Medical Specialties Commons^™

Are We Ready For A New Epidemic Of Under Recognized Liver Disease In South Asia Especially In Pakistan? Non Alcoholic Fatty Liver Disease, Om Parkash, Saeed Hamid

Section of Gastroenterology

Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as an important public health problem nowadays. NAFLD encompass a variety of liver pathologies including simple steatosis, NASH, fibrosis, cirrhosis and finally cancer. It is associated with obesity, metabolic syndrome, dyslipidaemia, Insulin resistance (IR) and type 2 diabetes. It is the most common chronic liver disease in USA and considered to be increasing in Asia Pacific region including South Asia however there is no community based study from Pakistan. Customarily NAFLD had been regarded as a benign disease; however clinical as well as epidemiological studies had contradicted this belief because approximately 20% …

Melatonin Supplementation Improves Glycemic Control While Lowering Oxidative Stress In Type 2 Diabetes, Carmine R. Grieco, Sheri R. Colberg, C. Thomas Somma, Andrew G. Thompson, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

The purpose of this investigation was to evaluate the effect of melatonin on glycemic control and oxidative stress (OS) in adults with type 2 diabetes (T2D). Fourteen subjects with T2D (10 female, 4 male; 52.5 ± 5.0 years) were randomly assigned to melatonin (MEL) or placebo groups (PLA) for 42 days, in a crossover design. Subjects ingested 10 mg of MEL or an identical placebo (PLA) 30 minutes prior to sleep. Fasting blood draws occurred at baseline, 42 days, and 84 days. Plasma malondialdehyde, a marker of OS, significantly decreased on MEL (-6.25±2.10 nmol/ml) compared to PLA (0.72±3.30, p=0.028). The …

The Big Blue Test: Effects Of 14 Minutes Of Physical Activity On Blood Glucose Levels, Sheri R. Colberg, Manuel J. Hernandez

Human Movement Studies & Special Education Faculty Publications

[First paragraph] For most with diabetes, physical activity has a blood glucose lowering effect (1). Hypoglycemia (i.e., blood glucose < 65 mg/dL) resulting from exercise is a concern, particularly for insulin users (2).

Prescribing Physical Activity To Prevent And Manage Gestational Diabetes, Sheri R. Colberg, Kristin Castorino, Lois Jovanovič

Human Movement Studies & Special Education Faculty Publications

Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. Women diagnosed with GDM have a substantially greater risk of developing type 2 diabetes within 5-10 years after delivery, and the risk is increased by excess body weight. Uncontrolled hyperglycemia during pregnancy is potentially harmful to both mother and fetus, resulting in a greater need for Caesarian-section deliveries, delivery of larger infants with more excess body fat, a greater risk of infant death and stillbirth, and an elevated risk of infant hypoglycemia immediately after birth. Fortunately, engaging in physical activity prior to and during pregnancy may lower the …

Race/Ethnicity, Subjective And Objective Sleep Quality, Physical And Psychological Symptoms In Breast Cancer Survivors, Pinky H. Budhrani

USF Tampa Graduate Theses and Dissertations

Breast cancer is a major health problem and comprises the largest population of cancer survivors in the United States, estimated at 2.9 million women, accounting for 22% of all cancer survivors (National Cancer Institute, 2013). The advances in breast cancer screening, diagnosis and treatment has increased the importance of survivorship needs. A major concern among breast cancer survivors (BCS) is sleep disturbances. This study used an innovative approach to examine ethnic and racial disparities in sleep disturbances present in BCS. In addition, this study also explored sleep disturbances across different races/ethnicities. This study was a secondary data analysis of baseline …

Interrogation Of Epor Fidelity In Myelodysplastic Syndrome Hematopoiesis And Stabilization By The Immunomodulatory Agent, Lenalidomide, Kathy Lynn Mcgraw

USF Tampa Graduate Theses and Dissertations

Myelodysplastic syndromes (MDS) include a spectrum of stem cell malignancies characterized by ineffective hematopoiesis and predisposition to acute myeloid leukemia (AML) transformation. Patients are predominantly older (greater than 60 years old), with progressive cytopenias resulting from ineffective and cytologically dysplastic hematopoiesis. MDS subtypes are classified by morphologic features and bone marrow blast percentage, as well as cytogenetic pattern, as is the case for deletion 5q MDS. Interstitial deletion of the long arm of chromosome 5, del(5q), is the most common chromosomal abnormality in patients with MDS, and the 5q- syndrome, represents a distinct subset of del(5q) MDS characterized by an …

