Medical Specialties Commons^™

Cat: A Conditional Association Test For Microbiome Data Using A Permutation Approach, Yushu Shi, Liangliang Zhang, Kim-Anh Do, Robert R Jenq, Christine B Peterson

Faculty, Staff and Student Publications

In microbiome analysis, researchers often seek to identify taxonomic features associated with an outcome of interest. However, microbiome features are intercorrelated and linked by phylogenetic relationships, making it challenging to assess the association between an individual feature and an outcome. This paper proposes a novel conditional association test, CAT, that can account for other features and phylogenetic relatedness when testing the association between a feature and an outcome. CAT adopts a permutation approach, measuring the importance of a feature in predicting the outcome by permuting operational taxonomic unit/amplicon sequence variant counts belonging to that feature from the data and quantifying …

Pol Θ-Mediated End-Joining Uses Microhomologies Containing Mismatches, Yuzhen Li, Ngoc K Dang, Wei He, Mark Returan, Denisse Carvajal-Maldonado, Adele T Guerin, Han Xu, Bin Liu, Richard D Wood

Faculty, Staff and Student Publications

DNA polymerase theta (Pol θ) initiates repair of DNA double-strand breaks by pairing single strands at short "microhomologies". It is important to understand microhomology selection, as some cancer cells rely on Pol θ for survival. Here, we investigate end-joining by purified human Pol θ, employing DNA sequencing of products generated from oligonucleotide libraries having diverse 3' ends. Pol θ overwhelmingly selects short internal microhomologies found within 15 nucleotides of the terminus of single-stranded DNAs, restricting deletion size during end-joining. Significantly, we find that the selected microhomologies are usually interrupted by mismatches and that base pairing within 6 nucleotides of the …

Serological Analysis Indicating The Exposure Of Two Volunteers To Relapsing Fever Borrelia Sp. In Nayarit, Mexico, Sofía L Luna-Rojas, Edwin Vázquez-Guerrero, Jose A Hernández-Martínez, Jeanet Serafín-López, Fernando Martínez-Hernández, José Alejandro Martinez-Ibarra, Rigoberto Hernández-Castro, Job E López, J Antonio Ibarra

Faculty, Staff and Students Publications

Relapsing fever caused by Borrelia sp. is a neglected disease in Mexico and more studies are needed to update its presence in multiple regions of the country. Here, recombinant proteins glycerophosphodiester phosphodiesterase (GlpQ) and three Borrelia immunogenic protein A (BipA) variants were used for serosurveillance in 142 human serum samples. Results showed that two persons were positive to Borrelia extracts and GlpQ but negative to all three BipA, suggesting they were infected by relapsing fever spirochetes of a yet to be determined species. This shows that testing for GlpQ and Borrelia extracts are a useful tool for potential infections and …

Pan-Cancer Copy Number Analysis Identifies Optimized Size Thresholds And Co-Occurrence Models For Individualized Risk Stratification, Minh P Nguyen, William C Chen, Kanish Mirchia, Abrar Choudhury, Naomi Zakimi, Vijay Nitturi, Tiemo J Klisch, Stephen T Magill, Calixto-Hope G Lucas, Akash J Patel, David R Raleigh

Faculty, Staff and Students Publications

Chromosome instability leading to aneuploidy and accumulation of copy number gains or losses is a hallmark of cancer. Copy number alteration (CNA) signatures are increasingly used for cancer risk stratification, but size thresholds for defining CNAs across cancers are variable and the biological and clinical implications of CNA size heterogeneity and co-occurrence are incompletely understood. Here we analyze CNA and clinical data from 691 meningiomas and 10,383 tumors from The Cancer Genome Atlas to develop cancer- and chromosome-specific size-dependent CNA and CNA co-occurrence models to predict tumor control and overall survival. Our results shed light on technical considerations for biomarker …

