Medical Specialties Commons^™

Rare Co-Occurrence Of Dural Arteriovenous Fistula And Arteriovenous Malformation With Bilateral Subcortical And Basal Ganglia Calcification, Raza Sayani, Zahid Anwar Khan, Tanveer-Ul-Haq, Rana Shoaib Hamid, Muhammed Azeemuddin

Department of Radiology

The present study describes the imaging findings in a patient with dural arteriovenous fistula (AVR) and arteriovenous malformation (AVM) with bilateral subcortical and basal ganglia calcification. A 29 year old male patient presented with chief complaint of recent onset of generalized tonic clonic seizures and mild disorientation. The imaging studies on MCT demonstrated diffuse, symmetric calcification in the bilateral basal ganglia and subcortical white matter. MR imaging and angiography revealed AVM in parietooccipital region with supply predominantly from left posterior cerebral and middle cerebral arteries. Multiple dural feeders from meningeal branches of occipital and superficial temporal branches of bilateral external …

Elective Tracheostomy In Mechanically Ventilated Children, Prem Kumar Maheshwari, Muhammad Rehan Khan, Anwarul Haque

Department of Paediatrics and Child Health

Tracheostomy is an important procedure in children requiring prolonged mechanical ventilation. We conducted a retrospective study to assess the frequency, indications, postoperative course and short-term outcome of elective tracheostomy in a Paediatric Intensive Care Unit (PICU) of Pakistan. Twenty-five patients underwent tracheostomy in last 5 years (2.2 % of all PICU admissions). Mean age of patients was 6 years and 60% were male. The most common indication for tracheostomy was prolonged mechanical ventilation secondary to neurological disease (60%), followed by upper airway obstruction (40%). Major complications included accidental decannulation (20%) and tube obstruction (20%). Three patients (12%) developed ventilator-associated pneumonia …

Volume 1 (2012), Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Snap-Ed New Mexico Social Marketing Campaign Phase 1 Report, Sally M. Davis, Glenda Canaca, Jose Canaca, Patty Keane, Pamela Monaghan-Geernaert, Mary Hanrahan

Reports & Documents

The Supplemental Nutrition Assistance Program (SNAP) of the United States Department of Agriculture (USDA) plays an essential role in the nutrition status of low-income families in the United States. Although it is not mandatory to provide nutrition education to SNAP recipients, USDA’s Food and Nutrition Service (FNS) highly encourages each state’s SNAP agency to educate SNAP participants (SNAP-Ed). The purpose of SNAP-Ed is to help SNAP eligible individuals to make healthy food choices consistent with the 2010 Dietary Guidelines for Americans, that fit within their limited budget. In New Mexico, SNAP and SNAP-Ed are administered by the State of New …

Threshold Primary Tumour Sizes For Nodal And Distant Metastases In Papillary And Follicular Thyroid Cancers., Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad, Jaweed Akhter, Najmul Islam, Qamar Masood, Asma Ahmed

Department of Radiology

Abstract

BACKGROUND:

In papillary and follicular thyroid cancers (PTC, FTC), nodal and distant metastasis are generally considered important determinants of recurrence and survival, respectively. However, there is no consensus about the threshold primarytumour size (PTS) for these determinants. The aim of this study was to assess size relationships for developing nodal, pulmonary, bone and overall distant metastases.

METHODS:

This prospective study covered 139 (93 females and 46 males) consecutive biopsy proven patients with PTC (114/139, mean age 41.0 ± 15.7 years, M: F, 35%:65%) and FTC (25/139, mean age 39.2 ± 14.3 years, M: F: 24%:76%).

RESULTS:

Average primary tumor …

Has The Significance Of Incidental Findings On Unenhanced Computed Tomography For Urolithiasis Been Overestimated? A Retrospective Review Of Over 800 Patients, Nadir Khan, M Hammad Ather, Farhan Ahmed, Abdul M. Zafar, Aamir Khan

Department of Radiology

Objectives: To evaluate the detection of clinically unsuspected pathologies using 64-slice multidetector computed tomography (CT) of the abdomen in patients with flank pain. The presence of significant incidental findings (those warranting immediate management) was also correlated with that of urolithiasis, to assess potential changes of management.PATIENTS AND Methods: The study included 899 patients undergoing CT in a 6-month period between June and December 2008. Patients who were referred from outside, with no medical record in the hospital where the study was conducted, and those who were lost to follow-up, were excluded. All of the CT examinations were reported after a …

Gender Differences In Risk Factors, Mortality, And Length Of Stay Of Patients Discharged From A Pakistani Stroke Unit: A Comparative Cross-Sectional Study, Farzin Majeed, Bilal Ahmed, Maria Khan, Shaista Anwar Siddiqi, Ayeesha Kamran Kamal

Department of Medicine

BACKGROUND: Differences between women and men in relation to stroke are increasingly being recognized. There is a scarcity of data on gender-based differences in stroke risk factors and outcomes from Pakistan.

