Digital Commons Network^™

Impact Of Implementing The Geriatric Resource Nurse Model On Fall And Hospital Acquired Pressure Ulcer Rates, And Length Of Stay In Older Adults In An Acute Care Hospital, Elzbieta Kmiecik, Cathie E. Guzzetta, Mary-Michael Brown, Qiuping Pearl Zhou, Desale Sameer

GW Research Days 2015

Background.Older adults are at high risk for adverse care outcomes, such as injuries from falls, hospital acquired pressure ulcers (HAPUs), and prolonged length of stay (LOS). Available evidence suggests outcomes may improve when older adults are cared for by healthcare providers with competence in geriatrics. To improve outcomes, an acute care not-for-profit teaching hospital in Washington DC area implemented a Geriatric Resource Nurse (GRN) model that prepares registered nurses (RNs) as clinical experts on core geriatric principles on four general care wards (three medical-surgical and one cardiac).

Objectives. Toexamine the effects of GRN model implementation on fall and …

Occupational Health Risk Factors For Schistosomiasis: Systematic Review And Analysis, Sarah Grace Sawyer, Amira Roess, Gisela Butera

GW Research Days 2015

Schistosomiasis is a neglected tropical disease caused by a parasitic flatworm which afflicts over 200 million people in the poorest regions of Africa. Carried by snails living in fresh, stagnant water, the parasite penetrates human skin upon contact, causing the victim to suffer a range of symptoms including diarrhea, blood in the urine, and eventual death. Despite its prevalence, schistosomiasis is preventable, treatable, and curable once a control program is implemented. Substantial reduction of schistosomiasis would relieve suffering and produce many socio-economic benefits, including higher productivity and higher school attendance rates. Disease transmission is directly tied to the environment, and …

Out And About In Medicine: Gw Out For Health, Michelle S. Davis, Daniel F. O'Neill, Robert Tollefson, Domenique Escobar, Chase Hiller, Lawrence R. Deyton

GW Research Days 2015

The time is right to devise and implement a more coordinated approach to LGBT patient care and health professional training within the Washington, DC metropolitan area and beyond. The following George Washington University School of Medicine and Health Sciences (GWSMHS) and Hospital (GWUH) LGBT Health Initiative proposal highlights possible strategies for addressing this need through a more centralized fashion. The seven focus areas proposed for the GW LGBT Health Initiative include: 1) Climate/Visibility; 2) Health Education; 3) Policy/Advocacy; 4) Community Outreach; 5) Research; 6) Patient Care; and 7) HIV/AIDS. A key stakeholder that is helping to realize this vision of …

Hepatitis C Virus Infection Screening Test Compliance At Primary Care Clinic, Talal Alzahrani, Brandon Rieders, Mohammed Fadlalla, Jason Gendell, Anne Cioletti

GW Research Days 2015

Introduction:

Hepatitis C Virus (HCV) is the most common cause of liver cirrhosis and hepatocellular carcinoma, and is the leading cause of liver transplantation in the US. About 3.2 million individuals are chronically infected with HCV. Most of these patients are unaware of their infection because they are largely asymptomatic. Approximately three-fourths of them were born between 1945-1965. Furthermore, with the advances in HCV treatment, it is imperative to identify chronically infected individuals in order to avert the long-term, costly, sequelae of the virus. The U.S. Preventive Services Task Force recently recommended a one-time screening test for HCV for those …

Blood, Brain And Now Bone – Learning More About An Often Overlooked Pathogen, Linda Lesky, Julianne Camba, Sarah De Los Santos, Alexander Fortenko, Talal Alzahrani

GW Research Days 2015

INTRODUCTION:

Arcanobacterium haemolyticum (previously Corynebacterium haemolyticum), a facultative anaerobe, Gram positive rod was first isolated from United States servicemen and indigenous populations of the South Pacific in 1946. Early reported cases detailed A. haemolyticum as a causative pathogen for exudative pharyngitis (most commonly in adolescents) and cutaneous infections. Osteomyelitis caused by A. haemolyticum has been described in less than five cases in the literature. Here, we describe our experience in diagnosing patient with osteomyelitis caused by A. haemolyticum.