Differential Efficacy Of Bevacizumab And Erlotinib In Preclinical Models Of Renal Medullary Carcinoma And Fumarate Hydratase-Deficient Renal Cell Carcinoma, Niki M Zacharias, Manuel Ozambela, Menuka Karki, Rong He, Pankaj K Chauhan, Pedro I Pesquera, Andres E Hernandez Gonzalez, Oscar Ochoa, Alberto Pieretti, Huiqin Chen, Carolyn De La Cerda, Zhiyuan Yu, Abha Grover, Samantha Hicks-Peña, Natalie W Fowlkes, Lei Wang, Tapati Maity, Priya Rao, Giannicola Genovese, Nizar M Tannir, Jose A Karam, Pavlos Msaouel

Faculty, Staff and Student Publications

Renal medullary carcinoma (RMC) and fumarate hydratase (FH)-deficient renal cell carcinoma (RCC) are rare and highly aggressive cancers. Although the combination of vascular endothelial growth factor (VEGF) inhibition by bevacizumab and epidermal growth factor receptor (EGFR) inhibition by erlotinib is clinically used for both diseases, the differential effect of each component has not been investigated. Transcriptomic profiling revealed that RMC and FH-deficient tumor tissues demonstrate increased EGFR but not VEGF expression compared with adjacent normal kidney. Subsequent in vitro studies revealed that RMC and FH-deficient cell lines are sensitive to erlotinib treatment, whereas clear cell RCC cell lines are resistant. …

Assessment Of Functioning Using The Whodas 20 Among People With Myasthenia Gravis-Associated Disability: A Nationwide Follow-Up Study, Jia-Pei Hong, Chih-Hong Lee, Chien Tai Hong, Lung Chan, Chen-Chih Chung, Prangthip Charoenpong, Hou-Chang Chiu, Tsan-Hon Liou

Faculty, Staff and Students Publications

Background: Advancements in treatment have increased the life expectancy of patients with Myasthenia Gravis (MG), yet the understanding of functional changes in these individuals remains limited. In our study, we explored the functional abilities of individuals with MG using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).

Methods: This observational study analyzed data from 286 patients with MG, acquired from the Data Bank of Persons with Disabilities (TDPD) in Taiwan between July 11, 2012, and December 31, 2021. Participants were diagnosed with MG after the acute phase. The functional disability outcome was assessed using the WHODAS 2.0. Due …

The Minnesota Conference Proposed Guidelines For Education And Training In Clinical Neuropsychology, Anthony Y Stringer, Kathleen Fuchs, Veronica Bordes Edgar, Thomas Bristow, Stephen Correia, Suzanne Penna, Anny Reyes, Douglas M Whiteside, Cady Block, Douglas Bodin, Sakina Butt, Matthew Calamia, Nyaz Didehbani, Peter Dodzik, Vonetta M Dotson, Mary Fernandes, Krista Freece, Richard Fuller, Glen Getz, Lana Harder, Farzin Irani, Laura Janzen, Brick Johnstone, Erin Kaseda, Megan Kramer, Cynthia Kubu, Jose Lafosse, Jennifer Lee-Darocha, Beatriz Macdonald, Adriana Macias Strutt, Michelle Madore, Will Mcbride, Luis Daniel Medina, Grace Mucci, Kritika Nayar, June Paltzer, Courtney Ray, Rebecca Ready, Taylor Rose Schmitt, Beth Rush, Shifali Singh, Scott Sperling, Lisa Stanford, William Stiers, Nikki Stricker, Allen Thornton, Ryan Van Patten, Susan Vandermorris, Kris Verroulx, Jaime Wilson, Ingram Wright, Andrea Zartman, Robert Bilder, Daryl Fujii, Amy Heffelfinger, Thomas Parsons, Antonio E Puente, Celiane Rey-Casserly, Brad Roper, Maureen Schmitter-Edgecombe

Faculty, Staff and Students Publications

Objective: The Houston Conference Guidelines (Hannay et al., 1998) provided an initial framework for North American neuropsychology training that served the specialty well for several decades. Subsequent advances in technology, increased diversity of the U.S. and Canadian populations, and the adoption of competency-based training models within Health Service Psychology have created a need to update neuropsychology training guidelines. Therefore, in 2022, the Minnesota Conference to Update Education and Training Guidelines in Clinical Neuropsychology began a two-year drafting process leading to the currently proposed update.

