Diagnosis Commons^™

A Novel Loop-Mediated Isothermal Amplification Assay For Serogroup Identification Of Neisseria Meningitidis In Cerebrospinal Fluid, Dokyung Lee, Eun Jin Kim, Paul E. Kilgore, Hideyuki Takahashi, Jun Tomono, Shigehiko Miyamoto, Daisuke Omagari, Dong Wook Kim, Mitsuko Seki

Department of Pharmacy Practice

We have developed a novel Neisseria meningitidis serogroup-specific loop-mediated isothermal amplification (LAMP) assay for six of the most common meningococcal serogroups (A, B, C, W, X, and Y). The assay was evaluated using a set of 31 meningococcal LAMP assay positive cerebrospinal fluid (CSF) specimens from 1574 children with suspected meningitis identified in prospective surveillance between 1998 and 2002 in Vietnam, China, and Korea. Primer specificity was validated using 15 N. meningitidis strains (including serogroups A, B, C, E, W, X, Y, and Z) and 19 non-N. meningitidis species. The N. meningitidis serogroup LAMP detected down to ten copies …

What Is Causing This Man's Rectal Pain And Urinary Retention?, Mikaela L. Mckenney-Drake, Kali E. Veness, Christopher T. Roman

Scholarship and Professional Work – COPHS

Case: A 23-year-old man presented to an urgent care office with a 2-week history of rectal pain and scant rectal bleeding. In the few days leading up to his presentation, he also had a fever of 101° F (38.3° C), inguinal lymphadenopathy, and urinary retention.

Race, Ethnicity, Psychosocial Factors, And Telomere Length In A Multicenter Setting, Shannon M. Lynch, M. K. Peek, Nandita Mitra, Krithika Ravichandran, Charles Branas, Elaine Spangler, Wenting Zhou, Electra D. Paskett, Sarah Gehlert, Cecilia Degraffinreid, Timothy R. Rebbeck, Harold Riethman

School of Medical Diagnostics & Translational Sciences Publications

Background

Leukocyte telomere length(LTL) has been associated with age, self-reported race/ethnicity, gender, education, and psychosocial factors, including perceived stress, and depression. However, inconsistencies in associations of LTL with disease and other phenotypes exist across studies. Population characteristics, including race/ethnicity, laboratory methods, and statistical approaches in LTL have not been comprehensively studied and could explain inconsistent LTL associations.

Methods

LTL was measured using Southern Blot in 1510 participants from a multi-ethnic, multi-center study combining data from 3 centers with different population characteristics and laboratory processing methods. Main associations between LTL and psychosocial factors and LTL and race/ethnicity were evaluated and then …

Aptameric Sensors: In Vitro Selection Of Dna That Binds Bromocresol Purple, Derek B. Miller

Honors Undergraduate Theses

Aptamers being used as sensors is an emerging field that has capabilities of being tomorrow’s diagnostic tools. As aptameric sensors have become more popular, their visualization systems have been limited. The majority of today’s aptameric sensors require expensive machinery such as a fluorometer in order to visualize results. We propose a system that will cut the need for instrumentation and be detected via the naked eye. With the selection of an aptamer to bind the pH indicating dye bromocresol purple (BCP) this may be achieved. When rendered active, the binding towards BCP will facilitate a color change from yellow to …

The Effects Of Testosterone Supplementation On Cognitive Functioning In Older Men, Eka Wahjoepramono, Prita Asih, Vilia Aniwiyanti, Kevin Taddei, Satvinder Dhaliwal, Stephanie Fuller, Jonathan Foster, Malcolm Carruthers, Giuseppe Verdile, Hamid R. Sohrabi, Ralph Martins

Research outputs 2014 to 2021

Reduction in testosterone levels in men during aging is associated with cognitive decline and risk of dementia. Animal studies have shown benefits for testosterone supplementation in improving cognition and reducing Alzheimer’s disease pathology. In a randomized, placebo-controlled, crossover study of men with subjective memory complaint and low testosterone levels, we investigated whether testosterone treatment significantly improved performance on various measures of cognitive functioning. Forty-four men were administered a battery of neuropsychological tests to establish the baseline prior to being randomly divided into two groups. The first group (Group A) received 24 weeks of testosterone treatment (T treatment) followed by 4 …

