Medicine and Health Sciences Commons^™

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Community Acquired Pneumonia Order Set Utilization Evaluation: A Retrospective Chart Review, Kristin Lytal Pharmd, Mspgx, Luke Keller Pharmd, Bcps, Bcccp, Blake Burton Pharmd, Bcps, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This poster evaluated adherence of antimicrobial regimen selection using a community acquired pneumonia (CAP) order set updated to Infectious Disease Society of America/American Thoracic Society guidelines.

A Review Of Guideline Directed Medication Therapy Adherence For Patients With Asthma., Jennifer Mccarthy Pharmd, Ms, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Bhavika Patel Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated a health system’s prescribing adherence to the 2022 GINA guideline update for inhaled corticosteroid (ICS) in combination with a long-acting beta agonist (LABA) as preferred reliever/rescue therapy for asthma within the ambulatory setting.

Medication Use Evaluation Of Il-17 And Il-23 Inhibitors At A Large Health System., Corey Uetrecht Pharmd Candidate, Robert D. Beckett , Pharmd, Bcps, Kevin Baumgartner Pharmd, Jennifer Sposito Pharmd

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings.

Evaluation Of Diabetic Ketoacidosis Management: Comparing The Effectiveness Of Computer Program-Directed Vs Physician-Directed Intravenous To Subcutaneous Insulin, Kendra Yarian Pharmd, Jennifer Sposito Pharmd, Bcps, Bcccp, Christina Ford Pharmd, Bcps, Zachary Crabill Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project compared effectiveness of computer-directed versus physician-directed intravenous (IV) to subcutaneous (SC) insulin transition in patients with diabetic ketoacidosis (DKA) by retrospectively reviewing blood glucose values and DKA recurrence.

Evaluation Of Intravenous Iron In The Inpatient Setting At A Large Health System., Abby Miller Pharmd Candidate, Robert D. Beckett Pharmd, Bcps, Cole Luty Pharmd, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings. This project set out to determine whether the inpatient use of intravenous (IV) iron replacement was justified and followed evidence-based guidelines.

Evaluation Of Intravenous Immunoglobulin Utilization In Pediatric And Neonate Population Within A Community Health System., Hannah Davis Pharm D Candidate, Robert D. Beckett Pharmd, Bcps, Heather Nichols Pharm D, Bcpps, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

This project evaluated appropriateness of intravenous immunoglobulin (IVIG) use in pediatric and neonatal patients within a community health system based on current evidence. Presented at 2023 ASHP Midyear Clinical Meeting

Heading Towards Relief: An Evaluation Of Headache Management In A Community Hospital., Caleb Hoppe Pharmd, Sarah Meeks Pharmd, Bcccp, Heather Nichols Pharmd, Bcpps, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This study sought to examine the treatment of acute headache at a community hospital including prescribing habits, dosing practices, use of consultants, and analgesic effect of each medication.

Evaluation Of Ambulatory Care Proton Pump Inhibitor Use, Jessica Offerle Pharmd, Shivani Bhakta Pharmd, Bcacp, Noah Budi Pharmd, Ashley Parrott Pharmd, Mba, Bcps, Bcacp, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

The objectives of this project were to assess appropriateness of PPI utilization and identify possible opportunities for alternative PPI or step-down therapy.

Efficacy And Safety Of Ciltacabtagene Autoleucel And Idecabtagene Vicleucel In Multiple Myeloma Patients, Buthainah Ghanem, Marc L. Fleming, Lawrence M. Brown, Rosa Rodriguez-Monguio, Enrique Seoane-Vazquez

Student Scholar Symposium Abstracts and Posters

Background: Ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) are chimeric antigen receptor (CAR) T-cell therapies used to treat adult patients with relapsed or refractory multiple myeloma (rrMM) after at least four lines of therapy. However, no head-to-head clinical trials to compare them have been conducted.

Objective: To compare between CARTITUDE-1 and KarMMa clinical trials in terms of efficacy, safety, and patient characteristics.

Method: Overall response rate (ORR) and safety signals were compared using reporting odds ratios (RORs) with 95% confidence intervals (CIs) at p < 0.05. Overall survival (OS) and progression-free survival (PFS) were compared using the Kaplan–Meier method with a log-rank test. Patient characteristics were compared using the chi-square test. Statistical analyses were conducted using Microsoft Excel and R version 4.0.5.

Results: Statistically significant differences were observed between cilta-cel and ide-cel in terms of ORR, complete response …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Ozgene: To Advance Humanity – Inspire Curiosity, Maarit Patrick, Mike Dixon

Huntsman School of Business Teaching Scholarship Series

The case introduces the students to Ozgene, an Australian firm that experienced a dramatic reduction in lead time of their products because of implementation of Lean principles. The case can be used in undergraduate or graduate courses in operations management or supply chain management as an introduction to Lean principles. The case also encourages students to consider the challenges that make-to-order differ from those of make-to-stock and explore production design principles.