METHODS: We enrolled 231 consecutive patients diagnosed with acute stroke. All patients received care along a standardized stroke pathway in a single stroke unit. We analyzed demographic and medical factors, NIHSS scores, and outcomes.

RESULTS: Of 213 consecutive hospitalized patients, 135 patients were men and 76 were women. The male to female ratio was 1.84. The mean age of males was 62.3913.56, as compared to females 61.15911.60 years. Hypertension, …

Hdl Cholesterol--How Do I Raise My Patients Good Cholesterol?, Quratulain Shaikh, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Post-Abortion Care Family Planning Use In Pakistan, Syed Khurram Azmat, Waqas Hameed, Muhammad Ishaque, Ghulam Mustafa, Aftab Ahmed

Community Health Sciences

Introduction: The stagnated CPR and high unmet need for contraception lead to approximately 890,000 induced abortions every year in Pakistan. A fairly recent study from Pakistan also revealed that around 40% of abortions are performed by unskilled workers in backstreet clinics. Considering these grave statistics, it should not come as surprise that unwanted pregnancies are the leading cause of induced abortions in Pakistan. Despite country's inferior situation, there is no data available in Pakistan that unveils the much needed information pertaining to post-abortion care family planning (PAC) use. Thus, this paper attempts to document socio-demographic profile seeking post-abortion care clients; …

Research Brief: An Examination Of The Social And Clinical Influences In Prostate Cancer Treatment In African American And White Men, Keith Elder, Bettina F. Drake, Sara Wagner, James Hebert

Journal of Health Disparities Research and Practice

BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced …

Cancer-Related Disparities Among Residents Of Appalachia Ohio, James L. Fisher, Holly L. Engelhardt, Julie A. Stephens, Bette R. Smith, Georgette G. Haydu, Robert W. Indian, Electra D. Paskett

Journal of Health Disparities Research and Practice

The authors sought to identify cancer-related disparities in Appalachia Ohio and better understand reasons for the disparities. Data from the Ohio Cancer Incidence Surveillance System, among other sources, were used to examine potential cancer disparities among residents of Appalachia Ohio. Using Ohio census data, the authors examined contributions of household income, educational attainment and population density to disparities in cancer incidence. Results suggest the following disparities in Appalachia Ohio (compared to non-Appalachia Ohio): greater cancer incidence and mortality rates for cancers of the cervix, colon and rectum, lung and bronchus and melanoma of the skin; a later stage at diagnosis …

Family Breast Cancer Education: A Model For African American Women, Frankie D. Powell, Edwin D. Bell, Jamilla Shepperson, Thomas Coaxum

Journal of Health Disparities Research and Practice

The purpose of this study, funded by the American Cancer Society, was to increase knowledge and understanding, i.e., the willingness and ability to discuss, of breast cancer in southern minority women and their families. A family model of health education guided the research questions. (a) To what extent will an action research intervention increase knowledge about the causes and treatment of breast cancer in minority women? (b) To what extent will an action research intervention increase willingness to talk with family members? The t-test analysis of a 67-item, self- administered survey indicated significant increases in knowledge of cancer and in …

Molecular Epidemiology Of Hiv-Associated Tuberculosis In Dar Es Salaam, Tanzania: Strain Predominance, Clustering, And Polyclonal Disease, Lisa V. Adams, Barry N. Kreiswirth, Robert D. Arbeit, Hanna Soini, Lillian Mtei, Mecky Matee, Muhammad Bakari, Timothy Lahey, Wendy Wieland-Alter