Histone Deacetylases As Targets For Melanoma Immunotherapy, David Michael Woods

USF Tampa Graduate Theses and Dissertations

Cancer represents the second leading cause of death in the United States. For many malignancies, currently available treatment options offer little long-lasting survival benefits to patients. However, recent studies have shown immunotherapeutic approaches to be an attractive strategy to cancer treatment. While many current immunotherapeutic strategies convey durable responses, such responses are only seen in a minority of patients. An increased understanding of the mechanisms governing tumor immunogenicity and the biology of immune responses is crucial to improving upon the efficacy of current and future cancer immunotherapies. Histone deacetylases (HDACs), enzymes classically associated with regulation of gene expression, have been …

Lipid Targets In Clinical Practice: Successes, Failures And Lessons To Be Learned, M Dunne, Oscar Mac Ananey, V Maher

Articles

Abstract

INTRODUCTION:

Optimal risk factor control is integral to managing patients with proven coronary heart disease (CHD+) and for those at risk of coronary heart disease (CHD-). The primary aim of the study was to assess the success rate of reaching lipid risk factor targets in a multiple risk factor clinic.

METHODS:

A retrospective audit was conducted in 488 patients (CHD+, n = 112; CHD-, n = 376) who attended the Cardiovascular Risk Factor Clinic at Tallaght Hospital, Dublin in 2009 and 2010.

RESULTS:

Risk factor targets achieved in CHD+ and CHD- patients were LDLc (54/62 %), HDLc (67/67 %), …

Role Of Complementary And Alternative Medicine In Cardiovascular Diseases, Waris Qidwai, Peng Nam Yeoh, Victor Inem, Kashmira Nanji, Tabinda Ashfaq

Department of Family Medicine

No abstract provided.

Should We Use Preoperative Epoetin-Α In The Mildly Anemic Patient Undergoing Simultaneous Total Knee Arthroplasty?, Lawrence A Delasotta, Fabio Orozco, S Mehdi Jafari, Jamie L Blair, Alvin Ong

Rothman Institute Papers

Simultaneous knee arthroplasty is associated with significant blood loss. To prevent transfusion, three preoperative doses of epoetin-α were offered to mildly anemic simultaneous knee arthroplasty patients. A retrospective review, using ICD-9 codes, identified twenty patients from 2007-2009. Epoetin-α increased hemoglobin levels preoperatively (12.6 to 13.9, p

Inhibitory Effect Of Il-17 On Neural Stem Cell Proliferation And Neural Cell Differentiation., Zichen Li, Ke Li, Lin Zhu, Quancheng Kan, Yaping Yan, Priyanka Kumar, Hui Xu, Abdolmohamad Rostami, Guang-Xian Zhang

Department of Neurology Faculty Papers

BACKGROUND: IL-17, a Th17 cell-derived proinflammatory molecule, has been found to play an important role in the pathogenesis of autoimmune diseases, including multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). While IL-17 receptor (IL-17R) is expressed in many immune-related cells, microglia, and astrocytes, it is not known whether IL-17 exerts a direct effect on neural stem cells (NSCs) and oligodendrocytes, thus inducing inflammatory demyelination in the central nervous system.

METHODS: We first detected IL-17 receptor expression in NSCs with immunostaining and real time PCR. We then cultured NSCs with IL-17 and determined NSC proliferation by neurosphere formation …

Inhibitory Effect Of Matrine On Blood-Brain Barrier Disruption For The Treatment Of Experimental Autoimmune Encephalomyelitis., Su Zhang, Quan-Cheng Kan, Yuming Xu, Guang-Xian Zhang, Lin Zhu

Department of Neurology Faculty Papers

Dysfunction of the blood-brain barrier (BBB) is a primary characteristic of experimental autoimmune encephalomyelitis (EAE), an experimental model of multiple sclerosis (MS). Matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae Flave, has been recently found to suppress clinical EAE and CNS inflammation. However, whether this effect of MAT is through protecting the integrity and function of the BBB is not known. In the present study, we show that MAT treatment had a therapeutic effect comparable to dexamethasone (DEX) in EAE rats, with reduced Evans Blue extravasation, increased expression of collagen IV, the major component of the basement …

Is Probiotic Supplementation Effective In Reducing The Incidence Of Atopic Dermatitis In Children Age 3 And Under?, Kristen M. Mclaughlin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not probiotic supplementation is effective in reducing the incidence of atopic dermatitis in children age 3 and younger.

