Medical Specialties Commons^™

The Write Stuff - Spring 2020 (Vol. 17, No. 2), Research Medical Library

Write Stuff 2020

• How to discuss your study's limitations effectively
• Reference letters vs. letters of support for NIH grant applications: What's the difference?
• NCI Bottom Line blog offers insight into grant funding and budgets
• Dissertations, Text Recycling, and Self-Plagiarism
• NIH Increases the use of Notices of Special Interest
• Tips for using Track Changes in Microsoft Word

Literature Review Of Retained Surgical Instruments Left In The Body, Michelle L. Mccalmont

Honors Capstone Enhancement Presentations

No abstract provided.

Does Race Impact Functional Outcomes In Patients Undergoing Robotic Partial Nephrectomy?, Ugo G Falagario, Alberto Martini, John Pfail, Patrick-Julien Treacy, Kennedy E Okhawere, Bheesham D Dayal, John P Sfakianos, Ronney Abaza, Daniel D Eun, Akshay Bhandari, James R Porter, Ashok K Hemal, Ketan K Badani

Surgery Articles

BACKGROUND: The role of race on functional outcomes after robotic partial nephrectomy (RPN) is still a matter of debate. We aimed to evaluate the clinical and pathologic characteristics of African American (AA) and Caucasian patients who underwent RPN and analyzed the association between race and functional outcomes.

METHODS: Data was obtained from a multi-institutional database of patients who underwent RPN in 6 institutions in the USA. We identified 999 patients with complete clinical data. Sixty-three patients (6.3%) were AA, and each patient was matched (1:3) to Caucasian patients by age at surgery, gender, Charlson Comorbidity Index (CCI) and renal score. …

Blood Cancers And Oral Health, Silvia Spivakovsky Dds, Gwen Nichols Md, Laura Romundstad Crnp, Msn, Elizabeth Kitlas Lmsw

The Journal of the Michigan Dental Association

Managing Blood Cancer Patients' Oral Complications: Preventive Strategies during and after Treatment

Blood cancers, encompassing leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN), bring complex challenges to patient management due to their impact on hematopoiesis, immunity, and overall health. This review focuses on equipping dental practitioners with essential insights into preventing and managing intricate oral manifestations during and after treatment. Patient care strategies are outlined for leukemia subtypes such as acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML), emphasizing the need for tailored dental approaches. In lymphomas encompassing Hodgkin …

Process Improvement To Improve Quality Measures In A Rural Primary Care Clinic, Lucille Yurko Vanderwoude

Doctoral Projects

Health disparities are differences in health that increase the amount of sickness in certain parts of the population, these inequalities in health are directly influenced by social, economic and environmental status (Healthy People 2020, 2008). Individuals living in poverty, violence, or disability have less opportunity for good healthcare and often have higher rates of chronic disease. Rural geographic locations additionally fall under this category (Healthy People 2020, 2008). These disparities can result from decreased exercise, violence in living situations, and unhealthy diet choices or options (CDC, 2018). Research has shown that health disparities increase with a reduction of individual’s income …

The Effect Of The Screening, Brief Intervention, Referral To Treatment (Sbirt) Model On Adult Depression In An Outpatient Setting, Genevieve E. Sweeney

Doctoral Projects

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model …

Improving Blood Pressure Control Among Patients Diagnosed With Hypertension In A Primary Care Setting, Eriko Apriliando

Doctoral Projects

Hypertension affects over 38% of adults or approximately 103 million Americans, costing around $131 billion annually in treatment and loss of productivity. It is also an independent risk factor for coronary events, heart failure, stroke, and end-stage renal disease contributing to 410,624 United States (U.S.) deaths in 2014. The American Heart Association (2016) has released the Measure Accurately, Act Rapidly, and Partner with Patient (MAP) protocol in order to address this issue. This project focused on implementing parts of the MAP protocol. The purpose was to improve blood pressure (BP) control of patients diagnosed with hypertension in a primary care …

Mobile Personal Healthcare System For Non-Invasive, Pervasive And Continuous Blood Pressure Monitoring: A Feasibility Study, Luis J. Mena, Vanessa G. Felix, Rodolfo Ostos, Armando J. Gonzalez, Rafael Martinez-Pelaez, Jesus D. Melgarejo, Gladys E. Maestre

School of Medicine Publications

Background: Smartphone-based blood pressure (BP) monitor using photoplethysmogram (PPG) technology has emerged as a promising approach to empower users with self-monitoring for effective diagnosis and control ofhypertension (HT).

