Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Characteristics And Clinical Outcomes Of Iud Insertion Under Conscious Sedation In Pediatric And Adolescent Patients, Alleana Corpin, Madeline Ross, Anne-Marie Priebe, Ashli A. Lawson

Research Days

Intrauterine devices (IUDs) are a favorable option for adolescents for contraception and menstrual suppression. However, few choose this option citing anxiety and concern for pain related to insertion procedure. Our institution proposes utilizing conscious sedation techniques for anxiolysis and analgesia during IUD insertion. The objective of this study was to identify characteristics of teens choosing conscious sedation for this procedure and likelihood of successful insertion.

Key Words: Intrauterine device (IUD), adolescent, conscious sedation

Experiences Of Families With Children/Youth With Special Health Care Needs In A Focused Emergency Preparedness Intervention, Franklin King

St. Chris Research Day

No abstract provided.

Improving Rates Of Sexual Orientation And Gender Identity (Sogi) Screening In A Primary Pediatric Clinic, A Quality Improvement Project, Pritha Dewanjee, Janet Lee, Dasam Jeong, Carolina Ramos

St. Chris Research Day

No abstract provided.

A Comparison Of Clinical Presentation And Outcomes In Down-Syndrome Associated Arthritis Compared To Juvenile Idiopathic Arthritis, Irene Chern, Jordan Jones

St. Chris Research Day

No abstract provided.

Addressing Fire Safety As Part Of A Home Preparedness Intervention For Families With Children And Youth With Special Health Care Needs, Manya Mittal, Jennifer Griffin, Zekarias Berhane, Renee Turchi

St. Chris Research Day

No abstract provided.

Understanding Vaccine Hesitancy: An Analysis Of Caregiver Influences On Pediatric Covid-19 Vaccination Decisions, Neiki Rokni, Shu Zhao Md, Matthew Nguyen, David Liu, Harrison Jordan Do, Jory Parson, Sidharth Sahni Do, Tanner Walsh Md, Ashley Henderson Md, Jennifer Higgins Md

St. Chris Research Day

No abstract provided.

Pediatric Caregiver Perspectives On Immigration Status In The Healthcare Setting, Anik Patel, Kimberly Randell, Jennifer Watts, John Cowden, Frances Turcotte Benedict, Juan Farias Torres, Ana Contreras, Ali Fowler, Estefania Bazan, Claudia Zepeda

Research Days

A qualitative study to explore pediatric parent/caregiver knowledge, attitudes, and beliefs regarding impacts of immigrant status on healthcare and describe health and social needs of families for whom one or more caregivers has undocumented immigration status as well as preferred methods for resource connections among undocumented caregivers.

Nrp, Pals, And Their Utilization During Code Events In A Pediatric Quaternary Hospital: A 'Compressed' Analysis, Mitch Kinkor, Deepa Kumar, Allison Taber, Stephen Pfeiffer, Jessica Brunkhorst, Danielle Reed

Research Days

Both the Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) algorithms are utilized for resuscitation during pediatric codes. The optimal time period to transition from NRP to PALS is not well studied. This study describes the utilization of chest compressions, prescribed medications, and patient outcomes during and after code events organized by the algorithm used to direct resuscitation (PALS or NRP) in a similarly aged patient population.

Health Disparities In Slipped Capital Femoral Epiphysis (Scfe) Presentation, Rithika Ginjupalli, George Thomas, Rohit Siddabattula, Richard M. Schwend, Caleb Grote

Research Days

This study identifies various health disparities in SCFE presentations using neighborhood-level determinants COI and ICE in addition to sociodemographic determinants such as race and gender.

Knowledge And Attitude Of Lebanese Adults Towards Asthma In Beirut, Lebanon, Farah Hatem Haidar, Doaa Issa, Maha Aboul Ela, Karim Raafat

BAU Journal - Health and Wellbeing

Asthma, a serious global health problem, has been an area of interest due to its increasing prevalence, expanding treatment costs, and rising burden on patients and the community. Since asthma cannot be cured, clinical episodes can be prevented and controlled by adequate management and sufficient knowledge of the disease. Appropriate treatment may relieve asthma symptoms and improve quality of life. However, poor knowledge of asthma disease and medication use, misdiagnoses, misuse of inhalers and inadequate self-management of disease symptoms may have a greater impact on the disease process. Therefore, assessment of the population’s knowledge and attitude toward asthma is essential. …