STUDY DESIGN: Systematic review of three Engligh language primary studies one published in 2009 and the other two in 2010.

DATA SOURCES: Three double blind randomized controlled trials comparing the efficacy of probiotic supplementation for reducing the incidence of atopic dermatitis in children ages 3 and under were found using Cochrane Library EBM and PubMed databases.

OUTCOMES MEASURED: Diagnosis of atopic dermatitis, via a positive …

Is The Use Of Intestinal Helminths Safe And Effective In The Treatment Of Allergic Rhinitis?, Tanner Mccalley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether the use of intestinal helminths is safe and effective in the treatment of allergic rhinitis.

STUDY DESIGN: Review of three English language, blinded randomized controlled trials from 2009, 2010, and 2010.

DATA SOURCE: Randomized, controlled, blinded trials comparing the use of intestinal helminths versus visually matched placebo as a treatment for allergic rhinitis found using PubMed and Ovid databases.

OUTCOMES MEASURED: Several different systems were used to evaluate the symptoms or occurrence of AR. Bager et al.2010 uses symptom scores of AR scale of 0 …

Is Laparoscopic Gastric Banding An Effective Treatment For Obesity In Adolescents And Adults As Measured By Physical Function?, Shawna Mccormick

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is laparoscopic gastric banding an effective treatment for obesity in adolescents and adults as measured by physical functioning?”

STUDY DESIGN: Review of all English language primary studies from 2009, 2010, and 2011.

DATA SOURCES: Two randomized control trials and one cohort study were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: There were multiple outcomes measured in the studies but the outcome of concern is quality of life post-operatively, specifically, physical functioning as measured by surveys including SF-36, Moorehead-Ardelt, BAROS, and CHQ CF-50. …

Does Immersion In Water During Labor Decrease The Likelihood Of Perineal Tears?, Julie Rikkers

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this review is to determine whether or not “Does water immersion in the course of labor decrease the risk of perineal injury during vaginal delivery?”

STUDY DESIGN: Review of three English Language primary studies published in 1996, 2001 and 2002.

DATA SOURCES: Two Randomized, Double-Blind, Controlled trials as well as One Case Control Study which evaluated Maternal and Neonatal Outcomes during labor and delivery were found using PubMed and Cochrane Databases.

OUTCOME MEASURED: Each study looked at women who used water immersion during labor and those that did not. The outcomes measured were those regarding …

Is Administration Of Depot Medroxyprogesterone Acetate Injections Every Three Months Effective In Decreasing Pain Associated With Endometriosis In Premenopausal Women?, Maria Kern

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic EBM review is to determine whether or not the administration of depot medroxyprogesterone acetate injections every three months are effective in decreasing pain associated with endometriosis in premenopausal women.

STUDY DESIGN: A review of two randomized controlled trials and one randomized comparative trial comparing pain improvement from depot medroxyprogesterone acetate (DMPA) injections at different time intervals and/or in comparison to other hormonal birth control methods in premenopausal patients suffering from endometriosis.

DATA SOURCES: Randomized controlled trials and a randomized comparative trial were found using PubMed and Ovid MEDLINE databases.

OUTCOME MEASURED: Outcomes were …

Is Dapsone Gel Safe And Effective For The Treatment Of Acne Vulgaris?, Amy Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dapsone gel is safe and effective for the treatment of acne vulgaris.

STUDY DESIGN: A review of three English language studies published in 2007. Includes two randomized, double-blind, controlled trials and one open label, noncomparative study. DATA SOURCES: Randomized, controlled trials comparing dapsone gel to vehicle gel control were found using PubMed and Cochrane database.