CASE REPORT:

A 30-year-old man with a history of peripheral neuropathy, diabetic foot ulcers, methicillin-resistant S. aureus osteomyelitis and amputation of the …

Fast Food: A Source Of Exposure To Phthalates And Bisphenol A In A Nationally Representative Sample, Cassandra Phillips, Susanna Mitro, Ami R. Zota

GW Research Days 2015

Background: Certain phthalates and bisphenol A (BPA) are industrial chemicals widely used in consumer products that can adversely impact human health. Diet is hypothesized to be a major source of exposure but little is known about the impact of specific food sources. This study aims to investigate the association between fast food consumption with human exposure to high-molecular weight phthalates (di(2-ethylhexyl) phthalate (DEHP) and diisononyl phthalate (DINP)) and BPA, in 8876 participants, aged 6 to 85 years old, from the National Health and Nutrition Examination Survey (NHANES), 2003-2010.

Methodology: During the NHANES mobile exam, participants: 1) provided a spot urine …

C-Anca Positive Necrotizing Crescentic Glomerulonephritis With Linear Immunoglobulin Staining, Akshita Mehta

GW Research Days 2015

Necrotizing crescentic glomerulonephritis is found in anti-glomerular basement membrane (GBM) disease (Type 1), immune complex (Type 2) deposition and anti-neutrophil cytoplasmic (ANCA)-related disease (Type 3).

ANCA positive glomerulonephritis is typically characterized on renal biopsy as pauci-immune, with mild or absent glomerular staining for immunoglobulin, or complement staining by immunofluorescence.

Rare cases of concomitant p-ANCA plus linear immunofluorescence pattern staining have been discussed, however none with prior association with c-ANCA.

We report a case of systemic c-ANCA pulmonary-renal syndrome with anti-GBM-disease-typical linear staining on renal biopsy immunofluorescence.

Laparoscopic Surgery For Patients With Severe Chronic Obstructive Lung Disease, Talal S. Alzahrani, Victor S. Saxena, Alexander Cho, Guillermo Gutierrez

GW Research Days 2015

Introduction: Laparoscopy is a minimally invasive procedure that associated with decreased morbidity and hospital stays. There are over two million laparoscopic surgeries performed annually in the US. Several studies have shown that patients with mild (Stage I) to moderate (Stage II) Chronic Obstructive Pulmonary Disease (COPD) develop hypercapnia during laparoscopy procedures. However, hypercapnia in this population did not affect the rate of complication or prolonged hospital stay. We report a case of very severe (Stage IV) COPD, who developed an acute respiratory failure with an increase in hospital stay during a laparoscopic procedure. We write this to bring awareness to …

A Very Rare Cause Of Pancytopenia., Talal Alzahrani, Dana Kay, Kelly Zhang, Linda Lesky

GW Research Days 2015

INTRODUCTION:

Levetiracetam (Keppra) is a pyrrolidone derivative and acts as an anti-epileptic medication by modulating neurotransmitter release. Pancytopenia is a very rare adverse effect caused by levetiracetam. There are fewer than four case reports in the medical literature discussing the association between levetiracetam and pancytopenia. The pathogenesis behind this relationship is unclear. Therefore, this case will serve to spread awareness of a rare cause of pancytopenia and to hypothesize how this medication causes pancytopenia.