C-Terminal Binding Protein 2 Is A Novel Tumor Suppressor Targeting The Myc-Irf4 Axis In Multiple Myeloma, Coty Hing Yau Cheung, Chi Keung Cheng, Kam Tong Leung, Chi Zhang, Chi Yan Ho, Xi Luo, Angel Yuet Fong Kam, Tian Xia, Thomas Shek Kong Wan, Herbert Augustus Pitts, Natalie Pui Ha Chan, Joyce Sin Cheung, Raymond Siu Ming Wong, Xiao-Bing Zhang, Margaret Heung Ling Ng

Journal Articles

Multiple myeloma (MM) cells are addicted to MYC and its direct transactivation targets IRF4 for proliferation and survival. MYC and IRF4 are still considered "undruggable," as most small-molecule inhibitors suffer from low potency, suboptimal pharmacokinetic properties, and undesirable off-target effects. Indirect inhibition of MYC/IRF4 emerges as a therapeutic vulnerability in MM. Here, we uncovered an unappreciated tumor-suppressive role of C-terminal binding protein 2 (CTBP2) in MM via strong inhibition of the MYC-IRF4 axis. In contrast to epithelial cancers, CTBP2 is frequently downregulated in MM, in association with shortened survival, hyperproliferative features, and adverse clinical outcomes. Restoration of CTBP2 exhibited potent …

Athletic Trainers’ Knowledge And Perceived Ability Of Recognizing And Treating Panic Attacks, Caitlin Hill, Chyrsten Gessel, Jaclyn Tate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Mental health is a condition of mental wellness that enables people to manage life's stressors, develop their potential, study and work effectively, and give back to their communities. One mental health condition is anxiety. Anxiety is the expectation of a threat in the future. There are multiple subtypes of anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, separation anxiety, and panic disorder. This study investigates the relationship between ATs' knowledge and their perceived ability to identify and treat panic attacks.

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

Non-Fatal Strangulation/Suffocation In Context Of Gender Violence: Medicolegal Aspects And Implications In Clinical Practice, Mónica Andrea Núñez Garrido, Sergio Herrera Umanzor

Revista de la Facultad de Medicina Humana

Despite the numerous efforts of the international community to eradicate all forms of violence against women, this problem is far from being resolved. According to the UN, one in three women has suffered physical or sexual violence from an intimate partner, sexual violence outside the couple, or both at least once in their life. Addressing this problem as a social health need of population groups allows an approach to gender violence as a collective health problem. At the level of physical violence, strangulation/suffocation has been identified as one of the most lethal forms of domestic violence and sexual assault. Victims …

Hyperglycemia As A Risk Factor For In-Hospital Mortality In Myocardial Infarction, Ciro Barrantes-Alarcon, Rosalia Fernández-Coronado, Adriel Olortegui-Yzu

Revista de la Facultad de Medicina Humana

Introduction: Myocardial infarction continues with high mortality rates, from 4.6% to 13.1%. There are predictive risk stratification models, such as the Grace Score, which does not include glycemia as a variable. Patients hospitalized for myocardial infarction with hyperglycemia on admission may have higher mortality, in ST elevated and non-elevated infarcts. Objectives: The objective of this review is to identify and systematize the evidence on hyperglycemia on admission as a biomarker of mortality and heart failure in acute myocardial infarction. Materials and Methods: The search was carried out in the MEDLINE database including the MeSH terms hyperglycemia and hospital mortality or …

Laura E. Rodríguez Dulanto: The First Clinical Trial Performed By A Female Physician In Peru., Oswaldo Salaverry García

Revista de la Facultad de Medicina Humana

Laura Gutiérrez Dulanto has been highlighted for her status as the first woman to graduate in Medicine in Peru. Her high intellectual qualities have been noted from various perspectives, as well as her effort and tenacity to overcome the difficulties of pursuing university studies, particularly in scientific disciplines, then reserved exclusively for men. It has been pointed out, however, that due to the limitations imposed on women at the time, she had a diminished professional activity and little scientific production, which has not been reviewed by existing historiography. This article analyzes his scientific production, especially a clinical study developed in …

Analysis Of Adverse Drug Reactions Caused By Antipsychotic Drugs In A Mexican Health Institute, Erick Rojas-Valladares, Ismael Aguilar-Salas, Karina Sánchez-Herrera, Ivo Heyerdahl-Viau, Jonatan Benitez-Morales, Juan Manuel Martínez-Núñez

