Van Vleet T.M.,Veterans Administration Medical Center |
DeGutis J.M.,Veterans Administration Medical Center
Cortex | Year: 2013
Prominent deficits in spatial attention evident in patients with hemispatial neglect are often accompanied by equally prominent deficits in non-spatial attention (e.g., poor sustained and selective attention, pronounced vigilance decrement). A number of studies now show that deficits in non-spatial attention influence spatial attention. Treatment strategies focused on improving vigilance or sustained attention may effectively remediate neglect. For example, a recent study employing Tonic and Phasic Alertness Training (TAPAT), a task that requires monitoring a constant stream of hundreds of novel scenes, demonstrated group-level (n= 12) improvements after training compared to a test-retest control group or active treatment control condition on measures of visual search, midpoint estimation and working memory (DeGutis and Van Vleet, 2010). To determine whether the modality of treatment or stimulus novelty are key factors to improving hemispatial neglect, we designed a similar continuous performance training task in which eight patients with chronic and moderate to severe neglect were challenged to rapidly and continuously discriminate a limited set of centrally presented auditory tones once a day for 9. days (36-min/day). All patients demonstrated significant improvement in several, untrained measures of spatial and non-spatial visual attention, and as a group failed to demonstrate a lateralized attention deficit 24-h post-training compared to a control group of chronic neglect patients who simply waited during the training period. The results indicate that TAPAT-related improvements in hemispatial neglect are likely due to improvements in the intrinsic regulation of supramodal, non-spatial attentional resources. © 2012.
Feng X.,University of Alabama at Birmingham |
McDonald J.M.,University of Alabama at Birmingham |
McDonald J.M.,Veterans Administration Medical Center
Annual Review of Pathology: Mechanisms of Disease | Year: 2011
The skeleton provides mechanical support for stature and locomotion, protects vital organs, and controls mineral homeostasis. A healthy skeleton must be maintained by constant bone modeling to carry out these crucial functions throughout life. Bone remodeling involves the removal of old or damaged bone by osteoclasts (bone resorption) and the subsequent replacement of new bone formed by osteoblasts (bone formation). Normal bone remodeling requires a tight coupling of bone resorption to bone formation to guarantee no alteration in bone mass or quality after each remodeling cycle. However, this important physiological process can be derailed by a variety of factors, including menopause-associated hormonal changes, age-related factors, changes in physical activity, drugs, and secondary diseases, which lead to the development of various bone disorders in both women and men. We review the major diseases of bone remodeling, emphasizing our current understanding of the underlying pathophysiological mechanisms. Copyright © 2011 by Annual Reviews. All rights reserved.
Winges K.M.,Veterans Administration Medical Center
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society | Year: 2013
Patients with multiple sclerosis (MS) demonstrate thinning of peripapillary retinal nerve fiber layer (RNFL) and decreased macular volume as measured by optical coherence tomography (OCT). To our knowledge, there are no previous reports from a large MS OCT database with strict quality control measures that quantitate RNFL and macula in patients with relapsing-remitting multiple sclerosis. The University of California Davis OCT Reading Center gathered OCT data at baseline as part of the North American phase 3 trial of fingolimod (Gilenya). Average RNFL thickness (RNFLT) and macular volume (TMV) were measured using time domain OCT (TD-OCT). RNFL quadrants, clock hours, and macular subfields were included. With strict quality control and accounting for signal strength differences, scans were categorized as "reduced" or "not reduced" for each field, based on being less than 5th percentile for age-matched controls derived from the normative database in the scanner software. Patients were deemed "abnormal" if at least 1 eye had reduced values for a given parameter. Patients with abnormalities in corresponding RNFL and macular subfields were compared by cross-tabulation. The TD-OCT data were prospectively collected from 939 of the 1,083 trial patients, 712 of whom met all final quality and data inclusion criteria. Of the final cohort, 242 (34.0%) demonstrated reduced (less than 5th percentile) average RNFLT in at least 1 eye. One hundred seventy-eight (25.0%) patients had reduced TMV. One hundred twenty-eight (18.0%) demonstrated both reduced TMV and RNFLT in the same eye, whereas 42 (5.8%) had reduced TMV and RNFLT in both eyes. Of the 242 patients with reduced average RNFL thickness, 128 (52.9%) also had reduced TMV. Fifty patients had reduced TMV in the absence of reduced RNFLT in at least 1 eye, a cohort prevalence of 7.0%. Quadrant and subfield analysis showed a predominance of temporal and inferior RNFL thinning, with inferior macular thinning corresponding best to RNFL thinning. RNFL and macular thinning/volume loss is common at baseline in relapsing-remitting multiple sclerosis, as measured by TD-OCT. When the RNFL is thin, the macular volume is reduced in more than half of the patients. There is a population of reduced TMV without any reduction in RNFLT. Documenting the prevalence and distribution of these structural abnormalities supports recent reports and suggests new retinal areas to probe for functional vision changes in MS.
