Digital Commons Network^™

2023 West Virginia Rural Health Conference Abstracts, Rich Sutphin

Marshall Journal of Medicine

The mission of the West Virginia Rural Health Association (WVRHA) is to unite people, communities, and organizations to strengthen rural health in West Virginia. The WVRHA annual conference brought together healthcare professionals, community leaders, and researchers, showcasing their efforts to improve the quality of life and access to excellent healthcare in rural areas. The abstracts covered a wide range of topics, including innovative healthcare delivery models, community health interventions, policy analysis, and the impacts of social determinants on health. These contributions reflect the dynamic work being done and the future directions in rural health, underscoring the WVRHA’s commitment to advancing …

Impact Of The Methamphetamine Epidemic On Healthcare, Amanda Brumfield

Theses, Dissertations and Capstones

Introduction: The surge in methamphetamine use in the U.S. has presented various challenges for individuals and healthcare systems. Research has shown high relapse rates, oral health issues, and increased susceptibility to blood-borne viruses among users, underscoring the gravity of the situation. Furthermore, the absence of approved pharmacological treatments and systemic barriers to effective treatment highlighted the pressing need for holistic approaches to address this epidemic successfully.

Purpose of the Study: The purpose of this research was to identify the challenges faced by treatment providers specializing in substance use disorder treatment amid rising instances of methamphetamine abuse, including managing heightened relapse …

Do Pediatric Patients That Receive Dexmedetomidine As Premedication Experience Less Emergence Delirium Than Pediatric Patients That Receive Midazolam As Premedication?, Shelby Mccloud

Theses, Dissertations and Capstones

Title: Do pediatric patients that receive dexmedetomidine as premedication experience less emergence delirium than pediatric patients that receive midazolam as premedication?

Problem Statement: Midazolam remains the current choice within the practice for premedication in the prevention of emergence delirium, however as research continues there could possibly be a gap between the research and current practice. Throughout the practice of pediatric anesthesia most providers choose to premedicate with midazolam while there may be a more beneficial option of dexmedetomidine.

Results: The study found a significant variance in the incidence of emergence delirium among pediatric patients, ranging from 18.1% to 89%, depending …

The Epidemic Of Opioid Usage In West Virginia, Kendra Lester, Carrington Hatfield

Theses, Dissertations and Capstones

The opioid epidemic in West Virginia is a complex interplay of factors, including poverty, low education, and high unemployment rates, which contribute to higher rates of substance use and opioid-related deaths. The number of people injecting drugs has risen from 36% in 2005 to 54% in 2015. WV recorded 871 overdose deaths from all drugs in 2019 with 76.8% involving at least one opioid. The purpose of this qualitative research study was to investigate and analyze the circumstances that contributed to West Virginia's opioid epidemic to determine if sociocultural factors, such as lifestyle, education, and demographics, influenced the epidemic as …

A Rheumatoid Nodule At The Sternoclavicular Joint: An Uncommon Presentation Of A Common Problem, Patrick M. Thomas, Nathan J. Cockerill, Christina M. Arcand, Alan R. Koester, Mark H. Cooper Md, Phd

Marshall Journal of Medicine

Most rheumatoid nodules are found at joints or pressure points. They rarely require medical intervention and even fewer require surgery. A 78-year-old female developed a 7.2 x 3.2 x 2.8 cm rheumatoid nodule originating at the right sternoclavicular joint, a novel site for a common pathology. Management involved a complex differential diagnosis and surgical treatment was resection from adjacent vascular and neural structures. Following surgical excision, the patient maintained good mobility and sensation of the neck and surrounding areas.

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

Complications And Hospital Admissions Among Pregnant Women With Substance Abuse, Melissa A. Nehls, Jamila Iqbal Ranavaya, Sydney Smith-Graham, Micah Ray, Aryana Misaghi, Jennie Yoost, Kelly Cummings

Marshall Journal of Medicine

Introduction

In recent times, there has been an increase in drug abuse in the general population and in women of reproductive age. Our objectives were to identify, classify, and describe the spectrum of complications, the average number of admissions, and the length of hospital stay among pregnant women with substance abuse. The aim was to understand complication prevalence better to improve management in this ever-growing population.

