Medical Specialties Commons^™

Brief Psychotherapy In Primary Care, Geoffrey Mills, Md, Phd

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Overview Case

Thread Goals

• Acknowledgement
• Rationale
• Background ‘theory’
• Framework(s) Practical applications

Response Of Extensively Drug Resistant Salmonella Typhi To Treatment With Meropenem And Azithromycin, In Pakistan, Sonia Qureshi, Abdullah B. Naveed, Mohammad Tahir Yousafzai, Khalil Ahmad, Sarwat Ansari, Heeramani Lohana, Aiman Mukhtar, Farah Naz Qamar

Department of Paediatrics and Child Health

Introduction: Salmonella Typhi is one of the leading health problems in Pakistan. With the emergence of extensively drug resistant (XDR) Salmonella Typhi, treatment options are limited. Here we report the clinical manifestations and the response to treatment of patients with XDR Typhoid fever. The patients were treated with either Meropenem or Azithromycin or a combination of both.
Methods: We reviewed the records of culture confirmed XDR typhoid who visited Aga Khan University Hospital (AKUH), Karachi and Aga Khan Secondary Care Hospital, Hyderabad from April 2017 to June 2018. Symptoms developed during disease, unplanned treatment extension and complications developed while on …

Optic Disc Pits: A Case Report And Review, Jeffrey A. Sterling Od, Faao, Fsls

Optometric Clinical Practice

Background: Congenital optic disc pits (ODP) are a rare clinical finding affecting approximately 1 in 11,000 people. Affected individuals are generally asymptomatic unless fluid accumulates in the macula resulting in severe vision loss. The management of ODPs depends mostly on clinical findings and can range from observation to surgery. Optometrists need to be aware of clinical presentations and possible complications of ODPs.

Case Report: This report will review a case of an asymptomatic optic disc pit and discuss the potential treatment options if complications arise.

Conclusion: Although rare, congenital optic disc pits need to be accurately assessed and diagnosed. Symptoms …

Transcatheter Aortic Valve Implantation: Bahrain Experience, Nooraldaem Yousif, Suddharsan Subbramaniyam, Babu Thevan, Mohammad Amin, Leena Sulaibikh, Nazar Bukamal, Habib Tareif, Sadananda Shivappa, Haitham Amin, Husam A. Noor

Journal of the Saudi Heart Association

STRUCTURED ABSTRACT

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that is considered a good alternative to surgical aortic valve replacement (sAVR) in selected patients. Our aim is to determine the baseline, procedural characteristics and one-year clinical outcomes of our TAVI registry.

METHODS: This study is a retrospective observational analysis of a prospectively designed cohort comprising 81 consecutive patients treated at Mohammed bin Khalifa Cardiac Centre (MKCC) who were enrolled in Bahrain TAVI registry from February 2014 to February 2019. The clinical endpoints were defined according to the updated Valve Academic Research Consortium-2 (VARC-2) consensus document.

RESULTS: …

Accuracy Of Rn Visual Quantification Of Emesis Volumes In The Neonatal Intensive Care Unit, Stephen Stoever

Seton Hall University DNP Final Projects

An important component of nursing assessment of feeding tolerance in the neonatal intensive care unit (NICU) for both low-risk and high-risk babies, is the quantification of emesis volumes. While some nurses attempt to weigh the items saturated in emesis in order to quantify volume loss (QEV), there is no or limited consistency in this practice across nurses in this unit. Rather, volumes are “best-guessed” or estimated (EEV) and reported to the practitioner for decision-making. Often feed advances are paused or limited due to perceived feeding intolerance connected to emesis events in neonates.

For this project, 158 NICU nurses at a …

Incorporating Kidney Disease Measures Into Cardiovascular Risk Prediction: Development And Validation In 9 Million Adults From 72 Datasets, Kunihiro Matsushita, Simerjot K. Jassal, Yingying Sang, Shoshana H. Ballew, Morgan E. Grams, Aditya Surapaneni, Johan Arnlov, Nisha Bansal, Milica Bozic, Tazeen H. Jafar

Section of Nephrology

Background: Chronic kidney disease (CKD) measures (estimated glomerular filtration rate [eGFR] and albuminuria) are frequently assessed in clinical practice and improve the prediction of incident cardiovascular disease (CVD), yet most major clinical guidelines do not have a standardized approach for incorporating these measures into CVD risk prediction. "CKD Patch" is a validated method to calibrate and improve the predicted risk from established equations according to CKD measures.
Methods: Utilizing data from 4,143,535 adults from 35 datasets, we developed several "CKD Patches" incorporating eGFR and albuminuria, to enhance prediction of risk of atherosclerotic CVD (ASCVD) by the Pooled Cohort Equation (PCE) …

