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Payne R.,Pennsylvania State Milton rshey Medical Center | Seaman S.,University of Iowa | Sieg E.,Pennsylvania State Milton rshey Medical Center | Langan S.,Pennsylvania State Milton rshey Medical Center | And 2 more authors.
Acta Neurochirurgica | Year: 2017

Background: Meralgia paresthetica is a mononeuropathy of the lateral femoral cutaneous nerve (LCFN). Surgical treatment involves transection or decompression of the LCFN. There is no clear consensus on the superiority of one technique over the other. We performed a systematic review of the literature to answer this question. Methods: Eligible studies included those that compared neurolysis versus neurectomy for the treatment of meralgia paresthetica after failure of conservative therapy. Our outcome of interest was resolution of symptoms. We performed a computerized search of MEDLINE (PubMed; all years) and of the Cochrane Central Register of Controlled Trials. Eligible studies had to include the words “meralgia paresthetica” and “surgery.” All patients regardless of age were included, and there was no language restriction. We then reviewed the articles’ titles and abstracts. All studies that compared neurolysis to neurectomy were included in the analysis. Results: Of the studies identified, none were randomized controlled trials. There were two German language articles that were translated by a third researcher. Each study was evaluated by two independent researchers who assigned a level of evidence according to American Association of Neurologist algorithm and also performed data extraction (neurolysis vs. neurectomy and resolution of pain symptoms). Each study was found to be level four evidence. Conclusion: After reviewing the data, there was insufficient evidence to recommended one method of treatment over the other. This highlights the importance of keeping a national registry in order to compare outcomes between the two methods of treatment. © 2017 Springer-Verlag Wien


Abar B.W.,Pennsylvania State University | Turrisi R.,Pennsylvania State University | Hillhouse J.,East Tennessee State University | Loken E.,Pennsylvania State University | And 2 more authors.
Health Psychology | Year: 2010

Objectives: To evaluate the effects of an appearance-focused intervention to reduce the risk of skin cancer by decreasing indoor tanning, examine potential heterogeneity in tanning across this time, and correlate the subtypes with predictors collected at baseline. Design: Randomized controlled trial with 379 female college students measured at 6 monthly time points. Main Outcome Measure: Self-reported indoor tanning frequency. Results: The intervention was effective at decreasing tanning over the period between the fall and spring. Longitudinal latent class analysis found 3 patterns of tann1ers among the treatment individuals: abstainers, moderate tanners, and heavy tanners. These classes appeared in both the treatment and control conditions, and the intervention had a harm reduction effect by reducing levels of exposure within the moderate and heavy tanner classes. Participant age and self-reported tanning patterns were found to be predictive of class membership. Conclusions: This research suggests that brief intervention approaches can be effective at reducing risk for skin cancer and illustrates several ways in which these protective effects can be enhanced. © 2010 American Psychological Association.


Barth B.M.,Pennsylvania State Milton rshey Medical Center | Sharma R.,Pennsylvania State University | Altinoglu E.I.,Pennsylvania State University | Morgan T.T.,Pennsylvania State University | And 7 more authors.
ACS Nano | Year: 2010

The early diagnosis of cancer is the critical element in successful treatment and long-term favorable patient prognoses. The high rate of mortality is mainly attributed to the tendency for late diagnoses as symptoms may not occur until the disease has metastasized, as well as the lack of effective systemic therapies. Late diagnosis is often associated with the lack of timely sensitive imaging modalities. The promise of nanotechnology is presently limited by the inability to simultaneously seek, treat, and image cancerous lesions. This study describes the design and synthesis of fluorescent calcium phosphosilicate nanocomposite particles (CPNPs) that can be systemically targeted to breast and pancreatic cancer lesions. The CPNPs are a ∼20 nm diameter composite composed of an amorphous calcium phosphate matrix doped with silicate in which a near-infrared imaging agent, indocyanine green (ICG), is embedded. In the present studies, we describe and validate CPNP bioconjugation of human holotransferrin, anti-CD71 antibody, and short gastrin peptides via an avidin-biotin or a novel PEG-maleimide coupling strategy. The conjugation of biotinylated human holotransferrin (diferric transferrin) and biotinylated anti-CD71 antibody (anti-transferrin receptor antibody) to avidin-conjugated CPNPs (Avidin-CPNPs) permits targeting of transferrin receptors, which are highly expressed on breast cancer cells. Similarly, the conjugation of biotinylated pentagastrin to Avidin-CPNPs and decagastrin (gastrin-10) to PEG-CPNPs via PEG-maleimide coupling permits targeting of gastrin receptors, which are overexpressed in pancreatic cancer lesions. These bioconjugated CPNPs have the potential to perform as a theranostic modality, simultaneously enhancing drug delivery, targeting, and imaging of breast and pancreatic cancer tumors. © 2010 American Chemical Society.