Dartmouth Scholarship

Molecular typing of Mycobacterium tuberculosis can be used to elucidate the epidemiology of tuberculosis, including the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families. We performed IS6110 typing and spoligotyping on M. tuberculosis strains isolated from HIV-infected subjects at baseline or during follow-up in the DarDar Trial in Tanzania and on selected community isolates. Clustering occurred in 203 (74%) of 275 subjects: 124 (80%) of 155 HIV-infected subjects with baseline isolates, 56 (69%) of 81 HIV-infected subjects with endpoint isolates, and 23 (59%) of 39 community controls. Overall, 113 (41%) subjects had an …

Hospitalized Cardiovascular Events In Patients With Diabetic Macular Edema., Bao-Anh Nguyen-Khoa, Earl L. Goehring, Winifred Werther, Anne E. Fung, Diana V. Do, Rajendra S. Apte, Judith K. Jones

Journal Articles: Ophthalmology

BACKGROUND: Microvascular and macrovascular complications in diabetes stem from chronic hyperglycemia and are thought to have overlapping pathophysiology. The aim of this study was to investigate the incidence rate of hospitalized myocardial infarctions (MI) and cerebrovascular accidents (CVA) in patients with diabetic macular edema (DME) compared with diabetic patients without retinal diseases.

METHODS: This was a retrospective cohort study of a commercially insured population in an administrative claims database. DME subjects (n = 3519) and diabetes controls without retinal disease (n = 10557) were matched by age and gender. Healthcare claims were analyzed for the study period from 1 January …

Inhibition Of Soluble Tumor Necrosis Factor Ameliorates Synaptic Alterations And Ca2+ Dysregulation In Aged Rats, Diana M. Sama, Hafiz Mohmmad Abdul, Jennifer L. Furman, Irina A. Artiushin, David E. Szymkowski, Stephen W. Scheff, Christopher M. Norris

Graduate Center for Gerontology Faculty Publications

The role of tumor necrosis factor α (TNF) in neural function has been investigated extensively in several neurodegenerative conditions, but rarely in brain aging, where cognitive and physiologic changes are milder and more variable. Here, we show that protein levels for TNF receptor 1 (TNFR1) are significantly elevated in the hippocampus relative to TNF receptor 2 (TNFR2) in aged (22 months) but not young adult (6 months) Fischer 344 rats. To determine if altered TNF/TNFR1 interactions contribute to key brain aging biomarkers, aged rats received chronic (4-6 week) intracranial infusions of XPro1595: a soluble dominant negative TNF that preferentially inhibits …

Does Initial Shunt Type For The Norwood Procedure Affect Echocardiographic Measures Of Cardiac Size And Function During Infancy?: The Single Vventricle Reconstruction Trial., Peter C. Frommelt, Lin T. Guey, L Luann Minich, Majeed Bhat, Tim J. Bradley, Steve D. Colan, Greg Ensing, Jessica Gorentz, Haleh Heydarian, J Blaine John, Wyman W. Lai, Jami C. Levine, William T. Mahle, Stephen G. Miller, Richard G. Ohye, Gail D. Pearson, Girish S. Shirali, Pierre C. Wong, Meryl S. Cohen, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Pediatric Heart Network trial comparing outcomes in 549 infants with single right ventricle undergoing a Norwood procedure randomized to modified Blalock-Taussig shunt or right ventricle-pulmonary artery shunt (RVPAS) found better 1-year transplant-free survival in those who received RVPAS. We sought to compare the impact of shunt type on echocardiographic indices of cardiac size and function up to 14 months of age.

METHODS AND RESULTS: A core laboratory measured indices of cardiac size and function from protocol exams: early after Norwood procedure (age 22.5 ± 13.4 days), before stage II procedure (age 4.8 ± 1.8 months), and at 14 …

Post-Traumatic Pseudoaneurysm Of Internal Carotid Artery: A Cause Of Intractable Epistaxis., Mohammad Adeel, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

In this case report, the authors are presenting a case of a 35-year-old lady who presented to our clinic with recurrent episodes of massive epistaxis and loss of right eye vision for last 6 months following road traffic accident. There was no other significant medical and surgical history. Bleeding episodes were sometimes very severe with loss up to 400-500 cc and would stop spontaneously. She was given multiple blood transfusions after these episodes. A complete otorhinolaryngological examination including rigid endoscopy and coagulation investigation did not reveal any abnormality. CT with contrast of paranasal region showed blood within the right sphenoid …