Distribution Of Microglial Phenotypes As A Function Of Age And Alzheimer's Disease Neuropathology In The Brains Of People With Down Syndrome, Alessandra C. Martini, Alex M. Helman, Katie L. Mccarty, Ira T. Lott, Eric Doran, Frederick A. Schmitt, Elizabeth Head

Sanders-Brown Center on Aging Faculty Publications

Introduction: Microglial cells play an important role in the development of Alzheimer's disease (AD). People with Down syndrome (DS) inevitably develop AD neuropathology (DSAD) by 40 years of age. We characterized the distribution of different microglial phenotypes in the brains of people with DS and DSAD.

Methods: Autopsy tissue from the posterior cingulate cortex (PCC) from people with DS, DSAD, and neurotypical controls was immunostained with the microglial marker Iba1 to assess five microglia morphological types.

Results: Individuals with DS have more hypertrophic microglial cells in their white matter. In the gray matter, individuals with DSAD had significantly fewer ramified …

Evaluating Implementation Of "Management Of Possible Serious Bacterial Infection (Psbi) When Referral Is Not Feasible" In Primary Health Care Facilities In Sindh Province, Pakistan, Maria Asif Bhura, Shabina Ariff, Shamim Ahmad Qazi, Zaitoon Qazi, Imran Ahmed, Yasir Bin Nisar, Zamir Suhag, Abdul Wahab Soomro, Sajid Bashir Soofi

Woman and Child Health

Background: The World Health Organization (WHO) launched a guideline in 2015 for managing Possible Serious Bacterial Infection (PSBI) when referral is not feasible in young infants aged 0-59 days. This guideline was implemented across 303 Basic Health Unit (BHU) Plus primary health care (PHC) facilities in peri-urban and rural settings of Sindh, Pakistan. We evaluated the implementation of PSBI guideline, and the quality of care provided to sick young infants at these facilities.
Methods: Thirty (10%) out of 303 BHU Plus facilities were randomly selected for evaluation. A survey team visited each facility for one day, assessed the health system …

Osseous Changes Following Reverse Total Shoulder Arthroplasty Combined With Latissimus Dorsi Transfer: A Case Series, Jason S Klein, Peter S Johnston, Benjamin W Sears, Manan S Patel, Armodios M Hatzidakis, Mark D. Lazarus

Department of Orthopaedic Surgery Faculty Papers

Background: This is the first report on the incidence of proximal humerus osseous changes and associated clinical consequences in reverse total shoulder arthroplasty combined with a latissimus dorsi tendon transfer (RTSA+LDT).

Methods: A multicenter, retrospective review identified all patients who had undergone a primary RTSA+LDT and had at least 3-month radiographic follow-up between 2012 and 2017. Data collection included demographics, oral steroid use, repair technique for LDT fixation, radiographic humeral osseous changes, complications, and need for revision surgery.

Results: Twenty-four patients were included with an average age of 70.7 ± 7.9 years and follow-up of 16.3 (3-50) months. Ten patients …

Ace2 Mouse Models: A Toolbox For Cardiovascular And Pulmonary Research, Hongpeng Jia, Xinping Yue, Eric Lazartigues

School of Medicine Faculty Publications

Angiotensin-converting enzyme 2 (ACE2) has been identified as the host entry receptor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for the COVID-19 pandemic. ACE2 is a regulatory enzyme of the renin-angiotensin system and has protective functions in many cardiovascular, pulmonary and metabolic diseases. This review summarizes available murine models with systemic or organ-specific deletion of ACE2, or with overexpression of murine or human ACE2. The purpose of this review is to provide researchers with the genetic tools available for further understanding of ACE2 biology and for the investigation of ACE2 in the pathogenesis and treatment of COVID-19.

Consequences Of A Missed History: A Case Of Antidepressant Discontinuation Syndrome, Sajid Hameed, Mukesh Kumar, Piyush Puri, Fnu Sapna, Pal Satyajit Singh Athwal

Section of Neurology

Antidepressant discontinuation syndrome (ADDS) is reported to occur in almost 30-50% of the patients who take antidepressants for a duration of at least four to six weeks and then suddenly discontinue the drug. Since there is an increase in the use of antidepressants for various reasons by general practitioners, patient education about when and how to discontinue a drug is not acknowledged enough. It is reported to occur with the use of different classes of antidepressants - selective serotonin reuptake inhibitor (SSRI), monoamineoxidase inhibitor (MAOI), tricyclic antidepressants (TCAs), and atypical antipsychotics like risperidone, trazodone, clozapine, and venlafaxine. Slow tapering off …

