Medical Specialties Commons^™

Assessment Of Auditory Dysfunction As An Extra-Articular Manifestation In Rheumatoid Arthritis Using Brainstem Auditory-Evoked Potential, Abeer H. Ismaiel, Ahmad M. A. Gawad, Amany F. Hakim, Soha S. Shaaban

Journal of Medicine in Scientific Research

Objectives The paper aims to study brainstem auditory-evoked potential parameter changes in rheumatoid arthritis (RA) patients, and their relation to the duration of illness, degree of disease activity, functional stage of the disease, and intensity of pain. Materials and methods Control (group 1) comprised 25 healthy female patients of age 50–60 years, while the study group (group 2) comprised 25 female patients with RA of more than 5 years. Proven cases of RA (according to american college of rheumatology (ACR) 2010 criteria) underwent brainstem auditory-evoked potentials. The recording was carried out by using RMS EMG EPMK2. In the RA group, …

Posterior Tympanotomy Versus Posterior Atticotomy In Creating Well-Ventilated Middle Ear Cleft Pros And Cons, Essam F. Abdelfattah, Wael A. Alzami

Journal of Medicine in Scientific Research

Background Cortical mastoidectomy is considered a cornerstone step in the surgical management of noncholesteatomatous chronic suppurative otitis media. It comprises the canal wall-up technique, preserving the posterior and superior bony canal walls. The goal of cortical mastoidectomy is mainly to ventilate the middle ear cleft besides eradication of diseased mastoid air cells. The ventilation of the middle ear cleft has no way except through the aditus ad antrum and patent epitympanic diaphragm besides well-functioning Eustachian tube. This way of ventilation is usually affected in chronic infected ears by edematous and polypoid mucosa, leading to its obstruction. Traditional practice used to …

Prediction Of Cardiac Surgery-Associated Acute Kidney Injury Using Cleveland And Mehta Scores, Maged M. A. Kisho

Journal of Medicine in Scientific Research

Objective To detect the clinical accuracy of two models for the prediction of cardiac surgery-associated acute kidney injury (AKI) and severe AKI that need renal replacement therapy according to Cleveland and Mehta scores and using Kidney Disease Improving Global Outcomes (KDIGO) definitions for AKI. Patients and methods In total, 742 patients who underwent cardiac surgery in the Department of Cardiac Surgery NHI of Egypt, between January 2016 and December 2018, were enrolled in this research. We evaluate the prediction for cardiac surgery-associated AKI using Cleveland and Mehta scores. We also evaluate the effect of hemofiltration during cardiopulmonary bypass as a …

Predictors Of Left Ventricular Systolic Dysfunction After Primary Percutaneous Coronary Intervention For Patients With Left Anterior Descending Artery Occlusion, Ahmed Galal A Fattah Fahmy, Mohamed E. L Bordy

Journal of Medicine in Scientific Research

Background Depressed left ventricular (LV) systolic function after acute coronary syndrome is the most important predictor affecting morbidity and mortality. The primary objective of reperfusion therapy is to restore epicardial flow and to reperfuse the myocardial tissue. However, not all the patients show improvement, and a group of patients may experience depression in heart function. Aim To determine the factors affecting impairment of LV function assessed by echocardiography following successful primary percutaneous coronary intervention (PCI) in patients with acute coronary syndrome involving the left anterior descending (LAD) artery. Patients and methods A total of 50 patients were included in this …

Metabolic Syndrome And Asthma, Therese S. Ghatas

Journal of Medicine in Scientific Research

Introduction Bronchial asthma is one of the chronic diseases that most commonly present worldwide. Asthma is still a poorly controlled disease despite the availability and intake of medications in a large percentage of asthmatic patients. Research studies are indicated to identify the effect of metabolic syndrome on the occurrence of asthma and its severity and also to clear the underlying important mechanisms. Patients and methods This cross-section study was carried out on 108 patients with asthma. Asthma was diagnosed and classify according to Global Initiative for Asthma guideline. All asthmatic patients were tested for the criteria of metabolic syndrome. Aim …

Health-Related Quality Of Life In Children And Adolescents With Chronic Kidney Diseases At Sohag, Egypt: A Case–Control Study, Ahmed M. Hegab, Eman Abdel-Baset Mohamed, Fouad M. A. Yousef, Rasha Gamal-El-Din Abu-El-Goud

