Medical Specialties Commons^™

Cutaneous Graft-Versus-Host Disease Within Chronic Photodamaged Skin: A Case Series Demonstrating Role For Topical 5-Fluorouracil., Ashley N Gray, Christina Avila, Catherine G Chung, Lucia Seminario-Vidal, Alice Mims, Brittany Dulmage, Karilyn Larkin, Hannah Choe, Samantha Jaglowski, Sumithira Vasu, Benjamin H Kaffenberger

Ambulatory and Primary Care Articles

No abstract provided.

Adult Female With A Painful And Pruritic Lower Extremity Skin Lesion., Chase Silvers, Christopher Lloyd

Ambulatory and Primary Care Articles

No abstract provided.

Intracept Technique At Adjacent Levels To Fusions With Pedicle Screws, David Stolzenberg, Paul Kitei, David Tran, Ryan Pfeifer

Rothman Institute Papers

No abstract provided.

Kawasaki Disease And Mis-C At A Community Children’S Hospital In Pennsylvania: A Five-And-A-Half Year Retrospective Study, Kelsey Kaplan Do, Kayle Barndt Do, Ruchi Gupta Md, Kris Rooney Md, Kyle Shaak Mph

Department of Pediatrics

No abstract provided.

Maternal Polychlorinated Biphenyl 126 (Pcb 126) Exposure Modulates Offspring Gut Microbiota Irrespective Of Diet And Exercise, Manisha Agarwal, Jessie Hoffman, Sara Y. Ngo Tenlep, Sara Santarossa, Kevin J. Pearson, Alexandra R. Sitarik, Andrea E. Cassidy-Bushrow, Michael C. Petriello

Markey Cancer Center Faculty Publications

The gut microbiota plays an important role throughout the lifespan in maintaining host health, and several factors can modulate microbiota composition including diet, exercise, and environmental exposures. Maternal microbiota is transferred to offspring during early life; thus, environmental exposures before gestation may also modulate offspring microbiota. Here we aimed to investigate the effects of maternal exposure to dioxin-like polychlorinated biphenyls (PCBs) on the microbiota of aged offspring and to determine if lifestyle factors, including maternal exercise or offspring high-fat feeding alter these associations. To test this, dams were exposed to PCB 126 (0.5 μmole/kg body weight) or vehicle oil by …

57 Yo Man With High Grade Astrocytoma With Piloid Features And 2 Other Cns Lesions, Joseph Fullmer

Conference Presentation Abstracts

Patient is a 57 yo man who presented with periodic headaches and lower back pain, initially attributed to lifting heavy weights but symptoms persisted. Eventual imaging was performed and revealed a 4 cm heterogeneously enhancing left cerebellar mass, 1 cm enhancing lateral right frontal subcortical lesion, and enhancing T12-L1 spinal cord lesion and multiple smaller spinal cord lesions suggestive of drop metastasis. The cerebellar lesion was first resected and final results, including methylome profiling, were consistent with high grade astrocytoma with piloid features (HGAP). The T12-L1 spinal lesion was later resected and had somewhat distinct histology although intraoperatively surgeon felt …

Neurosurgeons Deliver Similar Quality Care Regardless Of First Assistant Type: Resident Physician Versus Nonphysician Surgical Assistant, Grace Y. Ng, Ryan S. Gallagher, Austin J. Borja, Rashad Jabarkheel, Jianbo Na, Scott D. Mcclintock, H. Isaac Chen, Dmitriy Petrov, Brian T. Jankowitz, Neil R. Malhotra

Mathematics Faculty Publications

OBJECTIVE: There are limited data evaluating the out-comes of attending neurosurgeons with different types of first assistants. This study considers a common neurosurgical procedure (single-level, posterior-only lumbar fusion surgery) and examines whether attending surgeons deliver equal patient outcomes, regardless of the type of first assistant (resident physician vs. nonphysician surgical assistant [NPSA]), among otherwise exact-matched patients. -METHODS: The authors retrospectively analyzed 3395 adult patients undergoing single-level, posterior-only lumbar fusion at a single academic medical center. Primary outcomes included readmissions, emergency department visits, reoperation, and mortality within 30 and 90 days after surgery. Secondary outcome measures included discharge disposition, length of …