Sharma M.,Veterans Administration Medical Center
Advances in experimental medicine and biology | Year: 2013
The global rise in terrorism has increased the risk of radiological events aimed at creating chaos and destabilization, although they may cause relatively limited number of immediate casualties. We have proposed that a self-administered test would be valuable for initial triage following terrorist use of nuclear/radiological devices. The urine proteome may be a useful source of the biomarkers required for developing such a test. We have developed and extensively used a rat model to study the acute and late effect of total body (TBI) and partial body irradiation on critical organ systems. This model has proven valuable for correlating the structural and functional effects of radiation with molecular changes. Results show that nephron segments differ with regard to their sensitivity and response to ionizing radiation. The urine proteome was analyzed using LC-MS/MS at 24 h after TBI or local kidney irradiation using a 10 Gy single dose of X rays. LC-MS/MS data were analyzed and grouped under Gene Ontology categories Cellular Localization, Molecular Function and Biological Process. We observed a decrease in urine protein/creatinine ratio that corroborated with decreased spectral counts for urinary albumin and other major serum proteins. Interestingly, TBI caused greater decline in urinary albumin than local kidney irradiation. Analysis of acute-phase response proteins and markers of acute kidney injury showed increased urinary levels of cystatin superfamily proteins and alpha-1-acid glycoprotein. Among proteases and protease inhibitors, levels of Kallikrein 1-related peptidase b24, precursor and products of chymotrypsin-like activity, were noticeably increased. Among the amino acids that are susceptible to oxidation by free radicals, oxidized histidine levels were increased following irradiation. Our results suggest that proteomic analysis of early changes in urinary proteins will identify biomarkers for developing a self-administered test for radiation biodosimetry.
Levin B.E.,Veterans Administration Medical Center
Brain Research | Year: 2010
A majority of human obesity is inherited as a polygenic trait. Once obesity develops, over 90% of individuals repeatedly regain lost weight after dieting. Only surgical interventions offer long lasting weight loss. Thus, clinical data suggest that some individuals have a predisposition to develop and maintain an elevated body weight set-point once they are provided with sufficient calories to gain weight. This set-point is mediated by an integrated neural network that controls energy homeostasis. Unfortunately, currently available tools for identifying obesity-prone individuals and examining the functioning of these neural systems have insufficient resolution to identify specific neural factors that cause humans to develop and maintain the obese state. However, rodent models of polygenically inherited obesity allow us to investigate the factors that both predispose them to become obese and that prevent or enhance the development of such obesity. Maternal obesity during gestation and lactation in obesity-prone rodents enhances offspring obesity and alters their neural pathways involved in energy homeostasis regulation. Early postnatal exposure of obesity-resistant offspring to the milk of genetically obese dams alters their hypothalamic pathways involved in energy homeostasis causing them to become obese when fed a high fat diet as adults. Finally, short-term exercise begun in the early post-weaning period increases the sensitivity to the anorectic effects of leptin and protects obesity-prone offspring from becoming obese for months exercise cessation. Such studies suggest that early identification of obesity-prone humans and of the factors that can prevent them from becoming obese could provide an effective strategy for preventing the world wide epidemic of obesity. © 2010 Elsevier B.V. All rights reserved.