Methods

A retrospective chart review was conducted of pregnant women ages 18-45 with a history of substance abuse from 2013-2018 in the tri-state area of West Virginia, Ohio, and Kentucky. We collected the following …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Current And Novel Neuroregenerative Therapies, Arrin Brooks

Theses, Dissertations and Capstones

Underlying the physical and cognitive deficits consequent of many neuropathologies is one common factor, the loss of neurons. While neurodegenerative diseases, stroke, and traumatic brain injury arise from a variety of etiologies, they all ultimately result in injury and/or death of neuronal cells and concomitant functional deficits. In the present work we primarily focus on current and potential treatments for localized lesions, particularly those in the striatum of Parkinson’s disease (PD) or the cortex as in stroke. First, we discuss a new surgical technique for deep brain stimulator (DBS) placement, as DBS is a mainstay treatment for movement disorders including …

Impact Of A Faculty Development Course On Promotion At A Health Sciences Center, Sanja Kupesic Plavsic, Valerie Osland Paton Ph.D., Christiane Herber-Valdez, Consuelo Rosales, Martín D. García, Zuber D. Mulla

Marshall Journal of Medicine

Introduction

The objective of this study was to quantify the association between graduation from our annual comprehensive Institutional Faculty Development Course (IFDC) and being promoted from assistant professor to associate professor at our health sciences center.

Methods

A retrospective cohort study (October 2008-October 2019) was conducted using publicly-available faculty data. A total of 148 IFDC graduates were compared to 87 non-graduates. Subjects were full-time assistant professors at Texas Tech University Health Sciences Center El Paso at the start of follow-up. The binary outcome was promotion to associate professor. The outcome was measured annually from 2008 to 2019. Follow-up ended when …

Perceived Stress And Burnout In Athletic Training Students, Desiree Nicole Daniels

Theses, Dissertations and Capstones

Athletic training students can experience stress and symptoms of burnout and there is empirical support for a relationship between stress and burnout in health professions students in fields such as medicine and nursing. ^1-3 However, prior research on the relationship between stress and burnout has been limited in athletic training students. The purpose of the present study was to examine the relationship between perceived stress and symptoms of burnout in athletic training students. Two hundred thirty athletic training students from 61 institutions completed an online questionnaire consisting of the Perceived Stress Scale (PSS), the Burnout Clinical Subtype Questionnaire - Student …

Association Of Electronic Prescription In Controlled Substances Used, Archana Suwal, Jemima Akinyi Okonjo

Theses, Dissertations and Capstones

Introduction: Controlled substances have been described as pharmaceuticals or illegal medicines that act primarily on the central nervous system and could cause physical and mental dependence, eventually leading to addiction. Prescription opioids were a significant contributor to the opioid epidemic, accounting for more than 70,000 opioid-related overdose deaths, including illicit and prescription opioids, between 2018 and 2019. The Electronic Prescriptions for Controlled Substances (EPCS) initiative recently aimed to reduce rates of prescription opioid addiction, abuse, diversion, and death. The system for controlled substances had become more widely used as providers and governments trying to combat the opioid problem. Because …

The Opioid Epidemic In The United States: A Call For Practice Change In Pediatric Outpatient Surgeries, Emma Bacharach, Osama Al-Omar

Marshall Journal of Medicine

No abstract provided.

Providing Dental Care In The Current Covid-19 Crisis, Raj Khanna

Marshall Journal of Medicine

Dental procedures typically generate aerosol. With the current covid19 crisis this is a serious problem for providers and patients. The commentary addresses some of the problems and possible solutions for providing dental care in the current covid-19 crisis.