Khov N.,Pennsylvania State Milton rshey Medical Center | Sharma A.,Pennsylvania State Milton rshey Medical Center | Riley T.R.,Pennsylvania State Milton rshey Medical Center
World Journal of Gastroenterology | Year: 2014

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States. While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either on histology or imaging without a secondary cause of abnormal hepatic fat accumulation, no imaging modality is recommended as standard of care for screening or diagnosis. Bedside ultrasound has been evaluated as a non-invasive method of diagnosing NAFLD with the presence of characteristic sonographic findings. Prior studies suggest characteristic sonographic findings for NAFLD include bright hepatic echoes, increased hepatorenal echogenicity, vascular blurring of portal or hepatic vein and subcutaneous tissue thickness. These sonographic characteristics have not been shown to aid bedside clinicians easily identify potential cases of NAFLD. While sonographic findings such as attenuation of image, diffuse echogenicity, uniform heterogeneous liver, thick subcutaneous depth, and enlarged liver filling of the entire field could be identified by clinicians from bedside ultrasound. The accessibility, ease of use, and low-side effect profile of ultrasound make bedside ultrasound an appealing imaging modality in the detection of hepatic steatosis. When used with appropriate clinical risk factors and steatosis involves greater than 33% of the liver, ultrasound can reliably diagnose NAFLD. Despite the ability of ultrasound in detecting moderate hepatic steatosis, it cannot replace liver biopsy in staging the degree of fibrosis. The purpose of this review is to examine the diagnostic accuracy, utility, and limitations of ultrasound in the diagnosis of NAFLD and its potential use by clinicians in routine practices. © 2014 Baishideng Publishing Group Inc. All rights reserved.


Adair J.H.,Pennsylvania State University | Adair J.H.,Keytone Nano Inc. | Parette M.P.,Keytone Nano Inc. | Altinoglu E.I.,Pennsylvania State University | And 2 more authors.
ACS Nano | Year: 2010

The ability to apply nanomaterials as targeted delivery agents for drugs and other therapeutics holds promise for a wide variety of diseases, including many types of cancer. A nanodelivery vehicle must demonstrate in vivo efficacy, diminished or no toxicity, stability, improved pharmacokinetics, and controlled-release kinetics. In this issue, Lee et al.construct polymer nanobins that fulfill these requirements and demonstrate effective delivery of doxorubicin in vivo to breast cancer cells. This Perspective explores the outlook for these nanobins as well as other technologies in this field and the challenges that lie ahead. © 2010 American Chemical Society.


Salvaggio H.L.,Pennsylvania State University | Zaenglein A.L.,Pennsylvania State University | Zaenglein A.L.,Pennsylvania State Milton rshey Medical Center
Pediatric Dermatology | Year: 2012

The sight of needles and surgical equipment can often cause anxiety in children. We describe the use of "Magic Goggles," a distraction technique of use in pediatric dermatology procedures. © 2012 Wiley Periodicals, Inc.


Millington K.A.,Pennsylvania State Milton rshey Medical Center | Mani H.,Pennsylvania State Milton rshey Medical Center
Pediatric and Developmental Pathology | Year: 2013

Type 2 congenital pulmonary airwaymalformation (CPAM) has been reported in association with many other congenital anomalies. To the best of our knowledge, however, an association of type 2 CPAM with congenital nephrotic syndrome has not been heretofore reported. We present the 1st report of such an association in a boy who had a prenatal diagnosis of cystic lungmalformation andwas found to have congenital nephrotic syndrome (diffuse mesangial sclerosis) at 1 month of age. A prenatal ultrasonogram had also shown oligohydramnios, and additionally the child had cleft lip and palate. There was no family history of childhood renal or pulmonary disease, and genetic testing for genes mutated in congenital nephrotic syndrome was negative. © 2013 Society for Pediatric Pathology.