Objective: This study aimed to develop a mobile personal healthcare system for non-invasive, pervasive, and continuous estimation of BP level and variability to be user-friendly to elderly.

Methods: The proposed approach was integrated by a self-designed cuffless, calibration-free, wireless and wearable PPG-only sensor, and a native purposely-designed smartphone application using multilayer perceptron machine learning techniques from raw signals. We performed a pilot study with three elder adults (mean age 61.3 ± 1.5 …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Association Of Dairy Consumption With Metabolic Syndrome, Hypertension And Diabetes In 147 812 Individuals From 21 Countries, Balaji Bhavadharini, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Patrick Sheridan, Viswanathan Mohan, Romaina Iqbal, Rajeev Gupta, Scott Lear, Edelweiss Wentzel-Viljoen

Community Health Sciences

Objective: Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.
Methods: The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we …

Optimizing The Double-Row Construct: An Untied Medial Row Demonstrates Equivalent Mean Contact Pressures In A Rotator Cuff Model, Austin V. Stone, T. David Luo, Aman Sharma, Kerry A. Danelson, Michael De Gregorio, Michael T. Freehill

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: The merits of a double-row rotator cuff repair (RCR) construct are well-established for restoration of the footprint and lateral-row security. The theoretical benefit of leaving the medial row untied is to prevent damage to the rotator cuff by tissue strangulation, and the benefit of suture tape is a more even distribution of force across the repair site. These benefits, to our knowledge, have not been evaluated in the laboratory.

Hypothesis: Leaving the medial row untied and using a suture bridge technique with suture tape will offer more even pressure distribution across the repair site without compromising total contact force. …

Perinatal Drug Abuse And Neonatal Drug Withdrawal, Samarth Shukla, Lisa B. Zirkin, Enrique Gomez Pomar

Pediatrics Faculty Publications

Drug abuse and addiction have significantly increased over the last few decades; specifically, opioid abuse and dependence have increased to epidemic proportions. This increased use of drugs includes women of childbearing age and those who are pregnant. Drug abuse during pregnancy is a serious health risk for both mother and newborn infant. Infants exposed to maternal drugs in fetal life develop signs of drug withdrawal during early neonatal life. This group of withdrawal signs is known as neonatal abstinence syndrome (NAS). Although NAS is not a fatal condition, it results in significant illness and prolonged hospitalization.

Over-Medicalization And Criminalization Of Birth In The United States: Exploring The Outcomes, Meg Wallace 20

Honor Scholar Theses

This paper will examine the effects that over-medicalization and criminalization have had on the state of giving birth in the United States. It will attempt to offer insight on why the United States ranks near the bottom of countries that are considered “developed” in maternal mortality rates and infant mortality rates, despite spending the highest percentage of gross national product on health care. The paper will analyze: the history behind the medicalization of birth in the United States, different methods of over-medicalization, the impacts of unnecessary medical interventions, different incentives driving medicalization, the history of criminalization of pregnant women, the …

Compliance Of Hand Written Transfusion Requisition Form And Improvement After Online Request - A Clinical Audit, Nadia Nasir, Mohammad Usman Shaikh, Natasha Ali, Shabneez Hussain

Department of Pathology and Laboratory Medicine

Objective: To assess the compliance of healthcare personnel with regard to sending completely filled transfusion requisition forms.
Methods: The audit was conducted at Aga Khan University Hospital, Karachi, and comprised requisition slips received at the hospital blood bank from September 2014 to February 2015. The British Committee for Standards in Haematology guidelines was used as the standard. Percentage of each variable on the proforma was analsyed. Rating Results: The audit and the re-audit both comprised 1000 transfusion requisition forms each. In the audit, The sum of total scores of all the transfusion requisition forms was 4911, indicating a compliance rate …