Ua12/2/1 College Heights Herald, Vol. 96, No. 8, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Lowe, Julianna. A Look Inside – Jamison Moorehead, Quarantine
• Burris, Lily. Day in the Life – Sharon Hunter
• Collins, Michael & Lauren Deppen. Need to Know – COVID-19
• Frazier, Keilen. Homecoming in Barnes-Campbell Hall – Quarantine
• Lowe, Julianna. Survey to Student – Dining Services, Quarantine
• Collins, Michael. Kentucky Universities’ Records on COVID-19
• Burris, Lily. Voices on the Inside – Sam Padgett, Chris Willis, Parker Randall, River Carter, Iyanla Shackelford
• Hargrove, Matthew. Herd Tramples WKU – Football
• Gaylord, Kaden. Travis Hudson is the Greatest of All …

A Body Shape Index Significantly Predicts Mri-Defined Abdominal Adipose Tissue Depots In Non-Obese Asian Indians With Type 2 Diabetes Mellitus, Shajith Anoop, Jesse Krakauer, Nir Krakauer, Anoop Misra

Publications and Research

Introduction: We aimed to determine the correlations of volumes of subcutaneous abdominal adipose tissue (SCAT) (anterior, posterior, superficial and deep), total SCAT, intraperitoneal adipose tissue, retroperitoneal abdominal adipose tissue (RPAT), total intra-abdominal adipose tissue (IAAT), pancreatic volume, liver span, total body fat (TBF) and truncal fat mass (TFM) with anthropometric indices, viz., A Body Shape Index (ABSI), Hip Index, their Z scores and Anthropometric Risk Index in non-obese (body mass index (BMI) /m²) Asian Indians with type 2 diabetes mellitus (T2DM).

Research design and methods: Non-obese patients with T2DM (cases; n, 85) and BMI-matched, healthy subjects …

No Time To Die: The Consensus Immunoscore For Predicting Survival And Response To Chemotherapy Of Locally Advanced Colon Cancer Patients In A Multicenter International Study., Paolo A Ascierto, Francesco M Marincola, Bernard A Fox, Jérôme Galon

Articles, Abstracts, and Reports

The multicenter international Society for Immunotherapy of Cancer (SITC) study of the consensus Immunoscore demonstrated the prediction of survival and response to chemotherapy in 763 Stage III colon cancer (CC) patients. Similar Immunoscore groups were found in elderly patients, and densities of immune cells and intratumoral T-cell repertoire were not decreasing with age in the tumor microenvironment. In two independent cohorts, Immunoscore significantly predicted time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS), including within high-risk (T4 or N2) and low-risk (T1-3, N1) patients. In stratified Cox multivariable analysis for TTR, DFS, and OS, Immunoscore's association to outcomes …

Types And Risk Factors Of Violence Experienced By People Living With Hiv, Pakistan: A Cross-Sectional Study, Safia Awan, Nukhba Zia, Fatima Sharif, Sharaf Ali Shah, Bushra Jamil

Department of Medicine

Background: In Pakistan, data are lacking on the violence experienced by people living with HIV.
Aims: This study determined the prevalence and risk factors of violence (physical, psychological and sexual) in people living with HIV in Karachi, Pakistan.
Methods: This was a cross-sectional study in 2016 of people living with HIV attending clinics of Bridge Consultants Foundation, a community-based care provider. Date were collected using an interview-based questionnaire. Multivariate logistic regression analysis was done to assess the risk factors for violence with adjusted odds ratios (aOR) and 95% confidence intervals (CI) presented.
Results: The sample included 250 people living with …

Analysis Of Covid-19 Burden, Epidemiology And Mitigation Strategies In Muslim Majority Countries, Rachel Jardine, James Wright, Zainab Samad, Zulfiqar Ahmed Bhutta

Section of Cardiology

Background: Muslim majority countries have experienced a considerable burden of COVID-19 infection. However, there has been a relative lack of research comparing COVID-19 outbreaks and responses between Muslim-majority countries.
Aims: This study aimed to analyse COVID-19 burden, epidemiology and mitigation strategies in Muslim-majority countries.
Methods: We use a mixed-methods approach to describe the course of the COVID-19 pandemic throughout the Islamic world, highlight the range of non-pharmaceutical interventions used and the speed with which they were implemented, and investigate reasons behind the differing responses between Muslim-majority countries. The number of cases and deaths per million population, and the mean time …