Postoperative Outcomes And Resource Utilization Following Open Vs Endoscopic Far Lateral Lumbar Discectomy, John Connolly, Austin J. Borja, Svetlana Kvint, Gregory Glauser, Krista Strouz, Scott Mcclintock, Paul J. Marcotte, Neil R. Malhotra

Mathematics Faculty Publications

Background: Operative approaches for far lateral disc herniation (FLDH) repair may be classified as open or minimally invasive. The present study aims to compare postoperative outcomes and resource utilization between patients undergoing open and endoscopic (one such minimally invasive approach) FLDH surgeries. Methods: A total of 144 consecutive adult patients undergoing FLDH repair at a single, university health system over an 8-year period (2013-2020) were retrospectively reviewed. Patients were divided into 2 cohorts: "open" (n = 92) and "endoscopic" (n = 52). Logistic regression was performed to evaluate the impact of procedural type on postoperative outcomes, and resource utilization metrics …

Frequency Of Depression Among Patients With Parkinson Disease, Mohammad Lateef, Wasim Ikram Alvi, Abdul Malik, Neelum Jamal, Muhammad Umair, Muhammad Athar Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Parkinson's disease is a degenerative neurological condition that affects a large number of individuals worldwide. One of the common non-motor symptoms associated with this disease is depression, which can pose challenges for both patients and their caregivers. The main objective of this research was to determine the frequency of depression among patients with Parkinson disease.

Methods:This was a cross-sectional study that was conducted in Karachi, Pakistan, between March 26, 2022, and September 30, 2022. Male and female patients diagnosed with Parkinson's disease according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria, who were …

Mandatory Child Neurology Training For Adult Neurology Residents In Pakistan, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

National Guidelines For The Treatment Of Common Headaches Disorders In Pakistan, Abdul Malik, Sabrina Khan, Mohammad Wasay, Aziz Sonawalla, Samaira Younis, Faisal Mohammad Amin

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Association Of Hyperuricemia With Ischemic Stroke In Adult Population, Ijaz Ali, Zaid Waqar, Bushra Khalid, Maryam Naseem, Soban Khan, Sajid Ali, Muhammad Tariq, Muhammad Adil, Hira Badar Abbasi, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. Hyperuricemia is frequently seen in patients with vascular risk factors. The objective of this study was to determine the association of hyperuricemia with ischemic stroke in adult patients presenting to neurology department of a tertiary care hospital.

Methods:This was a case-control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factors and hyperuricemia. The setting was Pakistan Institute of Medical Sciences, Islamabad and study duration was …

Neurobehavioral And Biochemical Effects Of Choline Chloride Administration In Rats, Lubna Anis, Irfan Sajid, Shoaib Ahmad, Saida Haider

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Choline is an essential nutrient related to vitamin B complex activity. It can be received through different food sources. It is an important component of acetylcholine which is involved in different brain functions. The present study is designed to assess the behavioral effects of choline chloride in animal models.

Methods:This case-control study was performed in the Department of Biochemistry, Federal Urdu University, Karachi for eight months from May 2022 to December 2022. Twenty-four adult male albino Wister rats were divided into four groups, one control and three test groups. Choline chloride dissolved in saline was given …

Chronic Hepatitis B, C, And Stroke; Association And Pathophysiology, Hamza Imran, Adnan Yousuf, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objectives:

Hepatitis infection may raise the incidence of stroke and other cerebrovascular abnormalities, according to several studies. However, its association is controversial. This review looked to compile the most recent research on the relationship between HBV and HCV, atherosclerosis, and stroke.