Method: A Steering Committee worked with content experts, consultants, and delegates representing North American neuropsychological organizations …

Oxytocin Reduces Asymmetries In Dominance Relationships Between Pairs Of Captive Female Lions, Jessica C Burkhart, Abby Guthmann, Evianne M Dubois, Sarah R Heilbronner, Craig Packer

Faculty, Staff and Students Publications

Free-ranging female African lions maintain symmetrical social relationships by respecting each other's "ownership" of valuable food items rather than by supplanting subordinates according to well-defined dominance hierarchies. However, captivity often skews relationships in captive carnivores, hence we investigated whether captive female lions demonstrate obvious dominance relationships. Oxytocin has been shown to elicit context-specific impacts that equalize dominant subordinate relationships, thus we hypothesized that oxytocin would reduce any asymmetries found between dominants and subordinates in captive lions. We designed two experimental protocols for investigating pairwise relationships. We first identified dominant individuals by performing neutral trials that allowed each female equal opportunity …

Environmental Exposures Increase Health Risks In Childhood Cancer Survivors, Omar Shakeel, Nicole M Wood, Hannah M Thompson, Michael E Scheurer, Mark D Miller

Faculty, Staff and Students Publications

Childhood cancer survivors (CCSs) are at increased risk for chronic health issues due to late effects of cancer and its treatment. We address the impact of environmental exposures, such as air pollution, tobacco smoke, extreme weather events, and pesticides, on the health and survival of CCSs. These environmental hazards have been associated with worsening health outcomes and decreased survival among CCSs on a global scale. We also highlight that providers at a major pediatric cancer center in the United States have limited knowledge and practical skills about environmental risk factors and how to reduce exposures. Our survey results show that …

Immature Acta2r179c/+ Smooth Muscle Cells Cause Moyamoya-Like Cerebrovascular Lesions In Mice Prevented By Boosting Oxphos, Anita Kaw, Suravi Majumder, Jose E Esparza Pinelo, Ting Wu, Zbigniew Starosolski, Zhen Zhou, Albert J Pedroza, Xueyan Duan, Kaveeta Kaw, Angie D Gonzalez, Ripon Sarkar, Michael P Fischbein, Philip L Lorenzi, Lin Tan, Sara A Martinez, Iqbal Mahmud, Laxman Devkota, L Maximilian Buja, Heinrich Taegtmeyer, Ketan B Ghaghada, Sean P Marrelli, Callie S Kwartler, Dianna M Milewicz

Faculty, Staff and Student Publications

ACTA2 pathogenic variants altering arginine 179 cause childhood-onset strokes due to moyamoya disease (MMD)-like occlusions of the distal internal carotid arteries, but the mechanisms of pathogenesis are unknown and no preventive treatments exist. Here we show that Acta2R179C/+ smooth muscle cells (SMCs) fail to fully differentiate and maintain stem cell-like features, including increased migration and glycolytic flux compared to wildtype (WT) SMCs. Increasing mitochondrial respiration with nicotinamide riboside (NR) drives differentiation and decreases migration of Acta2R179C/+ SMCs. Carotid artery injury of Acta2SMC-R179C/+ mice leads to premature death, intraluminal SMC accumulation leading to MMD-like occlusive lesions, neurologic symptoms, …

Predictive Indicators For Graduation Upon Acceptance Into A Naacls-Approved Medical Laboratory Science Program, Warren Hovis

LSU Doctoral Dissertations

The primary purpose of this study was to determine the influence of selected academic and personal demographic characteristics on student success at a NAACLS-accredited medical laboratory science program in the southern portion of the United States.