Revista de la Facultad de Medicina Humana

Introduction: Adverse Drug Reactions (ADRs) are unwanted clinical or laboratory manifestations that are related to drug use. ADRs are common and are associated with significant risk of morbidity, mortality and hospital admissions. Antipsychotics have a reduced therapeutic window, and have been related to the manifestation of a variety of ADRs. Objective: To evaluate the pattern of ADRs due to antipsychotic drugs detected in patients treated at the Ramón de la Fuente Muñiz National Institute of Psychiatry between December 2021 and May 2022. Methods: Observational, descriptive, prospective and cross-sectional study of a series of cases. The seriousness, severity, and quality of …

Sociodemographic Characteristics And Bone Health In Argentine Adults With A Plant-Based Diet, Paula Taboada, Marcela Manuzza, Silvina Mastaglia

Revista de la Facultad de Medicina Humana

Objective: To analyze the sociodemographic characteristics and bone health among adult consumers of plant-based diets (PBD). Methods: Individuals aged 18 to 75 were invited to complete a self-administered survey via a digital platform. Results: A total of 1151 participants completed the survey; the majority were women [n=958 (83.2%)], young [age (years): 18-25: 35.8%; 26-35: 39.8%, and 36-45: 17.4%] and single (67.1%). The pattern of PBD consumption was mainly represented by veganism (54.0%), followed by lacto-ovo-vegetarianism (27.7%). The primary reason for their dietary choice was animal welfare (83.5%). Adherence to PBD, based on duration (years), was <1: >12.3%; 1-5: 67.4%; 10-15: 14.8%, …

Job Satisfaction In Crisis: The Impact Of Covid-19 On Health Personnel, Nora Nicole Itusaca Dueñas, Valeria Antuanne Ortiz Ramos

Revista de la Facultad de Medicina Humana

Dear Editor of the Revista de la Facultad de Medicina Humana, Lima, Perú: I am writing to you regarding the original article titled "Pre-pandemic climate and job satisfaction of nursing staff in an emergency service," published in Volume 23, Issue 02, of the year 2023. In the aforementioned study by Chávez M et al., the significant correlation between the work environment and job satisfaction within the nursing team at Vitarte Hospital is highlighted. However, considering the health emergency situation caused by the COVID-19 virus starting in the year 2020, we believe it is necessary to provide a global perspective on …

Mortality Of Patients Hospitalized By Covid-19 In Mexico, Systematic Review, Ana Portocarrerero Granados, Lya A Castro Rodriguez, Antonio Sandoval-Cabrera, María Del Socorro Romero Figueroa

Revista de la Facultad de Medicina Humana

Introduction: Since the start of the pandemic, Mexico was one of the countries with the highest mortality rates from COVID 19. Objective: To determine if type 2 diabetes mellitus, arterial hypertension, and obesity increase mortality in patients diagnosed with COVID-19 who required hospitalization in Mexico. Methods: Systematic review in Pubmed MeSH, Web of Science, Lilas, Scielo, and Google Scholar with the terms MeSH COVID-19, SARS-COV2, Coronavirus, and Mexico for the years 2020 and 2021, in English or Spanish. Two reviewers selected the studies, two additional reviewers participated in the analysis of the studies. Results: Seventy three studies carried out in …

Effect Of Oral Vitamin D Supplementation On Psoriasis Severity: Does It Generate Significant Benefits?, Juan Esteban Ospina Gómez, Maria Camila Forero Buelvas, Manuel Enrique Duarte Arias

Revista de la Facultad de Medicina Humana

Psoriasis is a chronic immune-mediated skin disease with a complex genetic and pathogenic basis, often leading to significant comorbidities and a reduced quality of life. Its prevalence varies globally and exhibits an increasing trend over time. Comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues further compound the burden of psoriasis. Treatment options range from topical therapies to systemic agents, with biologics playing a prominent role in recent years. However, the safety and efficacy of these treatments are continuously assessed through real-world data. Vitamin D has gained attention as a potential therapeutic target due to its role in …

Effect Of Bariatric Surgery On Quality Of Life In Obese Patients: A Global Systematic Review, Miguel Ángel López Espinoza, Nayaret Vega Albornoz, Ornela Navarro Mora