1h-Nmr Urinary Metabolomic Profiling For Diagnosis Of Gastric Cancer, Angela W. Chan, Pascal Mercier, Daniel Schiller, Robert Bailey, Sarah Robbins, Dean T. Eurich, Michael B. Sawyer, David Broadhurst

Research outputs 2014 to 2021

Background:

Metabolomics has shown promise in gastric cancer (GC) detection. This research sought to identify whether GC has a unique urinary metabolomic profile compared with benign gastric disease (BN) and healthy (HE) patients.

Methods:

Urine from 43 GC, 40 BN, and 40 matched HE patients was analysed using ¹H nuclear magnetic resonance (¹H-NMR) spectroscopy, generating 77 reproducible metabolites (QC-RSD < 25%). Univariate and multivariate (MVA) statistics were employed. A parsimonious biomarker profile of GC vs HE was investigated using LASSO regularised logistic regression (LASSO-LR). Model performance was assessed using Receiver Operating Characteristic (ROC) curves.

Results:

GC displayed a clear discriminatory biomarker profile; the BN profile overlapped with GC and HE. LASSO-LR identified …

Vague Neuroglycopenic Complaints Camouflage Diagnosis Of Adolescent Insulinoma: A Case Report., Kelsee Halpin, Ryan Mcdonough, Patria Alba, Jared Halpin, Vivekanand Singh, Yun Yan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Insulinoma is a rare diagnosis in the general population with estimates of 1 in 250,000 people per year. Reports of these pancreatic islet cell tumors are even more unusual in children and adolescents. Chronic hypoglycemia due to an insulinoma often presents with neuroglycopenic symptoms that can easily be overlooked, especially in adolescents where nonspecific complaints are common. This may result in delayed diagnosis with prolonged periods of untreated hypoglycemia and associated complications. The rarity of pediatric insulinoma, vagueness of presenting symptoms, and challenge of tumor localization make insulinoma a true diagnostic quandary for clinicians.

CASE PRESENTATION: In this report, …

Test–Retest, Retest, And Retest: Growth Curve Models Of Repeat Testing With Immediate Post-Concussion Assessment And Cognitive Testing (Impact), Arthur C. Maerlender, Caitlin J. Masterson, Tiffany D. James, Jonathan Beckwith, Per Gunner Brolinson, Joe Crisco, Stefan Duma, Laura A. Flashman, Rick Greenwald, Steven Rowson, Beth Wilcox, Tom W. Mcallister

Department of Psychology: Faculty Publications

Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond test–retest statistics. The current study analyzed data from Division I collegiate athletes who completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger National Institutes of Health (NIH) study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: Change in Verbal Memory was best represented …

The Physician’S Perspective On The Impact Of Interpretive Services On The Physician- Patient Relationship, Amrita Pandey

Williams Honors College, Honors Research Projects

The basis of the physician-patient relationship relies heavily on communication. It has been known that conversation between physician and patient is important in both diagnosing and providing therapeutic support. However, according to the US Census Bureau twenty percent of the US population does not use English as their first language. These residents face language barriers on a daily basis, including when they are being treated medically. The aim of this study was to research the physician’s perspective on the use of interpretive services and how it impacts the physician- patient relationship. The research consisted of surveying physicians who encounter patients …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

Diagnostic Practices Of Autism Spectrum Disorders In Brazil, Ana Claudia Vespa Mainer Dias

Master's Theses

In Brazil, in spite of over half a million students with special needs in primary education, little research has been conducted about ASD diagnostic practices. This involves learning about the training that professionals are receiving, what diagnostic practices are being implemented on the field, and whether those are being contextualized according to the Brazilian culture. Students with special needs are directly affected by the results of diagnostic practices, since identifying the individuals is one of the first steps. Lack of understanding about that stage may lead to the problematic realities of underidentification or overidentification, exclusion of children who should receive …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

Reducing Overutilization Of Testing For Clostridium Difficile Infection In A Pediatric Hospital System: A Quality Improvement Initiative., J Michael Klatte, Rangaraj Selvarangan, Mary Anne Jackson, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing.