Process Evaluation Of A Positive Youth Development Program In Hong Kong Based On Different Cohorts, Ben M. F. Law, Daniel T. L. Shek

Pediatrics Faculty Publications

There are only a few process evaluation studies on positive youth development programs, particularly in the Chinese context. This study aims to examine the quality of implementation of a positive youth development program (the Project P.A.T.H.S.: Positive Adolescent Training through Holistic Social Programmes) and investigate the relationships among program adherence, process factors, implementation quality, and perceived program success. Process evaluation of 97 classroom-based teaching units was conducted in 62 schools from 2005 to 2009. Findings based on different cohorts generally showed that there were high overall program adherence and implementation quality. Program adherence and implementation process were highly correlated with …

Secondary Data Analyses Of Subjective Outcome Evaluation Data Based On Nine Databases, Daniel T. L. Shek

Pediatrics Faculty Publications

The purpose of this study was to evaluate the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong by analyzing 1,327 school-based program reports submitted by program implementers. In each report, program implementers were invited to write down five conclusions based on an integration of the subjective outcome evaluation data collected from the program participants and program implementers. Secondary data analyses were carried out by aggregating nine databases, with 14,390 meaningful units extracted from 6,618 conclusions. Results showed that most of the conclusions were positive in nature. The findings …

Interim Evaluation Of The Project P.A.T.H.S.: Findings Based On Different Datasets, Daniel T. L. Shek, Lu Yu

Pediatrics Faculty Publications

Interim evaluation studies were carried out in order to examine the implementation details of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong. Quantitative results of the interim evaluation findings based on eight datasets collected from 2006 to 2009 are reported in this paper. Three hundred and seventy-eight schools were randomly selected to provide information on the implementation details of the program via face-to-face interviews, telephone interviews, and self-completed questionnaires. Results showed that a majority of the workers perceived that the students had positive responses to the program and the program …

Cloning And Purification Of Sas0397 From Community Associated Staphylococcus Aureus, Amber Wannemacher, H. Kathleen Dannelly

Symposium 2012

Methicillin resistant Staphylococcus aureus (MRSA) is a unique bacterium that can cause painful abscesses that require surgical treatment and can be confined to the skin surface or burrow into the skin causing life-threatening infections. There are two types of MRSA: hospital associated-MRSA (HA-MRSA) and community associated-MRSA (CA-MRSA). Community associated-MRSA is acquired through direct contact with an infected individual or sharing of personal items and is often seen in locations such as athletic facilities, dormitories, and daycare centers. This study involves cloning and purification of SAS0397, a putative exported protein predicted, according to bioinformatics, to be unique to community associated Staphylococcus …

Under The Gun: Ongoing Assaults On Bahrain’S Health System, Richard Sollom, Holly G. Atkinson

Publications and Research

In February 2011, the Government of Bahrain began targeting health professionals who treated protesters. In April 2012, PHR's Richard Sollom, Deputy Director, and Holly Atkinson, MD, FACP, past President of PHR's Board and volunteer expert, authored a report showing the devastation on Bahrain's health system that have resulted from the Government of Bahrain’s continued assault on doctors, patients, and the healthcare system.

Rhoa/Rock Pathway Is The Major Molecular Determinant Of Basal Tone In Intact Human Internal Anal Sphincter, Satish Rattan, Jagmohan Singh

Division of Gastroenterology and Hepatology Faculty Papers

Poster presented at: Digestive Disease Week (DDW) International meeting in San Diego, California.

Background and Aims

Knowledge of molecular control mechanisms underlying the basal tone in the intact human IAS is critical for the pathophysiology and rational therapy for debilitating rectoanal motility disorders.

Development Of Myogenic Ias Reconstructs From Human Internal Anal Sphincter (Ias) Smooth Muscle Cells (Smcs) With Functional And Molecular Properties Similar To Intact Human Ias, Jagmohan Singh, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

Poster presented at: Digestive Disease Week (DDW) International meeting in San Diego, California.

Background and Aims:

Rectoanal incontinence is associated with defective Internal Anal Sphincter (IAS). Current therapies are not satisfactory, raising a potential for the replacement of the dysfunctional IAS with the reconstructs. Present studies were performed to develop human IAS smooth muscle reconstructs with functional and molecular attributes similar to the intact human IAS Smooth muscle (SM).