Methods:This article reviews the literature on the connection between hepatitis B and C viruses with stroke and atherosclerosis. The search included articles from PubMed, PakMediNet, and Google Scholar, as well as a Medline search using specific keywords and MeSH terms. A total of 2655 articles were identified. Out of these 2655 articles we identified 134 articles …

Lack Of Stroke Care Centers In Sindh, Adnan Malik, Rahul Agia

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Terson Syndrome In A Patient With Unrepaired Tetralogy Of Fallot, Amina Saddiqa, Zaid Waqar, Maryam Khalil, Muhammad Anas, Zeeshan Munawar, Ifrah Ayaz, Zakir Jan, Haris Majid

Pakistan Journal of Neurological Sciences (PJNS)

Tetralogy of Fallot is the most commonly seen cyanotic congenital heart disease. It includes four cardinal features: right ventricular outflow tract obstruction, misaligned ventricular septal defect, overriding aorta, and concentric right ventricular hypertrophy. Intracranial pathologies such as brain abscesses, cerebrovascular accidents, and intracranial haemorrhage all have been reported with Tetralogy of Fallot. Here we present a case who had subarachnoid haemorrhage with vitreous haemorrhage in Tetralogy of Fallot.

Physician Perceptions On Cancer Screening For Lgbtq+ Patients, Nicolas Nelson, Joseph F. Lombardo, Ayako Shimada, Marissa L. Ruggiero, Alexandria P. Smith, Kevin Ko, Amy E. Leader, Edith P. Mitchell, Nicole L. Simone

Department of Radiation Oncology Faculty Papers

The LGBTQ+ community experiences cancer disparities due to increased risk factors and lower screening rates, attributable to health literacy gaps and systemic barriers. We sought to understand the experiences, perceptions, and knowledge base of healthcare providers regarding cancer screening for LGBTQ+ patients. A 20-item IRB-approved survey was distributed to physicians through professional organizations. The survey assessed experiences and education regarding the LGBTQ+ community and perceptions of patient concerns with different cancer screenings on a 5-point Likert scale. Complete responses were collected from 355 providers. Only 100 (28%) reported past LGBTQ+-related training and were more likely to be female (p = …

Expert Search For The "A Scoping Review Of The Relation Between Toothbrushing And Diabetes Knowledge, Glycemic Control, And Oral Health Outcomes In People With Type 2 Diabetes", Kelly K. O'Brien, Ruth D. Lipman

Expert Search Strategies

This search strategy was constructed to support the research for the peer reviewed article listed above. Full article abstract:

OBJECTIVE | Given the bidirectional relationship between type 2 diabetes and periodontal disease, this study sought to compile the available data regarding the relationship between home oral hygiene, specifically toothbrushing, and glycemic control and oral health in people with type 2 diabetes

METHODS | A systematic scoping review was conducted using a combination of controlled vocabulary and keyword terms for type 2 diabetes and home oral care in PubMed and CINHAL. Publications from the past 20 years were considered for inclusion. …

Postoperative Radiotherapy And Facial Nerve Outcomes Following Nerve Repair: A Systematic Review, Hannah L. Kenny, Rachel H. Jonas, Samuel L. Oyer

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To compare outcomes of facial nerve repair or grafting following facial nerve-sacrificing procedures among patients treated with and without postoperative radiotherapy (RT).

DATA SOURCES: PubMed, OVID, Conference Papers Index, Cochrane Library, ClinicalTrials.gov.

REVIEW METHODS: Databases were searched using terms including "facial nerve," "graft," "repair," and "radiotherapy." Abstracts mentioning facial nerve repair and evaluation of facial nerve function were included for full-text review. Studies that utilized the House-Brackmann or similar validated scale for evaluation of postoperative facial nerve function were selected for review. All identified studies were included in a pooled t test analysis.