Journal of Medicine in Scientific Research

Background and objectives Chronic kidney diseases (CKD) have multiple complications that could impair the quality of life in the affected children and their families. This study aimed to assess the health-related quality of life (HRQOL) and detect factors affecting it in children with CKD and their families at Sohag, Egypt. Patients and methods The study included 113 children and adolescents with CKD stages 1–5, aged 2–18 years old, attending the pediatric nephrology outpatient clinic and the pediatric dialysis unit at Sohag University Hospital. Two hundred twenty-six children were in the control-group age and sex matched to cases with urinary-system condition …

The Effect Of Cervical Spondylosis On Diaphragmatic Thickness And Excursion In Nonsmoking Adults, Akram A. Elaziz, Bishoy G. Khalil, Saif Mehmed, Tamer A. El-Kassas

Journal of Medicine in Scientific Research

Background Cervical spondylosis is defined as a series of signs and symptoms that result in anatomical and physiological changes in the vertebral column that may impair phrenic nerve function by compressing the C3/C5 that affect diaphragmatic movements. Purpose The purpose of this study was to investigate the effect of cervical spondylosis on diaphragmatic thickness and excursion in nonsmoking adults by using ultrasonographic evaluation of the diaphragm. Eighty-four nonsmoking volunteers participated in this study and were divided into two equal groups: group A, patients with cervical spondylosis and group B, healthy volunteers with a normal cervical spine. Both groups were evaluated …

Effectiveness Of Ultrasound-Guided Platelets Rich Plasma Injection In Knee Osteoarthritic Cases, Abeer N. A. Aziz, Gamal S.E E. Khalifa, Hesham Alshabrawy, Lamis Safwat

Journal of Medicine in Scientific Research

Backgroud Knee osteoarthritis is the most common articular disease. Different methods are used to alleviate the symptoms of patients with knee osteoarthritis, including analgesics, physical therapy, exercise prescription, and intra-articular injections (glucocorticoids, hyaluronic acid). New studies have focused on modern therapeutic methods that stimulate the cartilage healing process and improve the damage, including the use of platelet-rich plasma as a complex growth factor. Aim of the work To evaluate the effectiveness of intra articular PRP in mild to moderate degree knee osteoarthritis. Objectives To slow the rate of progression of knee Osteoarthritis by injection of PRP intraarticular. Decrease pain and …

Relationship Between Chronic Obstructive Pulmonary Disease And Helicobacter Pylori Infection, Moheb W. Elfaizy, Therese S. Ghatas

Journal of Medicine in Scientific Research

Introduction There are insignificant observations and few research studies that indicate the action of Helicobacter pylori in the induction of extra-gastrointestinal tract diseases, which include autoimmune, skin, and vascular diseases, and also some pulmonary diseases. Moreover, it has been documented that the incidence of chronic bronchitis may be elevated in patients who experienced H. pylori infection. Aim To assess infection with H. pylori in patients with chronic obstructive pulmonary disease (COPD) and in control persons and also to determine the association between serology level of H. pylori and spirometry parameters in patients experiencing COPD. Results A total of 100 individuals …

The Role Of Postoperative Imaging In Cochlear Implants, Essam F. Mohammed

Journal of Medicine in Scientific Research

Objective The aim was to evaluate the role and efficacy of high-resolution computed tomography (CT) scan after cochlear implantation in evaluating the integrity and insertion of the electrode, whether complete or incomplete, whether intracochlear or extracochlear, and whether to change the decision for revision or not. Sitting The study was conducted at the Hearing and Speech Institute. Patients and methods All the patients 300 cases undergo CT scan radiology within one week postoeratively and reevaluated for electrode insertion. Complete, incomplete, or over insertion. intracochlear or extracchlear. Results This study was carried out on 312 cases from January 2019 to December …

Patient–Valve Mismatch: A Comparison Of Mechanical Versus Biological Prostheses In Ischemic Mitral Patients Undergoing Chordal-Sparing Mitral Valve Replacement, Ahmed S. Ali, Rania D.E A. Shokka, Rasha H. Mohammed

Journal of Medicine in Scientific Research

Background Chordal-sparing mitral valve replacement (MVR) is now preferred over downsized annuloplasty repair in treating chronic severe ischemic mitral regurgitation. However, total leaflet preservation carries the risk of patient–valve mismatch (PVM). The authors aimed to investigate the incidence of PVM among those groups of patients who were treated with either mechanical or biological MVR. Objective This study aimed to compare the incidence of PVM in ischemic mitral regurgitation patients undergoing total revascularization together with chordal-sparing MVR with either biological or mechanical prosthesis. Patients and methods A controlled prospective study was carried out at the National Heart Institute Cairo, Egypt. 50 …