OUTCOMES MEASURED: Success on the Global Acne Assessment Score (GAAS) and reduction in acne lesion counts

RESULTS: The two randomized, controlled trials and the open-label noncomparative study …

Is Oral Rivaroxaban Safe And Effective In The Treatment Of Patients With Symptomatic Dvt?, Ami A. Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not oral rivaroxaban is safe and effective in the treatment of patients with symptomatic DVT.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published from 2007-2011.

DATA SOURCES: Three randomized controlled trials studying the effectiveness and safety of rivaroxaban in the treatment of patients with symptomatic DVT in comparison to enoxaparin and placebo.

OUTCOMES MEASURED: Outcomes measured were episodes of recurrent DVT and bleeding. Patients were monitored for the proposed treatment period and seen at fixed intervals that were matching …

Is Valdecoxib An Effective Treatment Option To Improve Pain In Adults With Diagnosed Osteoarthritis Of The Hip Or Knee?, Karen A. Mcsorley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Valdecoxib is an effective treatment option to improve pain in adults with osteoarthritis of the hip or knee.

STUDY DESIGN: This review consists of three randomized control trials; two were published in 2002 and the third in 2006.

DATA SOURCES: Sources were studies comparing groups taking Valdecoxib 10mg QD to placebo, which were found via Pubmed, MEDLINE, Ovid, and Cochrane databases.

OUTCOMES MEASURED: The three articles measured various outcomes: pain improvement, stiffness, physical improvement, adverse effects, and onset of analgesia during acute pain …

Are Triptan Drugs Safe And Effective For Use In The Prevention Of Menstrually Related Migraines (Mrms)?, Christina Ponzio

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Triptan drugs are safe and effective for use in the prevention of menstrually related migraines (MRMs).

STUDY DESIGN: Review of two English language randomized controlled trials and one pilot randomized control trial.

DATA SOURCES: Randomized controlled trials comparing Triptan drugs to a placebo group were found using Medline, PubMed, and OVID.

OUTCOMES MEASURED: Incidence of MRM based on patient self-report; number of relapses; patients’ subjective evaluations of effectiveness based on questionnaire; adverse effects of Triptan treatment.

RESULTS: Two randomized controlled trials …

Is Pramipexole Safe And Effective In Reducing Depressive Symptoms In Patients With Mild To Moderate Parkinson’S Disease And Depression?, Corinne J. Kern

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not pramipexole (Mirapex) is a safe and effective drug to treat depression in patients with mild to moderate Parkinson’s Disease (PD).

STUDY DESIGN: Review of three English language primary randomized controlled trials and one randomized prospective, observational study published between 2003-2010.

DATA SOURCES: Three randomized controlled trials and one randomized prospective, observational study comparing the efficacy of pramipexole to placebo, sertraline (an SSRI) and other dopamine agonists (pergolide) in the treatment of PD related depression symptoms were found using PubMed.

OUTCOME(S) MEASURED: Each of the …

Does Platelet-Rich Plasma Therapy In Arthroscopic Rotator Cuff Repair Improve Patient Outcome?, Elan B. Kennedy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not platelet rich plasma therapy (PRP) improves patient outcome in arthroscopic rotator cuff repair.

STUDY DESIGN: Review of three primary research studies published in the English language in 2011.

DATA SOURCES: Three double blind, randomized, controlled trials analyzing the effect of augmentation of rotator cuff repair surgery with PRP therapy were found using PubMed.

OUTCOMES MEASURED: Each of the three studies measured the effectiveness of PRP therapy in arthroscopic rotator cuff repair, with specific regards to pain improvement after surgery, healing time and …

Does Metformin Use During Pregnancy Effectively Reduce The Rate Of Early Pregnancy Loss In Women With Polycystic Ovary Syndrome?, Inna Prikhodko

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Does Metformin use during pregnancy effectively reduce the rate of early pregnancy loss in women with polycystic ovary syndrome?”

STUDY DESIGN: This review is based on two primary double-blind, randomized controlled trials and a prospective controlled trial that was not randomized or blinded to evaluate whether metformin, a medication used to manage PCOS, can also prevent early pregnancy loss in women with PCOS.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and located through PubMed, OVID and COCHRANE databases..