Both academic and demographic categories were selected on students who entered the medical laboratory science program from 2014 to 2019 (pre-COVID). The sanitized, archived data set was provided by the MLS department and the registrar and student affairs office at the participating school. The extant data set contained academic and demographic variables, collected over a five-year period, of initially over 170 accepted MLS students. …

The Effectiveness Of Myofascial Massage Of The Gastrocnemius Muscle On The Threshold And Pain Tolerance., Karolina Pawlikowska, Aleksandra Jażdżewska, Jakub Kortas

Baltic Journal of Health and Physical Activity

Background: The aim of the study was to assess the effectiveness of the myofascial self-massage technique of the gastrocnemius muscle in determining the possibility of increasing pain tolerance and individual pain threshold, which could increase exercise efficiency, allow for greater training loads and accelerate post-exercise regeneration, as well as to determine the subjective assessment of pain intensity using the VAS scale. Material and Methods: 85 students at Gdansk University of Physical Education and Sport took part in the research, including 37 women and 48 men aged 19–25 years. (M = 20.7; SD = 1.07). The test consisted of applying pressure …

2025-2026 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in advanced non-invasive imaging,, allergy/immunology, Pediatric EM/child abuse, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, congenital cardiac surgery, developmental-behavioral, epilepsy, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, …

Bone Marrow Aspirate Concentrate Adjunct For Acetabular Labral Tear Repair: A Systematic Review And Meta-Analysis, Seth Spicer, Hanna Brancaccio, Ashley Sundin, Jamie Bono, John Desrochers, Brandon Goodwin, Nicholas Averell, Seungkyu Park, Alexandra Goodwin, William Diciurcio, Richard Jermyn

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: The objective of this study was to determine the effect of bone marrow aspirate concentrate (BMAC) on long-term patient outcomes when used as an adjuvant to acetabular repair of the labrum.

METHODS: A systematic review and meta-analysis were completed following PRISMA 2020 guidelines. Included in the analysis were controlled studies which assessed functional outcomes via the International Hip Outcome Tool-33 (iHOT-33) 12 or 24 months after acetabular repair with BMAC adjunct. Four studies totaling 315 participants were analysed.

RESULTS: Pooled effect sizes for iHOT-33 scores were not significantly different between control and treatment groups at 12 (p = …

Commentary On Blaser's "Antibiotic Use And Its Consequences For The Normal Microbiome", Fred C. Tenover

AMR Commentary

If you have not read this eye-opening commentary by Dr. Martin Blaser about the negative impact of the widespread use of antibiotics in children, you should. The goal of giving antibiotics to children usually is to treat an infection — an earache, a respiratory tract infection, or perhaps a potentially deadly bloodstream infection. Those antibiotics, however, will often kill more than just the bacteria that are causing the infection. Humans have large quantities of “good bacteria” in our intestinal tracts, on our skin, and elsewhere on our body that play an important role in keeping us healthy.

Evaluation Of The Feasibility And Effectiveness Of Trauma-Focused Cognitive Behavioural Therapy For Children And Youth In Ukraine During The War, Elisa Pfeiffer, Maike Garbade, Renee Beer, Anette Birgersson, Natalie Cabrera, Judith A Cohen, Esther Deblinger, Rafaela Gjini, Veronica Kirsch, Zlatina Kostova, Michael Larsson, Anthony Mannarino, Gavin Moffitt, Marja Onsjö, Tale Ostensjo, Anna Vikgren, Hanna Weyler, Vitalii Klymchuk, Cedric Sachser

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war.

METHODS: The project "TF-CBT Ukraine" was implemented between March 2022 and May …

Familial Hypocalciuric Hypercalcemia Across Three Generations: Exploring Coexistent Primary Hyperparathyroidism, Liada Itzel Guerrero Arroyo Md, Anda Raluca Gonciuela Md, Sachin Majumdar Md

Posters

FHH due to CASR R220W variant may present with phenotypic variability, including features classically associated with PHPT. Genetic testing is essential in ambiguous cases to avoid unnecessary surgical interventions.

Sickle Cell: Acute Chest Syndrome, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Musculoskeletal Infection, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Appendicitis, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Novel Validation Of Hdr Brachy Therapy Dosimetry For Cervical Cancer Using Egs_Brachy Monte Carlo Simulations: A Comparative Analysis With Oncentra Treatment Planning System., Duong Thanh Tai, Nguyen Thi Anh Thu, Tran Thien Thanh, Pham Anh Tuan, Marc J P Chamberland, Peter Sandwall, David Bradley, James C L Chow

Oncology Articles

PURPOSE: This study aims to validate HDR brachytherapy dosimetry for cervical cancer patients utilizing the egs_brachy Monte Carlo (MC) simulation.