Processing Binding Data Using An Open-Source Workflow, Errol L G Samuel, Secondra L Holmes, Damian W Young

Faculty, Staff and Students Publications

The thermal shift assay (TSA)—also known as differential scanning fluorimetry (DSF), thermofluor, and Tm shift—is one of the most popular biophysical screening techniques used in fragment-based ligand discovery (FBLD) to detect protein–ligand interactions. By comparing the thermal stability of a target protein in the presence and absence of a ligand, potential binders can be identified. The technique is easy to set up, has low protein consumption, and can be run on most real-time polymerase chain reaction (PCR) instruments. While data analysis is straightforward in principle, it becomes cumbersome and time-consuming when the screens involve multiple 96- or 384-well plates. There …

Beyond The Raskin Protocol: Ketamine, Lidocaine, And Other Therapies For Refractory Chronic Migraine., Jeffrey J. Mojica, Eric S. Schwenk, Clinton Lauritsen, Stephanie J. Nahas

Department of Anesthesiology Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine.

RECENT FINDINGS: In carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine. Many patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingly common for these patients when all other treatments have failed. There is a clear need for prospective studies …

A Literature Review Of Mild Traumatic Brain Injury Research, Brindlea Peterson

Honors Theses

Mild traumatic brain injuries (mTBI) are a type of traumatic brain injury (TBI) usually sustained from an injury to the head and are hard to diagnose due to the lack of physical evidence seen in diagnostic radiology. The estimated worldwide rate of incidence each year is 42 million, making mTBIs rather common. In the US armed forces, that rate of incidence is even higher due to the dangerous nature of the work being done. Many complications can come from not properly addressing an mTBI after it happens which makes being able to determine an appropriate return-to-play or return-to-duty time very …

The Efficacy Of The Low-Fodmap Diet To Alleviate Symptoms Of Irritable Bowel Syndrome In Adults: A Systematic Review, Jacqueline Nicole Rustom

Theses and Dissertations

Irritable bowel syndrome (IBS) is a functional bowel disorder with 6.5% worldwide prevalence that causes gas production, abdominal distension, and abdominal pain or discomfort. This systematic review describes efficacy of the Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols (FODMAP) diet (Low-FODMAP diet or LFD) to alleviate IBS symptoms using the PRISMA guidelines. Nine randomized controlled trials (RCT) and one non-RCT consecutive controlled study published between 2015 to 2019 were identified using PubMed and CENTRAL. Included studies involved adult IBS participants with symptoms of abdominal pain, constipation, and/or diarrhea. A total of 530 participants completed the interventions from the 10 studies included …

Intra-Tumoral Nerve-Tracing In A Novel Syngeneic Model Of High-Grade Serous Ovarian Carcinoma, Jeffrey L Barr, Allison Kruse, Anthony C Restaino, Natalia Tulina, Sarah Stuckelberger, Samuel J Vermeer, Caitlin S Williamson, Daniel W Vermeer, Marianna Madeo, Jillian Stamp, Maria Bell, Mark Morgan, Ju-Yoon Yoon, Marilyn A Mitchell, Anna Budina, Dalia K Omran, Lauren E Schwartz, Ronny Drapkin, Paola D Vermeer

Faculty, Staff and Student Publications

Dense tumor innervation is associated with enhanced cancer progression and poor prognosis. We observed innervation in breast, prostate, pancreatic, lung, liver, ovarian, and colon cancers. Defining innervation in high-grade serous ovarian carcinoma (HGSOC) was a focus since sensory innervation was observed whereas the normal tissue contains predominantly sympathetic input. The origin, specific nerve type, and the mechanisms promoting innervation and driving nerve-cancer cell communications in ovarian cancer remain largely unknown. The technique of neuro-tracing enhances the study of tumor innervation by offering a means for identification and mapping of nerve sources that may directly and indirectly affect the tumor microenvironment. …

Radioembolization With Chemotherapy For Colorectal Liver Metastases: A Randomized, Open-Label, International, Multicenter, Phase Iii Trial, Mary F Mulcahy, Armeen Mahvash, Marc Pracht, Amir H Montazeri, Steve Bandula, Robert C G Martin, Ken Herrmann, Ewan Brown, Darryl Zuckerman, Gregory Wilson, Tae-You Kim, Andrew Weaver, Paul Ross, William P Harris, Janet Graham, Jamie Mills, Alfonso Yubero Esteban, Matthew S Johnson, Constantinos T Sofocleous, Siddharth A Padia, Robert J Lewandowski, Etienne Garin, Philip Sinclair, Riad Salem

Faculty, Staff and Student Publications

PURPOSE: To study the impact of transarterial Yttrium-90 radioembolization (TARE) in combination with second-line systemic chemotherapy for colorectal liver metastases (CLM).