Effect Of Pooled Human Intravenous Globulin (Ivig) On The Reversal Of Cholinergic Inhibition Of Smooth Muscle By Immunoglobulins (Iggs) From Patients With Scleroderma (Ssc), Jagmohan Singh, Vaibhav Mehendiratta, Sergio A. Jimenez, Sidney Cohen, Anthony J. Dimarino, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

Poster presented at: Digestive Disease Week (DDW) International meeting in San Diego, California.

Backgrounds and Aims:

The gastrointestinal (GI) tract is the most common internal organ system affected in SSc. We and others have shown before that the SSc immunoglobulins (IgGs) cause selective blockade of muscarinic type-3 cholinergic (M3-R) in the GI tract. Presently, there is no effective treatment for SSc although numerous cytotoxic and immunomodulatory agents have been employed with limited success and are marred with serious side effects. Present studies investigated the reversibility of SScIgGs-caused M3-R blockade by the pooled Intravenous immunoglobulins (IVIG).

The Systemic Inflammatory Response After Spinal Cord Injury In The Rat Is Decreased By Α4Β1 Integrin Blockade, Feng Bao, Vanessa Omana, Arthur Brown, Lynne C. Weaver

Paediatrics Publications

The systemic inflammatory response syndrome (SIRS) follows spinal cord injury (SCI) and causes damage to the lungs, kidney, and liver due to an influx of inflammatory cells from the circulation. After SCI in rats, the SIRS develops within 12 h and is sustained for at least 3 days. We have previously shown that blockade of CD11d/CD18 integrin reduces inflammation-driven secondary damage to the spinal cord. This treatment reduces the SIRS after SCI. In another study we found that blockade of α4β1 integrin limited secondary cord damage more effectively than blockade of CD11d/CD18. Therefore we considered it important to assess the …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

A Successful Model Of Road Traffic Injury Surveillance In A Developing Country: Process And Lessons Learnt, Junaid Abdul Razzak, Muhammad Shahzad Shamim, Amber Mehmood, Syed Ameer Hussain, Mir Shabbar Ali, Rashid Jooma

Department of Emergency Medicine

Background: Road Traffic Injuries (RTIs) are one of the leading causes of death and disability worldwide with 90% of global mortality concentrated in the low and middle income countries. RTI surveillance is recommended to define the burden, identify high risk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This paper shares the experience of setting up an urban RTI surveillance program in the emergency departments of five major hospitals in Karachi, Pakistan.
Method: We describe the process of establishing a surveillance …

Beta2-Adrenoceptor Agonists For Dysmenorrhoea, Zbys Fedorowicz, Mona Nasser, Vanitha A. Jagannath, Jessica H. Beaman, Kiran Ejaz, Esther J. Van Zuuren

Department of Emergency Medicine

Background:Dysmenorrhoea is a common gynaecological complaint that can affect as many as 50% of premenopausal women, 10% of whom suffer severely enough to be rendered incapacitated for one to three days during each menstrual cycle. Primary dysmenorrhoea is where women suffer from menstrual pain but lack any pathology in their pelvic anatomy. Beta2-adrenoceptor agonists have been used in the treatment of women with primary dysmenorrhoea but their effects are unclear.
Objectives:To determine the effectiveness and safety of beta2-adrenoceptor agonists in the treatment of primary dysmenorrhoea. Search methods: We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register, …

Egr-1 Induces Darpp-32 Expression In Striatal Medium Spiny Neurons Via A Conserved Intragenic Element., Serene Keilani, Samira Chandwani, Georgia Dolios, Alexey Bogush, Heike Beck, Antonis K Hatzopoulos, Gadiparthi N Rao, Elizabeth A Thomas, Rong Wang, Michelle E Ehrlich

Farber Institute for Neuroscience Faculty Papers

DARPP-32 (dopamine and adenosine 3', 5'-cyclic monophosphate cAMP-regulated phosphoprotein, 32 kDa) is a striatal-enriched protein that mediates signaling by dopamine and other first messengers in the medium spiny neurons. The transcriptional mechanisms that regulate striatal DARPP-32 expression remain enigmatic and are a subject of much interest in the efforts to induce a striatal phenotype in stem cells. We report the identification and characterization of a conserved region, also known as H10, in intron IV of the gene that codes for DARPP-32 (Ppp1r1b). This DNA sequence forms multiunit complexes with nuclear proteins from adult and embryonic striata of mice and rats. …