Elucidating The Regulon Of A Fur-Like Protein In Mycobacterium Avium Subsp. Paratuberculosis (Map), Fernanda Miyagaki Shoyama, Taveesak Janetanakit, John P. Bannantine, Raul G. Barletta, Srinand Sreevatsan

Nebraska Center for Virology: Faculty Publications

Intracellular iron concentration is tightly regulated to maintain cell viability. Iron plays important roles in electron transport, nucleic acid synthesis, and oxidative stress. A Mycobacterium avium subsp. paratuberculosis (MAP)-specific genomic island carries a putative metal transport operon that includes MAP3773c, which encodes a Fur-like protein. Although well characterized as a global regulator of iron homeostasis in multiple bacteria, the function of Fur (ferric uptake regulator) in MAP is unknown as this organism also carries IdeR (iron dependent regulator), a native iron regulatory protein specific to mycobacteria. Computational analysis using PRODORIC identified 23 different pathways involved in respiration, metabolism, and virulence …

Diabetes And Cardiovascular Disease In Women: Current Challenges And New Hope, Efstratios Koutroumpakis, David Aguilar

The Texas Heart Institute Journal

No abstract provided.

The Comfort Of Destiny, Jeremy A Ross

The Texas Heart Institute Journal

No abstract provided.

Oral Complications In Cancer Patients: A Review Of Practical Interventions In The Dental Setting, Caroline Bissonnette Dds, Kristin Mcnamara Dds, John Kalmar Dmd, Phd

The Journal of the Michigan Dental Association

Cancer prevalence in the United States is significant, with an estimated 40% of the population experiencing this diagnosis at some point in their lives. In 2020 alone, 1,806,590 new cancer cases were projected, encompassing 53,260 cases involving oral and oropharyngeal malignancies. Amidst barriers like financial constraints and irregular dental visits (highlighted by a 2014 American Dental Association survey indicating that 32.3% of the general population avoids yearly dentist appointments), patients battling cancer often encounter not just routine dental needs, but the intricate challenges arising from their malignancy and treatments. Dental professionals, pivotal in orchestrating optimal treatment strategies for cancer patients, …

Trace Elements In Maternal Serum And Their Relationships With Preterm Birth And Fetal Growth Restriction, Rima Irwinda, Ali Sungkar, Raymond Surya, Valerie Tiempo Guinto

Makara Journal of Health Research

Background: Preterm birth (PTB) and fetal growth restriction (FGR) contribute to high hospital costs. An imbalance in the concentration of the four trace elements (i.e., copper, zinc, iron, and calcium) was shown to be associated with complications during pregnancy. This study aimed to analyze the role of these trace elements in the occurrence of PTB and FGR.

Methods: A search was conducted in PubMed, Cochrane Library, and Ovid. The articles were filtered based on the inclusion and exclusion criteria, and further screening was based on the association of articles with the clinical question. The risk of bias in …

Cervical Cancer Vaccination Awareness And Acceptance Among The Females Of Punjab, Pakistan, Sadia Minhas, Aneequa Sajjad, Muhammad Kashif, Zobaria Rehman, Muhammad Idrees, Farheen Ansari

Makara Journal of Health Research

Background: In developing countries like Pakistan, it is essential for health care professionals to have comprehensive knowledge regarding cervical cancer.

Methods: A cross-sectional self-administered paper-based questionnaire was administered to patients from 2016 to 2018. This study included 200 females who attended the gynecological OPD of Lady Willingdon Hospital Lahore, Punjab. We evaluated cervical cancer knowledge, screening, prevention, and acceptance towards the vaccination. Data entry and analysis were performed using SPSS version 20.