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

Pharmacogenomic Precision Medicine: Best Practice Toolkit For Improving Patient Screening For Adult Metastatic Cancer Patients, Rena L. Stewart

Student Scholarly Projects

Precision medicine utilizes pharmacogenomic testing as a therapeutic approach. Genomic testing can assess the impact of an individual's genome on their reaction to specific medications. The main objective is to find variants that may affect an individual's response to a given medication. The implementation of pharmacogenomics in oncology facilitates informed decision-making by clinicians in drug selection and dosage determination.

The Implications Of Ferroptosis In Antibiotic Resistance, Marysol Hohl

Senior Honors Theses

Bacterial infections in the United States are becoming increasingly resistant to existing antibiotic treatments. Due to projected increases in resistance and the recent decrease in novel antibacterials, experts have determined that the United States is in the “post-antibiotic era.” The scientific community has failed to resolve resistance despite the continual discovery of new antibiotic compounds. In the past decade, a novel form of cell death called ferroptosis has been implicated in antibiotic treatment by employing the use of nanotechnology. This literature review will describe the problem of bacterial resistance and demonstrate how current research is pioneering a new age of …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Dynamic Changes In Methadone Utilisation For Opioid Use Disorder Treatment: A Retrospective Observational Study During The Covid-19 Pandemic, Amy L. Kennalley, Jessica L. Fanelli, John A. Furst, Nicholas J. Mynarski, Margaret A. Jarvis, Stephanie D. Nicholas, Kenneth L. Mccall, Brian J. Piper

Pharmacy Faculty Scholarship

Objectives: Opioid use disorder (OUD) is a major public health concern in the USA, resulting in high rates of overdose and other negative outcomes. Methadone, an OUD treatment, has been shown to be effective in reducing the risk of overdose and improving overall health and quality of life. This study analysed the distribution of methadone for the treatment of OUD across the USA over the past decade and through the COVID-19 pandemic. Design: Retrospective observational study using secondary data analysis of the Drug Enforcement Administration and Medicaid Databases. Setting: USA. Participants: Patients who were dispensed methadone at US opioid treatment …

Moving Beyond The 2018 Minimum International Care Considerations For Osteoporosis Management In Duchenne Muscular Dystrophy (Dmd): Meeting Report From The 3rd International Muscle-Bone Interactions Meeting 7th And 14th November 2022, Kim Phung, Nicola Crabtree, Anne M. Connolly, Pat Furlong, Eric P. Hoffman, Stefan A. Jackowski, Soher Nagi Jayash, Alex Johnson, Khaldoun Koujok, Craig F. Munns, Erik Niks, Frank Rauch, Rachel Schrader, Cathy Turner, Elizabeth Vroom, David R. Weber, Brenda L. Wong, Michela Guglieri, Leanne M. Ward, Sze Choong Wong

Pharmacy Faculty Scholarship

This current manuscript summarizes the proceedings of the “Third Muscle-bone interactions in Duchenne Muscular Dystrophy Symposium: Moving Beyond the 2018 Minimum International Standards of Care for Osteoporosis Management”, an event co-organized by the World Duchenne Organization (www.worldduchenne.org) and the International Conference on Children’s Bone Health (www.theiscbh.org). This virtual symposium, held on November 7th and 14th 2022, brought together a total of 385 delegates representing 55 countries registered for the symposium, which included 239 clinicians, 70 researchers, 40 patient representatives and others from pharmaceutical companies and regulators. This symposium aimed to review the evidence base that informed the 2018 international minimum …

Erythrocyte–Brain Endothelial Interactions Induce Microglial Responses And Cerebral Microhemorrhages In Vivo, Hai Zhang, Rachita K. Sumbria, Rudy Chang, Jiahong Sun, David H. Cribbs, Todd C. Holmes, Mark J. Fisher, Xiangmin Xu

Pharmacy Faculty Articles and Research

Background

Cerebral microhemorrhages (CMH) are associated with stroke, cognitive decline, and normal aging. Our previous study shows that the interaction between oxidatively stressed red blood cells (RBC) and cerebral endothelium may underlie CMH development. However, the real-time examination of altered RBC–brain endothelial interactions in vivo, and their relationship with clearance of stalled RBC, microglial responses, and CMH development, has not been reported.