CASE REPORT:

A brain MRI of a 79-year-old female with a medical history of hypertension, Type II diabetes, and CVA revealed a right temporoparietal mass. She …

Re-Expansion Pulmonary Edema, Talal Alzahrani, Nawaf Abaalkhail, Mayssam Nehme, Jalil Ahari

GW Research Days 2015

Re-expansion pulmonary edema (RPE) is a rare complication of therapeutic thoracentesis. Unfortunately, there is no definitive treatment modality for RPE. The high mortality rate, reported up to 21%, presses the issue for finding adequate prevention and treatment. Here we report a new management modality that is very useful for a patient with RPE.

Case Report: An 80-year-old man with a history of hypertension, atrial fibrillation, congestive heart failure with preserved ejection fraction, and sacral decubitus ulcer, who was admitted for surgical debridement of his ulcer. He developed hospital-acquired pneumonia and was resolved with antibiotics and aggressive hydration. He became hypoxic, …

A Rare Case Of Non-Cardiogenic Pulmonary Edema, Talal Alzahrani, Kelly Zhang, Angela Ryan, Yasir Alfi, Jeffrey Zweig

GW Research Days 2015

INTRODUCTION:

Nephrotic syndrome is identified by a significant proteinuria more than 3.5 g/day, hypoalbuminemia less than 3.5 g/dl, and peripheral edema. It associated with risks of thrombosis, infection, and hyperlipidemia due to loss of plasma protein. Several studies have shown patients with nephrotic syndrome do not develop non-cardiogenic pulmonary edema. However, we report a case of nephrotic syndrome caused by diabetic nephropathy and presented with non-cariogenic pulmonary edema.

CASE REPORT:

A 37-year old man with a past medical history of diabetes mellitus, hypertension, dyslipidemia, Charcot foot, who presented with dyspnea, orthopnea, and non-productive cough for two days. He had been …

Progressive Supranuclear Palsy Treatment- A Systematic Review, Samah Hassan Hajjar, James K. Cooper

GW Research Days 2015

Introduction

Progressive Supranuclear Palsy (PSP) is an uncommon neurodegenerative disease associated with postural instability, falling, and memory loss. Because of clinical similarities, it is often classified as atypical Parkinson's disease. PSP may present abruptly with a relatively rapid decline, leading to death in a few years. Different therapeutic approaches have been suggested for PSP, but their efficacy is unclear. To our knowledge, there has been no systematic review of PSP treatment.

Objective

To determine the effectiveness PSP treatments.

Methods

A systematic review of published literature was completed. We searched using PubMed and SCOPUS for related articles. The search terms are …

Medical Students In Microscopic Anatomy And Pathology Laboratories: Design Of An E-Learning Histology And Histopathology Atlas, Alexandra Mills, Michelle Davis, Donald Karcher, Patricia S. Latham, Janet Krum, Gisela Butera, Rosalyn A. Jurjus

GW Research Days 2015

Computer-assisted learning, also known as e-learning, has been successfully implemented to educate students in anatomical knowledge as well as transferable skills, such as critical analysis, teamwork, leadership and communication. E-learning allows students to self-teach material at their own paces and provides a platform for team-based laboratory approaches.

Several institutions have already integrated histology and physiology in team based laboratory approaches, but integration of histology and pathology instruction has been done to a lesser extent. Our aim was to develop an e-learning atlas that integrates microanatomy and pathology laboratory for an interdisciplinary pre-clinical medical curriculum.

A multidisciplinary team of teaching faculty …

Quit4baby: Results From A Pilot Test Of A Mobile Smoking Cessation Program For Pregnant Women, Lorien C. Abroms, Judy M. Van Alstyne, Christina L. Heminger, Leah E. Leavitt, Jennifer M. Schindler-Ruwisch

GW Research Days 2015

Background: Text messaging programs have been shown to be effective in helping adult smokers quit smoking. This study describes the results of a pilot test of Quit4baby, a smoking cessation text messaging program for pregnant smokers that was adapted from Text2quit.

Objective: The study aimed to demonstrate the feasibility and acceptability of Quit4baby for women currently enrolled in Text4baby, a perinatal health text messaging program.