METHODS: A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A …

Near Real-Time Early Cancer Detection Using A Graphics Processing Unit, Jason Helms

EWU Masters Thesis Collection

"Automatically detecting early cancer using medical images is challenging, yet very crucial to help save millions of lives in the early stages of cancer. In this work, we improved a method that was originally developed by Yamaguchi et al. from the Saga University in Saga Japan. The original method would first decompose the endoscopic image into four color elements: red, green, blue and luminance (RGBL). Next each component is again decomposed to non-overlapping blocks of smaller images. Each smaller image undergoes two phases of DWT(s) and finally the Fractal Dimension (FD) is calculated per smaller image and abnormal regions are …

Using Convolutional Neural Networks For Fine Grained Image Classification Of Acute Lymphoblastic Leukemia, Richard K. Sipes

EWU Masters Thesis Collection

Acute lymphoblastic leukemia (ALL) is a cancer of bone marrow stems cells that results in the overproduction of lymphoblasts. ALL is diagnosed through a series of tests which includes the minimally invasive microscopic examination of a stained peripheral blood smear. During examination, lymphocytes and other white blood cells (WBCs) are distinguished from abnormal lymphoblasts through fine-grained distinctions in morphology. Manual microscopy is a slow process with variable accuracy that depends on the laboratorian's skill level. Thus automating microscopy is a goal in cell biology. Current methods involve hand-selecting features from cell images for input to a variety of standard machine …

18f-Fdg Pet/Ct Imaging Of Extranodal Rosai-Dorfman Disease With Hepatopancreatic Involvement - A Pictorial And Literature Review., Faiq A. Shaikh Md, Omer Awan Md, Mph, Sohaib A. Mohiuddin Md, Saleem Farooqui, Salman A. Khan, William Mccartney

Department of Radiology & Diagnostic Medical Imaging

We share our experience with serial PET/CT imaging on a patient with extranodal Rosai-Dorfman disease (RDD) with hepatopancreatic involvement. RDD is a benign proliferative disorder of histiocytes mainly involving the lymph nodes. It typically presents with fever and painless cervical lymphadenopathy in young adults and less than half of RDS cases demonstrate extranodal involvement. RDD involvement of the liver and pancreas is extremely rare, and this case highlights the role of PET/CT in its management.

Therapeutic Exercises: A Conservative Approach To The Treatment Of Chronic Low Back Pain, Austin England

University Honors Program

Chronic low back pain is becoming a worldwide epidemic; millions suffer from this condition every year. Back pain is one of the most frequent reasons cited for patient visits every year. It is the second most reason for days of missed work following the flu. Chronic low back pain is defined as pain persisting in the low back region for greater than three months. This pain may originate from a variety of factors. These factors can include, but are not limited to injury, disease, or different stressors on the body. Pain in the low back region may be felt as …

Maternal Intuition Of Fetal Gender, Michael P. Mcfadzen, David P. Dielentheis, Ronda Kasten

Journal of Patient-Centered Research and Reviews

Background: Many pregnant mothers feel they have a perception or intuition as to the gender of their unborn baby. There is very little published scientific literature regarding this topic. The study’s goal is to determine accuracy of mothers’ perceptions as to gender of their unborn babies. Many scientists believe a pregnant woman could not determine her baby’s gender by intuition, with a 50% probability of correctly determining the gender. This study should be considered fun science.

Purpose: To objectively measure a pregnant mother’s perception as to the gender of her unborn baby and compare to sonographically proved gender. The study …

‘The Thing Is Not Knowing’: Patients' Perspectives On Surveillance Of An Indeterminate Pulmonary Nodule, Renda Soylemez Wiener, Michael K. Gould, Steven Woloshin, Lisa M. Schwartz, Jack Clark

Dartmouth Scholarship

Background: The hundreds of thousands of patients found to have a potentially malignant pulmonary nodule each year are faced with tremendous uncertainty regarding what the nodule is and how it should be evaluated.

Objective: To explore patients' responses to the detection and evaluation of a pulmonary nodule.

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.