Revista de la Facultad de Medicina Humana

In a situation of obesity and when treatment goals are not met, bariatric surgery can be a promising alternative; with effects at the physical level as well as at the psychological level of the quality of life. This study aims to determine the effect of bariatric surgery on the quality of life in obese men and women between 20 and 60 years of age. A Systematic Review (SR) was carried out with meta-analysis of randomized systematic reviews, which compare the quality of life in patients after bariatric surgery. Electronic databases were consulted: Ebsco, Scopus, Pubmed and Cochrane Library. The response …

A Panoramic View Of Anxiety And Lifestyle In Medical Students: An Updated Review., Anthony Diosdao Colque Durand

Revista de la Facultad de Medicina Humana

Introduction: Lifestyles encompass the decisions a person makes, simultaneously impacting their quality of life. Especially for those pursuing health-related careers, it can be a particularly demanding and challenging period. They frequently encounter stressful situations that significantly affect their well-being and lifestyle choices. Objective: To determine if there is an association between lifestyle and academic performance in medical students. Methods: The review was conducted through evidence-based literature search for articles published from 2013 to 2023, using search platforms such as Scopus, PubMed, Scielo, BVS, ScienceDirect, and Google Scholar. Results: Out of the 42 articles reviewed, 10 were excluded for not being …

Factors Associated With Postoperative Complications After Pancreatoduodenectomy (Whipple Procedure) In A Specialized Center, Jorge Cornejo, Lucy E. Correa López, Jose Cornejo, Mariela Vargas, Belkys Figueroa Depablos, Cesar Rodríguez

Revista de la Facultad de Medicina Humana

Introduction: Whipple procedure, also known as pancreatoduodenectomy (PD), is a widely used procedure for several types of peri-ampullary cancer. Objectives: To establish the factors associated with postoperative complications after PD in the Pancreas Surgery Service of the Edgardo Rebagliati Martins National Hospital in Lima, Peru. Methods: An observational, quantitative, analytical, cross-sectional, and retrospective study was carried out on 81 patients during the period from January 2017 to December 2019, who underwent PD. The dependent variable was postoperative complications and the independent variables were preoperative, perioperative, and postoperative variables. The medical records were reviewed. Logistic regression was performed to find the …

Concordance Between Two Questionaries For The Diagnosis Of Digital Eye Strain In Students Of A University In Peru, Guillermo Landa Guerra

Revista de la Facultad de Medicina Humana

Objective: Obtain the frequency of digital eye strain (DES) between two questionnaires among students of a private university in Lima, Peru; in order to estimate the degree of concordance between both methods. Methods: A cross-sectional study was carried out in a sample of 345 participants over 18 years of age, students at a university in Lima, Peru, and who completed the data collection instrument. The two methods used to measure DES were the Hayes questionnaire, which defines a positive case for DES with a score equal to or greater than 20; and the CVS-Q questionnaire of Seguí, which defines a …

The Control Of Growth And Development In The Reduction Of Anemia In Peru, Evelyn Gabriela Castro Mayta

Revista de la Facultad de Medicina Humana

Introducción: La anemia es un problema de salud pública que afecta principalmente a los niños menores de cinco años en el Perú, debido a la deficiencia de hierro. Objetivo: Determinar el impacto del control del crecimiento y desarrollo (CGD) en la reducción de la anemia en niños menores de cinco años en el Perú, considerando el análisis de la ENDES 2021. Método: Estudio analítico. Se realizó un análisis secundario de datos de la encuesta ENDES del año 2021. Resultados: El 31,4 % de los niños menores de cinco años presenta anemia, donde el 38,3 % corresponde a la zona rural, …

Evaluation Of Clinical Aspects Related To Lower Limb Amputation Among Individuals Living With Type 2 Diabetes Mellitus In Mexico, Julio Cesar Parra Acosta, Laura Ávila Jiménez, Antonio Monroy Noyola, Diana Lizbeth Gómez Galicia, Daniel Álvarez Escobedo, Cairo Toledano Jaimes

Revista de la Facultad de Medicina Humana

Introduction: Diabetes continues to be one of the leading causes of disability and death in the global population. It is estimated that approximately 25% of people living with diabetes will develop an ulcer on one of their lower pelvic limbs. Objective: The present study evaluates the clinical aspects related to lower pelvic limb amputation in a cohort of patients with diabetes mellitus. Materials and Methods: A retrospective cross-sectional study was conducted consisting in a review of the total census of patients with type 2 diabetes. They received medical attention in the setting of the study in the period January-May 2022. …