Silvis M.L.,Pennsylvania State Milton rshey Medical Center | Mosher T.J.,Pennsylvania State Milton rshey Medical Center | Smetana B.S.,Pennsylvania State Milton rshey Medical Center | Chinchilli V.M.,Pennsylvania State Milton rshey Medical Center | And 3 more authors.
American Journal of Sports Medicine | Year: 2011

Background: Prior retrospective studies have reported magnetic resonance imaging (MRI) findings of common adductor- abdominal rectus enthesopathy and acetabular labral tear in athletes treated for athletic pubalgia and hip pain. The true prevalence of these findings and association with symptoms in this population is unknown. Purpose: This study was undertaken to determine the prevalence of pelvic and hip MRI findings and association with clinical symptoms in professional and collegiate hockey players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study included 21 professional and 18 collegiate hockey players. Self-reported symptoms were measured using a modified Oswestry Disability Questionnaire. Participants underwent 3-T MRI evaluation of the pelvis and hips. The MRI scans were interpreted independently by 3 musculoskeletal radiologists in 2 sessions separated by 3 months using a 5-point Likert scale to assess for features associated with common adductor-abdominal rectus dysfunction and hip pathology. To estimate prevalence, MRI findings rated 4 or higher on 4 of the 6 interpretations were considered positive. A variance component analysis was applied to determine intrareader and interreader reliability and the lower 95% confidence limits (CLs). Results: No participants reported symptoms related to pelvic or hip disorders. The MRI findings of common adductor-abdominal rectus dysfunction were observed in 14 of 39 participants (36%) and hip pathologic changes in 25 of 39 (64%). There was moderate agreement between readings, with intrareader and interreader reliabilities ranging from 0.37 to 1.00. The interreader reliability was less for evaluation of hip pathologic abnormalities than for groin pathologic abnormalities, with the lowest reliability observed in reporting of hip osteochondral lesions (0.37 with lower 95% CL of 0.22) and fluid in the primary cleft (0.45 with lower 95% CL of 0.29) and perfect reliability in the absence of effusion and abdominal rectus tendon tears. Overall, 30 of 39 (77%) asymptomatic hockey players demonstrated MRI findings of hip or groin pathologic abnormalities. Conclusion: Given the high prevalence of MRI findings in asymptomatic hockey players, it is necessary to cautiously interpret the significance of these findings in association with clinical presentation. Future investigations will determine whether these asymptomatic findings predict future disabilities. © 2011 The Author(s).


Roszelle B.N.,Pennsylvania State University | Deutsch S.,Pennsylvania State University | Weiss W.J.,Pennsylvania State University | Weiss W.J.,Pennsylvania State Milton rshey Medical Center | Manning K.B.,Pennsylvania State University
Annals of Biomedical Engineering | Year: 2011

The aim of this study is to define the fluid mechanics of a pulsatile pneumatically driven pediatric ventricular assist device (PVAD), for the reduced flow rates encountered during device weaning and myocardial recovery, and relate the results to the potential for thromboembolic events. We place an acrylic model of the PVAD in a mock circulatory loop filled with a viscoelastic blood analog and operate at four stroke volumes (SVs), each with two different filling conditions, to mimic how the flow rate of the device may be reduced. Particle image velocimetry is used to acquire flow field data. We find that a SV reduction method provides better rotational flow and higher wall shear rates than a beat rate reduction method; that a quick filling condition with a compressed diastolic time is better than a slow filling condition; and, that a reduction in SV to 40% led to greatly reduced fluid movement and wall shear rates that could increase the thrombogenicity of the device. SV reduction is a viable option for flow reduction during weaning, however, it does lead to significant changes to the device flow field and future studies are needed to develop operational protocols for the PVAD during bridge-to-recovery. © 2011 Biomedical Engineering Society.


PubMed | Pennsylvania State Milton rshey Medical Center
Type: Case Reports | Journal: Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society | Year: 2013

Type 2 congenital pulmonary airway malformation (CPAM) has been reported in association with many other congenital anomalies. To the best of our knowledge, however, an association of type 2 CPAM with congenital nephrotic syndrome has not been heretofore reported. We present the 1st report of such an association in a boy who had a prenatal diagnosis of cystic lung malformation and was found to have congenital nephrotic syndrome (diffuse mesangial sclerosis) at 1 month of age. A prenatal ultrasonogram had also shown oligohydramnios, and additionally the child had cleft lip and palate. There was no family history of childhood renal or pulmonary disease, and genetic testing for genes mutated in congenital nephrotic syndrome was negative.

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