RESULTS: Twelve studies with 142 patients …

Head Injury In Older Adults: To Scan Or Not To Scan? Ten Tips To Make The Best Decision, Audrey-Anne Brousseau, Éric Mercier

Journal of Geriatric Emergency Medicine

Ground-level falls are a leading cause of emergency department (ED) visits by older adults. In addition to understanding the cause of the fall, the assessment of potential fall-induced injuries such as traumatic intracranial hemorrhage, can be highly challenging for emergency clinicians. Premorbid conditions, medications and concomitant injuries can all interfere with the physical examination and impact the prevalence of signs traditionally associated with traumatic brain injury (TBI). When it comes to the decision to potentially investigate for a traumatic intracranial hemorrhage with a brain imaging such as a head computed tomography (CT), many potential predictors and factors will be considered. …

Quality Of Glycemic Control In Type 2 Diabetes Mellitus (T2dm) And Its Association With Markers Of Coagulation And Inhibitors Of Fibrinolysis: A Case–Control Study In The Upper West Region, Ghana, Peter K. Selleh, Enoch O. Anto, Wina I. O. Boadu, Benedict Sackey, Lilian A. Boateng, Charles Nkansah, Frederick Nsafoah, Abdul R. Saasi, Selina Mintaah, Yaw A. Wiafe, Charles Derigubah, Emmanuel E. Korsah, Joseph Frimpong, Ezekiel Ansah, Valentine C. K. T. Tamakloe, Patrick Adu, Joseph Boachie, Otchere Addai-Mensah

Research outputs 2022 to 2026

Background and Aims: Type 2 diabetes mellitus (T2DM) individuals are at a higher risk of developing diabetes complications, with approximately 80% complication-related mortality. The increased morbidity and mortality among T2DM patients are partly due to dysregulated hemostasis. This study determined the quality of glycemic control in T2DM and its association with markers of coagulation and inhibitors of fibrinolysis. Methods: This case–control study recruited 90 participants involving: 30 T2DM patients with good glycemic control, 30 with poor glycemic control, and 30 nondiabetic subjects as controls at a Municipal Hospital in Ghana. Fasting blood glucose, glycated hemoglobin, activated partial thromboplastin time (APTT), …

The Effects Of Height-For-Age And Hiv On Cognitive Development Of School-Aged Children In Nairobi, Kenya: A Structural Equation Modelling Analysis, Rachel Maina, Jia He, Amina Abubakar, Miguel Perez-Garcia, Manasi Kumar, Jelte M. Wicherts

Brain and Mind Institute

Background: Empirical evidence indicates that both HIV infection and stunting impede cognitive functions of school-going children. However, there is less evidence on how these two risk factors amplify each other’s negative effects. This study aimed to examine the direct effects of stunting on cognitive outcomes and the extent to which stunting (partially) mediates the effects of HIV, age, and gender on cognitive outcomes.

Methodology: We applied structural equation modelling to cross-sectional data from 328 children living with HIV and 260 children living without HIV aged 6–14 years from Nairobi, Kenya to test the mediating effect of stunting and predictive …

Clinical Presentation, Evaluation, And Management Of Patients With Myasthenia Gravis At A Tertiary Care Center In Pakistan, Aziz Sonawalla, Shafaq Saleem, Salim Allana, Rabia Qaiser, Rohma Shamsi

Pakistan Journal of Neurological Sciences (PJNS)

Background and objectives:

Little is known about the clinical profile and outcome of myasthenia gravis in Pakistan. The objective of this study is to review the clinical characteristics of patients with myasthenia gravis in Pakistan, and the outcome of investigations and treatment.

Methods: The study comprised a retrospective review of charts of patients diagnosed with myasthenia gravis at Aga Khan University Hospital in Karachi, Pakistan, over a period of 16 years from 1987 to 2003. The following features were reviewed: (i) clinical presentation, (ii) investigations especially nerve conduction studies, acetylcholine receptor antibodies, and imaging studies of the thorax, (iii) treatments …

Cerebellar Manifestation Secondary To Rectal Neoplasia, Soban Khan, Zaid Waqar, Maryam Khalil, Bushra Khalid, Sajid Ali, Ijaz Ali, Muhammad Tariq, Muhammad Adil

Pakistan Journal of Neurological Sciences (PJNS)

The condition known as paraneoplastic cerebellar degeneration (PCD) is among the most disabling examples of a cancer's remote effects. Serology for paraneoplastic antibodies, clinical suspicion, and a targeted search for malignancy all play a role in the diagnosis. Tests for neuronal autoantibodies aid in diagnosis and point the way for the search for malignancy. Unfortunately, even with an early diagnosis, existing therapeutic approaches only have little success. Here we present the case of a young male who developed cerebellar syndrome secondary to rectal neoplasia.