METHODS: In this international, multicenter, open-label phase III trial, patients with CLM who progressed on oxaliplatin- or irinotecan-based first-line therapy were randomly assigned 1:1 to receive second-line chemotherapy with or without TARE. The two primary end points were progression-free survival (PFS) and hepatic PFS (hPFS), assessed by blinded independent central review. Random assignment was performed using a web- or voice-based system stratified by unilobar or bilobar disease, oxaliplatin- or irinotecan-based first-line chemotherapy, and

RESULTS: Four hundred twenty-eight patients from …

A Survey Of Delirium Self-Reported Knowledge And Practices Among Emergency Physicians In The United States, Anita N. Chary, Adriane Lesser, Sharon K. Inouye, Christopher R. Carpenter Md, Msc, Amy R. Stuck, Maura Kennedy

Journal of Geriatric Emergency Medicine

Objective: This study aimed to evaluate United States emergency physicians’ self-reported knowledge and practices regarding the detection, prevention, and management of delirium, a common and deadly syndrome that disproportionately affects older emergency department (ED) patients. Knowledge and practices of the broader emergency physician community about these priority topics in geriatric emergency medicine are understudied.

Design: Electronic self-administered online survey

Setting: United States

Participants: One-hundred ninety-seven emergency physicians of the American College of Emergency Physicians Emergency Medicine Practice Research Network

Measures: Descriptive statistics were generated from survey responses.

Results: Of 734 physicians in the research network who were sent the …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke

Department of Paediatrics and Child Health

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low …

Defining Disparities In Cochlear Implantation Through The Social Determinants Of Health, Marissa Schuh, Matthew L. Bush

Otolaryngology--Head & Neck Surgery Faculty Publications

Hearing loss is a global public health problem with high prevalence and profound impacts on health. Cochlear implantation (CI) is a well-established evidence-based treatment for hearing loss; however, there are significant disparities in utilization, access, and clinical outcomes among different populations. While variations in CI outcomes are influenced by innate biological differences, a wide array of social, environmental, and economic factors significantly impact optimal outcomes. These differences in hearing health are rooted in inequities of health-related socioeconomic resources. To define disparities and advance equity in CI, there is a pressing need to understand and target these social factors that influence …

Implementation Of A Pre-Anesthesia Take-Home Evaluation (Pathe) As A Means Of Process Improvement: A Best Practice Recommendation, Russell Gray, Hunter Brown, Trey Galloway

Doctoral Projects

The pre-anesthesia evaluation (PAE) is a vital component to anesthesia providers when choosing an appropriate anesthetic plan for patients requiring surgery. The PAE, pre-anesthesia risk-factor assessment, and provision of pre-anesthesia instructions are standards of care implemented in order to assess the patient’s likely outcome of surgery and anesthesia as well as stratify any known risk factors to optimize surgical/anesthetic outcomes. Any disruption in this process could potentially lead to decreased patient/provider satisfaction, reduced patient compliance with pre-anesthetic instructions, reduced patient safety, and unnecessary financial burden.

After the completion of a literature review, the need for a best practice recommendation was …

Exploring Occupational Therapy’S Role In Supporting Health And Wellness In The Transition To Motherhood, Katelynn A. Lillibridge, Karen Park, Susan Macdermott

Fall 2021 Virtual OTD Capstone Symposium

The transition to motherhood [matrescence] is a time of major life changes. All aspects of a new mother’s life are impacted during matrescence as she assumes her new role, identity, responsibilities, and learns the occupational skills of mothering. During this time, health, wellness, and occupational balance may all be impacted. This is a sensitive time for mothers with potential implications for both short and long-term health. Using an occupation-based approach can be a way to provide comprehensive support and care to mothers during this period to promote health and wellness, enhance occupational engagement, and support meaningful co-occupations. Currently …

An Online Educational Resource On Adaptive Sports For People With Spinal Cord Injuries, Rachel Morgan, Steven M. Gerardi