Comparison Of Outcomes Of Hct In Blast Phase Of Bcr-Abl1- Mpn With De Novo Aml And With Aml Following Mds, Vikas Gupta, Soyoung Kim, Zhen-Huan Hu, Ying Liu, Mahmoud Aljurf, Ulrike Bacher, Amer Beitinjaneh, Jean-Yves Cahn, Jan Cerny, Edward Copelan, Shahinaz M Gadalla, Robert Peter Gale, Siddhartha Ganguly, Biju George, Aaron T Gerds, Usama Gergis, Betty K Hamilton, Shahrukh Hashmi, Gerhard C Hildebrandt, Rammurti T Kamble, Tamila Kindwall-Keller, Hillard M Lazarus, Jane L Liesveld, Mark Litzow, Richard T Maziarz, Taiga Nishihori, Richard F Olsson, David Rizzieri, Bipin N Savani, Sachiko Seo, Melhem Solh, Jeff Szer, Leo F Verdonck, Baldeep Wirk, Ann Woolfrey, Jean A Yared, Edwin P Alyea, Uday R Popat, Ronald M Sobecks, Bart L Scott, Ryotaro Nakamura, Wael Saber

Department of Medical Oncology Faculty Papers

Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1- myeloproliferative neoplasms (MPNs) in blast phase (MPN-BP) vs de novo acute myeloid leukemia (AML), and AML with prior myelodysplastic syndromes (MDSs; post-MDS AML), are unknown. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared HCT outcomes in 177 MPN-BP patients with 4749 patients with de novo AML, and 1104 patients with post-MDS AML, using multivariate regression analysis in 2 separate comparisons. In a multivariate Cox model, no difference in overall survival (OS) or relapse was observed in patients with MPN-BP vs de novo AML with …

Genome-Wide Dna Methylation Profiling In Human Breast Tissue By Illumina Truseq Methyl Capture Epic Sequencing And Infinium Methylationepic Beadchip Microarray, Nan Lin, Jinpeng Liu, James Castle, Jun Wan, Aditi Shendre, Yunlong Liu, Chi Wang, Chunyan He

Markey Cancer Center Faculty Publications

A newly-developed platform, the Illumina TruSeq Methyl Capture EPIC library prep (TruSeq EPIC), builds on the content of the Infinium MethylationEPIC Beadchip Microarray (EPIC-array) and leverages the power of next-generation sequencing for targeted bisulphite sequencing. We empirically examined the performance of TruSeq EPIC and EPIC-array in assessing genome-wide DNA methylation in breast tissue samples. TruSeq EPIC provided data with a much higher density in the regions when compared to EPIC-array (~2.74 million CpGs with at least 10X coverage vs ~752 K CpGs, respectively). Approximately 398 K CpGs were common and measured across the two platforms in every sample. Overall, there …

Feasibility Of Removable Balloon Implant For Simultaneous Magnetic Nanoparticle Heating And Hdr Brachytherapy Of Brain Tumor Resection Cavities., Paul R. Stauffer, Dario B. Rodrigues, Robert Goldstein, Thinh Nguyen, Yan Yu, Shuying Wan, Richard Woodward, Michael Gibbs, Ilya L. Vasilchenko, Alexey M. Osintsev, Voichita Bar-Ad, Dennis B. Leeper, Wenyin Shi, Kevin D. Judy, Mark D. Hurwitz

Department of Radiation Oncology Faculty Papers

AIM: Hyperthermia (HT) has been shown to improve clinical response to radiation therapy (RT) for cancer. Synergism is dramatically enhanced if HT and RT are combined simultaneously, but appropriate technology to apply treatments together does not exist. This study investigates the feasibility of delivering HT with RT to a 5-10mm annular rim of at-risk tissue around a tumor resection cavity using a temporary thermobrachytherapy (TBT) balloon implant.

METHODS: A balloon catheter was designed to deliver radiation from High Dose Rate (HDR) brachytherapy concurrent with HT delivered by filling the balloon with magnetic nanoparticles (MNP) and immersing it in a radiofrequency …

Outcomes And Management Approaches Of Resuscitative Endovascular Balloon Occlusion Of The Aorta Based On The Income Of Countries, Ramiro Manzano-Nunez, David Mcgreevy, Claudia P. Orlas, Alberto F. Garciá, Tal M. Hörer, Joseph Dubose, Carlos A. Ordoñez, Aast-Aorta Investigators And The Abotrauma Registry Group