Medical Tourism: The Impact Of Cost And Wait Time In Relation To Cardiac Surgeries Among Individuals In The United States, Karen Eberechukwu

Theses, Dissertations and Capstones

Introduction: Medical tourism has been defined as consumer movement whereby individuals travel abroad to get treatment, incur out-of-pocket and third-party payments. As American health care continues to face extraordinary increases in cost and long wait time. Medical tourism has made it possible for cardiac patients to do their surgeries at a more affordable rate with shorter wait times while achieving quality care.

Methodology: The methodology of this study was a literature review used to examine the research. 5 electronic databases and government websites were utilized, with Only 42 sources referenced in the literature review.

Results: The research …

Group A Streptococcus Brain Abscess In A Patient On Adalimumab Therapy, Ryan Carroll, Ahmad Abu-Hashyeh, James Gainer, Kara Willenburg, Charles Meadows

Marshall Journal of Medicine

Brain abscesses represent a group of dangerous infections typically caused by a number of classic organisms. Group A Streptococcus is a rare cause of brain abscesses and those patients that do have this particular condition will typically have a distal source of infection. We present a case of patient with a biopsy confirmed Group A Streptococcal without a distal source of infection. His only identifiable risk factor was his adalimumab therapy for ankylosing spondylitis. While adalimumab has not been linked to Streptococcal infection in the past, it has been associated with multiple atypical infections and some of the consequences of …

Hemimegalencephaly With Prominent Ipsilateral Facial Hypertrophy, Seraj Saleh Ajaj, Faisal Bentaleb, Jamal Elasfer, Khawla Shlaibek

Marshall Journal of Medicine

Hemimegalencephaly is uncommon congenital malformation with unilateral enlargement of the hemicerebrum. Here we report a 1 month-old male child presented at our neurosurgery outpatient’s clinic with recurrent seizures and facial asymmetry. CT and MRI of the brain revealed diagnostic characteristic features of Hemimegalencephaly associated with ipsilateral Facial Congenital Infiltrating Lipomatosis.

Does Prophylactic Administration Of Ondansetron Prior To Spinal Anesthesia Decrease Spinal-Anesthesia Induced Hypotension In Obstetric And Non-Obstetric Patients?: A Literature Review, Quinnton Rees

Theses, Dissertations and Capstones

Introduction: Neuraxial (spinal) anesthesia is a favored modality in the care of obstetric patients undergoing a cesarean-section (C-section). Spinal anesthesia is additionally popular as an alternative method for various surgical procedures in non-obstetric patients allowing practitioners to avoid potential risks associated with the use of general anesthesia. Spinal anesthesia-induced hypotension (SAIH) is a common side effect that presents status post-initiation of spinal anesthesia. The source of the hypotension produced after the initiation of spinal anesthesia is due to inhibition of the sympathetic nervous system (sympathectomy) and bradycardia caused by stimulation of the Bezold-Jarisch Reflex. A relatively new intervention that …

Occupational Exposure To Blood And Bodily Fluids Among Health Care Workers In A Medical Teaching Hospital, R. A. Alhazmi, Sarah J. Surber

Applied Safety & Technology Faculty Research

The objective of this study was to evaluate blood and bodily fluids exposure through needlestick injuries (NSI) and non-percutaneous incidents among healthcare workers (HCWs). This project utilized a dataset collected from J. W. Ruby Memorial Hospital in Morgantown, West Virginia, between January 1, 2014 and August 15, 2017. Data included de-identified codes of employees, occupations, types of exposure to bloodborne pathogens, routes of exposure, infectious disease exposures, and time incidents. During this time period, 655 incident reports were documented and finalized in regards to blood or body fluid exposure. HCWs had 506 (77.25%) NSIs and 149 (22.74%) non-percutaneous incidents. The …

Medicine Outside The Clinic: The Growing Need For Physicians In Sexual Education Policy, Zachary Sanford