Fall 2021 Virtual OTD Capstone Symposium

A spinal cord injury (SCI) has a serious impact on an individual’s participation in everyday life activities, leading to a high risk of a sedentary life-style. There is a paucity of research pertaining to adaptive sport participation post-injury and the role of occupational therapy (OT). Additionally, there are limited resources available that inform people with SCI on the benefits of adapted sports or where to go to engage in them. As such, this paper describes the development of a doctoral capstone project to address this need. The purpose of this capstone project was to create an educational web page that …

Transition Program To Postsecondary Education For Students With Traumatic Brain Injury, Eung Gyeong Park, Susan Macdermott, Becki Cohill, Karen Park

Fall 2021 Virtual OTD Capstone Symposium

Traumatic brain injury (TBI) is a condition that occurs due to an external blow to the skull that damages the brain (Carulli et al., 2018). According to the Centers for Disease Control and Prevention, 2.5 million TBI have been reported each year. Many students with TBI face physical, cognitive, environmental, and social challenges in their transition to post-secondary education (Bedell et al., 2017). Individuals with TBI experience social and behavioral changes that interfere with their participation as they face difficulties initiating, regulating their social behaviors, and experiencing increased introversion (Bedell et al., 2017). Physical challenges include fatigue, headaches, sleep disturbances, …

Go Baby Go! Facilitating Play And Social Participation With Blind & Visually Impaired Children, Kennedy Wischmeyer, Angela Blackwell, Gina Benevente

Fall 2021 Virtual OTD Capstone Symposium

ABSTRACT NEEDED

Evaluation Of Pediatric Rheumatology Telehealth Satisfaction During The Covid-19 Pandemic, Lindsay N Waqar-Cowles, John Chuo, Pamela F Weiss, Sabrina Gmuca, Marianna Lanoue, Jon M Burnham

College of Population Health Faculty Papers

Background: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients.

Methods: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total …

Coping In Pediatric Burn Survivors And Its Relation To Social Functioning And Self-Concept, Mira D H Snider, Sarah Young, Paul T Enlow, Corrine Ahrabi-Nejad, Ariel M Aballay, Christina L Duncan

Department of Pediatrics Faculty Papers

Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, …

Dementia Risk Reduction: Why Haven't The Pharmacological Risk Reduction Trials Worked? An In-Depth Exploration Of Seven Established Risk Factors, Ruth Peters, John Breitner, Sarah James, Gregory A. Jicha, Pierre-Francois Meyer, Marcus Richards, A. David Smith, Hussein N. Yassine, Erin L. Abner, Atticus H. Hainsworth, Patrick G. Kehoe, Nigel Beckett, Christopher Weber, Craig Anderson, Kaarin J. Anstey, Hiroko H. Dodge

Neurology Faculty Publications

Identifying the leading health and lifestyle factors for the risk of incident dementia and Alzheimer's disease has yet to translate to risk reduction. To understand why, we examined the discrepancies between observational and clinical trial evidence for seven modifiable risk factors: type 2 diabetes, dyslipidemia, hypertension, estrogens, inflammation, omega-3 fatty acids, and hyperhomocysteinemia. Sample heterogeneity and paucity of intervention details (dose, timing, formulation) were common themes. Epidemiological evidence is more mature for some interventions (eg, non-steroidal anti-inflammatory drugs [NSAIDs]) than others. Trial data are promising for anti-hypertensives and B vitamin supplementation. Taken together, these risk factors highlight a future need …

Macrophages Expressing Uncoupling Protein 1 Increase In Adipose Tissue In Response To Cold In Humans, Brian S. Finlin, Hasiyet Memetimin, Amy L. Confides, Beibei Zhu, Philip M. Westgate, Esther E. Dupont-Versteegden, Philip A. Kern

Internal Medicine Faculty Publications

Acute cold induces beige adipocyte protein marker expression in human subcutaneous white adipose tissue (SC WAT) from both the cold treated and contralateral leg, and the immune system regulates SC WAT beiging in mice. Cold treatment significantly increased the gene expression of the macrophage markers CD68 and 86 in SC WAT. Therefore, we comprehensively investigated the involvement of macrophages in SC WAT beiging in lean and obese humans by immunohistochemistry. Cold treatment significantly increased CD163/CD68 macrophages in SC WAT from the cold treated and contralateral legs of lean and obese subjects, and had similar effects on CD206/CD68 macrophages, whereas the …