METHODS: Three cervical cancer patients treated with

RESULTS: TPS-calculated doses were greater than those obtained from MC simulations. For the CTV, the median percentage differences were 7.9% (Q1: 6.4%, Q3: 9.8%; range: 0.4%-10.4%) for D

CONCLUSION: CTV and critical organ doses calculated by the TPS were consistently greater than those obtained from MC simulations. This suggests that the TPS may overestimate dose distributions, especially in heterogeneous regions like the pelvis. These results emphasize the need for continued validation of TPS …

Novel Aspiration Thrombectomy And Blood Reinfusion System For Acute Intermediate-Risk Pulmonary Embolism: Aventus Trial Results., Saher Sabri, Samuel Horr, Brian Stegman, Wissam A Jaber, Michael A Jolly, Christopher M Huff, David O'Connor, Ahmad Younes, Nora E Tabori, Peter P Monteleone, Raghu Kolluri, Mehdi H Shishehbor, Jun Li

OhioHealth Research Institute Articles

BACKGROUND: Mechanical thrombectomy has become a first-line adjunctive therapy for anticoagulation in patients with acute intermediate-risk pulmonary embolism (PE). This prospective study evaluated the safety and efficacy of percutaneous mechanical aspiration thrombectomy with autologous blood reinfusion using the next-generation AVENTUS Thrombectomy System (Inquis Medical) in subjects with acute intermediate-risk PE.

METHODS: Subjects with acute intermediate-risk PE with symptoms ≤14 days were enrolled in this prospective, multicenter, single-arm study. Primary efficacy (defined as the change in the right ventricle to left ventricle [RV/LV] ratio from baseline) and safety defined as a composite rate of device-related major adverse events were both assessed …

Economic Evaluation Of Caregiver Interventions For Children With Developmental Disabilities: A Scoping Review, Angela Kairu, Edwin Dzoro, Vibian Angweny, Charles Newton, Charlotte Hanlon, Rosa Hoekstra, Amina Abubakar, Edwine Barasa

Institute for Human Development, East Africa

Globally, families with children with developmental disabilities (DDs) experience challenges, including social isolation, stigma, and poverty, especially in low-income settings in Africa. Most children with DDs in Africa remain unidentified and receive no formal support. Caregiver interventions focusing on education and training for the carers/parents have been shown to be adaptable and low intensity in implementation, although the economic evidence is limited. This review aimed to describe the evidence and methodological aspects of economic evaluations for caregiver interventions for DDs. The Arksey and O’Malley framework was applied. Seven electronic databases, grey literature and cited references were systematically searched to identify …

Surface Keratin 1, A Tumor-Selective Peptide Target In Human Triple-Negative Breast Cancer, Shih-Jing Yao, Farideh Amirrad, Elmira Ziaei, Azam Saghaeidehkordi, Moom R. Roosan, Kiumars Shamloo, Ajay Sharma, Rachita K. Sumbria, Surya M. Nauli, Christopher G. Bunick, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Targeting drugs to cancer cells via overexpressed cell-surface receptors has emerged as an effective therapeutic strategy for several cancers. However, identifying cell-surface receptors that allow selective uptake of targeting ligands by cancer cells—while sparing normal cells—remains a challenge, especially for triple-negative breast cancer (TNBC), which lacks a well-defined receptor for targeted delivery. In this study, immunohistochemical (IHC) analysis revealed that human TNBC patient tissues have significantly higher levels of keratin 1 (K1) compared to normal breast tissues. Among TNBC tissues, grade 3 tumors showed significantly higher (threefold) K1 expression compared to grade 2 tumors. We analyzed human TNBC and normal …

Alfred Russel Wallace Notes 37. What About Wallace On Vaccination . . . ?, Charles H. Smith

Faculty/Staff Personal Papers

Best known for his natural history studies on evolution and biogeography, Alfred Russel Wallace (1823−1913) had a significant second career as a social critic. One of his most controversial stances was his position on (smallpox) vaccination. Anti-vaxxers of the present frequently bring up his name as a resource for their side, but the situation is not so easily reducible to that.