Methods

RBC were oxidatively stressed using tert-butylhydroperoxide (t-BHP), fluorescently labeled and injected into adult Tie2-GFP mice. In vivo two-photon imaging and ex vivo confocal microscopy were used to evaluate the temporal profile of RBC–brain endothelial interactions associated with …

The Therapeutic Potential Of Nelumbo Nucifera: A Comprehensive Review Of Its Phytochemistry And Medicinal Properties, Sparsh Bhat, Suresh Joghee, Meenakshi S. Iyer

International Journal of Health and Allied Sciences

Nelumbo nucifera generally known as ‘sacred lotus’ is a plant with high medicinal value in traditional medicine system especially in Chinese medicine system which is having a wide distribution worldwide in Asian, Western European, American and Australian continent. All the parts of the plant have different medicinal value, as their extract contains various valuable chemical constituents which yield desired remedial effects against many diseases. The plant is used traditionally more compared to its commercial usage. It has also been used for dental and skin care products in many herbal formulations. In this review, data about its general description, its distribution, …

Primary Care Intervention: Medication Reconciliation Reduces Rehospitalizations, Dianna Twombly

Student Scholarly Projects

Practice Problem: Patients are put at risk for adverse medications events when diligent care is not taken by healthcare staff. Medication discrepancies and oversights from medical personal can lead to severe illness or even death of a patient.

PICOT: The PICOT question for this project is: For patients 65 years and older (P) does a review of a hard copy of discharge instructions (I)compared to current practice during a visit, (C) impact the number of hospital readmission (O)in eight weeks (T)?

Evidence: Medication reconciliation at each point of care, patient education on medication management, and involving patients in their own …

Early Life Exposure To Broccoli Sprouts Confers Stronger Protection Against Enterocolitis Development In An Immunological Mouse Model Of Inflammatory Bowel Disease, Lola Holcomb, Johanna M. Holman, Molly Hurd, Brigitte Lavoie, Louisa Colucci, Benjamin Hunt, Timothy Hunt, Marissa Kinney, Jahnavi Pathak, Gary M. Mawe, Peter L. Moses, Emma Perry, Allesandra Stratigakis, Tao Zhang, Grace Chen, Suzanne L. Ishaq, Yanyan Li

Pharmacy Faculty Scholarship

Crohn’s disease (CD) is a presentation of inflammatory bowel disease (IBD) that manifests in childhood and adolescence and involves chronic and severe enterocolitis, immune and gut microbial dysregulation, and other complications. Diet and gut-microbiota-produced metabolites are sources of anti-inflammatories that could ameliorate symptoms. However, questions remain on how IBD influences biogeographic patterns of microbial location and function in the gut, how early life transitional gut communities are affected by IBD and diet interventions, and how disruption to biogeography alters disease mediation by diet components or microbial metabolites. Many studies on diet and IBD use a chemically induced ulcerative colitis model, …

Brain Microvascular Endothelial Cells Possess A Second Cilium That Arises From The Daughter Centriole, Karthikeyan Thirugnanam, Ankan Gupta, Francisco Nunez, Shubhangi Prabhudesai, Amy Y. Pan, Surya M. Nauli, Ramani Ramchandran

Pharmacy Faculty Articles and Research

Primary cilia from the brain microvascular endothelial cells (ECs) are specialized cell-surface organelles involved in mediating sensory perception, cell signaling, and vascular stability. Immunofluorescence (IF) analysis of human primary brain microvascular ECs reveals two cilia per cell. To confirm the in vitro observation of the two-cilia phenotype in human primary brain ECs, ECs isolated from mouse brain were cultured and stained for cilium. Indeed, brain ECs from a ciliopathic mouse (polycystic kidney disease or Pkd2−/−) also possess more than one cilium. Primary cilium emerges from the mother centriole. Centriole analysis by IF suggests that in brain ECs, markers …

Interprofessional Health Fairs: An Effective Tool For Interprofessional Education?, Caleb Holloway, Ashley Barbo, Bryan Donald, Min Jee Kim

Journal of Interprofessional Practice and Collaboration

Purpose: The purpose of this study was to determine whether interprofessional health fairs have a significant impact on the interprofessional education of students in health care disciplines.

Methods: An optional survey was administered to students participating in the health fairs in 2021 and 2022. The survey utilized four retrospective pre and post ICCAS assessment questions to address IPEC core competencies and two open ended questions to provide feedback about the health fair and report anything new learned from or about another health care discipline. The self-assessment questions were reported on a 5-point Likert scale and recorded in aggregate for both …

Cgm Use With Interprofessional Therapy Management Improves Hba1c Levels In T2dm Patients, Stephen R. Hill, Courtney Robertson, Teri B. O'Neal, Sonia Garner

Journal of Interprofessional Practice and Collaboration

Background

Type 2 Diabetes Mellitus (T2DM) is a chronic disease state with increased complications over time from uncontrolled glucose. Significant data has shown benefits of continuous glucose monitoring (CGM) in reducing glycated hemoglobin (HbA1c) levels of Type 1 Diabetes Mellitus (T1DM) patients, but a lack of robust evidence is seen in T2DM. This study assessed the impact of short-term CGM placement on HbA1c levels in T2DM.