Frequency Of Hyperlipedemia In Patients Coming With Ischemic Stroke In Tertiary Care Hospital Karachi, Bushra Ammad, Abdul Malik, Rabia Sana Muhammad, Maryam Javed, Hina Imtiaz

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective:

Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi.

Methods:This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Go With The Flow: An Experimental Analysis With Tubing Alternative With Irrigation., Scott S Hyland, Daniel T Degenova, Joseph P Scheschuk, Benjamin C Taylor

Trauma and Acute Care Articles

BACKGROUND AND AIMS: Literature regarding alternative tubing for fluid delivery in irrigation and debridement procedures is lacking. The purpose of this study was to compare three different apparatuses with varying quantities of irrigation fluid to assess efficiency of administration and evaluate overall time for fluid administration.

METHODS: This model was designed to compare available methods of gravity irrigation used in practice. Fluid flow time was measured for three types of tubing: single-lumen cystoscopy tubing, Y-type double-lumen cystoscopy tubing, and nonconductive suction tubing. Irrigation times were assessed for varying volumes of 3, 6, and 9 L to investigate the relationship between …

Does Proton Arc Therapy Has Potential Clinical Benefits For Hepatocellular Carcinoma?, Peilin Liu, R Dalfsen, M Soukup, Shupeng Chen, Lewei Zhao, Z Wang, X S. Gao, Thomas Quinn, Craig Stevens, Rohan Deraniyagala, Xiaoqiang Li, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: To investigate the potential clinical benefits and dose-averaged Linear Energy Transfer (LETd) sparing, utilizing proton arc plan for Hepatocellular carcinoma (HCC) patients in comparison with Intensity Modulated Proton Therapy (IMPT). Methods: Ten HCC patients have been retrospectively selected. Two planning groups were created: Proton Arc plans using Monaco ver. 6 and the clinical IMPT plan. Both planning groups used the same robustness parameters. The prescription dose is 67.5 Gy (RBE) in 15 fractions/ 66 GyE in 10 fractions of the Clinical Target Volume (CTV) following clinical IMPT plan. Robustness evaluations were performed to ensure target dose coverage. Normal Tissue …

A Novel Planning Framework For The Efficient Spot-Scanning Proton Arc Therapy Via The Particle Swarm Optimization (Sparc-Particle Swarm), Y Qian, R Dao, G Liu, Xiaoqiang Li, H Quan, Xuanfeng Ding

Conference Presentation Abstracts

Purpose: The delivery efficiency is the bottleneck of spot-scanning proton arc therapy (SPArc) because of the numerous energy layers (EL) ascending switches. This study aims to develop a new algorithm to mitigate the need of EL ascending via water equivalent thickness (WET) sector selection followed by the particle swarm optimization (SPArc- particle swarm). Methods: SPArc- particle swarm divided the full arc trajectory into the optimal sectors based on the K-means clustering analysis of the relative mean WET. Within the sector, particle swarm optimization was used to minimize the total energy switch time, in which it optimized the energy selection integrated …

Application Of A Novel Optical Tool For Linac Calibrations, Cory S. Knill, Brian Loughery, Raminder P. Sandhu, Lifeng Lin, Mark Stefani

Conference Presentation Abstracts

Purpose: Maintaining a linac within tight stereotactic isocentricity tolerances requires minimizing errors in individual components of the linac. However, while isocentricity can be measured using a Winston-Lutz test, contributions from individual components can be difficult to discern. The disconnect between how individual components contribute to isocentricity can lead to lengthy troubleshooting exercises when isocentricity is outside tolerance. To provide more info rmation to physicists and increase the speed of isocentricity adjustments, a new tool that uses optical tracking to investigate and adjust individual linac components that contribute to isocentricity was tested on three clinical linacs. Methods: The optical tracking tool …