Medical Specialties Commons^™

Renal Basolateral Transport Of Glucuronides And Other Organic Anions In Rat In Vitro Models, Sarah L. Miles

Theses, Dissertations and Capstones

Glucuronidation is a common Phase II biotransformation reaction that increases the hydrophilicity, and thus elimination, of toxins, xenobiotics, and endogenous compounds. Previous studies suggest that the kidney can secrete glucuronide conjugates, but the renal transport mechanisms for glucuronide secretion have not been determined. Based on the chemical nature of glucuronide metabolites, it is hypothesized that organic anion transporter (OAT) proteins along the basolateral membrane of the renal proximal tubule promote renal accumulation of glucuronide conjugates. The purpose of this study was to develop a rat renal proximal tubule model which demonstrates OAT activity and by which the contribution of OAT …

Environmental Risk Factors In Hospital Suicide., Daniel Z Lieberman, Harvey L P Resnik, Vicenzio Holder-Perkins

Psychiatry and Behavioral Sciences Faculty Publications

Suicide of hospitalized patients is the most common sentinel event reviewed by The Joint Commission on Accreditation of Healthcare Organizations. Shorter lengths of stay, sicker patients, and higher patient to staff ratios challenge the ability of the hospital to maintain safety. Risk factors associated with the physical environment of the inpatient psychiatric unit, cited as the most common root cause of inpatient suicide, may be neglected because evaluation of these factors is generally not included in medical education and training. Minimization of fixtures that can facilitate strangulation and other high risk aspects within the hospital environment is an important element …

Research Annual Report 2003, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

An Experience With Free Scapular Flap For Reconstruction Of Lower Extremity Defects At Aga Khan University Hospital Karachi, Pervaiz Mehmood Hashmi

Section of Orthopaedic Surgery

Background: Reconstruction of large composite tissue defects with exposed vital structures and weight bearing surfaces are extremely difficult for reconstructive surgeons. Coverage of such difficult defects can be achieved with free tissue transfer provided microsurgical expertise is available. This study was carried out to determine the outcome of free scapular flaps performed for lower extremity defects.
Methods: Clinical records of the patients were reviewed and important variables included demographic data, etiology of soft tissue defects, site and size of defect, complications and percentage of wound coverage by flap. Patient satisfaction and objective assessment of flap coverage and motion of involved …

Successful Use Of Angiographic Embolization To Control Hemorrhage From Blunt Pelvic Trauma In A Pediatric Patient, Z A. Qasim, R Masood, M A. Mateen

Section of Paediatric Surgery

No abstract provided.

Peer Review Audit Of Trauma Deaths In A Developing Country, Aa Jat, Mr Khan, Hasnain Zafar, Aj Raja, Q Hoda, R Rehmani, Rh Lakdawala, S. Bashir

Section of General Surgery

OBJECTIVES: Peer review of trauma deaths can be used to evaluate the efficacy of trauma systems. The objective of this study was to estimate teh proportion of preventable trauma deaths and the factors contributing to poor outcome using peer review in a tertiary care hospital in a developing country.
METHODS: All trauma deaths during a 2-year period (1 January 1998 to 30 December 1998) were identified and registered in a computerized trauma registry, and the probability of survival was calculated for all patients. Summary data, including registry information and details of prehospital, emergency room, and definitive care, were provided to …

Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman

Section of Neurosurgery

A case of 9 years old female presenting with rapidly progressive paraparesis during remission phase of acute myeloblastic leukemia is reported. Radiological imaging revealed an extradural mass in the upper dorsal spine producing significant cord compression. The patient showed a dramatic neurological recovery after spinal cord decompression and subsequently treated with appropriate chemotherapy and local radiotherapy.

Barriers To Smoking Cessation: Results Of A Survey Among Family Practice Patients, Waris Qidwai

Department of Family Medicine

Background and Objectives: Tobacco smoking is a major public health problem. We have studied barriers to smoking cessation among family practice patients.
Methods: It was a questionnaire based survey, conducted at Family Pr actice Center, Aga Khan University Hospital, Karachi, Pakistan, in July 2003. A trained volunteer administered the questionnaire that included data on demographic profile of the patient and information barriers to smoking cessa tion.Ethical requirement including the administration of written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management.
Results: A total of 100 patients were interviewed, of which …

Level Of Preparedness Of Patients For Medical Emergency, Waris Qidwai, Ss Ali, M Baqir, S Ayub

Department of Family Medicine

No abstract provided.

Meta-Analysis, Spatial, And Temporal Models To Analyze The Possible Association Between Childhood Leukemia In Proximity To Nuclear Facilities, Peter Baker

MUSC Theses and Dissertations

The purpose of this dissertation was to gain a better understanding of the possible association between childhood leukemia and nuclear facilities by conducting a meta-analysis and by the use of spatial and temporal models with respect to Pickering Nuclear Generator (PNG) in Ontario, Canada. The meta-analysis was conducted to combine and statistically analyze the many studies of childhood leukemia in the vicinity of nuclear facilities. Our focus was on studies that calculated SMRs or SIRs for individual nuclear sites. Due to variability between studies in defining age and geographic zones, eight separate analyses were performed based on age and zone …

Evidence Based Medicine: Transforming Research Into Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.