News Article | December 19, 2016
The International Association of HealthCare Professionals is pleased to welcome Donald R. Gore, MD, MS, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. Dr. Gore is a highly-trained and qualified orthopedic surgeon with an extensive expertise in all facets of orthopedic surgery. Dr. Donald R. Gore joined the Sheboygan Orthopedic Associates in 1968, an active orthopedic practice until 2013, and is currently retired from caring for individual patients, but is available for medical legal consultations. Dr. Donald R. Gore’s career in medicine began in 1960, when he graduated with his Medical Degree from the University of Illinois, followed by an internship at Milwaukee County General Hospital. During his training, Dr. Gore was a Captain in the United States Air Force, gaining extensive training in general surgery and all aspects of orthopedic surgery. He then completed a six month biomechanic fellowship at the University of California, San Francisco. Dr. Gore was board certified in Orthopedic Surgery, and became a clinical professor at the Medical College of Wisconsin in 1980. In addition to his clinical practice, Dr. Gore was involved with teaching orthopaedic residents and medical students, and was also involved in clinical and basic research at the Medical College of Wisconsin and Wood Veterans Administration Medical Center in Wood, Wisconsin. He has authored and coauthored over 50 scientific publications, and in the later part of his career he became interested in degenerative disorders of the cervical spine. For his excellence, Dr. Gore has received a Distinguished Service Award from the Department of Orthopedic Surgery at the Medical College of Wisconsin, and a Teacher of the Year Award for Orthopedic Residents from the Medical College of Wisconsin in 1977 and 1984. He has also been recognized by the Best Doctors in America in 1996, and Who’s Who in the World in 2001. Dr. Gore was an active member of the Cervical Spine Research Society, American Medical Association, American Academy of Orthopaedic Surgeons, and over 20 other medical society memberships. Dr. Gore attributes his great success to his strong education, and the support of his family, especially his wife. In his free time, Dr. Gore enjoys fly fishing and downhill skiing. Learn more about Dr. Gore by reading his upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics. Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise. A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life. For more information about FindaTopDoc, visit http://www.findatopdoc.com
News Article | December 16, 2016
The International Association of HealthCare Professionals is pleased to welcome Gordon L. Fung, MD, MPH, PhD, Cardiologist, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. Dr. Fung is a highly trained and qualified cardiologist with a vast expertise in all facets of his work, especially in the treatment of heart disease with a special interest in cardiac rehabilitation, cardiovascular pharmacology, echocardiography, and preventive cardiology. Dr. Fung has been practicing for more than three decades and is currently serving at the University of California, San Francisco Medical Center, where he is director of the Cardiology Consultation Service, the Cardiac Noninvasive Laboratory, and the Enhanced External Counterpulsation Unit. Working within the University of California, San Francisco, Dr. Fung is also an Associate Clinical Professor of medicine and cardiology. Dr. Fung graduated with his Master Degree in Public Health in Hospital Economics and Administration, and his Medical Degree from the University of California, San Francisco School of Medicine. He subsequently completed his Internal Medicine residency at Highland General Hospital, where he served as Chief Resident, before undertaking his fellowship training in Cardiology at the Veterans Administration Medical Center.. Dr. Fung has been active in the activities of the American Heart Association and has served on the association’s national board of directors. To keep up to date with the latest advances and developments in his field, Dr. Fung maintains a professional membership with the San Francisco Medical Society, the California Medical Association, the American Medical Association, the American College of Physicians, the International Academy of Cardiology, the American Society of Preventative Care, and the American Society of Hypertension. Dr. Fung holds dual board certification in Cardiology, Internal Medicine, and is also a Clinical Specialist in Hypertension. He attributes his great success to his focus on patient care and teaching, and when he is not working, Dr. Fung dedicates his free time to music and philosophy. Learn more about Dr. Fung by reading his upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics. Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise. A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life. For more information about FindaTopDoc, visit:http://www.findatopdoc.com
News Article | December 27, 2016
After all the lifting, hauling, and wrapping, worn out gift givers may blame the season's physical strain for any shoulder soreness they are feeling. It turns out there could be another reason. A new study led by investigators at the University of Utah School of Medicine finds that individuals with symptoms that put them at increased risk for heart disease could be more likely to have shoulder problems, including joint pain and rotator cuff injury. "If someone has rotator cuff problems, it could be a sign that there is something else going on. They may need to manage risk factors for heart disease," says the study's lead author Kurt Hegmann, M.D., M.P.H., Professor of Family and Preventive Medicine and Director of the Rocky Mountain Center for Occupational and Environmental Health. The research was published in the Journal of Occupational and Environmental Medicine. Repeated physical stress is most frequently blamed for aggravating shoulder joints and the muscles and tendons that surround them. Think about a pitcher who throws a baseball 100 times a day. While physical exertion can certainly be an irritant, accumulating evidence points other factors that could also be at play. Previous research found that people who had an increased risk for heart disease also had a tendency toward carpal tunnel syndrome, Achilles tendinitis, and tennis elbow, all musculoskeletal disorders. The current study by Hegmann and colleagues adds shoulder problems to the list and takes the connection one step further. The more heart disease risk factors that each of the study participants had racked up - including high blood pressure, high cholesterol, diabetes - the more likely they were to have had shoulder trouble. 36 participants with the most severe collection of risk factors were 4.6 times more likely than those with none of the risk factors to have had shoulder joint pain. They were also nearly six times more likely to have had a second shoulder condition, rotator cuff tendinopathy. Participants with mid-level heart risk were less likely to have had either shoulder condition, at 1.5 to 3-fold. Shared trends bolster that there could be a relationship between heart risk and shoulder problems, but researchers will need to follow up with a prospective study to prove cause and effect. It may seem like physical strain would be at least just as likely to cause shoulder pain but data from the 1,226 skilled laborers who took part in the study suggest otherwise. Ergonomists carefully monitored airbag manufacturers, meat, processors, cabinet makers and skilled laborers. Every forceful twist, push, and pull was factored into a strain index assigned to each worker. But a more straining job did not translate to an uptick in shoulder difficulties. Nor did more time spent doing other physical activities. "What we think we are seeing is that high force can accelerate rotator cuff issues but is not the primary driver," says Hegmann. "Cardiovascular disease risk factors could be more important than job factors for incurring these types of problems." He says it's possible that controlling blood pressure and other heart risk factors could alleviate shoulder discomfort, too. The research was supported by the National Institute on Occupational Safety and Health and published as "Association as Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy". In addition to Hegmann, co-authors include Kara Applegate, Matthew Thiese, Eric Wood, Richard Kendall and Andrew Merryweather from the University of Utah, Jay Kapellusch, James Foster and Arun Garg from the University of Wisconsin-Milwaukee, and David Drury from the Veterans Administration Medical Center, Milwaukee, Wisconsin.