Results: The perception and knowledge related to cervical cancer (28%), screening (3%), prevention (3%), and vaccination (1%) among the females were poor, but a positive …

An Investigation Into Differences In The Infant Intestinal Microbiome Based On Method Of Delivery, Savannah Whitney

Senior Honors Theses

The infant intestinal microbiome is greatly influenced by method of delivery in relation to bacterial composition, diversity, and richness. The intestinal tracts of cesarean delivered infants are more likely to be colonized with skin microbiota like Clostridium, Staphylococcus, Streptococcus, and Corynebacterium, and have less bacterial diversity and richness than their vaginally delivered counterparts, who are more likely to be colonized with Bacteroides, Bifidobacterium, and Lactobacillus, which are common vaginal bacteria. These microbial differences make cesarean delivered infants more likely to develop allergies, asthma, eczema, gastrointestinal conditions, obesity, and diabetes, among other diseases. Though vaginal seeding has been proposed …

Disseminated Carcinomatosis Of Bone Marrow In An African Man With Metastatic Descending Colon Carcinoma, Harrison Chuwa, Nadeem Kassam, Casmir Wambura, Omar Sherman, Salim Surani

Internal Medicine, East Africa

Colorectal cancer (CRC) is ranked third worldwide and seventh in Tanzania. The liver and lungs are the most commonly involved sites. Disseminated carcinomatosis of the bone marrow (DCBM) from colorectal carcinoma is rare and typically indicates widespread disease and poor prognosis. We report a case of a 40-year-old African male, who presented to us with abdominal distension, weight loss, fever and change in bowel habit over the past month. He underwent colonoscopy which revealed a necrotic mass in the descending colon. Biopsies were taken, and histopathology confirmed the presence of poorly differentiated mucin-producing adenocarcinoma. The patient suffered a colonic perforation …

Retroperitoneal Isolated Enteric Duplication Cyst, Fariha Fazal, Patricia Okiro

General Surgery, East Africa

Enteric duplication cysts are rare congenital malformations of the gastrointestinal tract with an estimated incidence of 1:100,000 live births. Fewer still are isolated enteric duplication cysts (IEDC). Accurate diagnosis and timely excision of IEDCs can help in avoiding possible complications including bleeding from gastric mucosa and malignant transformation later in life. Currently, in the paediatric population, there are twenty reported cases in the literature worldwide. Of these, only three have been described in the retro peritoneum. We present a retroperitoneal IEDC, which was juxtaposed to the inferior vena cava. To the best of our knowledge, this has not been reported …

Sustaining The National Spinal Cord Injury Registry Of Iran (Nscir-Ir) In A Regional Center: Challenges And Solutions, Zahra Azadmanjir, Zahra Mohtasham-Amiri, Seyed-Mahdi Ziabari, Leila Kochakinejad, Hamid Haidari, Guilan University Of Medical Sciences, Hadis Sabour, Zahra Khazaeipour, Mahdi Sharif-Alhoseini, Zahra Ghodsi, Abbas Amirjamshidi, Farshad Akbarzadeh, Kazem Zendehdel, Amir Azarhomayouon, Khatereh Naghdi, Gerard Oreilly, Ellen Merete, Alexander Vaccaro, Edward C. Benzel, Seyed Behzad Jazayeri, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Background: The National Traumatic Spinal Cord Injury Registry in Iran (NSCIR-IR), was implemented initially in three hospitals as a pilot phase from 11 Oct 2015 to 19 Jun 2016 and has been active in eight centers from 19 Jun 2016. Poursina Hospital, a trauma care referral center in Rasht, Guilan Province of Iran is one of the registry sites, and has been involved in registering eligible patients since 1 Jan 2016. This study aimed to identify the challenges and solutions for sustaining the NSCIR-IR in a regional center.

Methods: This was a mixed-methods study. For the quantitative analysis, a retrospective …

Anaesthetic Management For Hiatal Hernia Repair In A Child With Bartter's Syndrome: A Case Report, Durriya Raza, Fauzia Khan

Department of Anaesthesia

Bartter syndrome is a rare disorder characterized by reduced sodium chloride transport in the distal nephrons of the kidney. Its clinical features are renal salt wasting, hypokalemic metabolic alkalosis, elevated renin and aldosterone levels with normal or low blood pressure, polyuria, hypercalciuria and malnutrition. The pathophysiologic and biochemical changes in these patients should be kept in mind when considering anaesthetic management. This case report describes our management in a nineteen months old, 3.6 kg weight male child with Bartter's syndrome who underwent elective repair of hiatal hernia and gastrostomy.