Methods: Pregnant women enrolled in Text4baby and who were current smokers or had quit within the last 4 weeks (N=20) were enrolled in Quit4baby. Those under age 18, not pregnant, not current smokers, …

Parcellation Scheme For A Spatio-Temporal Atlas Of Fetal Brain Lobe Development, Jasmine Kaidbey

GW Research Days 2015

Introduction

Fetal brain development is a complex and dynamic process. During the third trimester of pregnancy the brain’s surface landscape changes from a smooth layer into a complex canopy with convolutions called gyri. The emergence of quantitative magnetic resonance imaging (MRI) has allowed for in vivo acquisition of high-resolution images of the fetal brain. Although a timeline for the emergence of important gyri exists; we currently lack an in vivo MRI model—or atlas—of the developing brain. Therefore, our objective was to develop a scheme to parcelate the third trimester in vivo fetal brain into lobes, and apply this scheme onto …

Minimal Increase In Contrast Enhancement After Chemo-Radiotherapy (Crt) For Glioblastoma Predicts Worse Survival And Progression-Free Survival, Sameer Aggarwal, Jason Molitoris, Cecelia Gzell, Minesh Mehta

GW Research Days 2015

No abstract provided.

Impact Of Condition Specific Camps On Resiliency And Adaptive Behavior In Children With Heart Conditions, Jeanette Fong, Sandra Cushner-Weinstein

GW Research Days 2015

Objectives: Resilience is the ability to adapt in stressful situations and overcome adversity through the use of effective coping strategies. Previous studies have demonstrated that condition-specific camps designed for children with epilepsy can increase adaptive coping skills including social interactions, cooperation, initiative, and communication in participants over a three-year period ^[1,2]. Additionally, research indicates that as a group, individuals who live with chronic health disorders exhibit less hope and have worse health outcomes when compared to their normative peers. The aim of this study was to determine the impact of condition-specific camps on children with heart conditions.

Methods: 39 …

Further Expansion Of Nested E-Modules To Address Anatomical Knowledge Retention In Medical Students Entering The Obstetrics And Gynecology Clinical Rotation, Abigail Armstrong, Jill A. Krapf, Kirsten Brown, Gisela Butera, Ellen F. Goldman, Rosalyn A. Jurjus

GW Research Days 2015

Previous work has shown that a curriculum that included computer-based teaching modules (“e-modules”) improved retention of preclinical concepts of gross anatomy, as medical students transitioned to the third-year OBGYN clerkship. However, data showed that deficiencies still remained in areas not addressed by the curriculum. Two of these areas were microscopic anatomy and embryology, where retention scores were 4% and 38%, respectively (Jurjus et al., unpublished). Based on this research, an expanded series of e-modules will be created to target these anatomical topics that still require improvement, specifically in microscopic anatomy and embryology: 1) Ultrasound in Pregnancy using Embryological Knowledge 2) …

Rate Control Of Atrial Arrhythmias Can Be Achieved By Selective Cardiac Neurostimulation, Mark Marchitto, Aditya C. Sharma, Jeffrey P. Moak, Dingchao He, Conor Hynes, Gregory Trachiotis, Andy Blichard, Erin Montague, Xiyan Li, Gene Bornzin, Charles I. Berul, Richard A. Jonas, Marco A. Mercader

GW Research Days 2015

Introduction: Atrial arrhythmias (AA) occur in up to 40% of patients recovering from open-heart surgery (OHS). Pharmacologic treatment has been the main strategy used for the control of post-operative AA, but is associated with hypotension, pro-arrhythmia and myocardial dysfunction. There is a need for a reversible, modulated solution to rate control. We demonstrated the efficacy of vagal stimulation at inferior right fat pad (FP) to slow the ventricular response (VR) of atrial fibrillation (AF) and junctional ectopic tachycardia (JET). We hypothesized that the VR response to AA could be improved by alterations in 1) the site of stimulation (anterior right …