OUTCOMES MEASURED: …

Is Electrical Muscle Stimulation Effective In The Progression Of Oral Feeding, For Patients With Dysphagia, Caused By A Stroke?, Kristen Iaconelli

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not electrical muscle stimulation is effective in the progression of oral feeding, for patients with dysphagia, caused by a stroke.

STUDY DESIGN: Review of 3 randomized controlled trials, published between 2008-2009.

DATA SOURCES: All 3 randomized controlled trials were found using the Cochrane database.

OUTCOMES MEASURED: All 3 studies measured subjective swallowing function pre- and post-treatment, however, each trial differed in the way they measured this. Permsirivanich et al used a functional oral intake scale (FOIS), or a 7-point scale reflecting the patient’s report of …

Does The Addition Of Muramyl Tripeptide To Chemotherapy Improve Overall Survival For Patients With Osteosarcoma?, Jennifer Jones

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does the addition of muramyl tripeptide to chemotherapy improve overall survival for patients with osteosarcoma?”

STUDY DESIGN: Review of three English language primary randomized controlled trials published between 2005 and 2009.

DATA SOURCES: Randomized controlled trials evaluating the addition of muramyl tripeptide (MTP) to chemotherapy for patients with osteosarcoma were found using Medline/PubMed databases.

OUTCOMES MEASURED: Event-free survival (EFS) and overall survival were the outcome measures used to determine the effectiveness of the additional chemotherapy treatment in osteosarcoma patients. EFS was defined as …

Is Dabigatran Superior To Warfarin In Treating Patients With Atrial Fibrillation?, Kelly Higgins

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Dabigatran is superior to Warfarin in patients with atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published in 2007, 2009, and 2010.

DATA SOURCES: Three randomized control trials found using Cochrane Database.

OUTCOME(S) MEASURED: Outcomes measured were presence or absence of stroke or systolic embolism and intracranial hemorrhage. The absence of these events preserved neurologic function in patients with atrial fibrillation.

RESULTS: In both VKA-naïve and VKA-experienced patients, Dabigatran 150 mg was superior to Warfarin in both the prevention of stroke …

Are Sodium Alginate Solutions Effective In Reducing Postprandial Symptoms In Adults With Gastroesophageal Reflux?, Kristi L. Hackman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sodium alginate solutions are effective in reducing postprandial symptoms in adults with gastroesophageal reflux?

STUDY DESIGN: A review of three English language studies published from 2006-2011. Includes two randomized, double-blind, controlled trials and one controlled case series.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of sodium alginate solutions (Gaviscon) for managing gastroesophageal reflux disease (GERD) symptoms in adults were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the Reflux Severity Index Questionnaire …

Does Daily Intake Of Glucosamine Supplements Prevent The Need For Knee Replacements Later In Life For Adult Patients Predisposed To Osteoarthritis?, Nancy Helmy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not daily intake of glucosamine supplements prevents the need for knee replacements later in life for adults predisposed to osteoarthritis.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published between 2001 and 2008

DATA SOURCES: Three double blind randomized control trials comparing glucosamine supplements to placebo were found using PubMed.

OUTCOMES MEASURED: Outcomes were measured using radiographic studies of the knees, joint space measurements, and symptoms were evaluated using Lequesne and WOMAC indexes.

RESULTS: The Reginster (2001) and Pavelka (2002) studies demonstrated no …

Is Fentanyl Pectin Nasal Spray Safe And Effective For Patients With Breakthrough Cancer Pain?, Salina G. Elengical

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether fentanyl pectin nasal spray (FPNS) is safe and effective treatment for patients with breakthrough cancer pain.

STUDY DESIGN: Review of three English language primary randomized controlled trials published 2010-2011.

DATA SOURCES: Multicenter, randomized, double-blind, double-dummy, placebo-controlled trials comparing fentanyl pectin nasal spray, immediate-release morphine sulfate, and/or nasal spray placebo were found using PubMed, COCHRANE, and Medline databases.

OUTCOME MEASURED: All three studies essentially used similar parameters to measure effectiveness and safety of fentanyl pectin nasal spray compared to oral immediate-release morphine sulfate and/or placebo. Baseline pain intensity …