Structured Feedback From Students In Tutorial Teaching, Waris Qidwai

Department of Family Medicine

No abstract provided.

Department Of Radiology-Annual Executive Summary Report-July 1, 2003 To June 30, 2004, Vijay M. Rao, M.D.

Department of Radiology Administrative Documents and Reports

85 page Department of Radiology Annual Executive Summary Report, July 1, 2003 to June 30, 2004, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Evaluation Of The Ume-21 Initiative At 18 Medical Schools Between 1999 And 2001, J. Jon Veloski, Barbara Barzansky

CRMEHC Faculty Papers

BACKGROUND: This study evaluated the processes of curricular change and the initial outcomes of the Undergraduate Medical Education for the 21st Century (UME-21) project at 18 schools.

METHODS: Site visits were conducted at eight partner schools in 1999 and 2001. Written proposals, progress reports, and final reports of 18 schools were reviewed. Senior medical students' responses to questionnaires, including the annual Association of American Medical Colleges Graduation Questionnaire and a UME-21 supplemental graduation questionnaire, were analyzed.

RESULTS: There was variation among the schools in the curriculum at baseline, in the structure of the UME-21 innovation that was introduced, and in …

The Therapeutic Effects Of Exercise On Fatigue, Davina Porock, Mei Fu

Publications and Research

No abstract provided.

Perceptions Of Pediatric Overweight And Weight Management: A Comparison Of Parents And Physicians, Lisa K. Thomason

Masters Theses & Specialist Projects

Pediatric overweight is of paramount importance in Kentucky, as studies show prevalence rates are higher in the state than the national average. Research suggests that comprehensive treatments involving diet training, exercise training, and psychological counseling are most effective at reducing overweight in children. Little research has been done, however, to compare parents' and physicians' perceptions of obesity, its treatment, or barriers to weight management.

The purpose of this study is to examine differences in attitudes toward pediatric obesity and weight management among parents and physicians, specifically related to the importance of diet training, exercise training, and psychological counseling. Surveys were …

The Obligation Of Physicians To Medical Outliers: A Kantian And Hegelian Synthesis, Thomas J. Papadimos, Alan P. Marco

Anesthesiology Faculty Publications

Background

Patients who present to medical practices without health insurance or with serious co-morbidities can become fiscal disasters to those who care for them. Their consumption of scarce resources has caused consternation among providers and institutions, especially as it concerns the amount and type of care they should receive. In fact, some providers may try to avoid caring for them altogether, or at least try to limit their institutional or practice exposure to them.

Discussion

We present a philosophical discourse, with emphasis on the writings of Immanuel Kant and G.F.W. Hegel, as to why physicians have the moral imperative to …

Informed Consent For Medical Research: Case Studies, Catherine A. Marco

Emergency Medicine Faculty Publications

Informed consent for medical research is an essential, but challenging, process to assure the protection of the rights of potential research subjects. Numerous barriers to the informed consent process exist among patients, including impaired decisional capacity, impaired cognition, language barriers, illiteracy, insufficient time and communication, and numerous others. Because of the inherent vulnerability of patients, particular attention should be paid to addressing barriers to adequate informed consent, and steps should be taken to ensure adequate delivery of information, understanding of the study and its risks and benefits, and voluntariness of the informed consent.

Maximum Tolerable Dose Of Cyclophosphamide And Azathioprine In Pakistani Patients With Primary Renal Disease, S S. Ali, M A. Rabbani, S S M Moinuddin, Salim S. Virani, F Farooque, A Salam, A Ahmad

Section of Nephrology

Objective: The immunosuppressive regimens, at present, mainly rely on western guidelines that were derived from studies conducted in western populations. No such study exists for South Asian population, which is home to almost two billion people different in both genetics and environment from west. Locally derived thresholds for side effects markedly different from western figures may warrant re-adjustment of current local immunosuppressive regimens that are at present based largely on western guidelines. In order to define optimum dose for Cyclophosphamide (CYC) and Azathioprine (AZA) based immunosuppressive therapy, we conducted this study to find out maximum tolerable doses of azathioprine (AZA) …

Therapeutic Efficacy Of Sulfadoxine-Pyrimethamine And Prevalence Of Resistance Markers In Tanzania Prior To Revision Of Malaria Treatment Policy: Plasmodium Falciparum Dihydrofolate Reductase And Dihydropteroate Synthase Mutations In Monitoring In Vivo Resistance, K. Mugittu, M. Ndejembi, A. Malisa, M. Lemnge, Zul Premji, A. Mwita, W. Nkya, J. Kataraihya, S. Abdulla, H.-P. Beck, H. Mshinda