Marshall Journal of Medicine

Sex and sexuality are both topics of immense social and personal importance, owing their openness or constraint in large part to the society in which they are discussed. In homogenous groups it may be possible to reach firm consensus on what is, or is not, appropriate to consider a sexual norm and use an overarching set of religious or spiritual morals to reaffirm this decision. However, in western society and specifically in the United States, a theme of integration and amalgamation of wildly different cultures has presented an interesting case study in searching for common ground on basic social issues. …

Could The Pharmaceutical Industry Benefit From Full-Scale Adoption Of Radio-Frequency Identification (Rfid) Technology With New Regulations?, Alberto Coustasse Drph, Md, Mba, Mph, Craig Kimble Pharmd, Mba, Ms, Bcacp, Robert B. Stanton Mba, Pharmd, Mariah Naylor

Management Faculty Research

Healthcare regulators are directing attention to the pharmaceutical supply chain with the passage of the Drug Quality and Security Act (DQSA) and the Drug Supply Chain Security Act (DSCSA). Adoption of Radio-Frequency Identification (RFID) technology has the ability to improve compliance, reduce costs, and improve safety in the supply chain but its implementation has been limited; primarily because of hardware and tag costs. The purpose of this research study was to analyze the benefits to the pharmaceutical industry and healthcare system of the adoption of RFID technology as a result of newly implemented supply chain regulations. The methodology was a …

Primary Retroperitoneal Melanoma Presented In A Rare Extracutaneous Site For Malignant Melanoma, Mohamed Alsharedi, Nadim Bou Zgheib, Yousef Khelfa, Ali Raufi, Nabiha Elmsherghi, Yehuda Lebowicz

Hematology and Oncology

Malignant melanoma, as the name implies, is a malignant tumor of melanocytes, found in the skin, eyes, meningeal lining and the mucosal epithelium of the aero-digestive and genitourinary tracts. Malignant melanoma is typically skin malignancy, which rarely presents at extracutaneous site. Here we present a rare case of primary retroperitoneal melanoma and review the findings in comparison with other cases described in literature.

The Future Is In The Numbers: The Power Of Predictive Analysis In The Biomedical Educational Environment, Charles A. Gullo Phd

Biochemistry and Microbiology

Biomedical programs have a potential treasure trove of data they can mine to assist admissions committees in identification of students who are likely to do well and help educational committees in the identification of students who are likely to do poorly on standardized national exams and who may need remediation. In this article, we provide a step-by-step approach that schools can utilize to generate data that are useful when predicting the future performance of current students in any given program. We discuss the use of linear regression analysis as the means of generating that data and highlight some of the …

Current Prevalence Rate Of Latex Allergy: Why It Remains A Problem?, Miaozong Wu, James Mcintosh, Jian Liu

MIIR Faculty Research

OBJECTIVES: This article aims to review the current prevalence rate of latex allergy among healthcare workers, susceptible patients, and the general public, and to investigate why latex is still a ubiquitous occupational health hazard.

METHODS: Scientific publications on PubMed, particularly those published within the last five years, and current regulations from agencies such as Food and Drug Administration (FDA) were reviewed. Consumer and commercial products that may contain latex were also surveyed.

RESULTS: Approximately 12 million tons of natural rubber latex is produced annually and is widely used to manufacture millions of consumer and commercial products. Only limited number of …

Proton Pump Inhibitors And Corticosteroids As Synergistic Risk Factors For Candida Esophagitis, Nihar Shah Md, Yana Cavanagh, Oleg Shulik, Pooja Patel, Vincent A. Debari, Walid Baddoura

Gastroenterology

Abstract:

Introduction: Inhaled & systemic steroids are one of the well-documented risks factors for Candida esophagitis. However, the role of gastric acid suppression remains controversial.

Methods:

We conducted a retrospective case-control study of 420 patients consisting of 84 cases of Candida esophagitis and 336 matched controls. Our cohort was gathered from subjects evaluated from 2001 to 2012. The diagnosis of Candida esophagitis was based on endoscopic and/or histological criteria.