Objectives

The primary outcome was the change in baseline HbA1c levels in patients with T2DM up to six months after CGM placement. Secondary outcomes assessed intensification of diabetes medications made by an interprofessional team …

Diabetes-Associated Hyperglycemia Causes Rapid-Onset Ocular Surface Damage, Judy Weng, Christopher Ross, Jacob Baker, Saleh Alfuraih, Kiumars Shamloo, Ajay Sharma

Pharmacy Faculty Articles and Research

Purpose: The metabolic alterations due to chronic hyperglycemia are well-known to cause diabetes-associated complications. Short-term hyperglycemia has also been shown to cause many acute changes, including hemodynamic alterations and osmotic, oxidative, and inflammatory stress. The present study was designed to investigate whether diabetes-associated hyperglycemia can cause rapid-onset detrimental effects on the tear film, goblet cells, and glycocalyx and can lead to activation of an inflammatory cascade or cellular stress response in the cornea.

Methods: Mouse models of type 1 and type 2 diabetes were used. Tear film volume, goblet cell number, and corneal glycocalyx area were measured on …

Demonstrating The Benefits Of Antihypertensive Nighttime Dosing And Indapamide Usage In Hypertension Management, Jonathon S. Newsome

Pharmacy Faculty Publications and Presentations

Background: Uncontrolled hypertension, specifically nocturnal hypertension, increases the risk for significant clinical outcomes. Evidence on the use of nighttime antihypertensives is scant and conflicting. In addition, hydrochlorothiazide continues to be the primary thiazide used despite being the least potent. Objective: The primary purpose of this study was to evaluate instituting nighttime dosing to control hypertension and compare the short-term effectiveness of blood pressure control with indapamide versus hydrochlorothiazide. Methods: This was a retrospective, observational study. Participant inclusion criteria consisted of patients 18 years of age or older, a current diagnosis of hypertension, and hypertension that required medical therapy. The investigator …

Liposome Synthesis And Evaluation In The Hek-293 Cell Line, Christine Skibinski

Harrisburg University Research Symposium: Highlighting Research, Innovation, & Creativity

Liposomes were synthesized using the thin film method. A lyophilized power of egg-derived phosphatidylcholine, stearylamine, and cholesterol were added to ethanol and dried under argon to form a lipid cake. The lipid cake was rehydrated with dPBS and sonicated at 60°C forming a heterogenous batch of liposomes. Our results revealed the average size of the liposomes, determined by Dynamic Light Scattering, was approximately 223.1nm, while demonstrating a weakly positive zeta-potential of 1.9± 8.07mv. Next, we tested the antitumor action of the liposomes in the HEK-293 cell line via an MTT assay. We observed that the liposomes were able to inhibit …

Untargeted Metabolomics Analysis On Kidney Tissues From Mice Reveals Potential Hypoxia Biomarkers, Muhammad Imran Sajid, Francisco J. Nunez, Farideh Amirrad, Moom Rahman Roosan, Tom Vojtko, Scott Mcculloch, Amal Alachkar, Surya M. Nauli

Pharmacy Faculty Articles and Research

Chronic hypoxia may have a huge impact on the cardiovascular and renal systems. Advancements in microscopy, metabolomics, and bioinformatics provide opportunities to identify new biomarkers. In this study, we aimed at elucidating the metabolic alterations in kidney tissues induced by chronic hypoxia using untargeted metabolomic analyses. Reverse phase ultrahigh performance liquid chromatography-mass spectroscopy/mass spectroscopy (RP–UPLC–MS/MS) and hydrophilic interaction liquid chromatography (HILIC)–UPLC–MS/MS methods with positive and negative ion mode electrospray ionization were used for metabolic profiling. The metabolomic profiling revealed an increase in metabolites related to carnitine synthesis and purine metabolism. Additionally, there was a notable increase in bilirubin. Heme, N-acetyl-L-aspartic …

Tolfenamic Acid Derivatives: A New Class Of Transcriptional Modulators With Potential Therapeutic Applications For Alzheimer’S Disease And Related Disorders, Juanetta Hill, Karim E. Shalaby, Syed W. Bihaqi, Bothaina H. Alansi, Benjamin Barlock, Keykavous Parang, Richard Thompson, Khalid Ourarhni, Nasser H. Zawia

Pharmacy Faculty Articles and Research

The field of Alzheimer’s disease (AD) has witnessed recent breakthroughs in the development of disease-modifying biologics and diagnostic markers. While immunotherapeutic interventions have provided much-awaited solutions, nucleic acid-based tools represent other avenues of intervention; however, these approaches are costly and invasive, and they have serious side effects. Previously, we have shown in AD animal models that tolfenamic acid (TA) can lower the expression of AD-related genes and their products and subsequently reduce pathological burden and improve cognition. Using TA as a scaffold and the zinc finger domain of SP1 as a pharmacophore, we developed safer and more potent brain-penetrating analogs …