A Case Report Of Disseminated Intravascular Coagulation After Intrauterine Fetal Demise., Gabrielle A Agcaoili, Kyriaki V Schooley, Elizabeth Johnson-Gray, Vincent Relli-Dempsey, Greeshma Allareddy

Women’s Health Articles

Disseminated intravascular coagulation (DIC) is a rare, life-threatening complication of pregnancy in which a hypercoagulable state develops secondary to the contact of tissue factor with circulating blood and causes widespread abnormal clotting. This pathological process disrupts normal blood flow, which can cause multi-organ dysfunction and is associated with very high maternal morbidity and mortality. Occurring in two phases, DIC begins with overactive clotting, which leads to the formation of blood clots within the vessels, and ultimately, the overactive clotting process uses up the body's stores of platelets and clotting factors. The most common obstetric cause of DIC is placental abruption, …

Issue 14: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 14

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics: Original Study Summaries: stereotactic body radiotherapy, surveillance over surgery for small pulmonary subsolid nodules, EBUS-TBNA sample acquisition and handling, Systolic arterial pressure targets in shock, stroke risk after AF, methotrexate versus prednisone, corticosteroid use in community-acquired …

A Child With Severe Pneumonia Cannot Feed, Causing Malnutrition: Exploring Health Worker And Caregiver Perspectives And Practices For Mitigating Malnutrition Among Children With Severe Pneumonia, A Case Of Uganda, Damalie Nalwanga, Robert Opoka, Andrew Sentoogo Ssemata, Lawrence Kakooza, Andrew Kiggwe, Victor Musiime, Sarah Kiguli

Paediatrics and Child Health, East Africa

Background: Severe pneumonia remains the leading cause of morbidity and mortality among children worldwide. Severe pneumonia causes death during hospitalization, and survivors are prone to malnutrition after discharge from the hospital. The World Health Organization and United Nations International Children’s Fund recommend ‘continued’ feeding following a severe pneumonia illness without specific recommendations on nutritional support. This recommendation could influence health workers’ and caregivers’ nutritional practices. This study aimed to explore the perspectives and practices of health workers and caregivers for mitigating malnutrition among children with severe pneumonia.

Methods: We conducted a cross-sectional qualitative study between June and November 2021 among …

Investment In Family Medicine To Improve Health Outcomes In Sub-Saharan Africa, Sunanda C. Ray, Mpundu Makasa, Innocent Besigye, Jacob Shabani, Martha Makwero

Family Medicine, East Africa

Family physicians (FPs), as educators, capacity builders and clinical governance leaders of primary care (PC) teams, work to make them more effective and responsive to the needs of their patients. Various strategies are required to raise the profile of Family Medicine (FM) to ensure stronger representation in health sector planning and policy development for advocacy on behalf of the communities they serve. An illustration is given of the need for FP leaders to become equal partners in the National Surgical, Obstetric and Anaesthesia Planning process to ensure safer surgery at district hospitals and to address unmet surgical needs. Integrating FM …

Telogen Effluvium And Anesthesia Considerations: A Case Report., Elizabeth Johnson-Gray, Samantha A Currier, Hanen Fernandez, Matt Brown, Matthias Franzen

Ambulatory and Primary Care Articles

Telogen effluvium is a form of non-scarring hair loss characterized by premature shedding of hair. Pathophysiologically, telogen effluvium occurs when a significant number of hair follicles prematurely enter the telogen phase, resulting in excessive shedding. The exact mechanism is unclear, but it is believed to involve alterations in the hair follicle's growth cycle, possibly mediated by illness, infection, major surgery, low protein intake, or hormonal changes. Some medications can also be linked to this disease, such as beta blockers, carbamazepine, and vitamin A. When affected hairs are in the resting phase, noticeable hair shedding occurs. Our patient was a 61-year-old …