Department of Surgery Faculty Publications

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) could provide a survival benefit to severely injured patients as it may improve their initial ability to survive the hemorrhagic shock. Although the evidence supporting the use of REBOA is not conclusive, its use has expanded worldwide. We aim to compare the management approaches and clinical outcomes of trauma patients treated with REBOA according to the countries' income based on the World Bank Country and Lending Groups. Methods: We used data from the AORTA (USA) and the ABOTrauma (multinational) registries. Patients were stratified into two groups: (1) high-income countries (HICs) and …

Clinical Application Of Oncolytic Viruses: A Systematic Review, Mary Cook, Aman Chauhan

Internal Medicine Faculty Publications

Leveraging the immune system to thwart cancer is not a novel strategy and has been explored via cancer vaccines and use of immunomodulators like interferons. However, it was not until the introduction of immune checkpoint inhibitors that we realized the true potential of immunotherapy in combating cancer. Oncolytic viruses are one such immunotherapeutic tool that is currently being explored in cancer therapeutics. We present the most comprehensive systematic review of all oncolytic viruses in Phase 1, 2, and 3 clinical trials published to date. We performed a systematic review of all published clinical trials indexed in PubMed that utilized oncolytic …

A Roller Coaster Ride Of Idiopathic Fibrosing Mediastinitis, Qian Zhang, Khine Shan

Abington Jefferson Health Papers

No abstract provided.

Ratings Of Performance In Multisource Feedback: Comparing Performance Theories Of Residents And Nurses, Muhammed Tariq, Marjan Govaerts, Azam Afzal, Syed Ahsan Ali, Tabassum Zehra

Department for Educational Development

Background: Multisource feedback (MSF) is increasingly being used to assess trainee performance, with different assessor groups fulfilling a crucial role in utility of assessment data. However, in health professions education, research on assessor behaviors in MSF is limited. When assessing trainee performance in work settings, assessors use multidimensional conceptualizations of what constitutes effective performance, also called personal performance theories, to distinguish between various behaviors and sub competencies., This may not only explain assessor variability in Multi Source Feedback, but also result in differing acceptance (and use) of assessment data for developmental purposes. The purpose of this study was to explore …

A Community Assessment Of Rapid Response Team Events Preceding Cardiopulmonary Arrest: Does It Improve Outcomes?, Vincent Chan, Ahmad Raza, Qian Zhang, Artem Minalyan, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

Rare Cause Of Fatal Liver Disease: A Case Of Acute Liver Failure In A Patient With Recently Diagnosed Metastatic Ovarian Carcinoma, Artem Minalyan, Qian Zhang, Vincent Chan

Abington Jefferson Health Papers

No abstract provided.

An Unlikely Combination Of Neutrophilic Predominant Pleural Effusion With Acid-Fast Bacilli Positivity, Vincent Chan, Qian Zhang, Ahmad Raza, Artem Minalyan, William Ward

Abington Jefferson Health Papers

No abstract provided.

"Brain Dead" Donor: A Case Of Brain Death Mimic Due To Pentobarbital Overdose, Artem Minalyan, Vincent Chan, Qian Zhang

Abington Jefferson Health Papers

No abstract provided.

Survival Analysis Based On The Duration Of Cpr After In-Hospital Cardiac Arrest, Ahmad Raza, Nayab Nadeem, Ahmad Arslan, Zain Ali, Qian Zhang, Usama Sadiq, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

The Role Of Adhesives In Dermatologic Surgery: Tips, Tricks And Review, Adam Chahine, Stefanie Lynn Altmann, Mariam Salman, Karthik Krishnamurthy

Dermatology

Background: The utilization of tissue adhesives for wound closure has historically been well established in the emergency department setting. More recently, it has been adopted by dermatologists and other surgical specialties as an alternative or adjunct to more traditional bilayered wound closures.

Purpose: This serves as a comprehensive review of the available scientific literature on the utilization of tissue adhesives compared to traditional bilayered closures. We discuss benefits, drawbacks, as well as novel surgical techniques, as applicable to dermatologic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE for relevant articles related to the use of adhesives and …

Metastatic Squamous Cell Carcinoma: A Cautionary Tale, Colby Shreve, Chase Shropshire, David G. Cotter

School of Medicine Faculty Research

Cutaneous squamous cell carcinoma (cSCC) typically arises from a malignant proliferation of keratinocytes. It is the second most common cancer in the United States and typically affects older white men. Risk factors for cSCC include ultraviolet radiation exposure, light skin tone, and immunosuppression. Although metastasis in cSCC is rare, primary tumor characteristics such as location, size, and depth of invasion, among others, can help risk-stratify lesions for local recurrence, metastatic events, and death. We present a case of primary cutaneous metastatic squamous cell carcinoma masquerading as a cyst on the left temple of a 73-year-old Caucasian man following numerous treatments …