Pathology, East Africa

Prior to the 2001 malarial treatment policy change in Tanzania, we conducted trials to assess the efficacy of sulfadoxine-pyrimethamine (SP) and the usefulness of molecular markers in monitoring resistance. A total of 383 uncomplicated Plasmodium falciparum malaria patients (between 6 and 59 months old) were treated with SP and their responses were assessed. Mutations in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes in admission day blood samples were analyzed. Results indicated that 85.6% of the patients showed an adequate clinical response, 9.7% an early treatment failure, and 4.7% a late treatment failure. The quintuple mutant genotype …

Oral Contrast-Enhanced Ct Cholangiography--An Initial Experience, I Naseem, J Rees

Department of Radiology

Objective: To describe our experience of CT (Computed tomographic) Cholangiography examination for detection of choledocholithiasis at the Aga Khan University Hospital (AKUH) Karachi Pakistan.Methods: Seven patients underwent helical CT cholangiography for suspected choledocholithiasis. Iopanoic acid (6 grams) was administered orally 8-12 hours before acquisition of a helical CT cholangiogram. Three-dimensional reconstructions and curved multiplanar reformations were generated from a set of axial source images.Results: Our patients had no adverse reactions to iopanoic acid. The degree of biliary opacification was sufficient to perform three-dimensional and curved planar reformations in 5 patients. In two patients, the biliary tree was not opacified. Both …

Ionizing Radiation Induces A Stress Response In Primary Cultures Of Rainbow Trout Skin, Fiona Lyng, M. Lyons-Alcantara, P. Owell, Sharon Ni Shuilleabhain, Colin Seymour, D. Cottell, Carmel Mothersill

Articles

Fish skin is very vulnerable to damage from physical and chemical pollutants because it is in direct contact with the aquatic environment. In this study, the effect of g radiation on primary cultures of rainbow trout skin was investigated. Primary cultures containing two cell types, epidermal cells and goblet mucous cells, were exposed to doses ranging from 0.5–15 Gy 60Co g radiation. Expression of PCNA, c-myc and BCL2 was investigated as well as growth and levels of apoptosis and necrosis. Morphological and functional changes were also studied. The irradiated cultures showed evidence of a dose-dependent increase in necrosis and enhanced …

Mammographic Criteria For Determining The Diagnostic Value Of Microcalcifications In The Detection Of Early Breast Cancer, M Yunus, N Ahmed, I Masroor, J Yaqoob

Department of Radiology

Objective: To evaluate the importance of microcalcifications in the detection of breast carcinoma in conventional mammography.Methods: This prospective study was carried out at Aga Khan University Hospital (AKUH). Mammograms of 68 patients with microcalcifications were evaluated. Craniocaudal and oblique views of both breasts were acquired on routine basis with cone compression and magnified views when required.Results: Among 68 patients with microcalcifications, 61 (89%) had clustered microcalcifications while 7 patients (10.29%) had scattered microcalcifications. Microcalcifications can occur in benign and malignant diseases. While evaluating clustered microcalcifications, few criteria have been established to determine malignant clustered microcalcifications, these include specific and nonspecific …

Oncolog, Volume 49, Number 01, January 2004, David Galloway, Katie Prout Matias, Karin M.E.H. Gwyn Md, Richard L. Theriault Do

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Pregnancy and Cancer Treatment Often Are Not Mutually Exclusive
• Studies of the Viral Origins of Some Cancers Lead to New Prevention, Treatment Strategies
• House Call: Cancer and Your Weight
• DiaLog: Treating Breast Cancer during Pregnancy, by Karin M.E.H. Gwyn, MD, Assistant Professor, and Richard L. Theriault, DO, Professor, Department of Breast Medical Oncology

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2004), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2004 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• 5 Point Plan
• In Memoriam Albert F. D’Alonzo, DO ’56
• Stem Cell Research
• The O. J. Snyder Memorial Medal Recipient
• Mason W. Pressly Memorial Medal Recipient
• The Closing of Parkview Hospital
• Cover Story: It’s our Move: Creating Training Opportunities in a Shrinking Health Care Delivery System
• Class Notes
• In Memoriam
• My Turn
• PCOM Alumni Weekend 2004
• PCOM Events

Physician Assistant Class Of 2004, Philadelphia College Of Osteopathic Medicine

All Yearbooks

Includes Accomplishments, National Physician Assistant Day, Physician Assistant Olympics, Challenge Bowl, Classroom candids, Retreat at Camp Ockanickon,

Role Of Estrogens In The Secondary Hormonal Manipulation Of Hormone Refractory Prostate Cancer, Khurram M. Siddiqui, Farhat Abbas, Syed Raziuddin Biyabani, Muhammad Hammad Ather, Jamsheer J. Talati

Section of Urology

Objective: To evaluate the role of Estrogens (Honvan) in the secondary hormonal manipulation of patients with hormone refractory prostate cancer (HRCP). Methods: Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days (Fosfestrol, a synthetic phosphorylated estrogen derivative), followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen (PSA) level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were …

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …