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HEALTH SCIENCES PAPER ABSTRACTS.

ILEAL INTERPOSITION SURGERY CANNOT PREVENT THE ONSET OF TYPE 2 DIABETES IN RATS. PING ZHAO, UNIVERSITY OF NORTH ALABAMA. APRIL STRADER, SOUTHERN ILLINOIS UNIVERSITY CARBONDALE.

Background: Bariatric surgeries are effective in resolving type 2 diabetes independent of body weight loss. We have used ileal interposition (IT) surgery, a special type of bariatric surgeries, to study the role of the lower intestine in metabolic improvement. The surgery effectively improved glucose tolerance after the rats were treated by low-dose streptozotocin (STZ). However, no one knows if the surgery could have the similar effect if it gets done before STZ treatment.

Methods: Fourteen male Long-Evans rats received either sham or IT surgery first and then treated with STZ (35 mg/kg) eleven weeks after the surgeries. Body weight was measured as well as food intake, body composition and glucose tolerance before and after the surgeries. Results: IT surgery improved glucose tolerance before STZ treatment. However, IT surgery did not delay the onset of diabetes as glucose tolerance was not improved four weeks after STZ treatment. No significant difference was found in either body weight or body composition during the whole experiment period.

Conclusion: IT surgery effectively can improve glucose tolerance in euglycemic rats without STZ treatment; but IT surgery cannot not prevent the onset of diabetes caused by low-dose streptozotocin (STZ).

MAJOR DISEASE MORTALITY RATES IN ALABAMA WATERSHEDS. RONALD HUNSINGER AND SUZANNE OBERHOLSTER, SAMFORD UNIVERSITY.

Alabama is noted for its abundance of lakes and waterways. Accusations have been made concerning human health problems due to various toxic pollutants discharged into these waterways. This study used the Alabama Department of Public Health (ADPH) data bank for disease mortality rates (years 2010 through 2013) for counties in the watersheds of Alabama Lakes and/or Rivers. Five major diseases were used as health indicators in these watersheds: cancer, Alzheimer's disease (AD), heart disease, stroke, and diabetes. Rates were statistically compared to the state- and waterway cohort county- rates for each disease. Of the five health indicators examined, results showed that the mortality rates for cancer were higher in the Weiss Lake watershed, which essentially encompasses only Cherokee County. Alzheimer's disease (AD) mortality rates were also significantly higher in the Weiss Lake watershed. Fish advisories for PCBs in fish are present in Weiss Lake. While AD mortality rates were somewhat elevated in the Wheeler Lake area (upper Tennessee River in Northwest Alabama watershed), this was due to the excessively high mortality rates of the disease in only one county of this watershed, Lauderdale. AD mortality rates in this county were the highest in the state. Animal studies have shown neurodegeneration following perfluorooctanoic acid (PFOA) exposure. However, Lauderdale County is considerably downstream and separated by two dams from a disputed point source of perfluorooctanoic acid (PFOA)/perfluorooctyl sulfonate (PFOS) discharge, which is in Lawrence County. Other considerations that might be linked to high AD mortality rates in Lauderdale County area are a history of coal ash contamination, containing heavy metals, and an aluminum plant was once operational in the county. Neighboring Colbert County, home for the coal ash plant and directly across the Tennessee River from Lauderdale County, showed only a slight, but insignificant, increase in AD mortality rates, as compared to other watershed areas and to state rates. Other counties in the Wheeler Lake area showed no significant increase in the disease mortalities examined in this study. Further analysis of ADPH data banks, show that the rates of AD mortality tended to be higher than the state rate in other watersheds, except for Lake Martin, which coincidentally, does not carry any fish advisories. ADPH fish advisories are present in most of these waterways due to mercury and, in the case of Weiss Lake, due to PCBs. Surprisingly, AD mortality rates were also notably higher in the lower southeastern counties of the state, a region without any significant rivers and watersheds. Thus, it is not clear why AD mortality rates were elevated in these areas, although small creeks and tributaries there do carry fish advisories due to mercury contamination. In conclusion, this study showed that no definite geographical causal effect exists between PFOA/PFOS and AD mortality rates. The role of Hg and PCB contamination in contributing to AD in the study areas is possible. Non-pollution factors that might contribute to higher AD mortality rates in the lake areas of Alabama could possibly include such things as a demographic predisposition for retired individuals to settle and age. Indeed, Russ et al. (2014) in a meta-study, show that rurality (living in, or more specifically growing up in, rural areas) in and of itself is positively correlated with AD mortality.

SCHOOL-BASED INTERPROFESSIONAL ASTHMA SELF-MANAGEMENT PROGRAM FOR MIDDLE SCHOOL STUDENTS: A FEASIBILITY TRIAL. DONNA COPELAND, DONNA COPELAND, TIM OP'T HOLT, KRISTINA MILLER, KIM NORRIS AND RHONDA LUCAS, UNIVERSITY OF SOUTH ALABAMA. ELLEN BUCKNER, SAMFORD UNIVERSITY.

Asthma is the most common chronic disease in children and is a major cause of morbidity loss of school days, and increased hospitalizations resulting in increased healthcare expenditures. As a result, a new model for healthcare provision and education needs to be developed. The utilization of a common communication among adolescents, parents, primary providers and school nurses using a web-portal and common Asthma Action Plan has been shown to reduce symptoms, improve control, reduce school absences, and reduce unnecessary costs. Therefore, an inter-professional team consisting of faculty, nursing students (NS), respiratory therapy (RT), and computer science (CS) students implemented a pilot asthma self-management program in a medically underserved area. NS and RT students provided asthma assessments, one-to-one coaching, and group education over five sessions, using Power Breathing for Teens, curriculum. CS students collaborated with NS/RT to develop web-based e-portal and android app Two groups of middle school students with significant asthma participated in the study. After completion of the program asthma symptoms decreased, control increased, and self-efficacy and asthma responsibility increased over the intervention period.

The study examined asthma control, self-efficacy, and asthma self-management responsibility. Further significance of the project was defined in terms of interdisciplinary collaboration skills, the feasibility of implementing a school-based program in the community, and integration of technology. These elements propose a new model for providing asthma education. A model of adaptation integrates the multiple factors in the development of the adolescent's self-management. This multi-dimensional approach has promise for improving health in the middle-school aged medically-underserved population.

COMPUTED TOMOGRAPHY CONTRAST INJECTIONS. DONNA CLEVELAND, UNIVERSITY OF SOUTH ALABAMA.

Intravenous contrast agents are used in computed tomography for several reasons. The initial vascular opacification can be used for anatomic localization; distinguishing vessels from a mass; and determining vascular displacement or invasion by a tumor. Specific vascular diseases such as aneurysms, stenosis, loss of vascular integrity or extravasation of the contrast medium may also be assessed from the initial contrast injection. To some extent, urinary tract function may be assessed. Tumors and normal parenchyma do not contrast enhance to the same extent or at the same time. This differential enhancement can be used to maximize lesion detectability. The timing of the CT scans and the contrast injection protocols must be chosen carefully. Sometimes a lesion will be hypovascular compared to normal tissue, and in some cases a lesion may be hypervascular to the surrounding tissue in a certain phase of enhancement. It is important to know in which phase a CT should be performed depending on the pathology you are looking for.

The degree of contrast medium enhancement is the result of a combination of complex factors including the rate, amount, concentration of contrast material administered; the speed of injection; the timing of the scans; cardiac output; extravascular redistribution; and renal filtration and excretion of contrast material. A drip infusion of IV contrast medium usually does not result in ideal enhancement because of inconsistent flow rates and too slow a rise of plasma iodine concentration. This method has largely been replaced by bolus injections from a mechanical injector. Mechanical injectors are mandatory for use of injection rates as high as 5 or 6ml/s and to obtain a sustained, reproducible level of contrast medium enhancement. The major disadvantage of a power injector is the slight risk of extravasation of contrast material into the soft tissues. It is therefore imperative that the patient be able to alert the technologist immediately if a local burning sensation occurs so that the injection can be stopped, preventing tissue damage. The injector is loaded with 100 to 180 ml of 60% contrast medium, with injection rates varying from 1 to 6 ml/s depending on the specific indication. Different delay times are used to match scanning with the arrival of contrast medium to the appropriate vessels and organs. With the use of spiral or helical volumetric scanning a large region such as the liver (typically 30 cm or more) can easily be examined in several seconds.

With a single bolus injection of contrast medium, the pattern of vascular enhancement during the first circulation and the pattern of vascular and tissue enhancement during recirculation can be studied. This paper focuses on images that display the different phases of enhancement, the timing of CT scanning that capture those phases, and a few scanning protocols that are important for a successful diagnostic CT scan using contrast enhancement.
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Publication:Journal of the Alabama Academy of Science
Date:Feb 1, 2017
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