine how a physically active lifestyle during late pregnancy influences infant anthropometrics at birth. Pregnant women (34-39 weeks gestation) with low-risk pregnancies were given the Pregnancy Physical Activity Questionnaire (PPAQ) and an accelerometer to wear on their non-dominant wrist for seven consecutive days. Approximately 24-48 hours after delivery, infant body composition was assessed utilizing air displacement plethysmography at the patients’ bedside. Fifty-five pregnant women participated (age: …

Reliability And Validity Of An Assessment Of Engagement In Nursing Home Residents During Bingocize®, Elizabeth Batson Apelt

Masters Theses & Specialist Projects

Research suggests nursing home residents are often socially isolated and physically inactive despite overwhelming evidence that both social engagement and physical activity are crucial for healthy aging (Jones, Sung, & Moyle, 2018; Yen & Lin, 2018; Ice, 2002; Jansson et al., 2017). Bingocize® is a program that combines exercise and the game of Bingo to improve the quality of life, physical health, and social engagement of certified nursing facility (CNF) residents. The purpose of this study is to determine the level of social engagement displayed by CNF residents during Bingocize® using the Fun and Social Engagement Evaluation (FUSE). Reliability and …

Factors Influencing Both Maternal And Infant Body Composition At Two Years Postpartum, Samantha Henry

Masters Theses & Specialist Projects

Maternal body composition (BC) and physical activity (PA) level during pregnancy both contribute to infant body composition; however, few studies follow children beyond the early weeks to determine the longer-term implications of maternal lifestyle on offspring health. The purpose of this study was threefold: 1) Determine the role of maternal obesity on offspring BC at 2 years of age; 2) Determine the role of PA during pregnancy on maternal and infant BC at two years postpartum; and 3) Determine whether BC at birth (assessed via air displacement plethysmography [PEA POD]) is related to BC at two years of age (assessed …

Organizational Guidance For The Care Of Patients With Head-And-Neck Cancer In Ontario., J Irish, J Kim, J Waldron, A C Wei, E Winquist, J Yoo, A Boasie, M Brouwers, E Meertens, S Mcnair, C Walker-Dilks

Paediatrics Publications

Background: At the request of the Head and Neck Cancers Advisory Committee of Ontario Health (Cancer Care Ontario), a working group and expert panel of clinicians with expertise in the management of head-and-neck cancer developed the present guideline. The purpose of the guideline is to provide advice about the organization and delivery of health care services for adult patients with head-and-neck cancer.

Methods: This document updates the recommendations published in the Ontario Health (Cancer Care Ontario) 2009 organizational guideline

Results: To ensure that all patients have access to the highest standard of care available in Ontario, the guideline establishes the …

Pharmacogenomic Testing: Enhancing Personalized Medication Use For Patients., Catrina M Loucks, Gabriella Groeneweg, Carl Roy, David K Lee, Michael J Rieder, Denis Lebel, Shinya Ito, Colin J Ross, Bruce C Carleton

Paediatrics Publications

No abstract provided.

Sjs/Ten 2019: From Science To Translation., Wan-Chun Chang, Riichiro Abe, Paul Anderson, Wanpen Anderson, Michael R Ardern-Jones, Thomas M Beachkofsky, Teresa Bellón, Agnieszka K Biala, Charles Bouchard, Gianpiero L Cavalleri, Nicole Chapman, James Chodosh, Hyon K Choi, Ricardo R Cibotti, Sherrie J Divito, Karen Dewar, Ulrike Dehaeck, Mahyar Etminan, Diane Forbes, Esther Fuchs, Jennifer L Goldman, James H Holmes, Elyse A Hope, Shuen-Iu Hung, Chia-Ling Hsieh, Alfonso Iovieno, Julienne Jagdeo, Mee Kum Kim, David M Koelle, Mario E Lacouture, Sophie Le Pallec, Rannakoe J Lehloenya, Robyn Lim, Angie Lowe, Jean Mccawley, Julie Mccawley, Robert G Micheletti, Maja Mockenhaupt, Katie Niemeyer, Michael A Norcross, Douglas Oboh, Cristina Olteanu, Helena B Pasieka, Jonathan Peter, Munir Pirmohamed, Michael Rieder, Hajirah N Saeed, Neil H Shear, Christine Shieh, Sabine Straus, Chonlaphat Sukasem, Cynthia Sung, Jason A Trubiano, Sheng-Ying Tsou, Mayumi Ueta, Simona Volpi, Chen Wan, Hongsheng Wang, Zhao-Qing Wang, Jessica Weintraub, Cindy Whale, Lisa M Wheatley, Sonia Whyte-Croasdaile, Kristina B Williams, Galen Wright, Sonia N Yeung, Li Zhou, Wen-Hung Chung, Elizabeth J Phillips, Bruce C Carleton