News Article | December 1, 2016
The International Nurses Association is pleased to welcome Eunice Dube, RN, RHV, to their prestigious organization with her upcoming publication in the Worldwide Leaders in Healthcare. Eunice Dube is a Registered Nurse currently serving patients at Veterans Administration Medical Center in Baltimore, Maryland. With over 42 years of experience and an extensive expertise in all facets of nursing, Eunice is a Staff Nurse and specialist inpatient and behavioral health unit nurse. Eunice Dube graduated with her General Nursing Diploma in 1974 from the Mpilo School of Nursing in her native country of Zimbabwe, becoming a Registered Nurse. She has worked and studied on several continents, gaining midwifery and public health qualifications in Scotland, a Bachelor Degree from the Science University of South Africa, studied for a Master of Science Degree in Social Interventions for Public Health at Imperial College, London, and a Master of Public Health Degree at the Liverpool University Online, England. With her wealth of experience and qualifications, Eunice is an expert in many areas, and is a public health specialist. She has had articles published in this area, and to keep up to date with the latest advances in her field, she maintains a professional membership with the American Public Health Association, and volunteering in women’s, adolescents’ and children’s health issues in southern Africa. Eunice attributes her great success to the support of her parents, and the wonderful mentors she’s had throughout her career. When she is not assisting patients, Eunice enjoys walking, listening to music, and writing poetry. Learn more about Eunice Dube here: http://inanurse.org/network/index.php?do=/4130589/info/ and read her upcoming publication in Worldwide Leaders in Healthcare.
News Article | February 15, 2017
Dr. Maria A. Jalloh has joined Dentalcare Associates, a multi-specialty dental practice helping patients for nearly six decades. She joins Dr. Robert V. Scalera, Jr., Dr. Martin L. Marks, and Dr. Lara Merker. “Dr. Jalloh is a welcome addition to our practice,” said Dr. Scalera, Jr., a general dentist and director of Dentalcare Associates (567 Park Avenue, Scotch Plains). “She understands the philosophy of our office. We believe in providing healthy smiles for a lifetime. Preventive care and education are the keys to the best dental health.” Dr. Jalloh is a graduate of Rutgers University. After earning her degree from Rutgers, she studied biomedical sciences at the University of Medicine and Dentistry of New Jersey, now part of Rutgers. She went on to earn her Doctor of Dental Surgery degree at New York University College of Dentistry. At New York University, she was a member of a team, consisting of prosthodontists and biomedical engineers, researching “Osseointegration in Dental Implants.” She was awarded an Honors in Research for her contributions to the study. After dental school, Dr. Jalloh completed a general practice residency at the Veterans Administration Medical Center at Lyons, N.J. She is Invisalign certified and provides all phases of general dentistry. She is a member of the American Academy of Cosmetic Dentistry, the Academy of General Dentistry and the American Dental Association. “I am very happy to be part of such a diverse and modern practice,” Dr. Jalloh said. “I look forward to being part of the Dentalcare team and keeping many more smiles in central New Jersey healthy and bright.” All phases of dentistry are offered at Dentalcare Associates (njdentalcare.com/) in a comfortable, modern office setting. The practice provides reduced radiation digital x-rays, intro-oral imaging, computerized cavity detection and strict sterilization procedures. The practice offers dental services for all ages including exams, x-rays, cleanings, sealants, fillings, crowns, root canals, periodontal therapy, dental implants and dentures. Some of the denture services include implant overdentures, full and partial dentures, flexible partials, emergency denture replacement and relines. A lab on the premises many times offers same day denture repairs. Find out more about the practice at njdentalcare.com/