Modified Danielson Technique For Prosthetic Aortic Valve Endocarditis And Aortoventricular Discontinuity, Gianfranco Filippone, Claudia Calia, Mario Finazzo, Fabio Fazzari, Giovanni Caruana, Vincenzo Argano

The Texas Heart Institute Journal

Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aortic annulus destruction and aortoventricular …

Robotic-Assisted Percutaneous Coronary Intervention Through Transradial Approach: Experience In 4 Patients With Complex Lesions, Amornpol Anuwatworn, Muhammad Ali Kahn, Tomasz Stys, Marian Petrasko, Adam Stys

The Texas Heart Institute Journal

Robotic-assisted percutaneous coronary intervention can reduce the exposure of interventional cardiologists to radiation and minimize the risk of occupational orthopedic injuries from wearing heavy protective aprons. The PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) study showed the efficacy and safety of robotic-assisted procedures for relatively low-risk lesions in single coronary arteries. Several reports have described robotic-assisted treatment of complex high-risk lesions, mostly through the transfemoral approach. We report 4 cases of patients in whom we used the transradial approach to treat complex lesions in the left anterior descending coronary artery with bifurcation balloon angioplasty reconstruction (2 cases), in the ostium of the …

Histologic Abnormalities Of The Ascending Aorta: Effects On Aortic Remodeling After Intracardiac Repair Of Tetralogy Of Fallot, Ujjwal Kumar Chowdhury, Lakshmi Kumari Sankhyan, Sheil Avneesh, Ruma Ray, Mani Kalaivani, Suruchi Hasija, Abhinavsingh Chauhan

The Texas Heart Institute Journal

We evaluated aortic tissue specimens from patients undergoing tetralogy of Fallot repair, to determine whether histologic abnormalities affect postsurgical aortic remodeling and other patient-related variables.

Using light microscopy, we studied full-thickness aortic wall tissue operatively excised from 118 consecutive patients undergoing intracardiac repair of tetralogy of Fallot. We performed multiple linear regression analysis to identify independent predictors of change in aortic root dimensions, which we measured with echocardiography after repair and every 3 months thereafter.

Thirty histologically normal specimens were used as controls. Elastic fiber fragmentation was found in 74.6% of the abnormal specimens, mucoid extracellular matrix accumulation in 49.2%, …

Speckle-Tracking Echocardiography In Cardio-Oncology And Beyond, Raymundo A Quintana, Linh P Bui, Rohit Moudgil, Nicolas Palaskas, Saamir Hassan, Jun-Ichi Abe, Elie Mouhayar, Syed Wamique Yusuf, Antonieta Hernandez, Jose Banchs

The Texas Heart Institute Journal

Speckle-tracking echocardiography has enabled clinicians to detect changes in myocardial function with more sensitivity than that afforded by traditional diastolic and systolic functional measurements, including left ventricular ejection fraction. Speckle-tracking echocardiography enables evaluation of myocardial strain in terms of strain (percent change in length of a myocardial segment relative to its length at baseline) and strain rate (strain per unit of time). Both measurements have potential for use in diagnosing and monitoring the cardiovascular side effects of cancer therapy. Regional and global strain measurements can independently predict outcomes not only in patients who experience cardiovascular complications of cancer and cancer …

Supporting Self-Regulation Of Children With Adhd Using Wearables: Tensions And Design Challenges, Franceli L. Cibrian, Kimberley D. Lakes, Arya Tavakoulnia, Kayla Guzman, Sabrina Schuck, Gillian R. Hayes

Engineering Faculty Articles and Research

The design of wearable applications supporting children with Attention Deficit Hyperactivity Disorders (ADHD) requires a deep understanding not only of what is possible from a clinical standpoint but also how the children might understand and orient towards wearable technologies, such as a smartwatch. Through a series of participatory design workshops with children with ADHD and their caregivers, we identified tensions and challenges in designing wearable applications supporting the self-regulation of children with ADHD. In this paper, we describe the specific challenges of smartwatches for this population, the balance between self-regulation and co-regulation, and tensions when receiving notifications on a smartwatch …