Paediatrics Publications

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care …

Computational Approach To Correcting Joint Instability In Patients With Recurrent Patellar Dislocation, Oliver Alvarez, Robert N. Steensen, Paul J. Rullkoetter, Clare K. Fitzpatrick

Mechanical and Biomedical Engineering Faculty Publications and Presentations

Patellar dislocation is a debilitating injury common in active adolescents and young adults. Conservative treatment after initial dislocation is often recommended, but almost half of these patients continue to suffer from recurrent dislocation. The objective of this study was to compare preoperative patellofemoral joint stability with stability after a series of simulated procedures, including restorative surgery to correct to pre-injury state, generic tibial tubercle osteotomy, patient-specific reconstructive surgery to correct anatomic abnormality, less invasive patient-specific surgery, and equivalent healthy controls. Three-dimensional, subject-specific finite element models of the patellofemoral joint were developed for 28 patients with recurrent patellar dislocation. A …

Evaluation Of The Integration Of Behavioral Health Services Into Primary Care, David B. Vander Ark

Doctoral Projects

Background: Primary care providers are increasingly challenged with managing individuals with behavioral health needs. Evidence suggests that integrating behavioral health services into primary care can improve individual health outcomes and can improve access to behavioral health services.

Objectives: The purpose of this project is to evaluate key outcomes following the evidencebased integration of behavioral health services into a primary care practice.

Methods: Using the Collaborative Practice Model as the implementation model, the behavioral health leadership team added a licensed social worker to a primary care practice on a pilot basis. The social worker offers short-term solution-focused therapy, focusing on depression …

A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel

Doctoral Projects

Background and Objectives: Home palliative care services are challenging to bill due to the complexity of services and competing time demands. Objectives and protocol were developed to guide coding and billing to increase Relative Value Unit generation and improve financial sustainability.

Design: A quality improvement project.

Setting: A home-based palliative care program in one health system in the Midwest.

Participants: Participants included 7 nurse practitioners.

Intervention: Coding protocol were developed, providers were educated, electronic health record audits were conducted to collect data on improvement, and feedback provided to prompt improvement.

Measurement and Analysis: Documentation of advanced care planning and billing, …

A Survey Of Feature Extraction And Fusion Of Deep Learning For Detection Of Abnormalities In Video Endoscopy Of Gastrointestinal-Tract, Hussam Ali, Muhammad Sharif, Mussarat Yasmin, Mubashir Husain Rehmani, Farhan Riaz

Publications

A standard screening procedure involves video endoscopy of the Gastrointestinal tract. It is a less invasive method which is practiced for early diagnosis of gastric diseases. Manual inspection of a large number of gastric frames is an exhaustive, time-consuming task, and requires expertise. Conversely, several computer-aided diagnosis systems have been proposed by researchers to cope with the dilemma of manual inspection of the massive volume of frames. This article gives an overview of different available alternatives for automated inspection, detection, and classification of various GI abnormalities. Also, this work elaborates techniques associated with content-based image retrieval and automated systems for …

Case Report: Effects Of Therapeutic Exercise On A Patient With Metastatic Osteosarcoma And Pathological Fracture, Jessica Phung, Sarah Mathew

San Marcos, Spring 2020

Purpose: The purpose of this case report is to demonstrate how conditioning exercise for patients with active metastatic neoplasms can improve quality of life (QoL) after a pathological fracture of lumbar vertebrae. Spinal metastasis, in this case from breast cancer, is primarily asymptomatic, and therefore, difficult to detect during early stages. Detection and diagnosis usually occur after initial manifestation of a pathological fracture leading to debilitating effects. Complications with metastatic bone cancer and surgical contraindications may bring patients into outpatient physical therapy to address the pathological fractures and QoL for patients.

Case Description & Methods: The patient is a 44-year …

Predictors Of New-Onset Atrial Fibrillation In Geriatric Trauma Patients, Catherine A. Marco, Jennifer Lynde, Blake Nelson, Joshua Madden, Adam Schaefer, Claire Hardman, Mary Mccarthy

Emergency Medicine Faculty Publications

Geriatric patients (age >65) comprise a growing segment of the trauma population. New-onset atrial fibrillation may occur after injury, complicating clinical management and resulting in significant morbidity and mortality. This study was undertaken to identify clinical and demographic factors associated with new-onset atrial fibrillation among geriatric trauma patients . Methods: In this case control study, eligible participants included admitted trauma patients age 65 and older who developed new-onset atrial fibrillation during the hospitalization. Controls were admitted trauma patients who were matched for age and injury severity score, who did not develop atrial fibrillation. We evaluated the associations between new-onset atrial …