Results:

On univariate analysis, proton pump inhibitors were associated with higher risk (OR = 2.14; 95 % CI: 1.30 to 3.54); steroid use also increased the risk (OR = 3.55; 95% …

Differences In Health-Related Behaviors And Attitudes Between Urban, Rural, And Isolated Households In Western West Virginia, Michael Newsome Phd, Tim Hazelett, Monika Sawhney Phd, Msw

Economics Faculty Research

This study uses data from a 2013 survey of 275 randomly sampled households across nine counties in western West Virginia to examine the significant differences between the health behaviors and attitudes of rural and isolated populations. The results show that age, education, and income are significant factors in explaining differences in health-related behaviors and attitudes for all urban, rural and isolated respondents. However, after controlling for socio-demographic differences, isolation is found to have only a few significant effects, and some of the effects run counter to stereotypes of isolated populations. Rural respondents are significantly more likely than isolated respondents to …

An Unusual Initial Presentation Of Hepatocellular Carcinoma As A Sellar Mass, Nihar Shah Md, Yana Cavanagh, Hamid Shaaban, Beth Stein, Sohail N. Shaikh, Dharmesh H. Kaswala, Walid Baddoura

Gastroenterology

Sellar masses are frequently adenomatous pituitary tumors. Metastatic disease is unusual, often mimicking the presentations of adenomas. Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy but unusual to have a pituitary metastasis (PM). A 65-year-old man presented with headache, diplopia, ptosis, decreased vision in the right eye and unintentional weight loss of 32lbs. Preliminary out-patient work-up revealed a mass in the pituitary region. Cranial imaging showed 3.1 cm × 3.2 cm × 4.4 cm lesion. Abdominal imaging (computed tomography and magnetic resonance imaging) demonstrated a lobulated, nodular and heterogeneous right lobe of the liver. Trans-sphenoidal resection of the …

Inhalation Anesthesia Vs. Total Intravenous Anesthesia For Ambulatory Dental Surgery In Children, Kristin D. Neal

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to compare inhalation anesthesia with sevoflurane versus Total Intra Venous Anesthesia (TIVA) with propofol infusion as it relates to the quality of recovery including postoperative pain, Post Operative Nausea and Vomiting (PONV), and Post Anesthesia Care Unit (PACU) Length Of Stay (LOS) in pediatric patients undergoing ambulatory dental surgery. Introduction: Pediatric dental procedures are increasingly performed in an outpatient setting under general anesthesia due to inadequate cooperation, circumstantial anxiety, and other behavioral and health issues. Commonly used inhalation anesthetics, such as sevoflurane, can induce hyperalgesia in children. While sevoflurane increases the risk PONV, …

From Lcme Probation To Compliance: The Marshall University Joan C Edwards School Of Medicine Experience, Bobby Miller, Brian Dzwonek, Aaron Mcguffin, Joseph I. Shapiro Md

Biochemistry and Microbiology

The Joan C Edwards School of Medicine (Marshall University, Huntington, WV, USA) was placed on probation by the Liaison Committee on Medical Education (LCME) in June 2011. In the following 2 years, extensive changes were made to address the numerous citations that resulted in this probation. In October 2013, the LCME lifted probation. In this article, we detail the challenges and solutions identified relevant to our struggle with compliance.

Medicare Fraud In The United States: Can It Ever Be Stopped?, Chelsea Hill, Alex Hunter, Leslie Johnson, Alberto Coustasse

Management Faculty Research

The majority of the United States health care fraud has been focused on the major public program, Medicare. The yearly financial loss from Medicare fraud has been estimated at about $54 billion. The purpose of this research study was to explore the current state of Medicare fraud in the United States, identify current policies and laws that foster Medicare fraud, and determine the financial impact of Medicare fraud. The methodology for this study was a literature review. Research was conducted using a scholarly online database search and government Web sites. The number of individuals charged with criminal fraud increased from …