Urinary Epidermal Growth Factor As A Marker Of Disease Progression In Children With Nephrotic Syndrome., Debbie S Gipson, Howard Trachtman, Anne Waldo, Keisha L Gibson, Sean Eddy, Katherine M Dell, Tarak Srivastava, Kevin V Lemley, Larry A Greenbaum, Sangeeta Hingorani, Kevin E Meyers, Frederick J Kaskel, Kimberly J Reidy, Christine B Sethna, Cheryl L Tran, Chia-Shi Wang, Katherine Tuttle, Gia Oh, Alicia M Neu, Elizabeth Brown, Jen-Jar Lin, Jennifer Lai Yee, Therese M Roth, Jonathan P Troost, Brenda W Gillespie, Matthew G Sampson, Matthias Kretzler, Wenjun Ju

Articles, Abstracts, and Reports

Introduction: Childhood-onset nephrotic syndrome has a variable clinical course. Improved predictive markers of long-term outcomes in children with nephrotic syndrome are needed. This study tests the association between baseline urinary epidermal growth factor (uEGF) excretion and longitudinal kidney function in children with nephrotic syndrome.

Methods: The study evaluated 191 participants younger than 18 years enrolled in the Nephrotic Syndrome Study Network, including 118 with their first clinically indicated kidney biopsy (68 minimal change disease; 50 focal segmental glomerulosclerosis) and 73 with incident nephrotic syndrome without a biopsy. uEGF was measured at baseline for all participants and normalized by the urine …

Laparoscopic Total Colectomy In An Eight-Year-Old With Familial Adenomatous Polyposis: A Case Report, Sarah Jeelani, Ayesha Saleem, Sohail Asghar Dogar, Amir Hafeez Shariff, Saqib Hamid Qazi

Section of Paediatric Surgery

Familial Adenomatous Polyposis accounts for20 years of age. Endoscopy is essential for the diagnosis with definitive treatment involving prophylactic total colectomy. With current surgical advances, this is routinely being performed with the aid of laparoscopy. Due to resource limitations and non-availability of the screening programs in the developing world, such cases remain under diagnosed. Genetic testing is necessary for prognostication of both the index case and their at-risk family members. Thus, we present a rare case of an eight-year-old female, with an early onset progression to colorectal cancer with Familial Adenomatous Polyposis. We performed a prophylactic laparoscopic total procto-colectomy with …

Utility Of Tranexamic Acid To Minimize Blood Loss In Brain Tumour Surgery, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

Tranexamic acid is emerging as a useful option for a number of clinical indications, by virtue of its anti-fibrinolytic properties that allow better haemostasis and lesser blood loss. Herein, the authors have attempted to summarize the existing evidence on the possible role of tranexamic acid in brain tumour surgeries.

Levosulpiride-Induced Hyperprolactinemia, Sarah Nadeem, Bhagwan Das

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.

Peripherally Inserted Central Catheters (Picc) Use In Patients With Chronic Kidney Disease (Ckd), Sonia Yaqub, Muhammad Raheel Abdul Razzaque

Section of Nephrology

No abstract provided.

Musical Shoes Shine A New Light On The Clinical World, Emma Madonna

Transformations: Presentation Slides

This study focused on the application of a unique technology designed originally to supply biofeedback to dancers, but in this case was used to assist a child learning to walk while battling the effects of Cerebral Palsy. The music shoes, called “Electroskip”, utilize a biofeedback system that generates different sounds/beats/songs when an individual is walking and placing pressure on their heel or toe. The study lasted six weeks with 2 sessions per week. While the Electroskip technology was worn for each session, it was only activated every other session. Data indicated that at the end of the study the child …

Follicular Sensitivity Index: A Tool To Predict Successful Conception After Intra-Cytoplasmic Sperm Injection, Rehana Rehman, Amara Zafar, Nida Zahid, Nuruddin Badruddin Mohammed

Department of Biological & Biomedical Sciences

Follicular sensitivity index (FSI) is used for estimation of follicular responsiveness to controlled ovarian hyperstimulation (COH) during intra-cytoplasmic sperm injection (ICSI). In a retrospective study, FSI of 1,385 females was calculated as [pre-ovulatory follicle count (PFC) × 100,000]/ [antral follicle count (AFC) × total received stimulation doses]. Females were then categorised into low, middle and high FSI groups according to FSI tertile values. FSI was 8.65 ±2.82 in non-pregnant as compared to 12.02 ±2.04 (p <0.01) in pregnant cohort. FSI turned out to be a strong predictor of successful conception on the receiver operating curve with cutoff value 10.36 at 76% specificity, sensitivity of 86% and area under the curve (AUC; 0.83). Calculation of FSI can thus predict the chances of successful conception in females with different causes of infertility.