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Full-Text Articles in Medicine and Health Sciences

Promoting Measles Prevention And Awareness, Elizabeth P. Lanata Jan 2021

Promoting Measles Prevention And Awareness, Elizabeth P. Lanata

Family Medicine Clerkship Student Projects

No abstract provided.


2020, Southwestern Oklahoma State University Jul 2020

2020, Southwestern Oklahoma State University

Apothecary

This publication is dedicated to the Southwestern College of Pharmacy faculty, staff, alumni, and students. We congratulate this year's graduating seniors and wish you success in your professional careers.

It is with great honor we present the 2020 Apothecary issue. This year’s Apothecary was made possible by the provision of generous financial contributions from many stores, businesses, and Southwestern College of Pharmacy alumni. We greatly appreciate and thank you for your continued support.


The Scoop, Vol. 7 Issue 3-4, Summer 2020, Health Sciences Library Jun 2020

The Scoop, Vol. 7 Issue 3-4, Summer 2020, Health Sciences Library

Volume 7

Latest news and events from the Health Sciences Library in our monthly newsletter for Summer 2020.


Reliability Of The Arch Height Index Tool As A Foot Measure In Children Ages 1-7 Years, Jessica White, Anna Rushing, Katie Durisek May 2020

Reliability Of The Arch Height Index Tool As A Foot Measure In Children Ages 1-7 Years, Jessica White, Anna Rushing, Katie Durisek

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: An objective and reliable measure is needed to track longitudinal changes in the young child’s foot. The Arch Height Index (AHI) tool measures the arch height of a foot. There is one study investigating the reliability of the AHI tool in children ages 6-12 years. Currently, no studies have determined the reliability of the AHI tool in children younger than 6 years. The purpose of this study was to determine the intra-rater and inter-rater reliability of the AHI tool in daycare, preschool and early school-aged children as an objective foot measure.

Methods: Thirty-two children (13 males, 19 ...


Effects Of Extracurricular Physical Activity On Strength, Balance, Endurance And Quality Of Life On Children With Disabilities, Christy Lee, Alana Mathews, Kayla Ayers, Madison Weisbarth, Melissa Spurbeck May 2020

Effects Of Extracurricular Physical Activity On Strength, Balance, Endurance And Quality Of Life On Children With Disabilities, Christy Lee, Alana Mathews, Kayla Ayers, Madison Weisbarth, Melissa Spurbeck

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: The purpose of this study was to investigate the effects of extracurricular physical activity on strength, balance, endurance and quality of life on children with disabilities.

Methods: Eighteen children (10 males, 8 females) ranging in age from 11-18 years participated in a local inclusive kickball program. All children and their parents were aware that participation was voluntary and signed consent or assent forms. Diagnoses of the children included Down Syndrome, Asbergers, Expressive Language Delay and Developmental Delay. The children participated in 60 minute kickball sessions led by a program director, 1 time per week for 6 weeks. The ...


Frontal And Sagittal Plane Lower Extremity Mechanics During Single-Limb Squatting In Chronic Ankle Instability, David M. Werner, Kati Brubakken, Claire Grace, Mike Lawless, Aaron Lewis, Marc Mccuen, Dennis Mirosh, Joaquin Alberto Barrios May 2020

Frontal And Sagittal Plane Lower Extremity Mechanics During Single-Limb Squatting In Chronic Ankle Instability, David M. Werner, Kati Brubakken, Claire Grace, Mike Lawless, Aaron Lewis, Marc Mccuen, Dennis Mirosh, Joaquin Alberto Barrios

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Chronic ankle instability is a common sequelae to the lateral ankle sprain. Individuals with CAI have a higher risk of developing osteoarthritis and reporting lower quality of life scores. Biomechanical variations have been observed in individuals with CAI during ambulation and landing. To the authors’ knowledge there are no studies investigating the biomechanical profile of the SLS in individuals with CAI. The purpose of this study was to compare the biomechanics of the SLS in individuals with unilateral CAI. We hypothesized that inter-limb biomechanical differences would be observed in individuals with unilateral CAI.

Methods: Participants were recruited from ...


Effect Of Ankle-Foot Orthosis On Reactive Stepping In Healthy Young Adults: A Pilot Study, Kyra Twohy, Hunter Andrews, Ryan Christopher, Aaron Scott, Katie Valentine, Kurt Jackson May 2020

Effect Of Ankle-Foot Orthosis On Reactive Stepping In Healthy Young Adults: A Pilot Study, Kyra Twohy, Hunter Andrews, Ryan Christopher, Aaron Scott, Katie Valentine, Kurt Jackson

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Ankle-Foot orthoses (AFOs) are commonly used in individuals with neurologic disorders such as MS and stroke. However, a rigid style of AFO may impact an individual's ability to complete dynamic balance tasks especially reactive stepping movements in the instance of losing balance. The impact a rigid AFO has on reactive stepping has not been investigated. The primary purpose of this study was to determine the impact rigid AFOs have on reactive stepping preference in healthy young adults, thus providing preliminary data on healthy individuals’ stepping strategies that could be used for further research with more neurologically-involved populations ...


Scapular Acceleration During Upper Extremity Elevation In Healthy Individuals With And Without Scapular Dyskinesis, Joseph M. Day, Taylor Hunter, Kayla Eiben, Yitz Berger May 2020

Scapular Acceleration During Upper Extremity Elevation In Healthy Individuals With And Without Scapular Dyskinesis, Joseph M. Day, Taylor Hunter, Kayla Eiben, Yitz Berger

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Individuals with upper extremity pathology often present with altered scapular motion and muscle performance. There are few clinical tools that are capable of collecting specific and efficient data on alterations in scapular motion and even fewer studies have looked at variations in scapular acceleration. The primary purpose of this study was to determine the effectiveness of wireless accelerometers for detecting changes in acceleration in individuals with and without scapular dyskinesis.

Methods: Twenty-seven subjects, mean age 24 (SD1.49). Healthy subjects were visually screened for scapular dyskinesis. Subjects were positioned in a standardized standing posture and anatomical references ...


Arm Function In Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Taylor Bergin, Christine Delong May 2020

Arm Function In Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Taylor Bergin, Christine Delong

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Women with breast cancer (WBC) report decreased function following cancer treatment, yet objective measures of function typically return within the first year after surgery. Kinesiophobia, or fear of physical activity (PA), has been documented following other musculoskeletal pathologies. This study explored the relationships between fear of PA and self-reported arm function, QOL, perceived stress, and objective measures of range of motion (ROM), strength, and muscular endurance in WBC.

Methods: Women (n=30) diagnosed with stage 0-3 breast cancer 6-60 months prior to enrollment participated; WBC were excluded with metastatic disease, shoulder pathology, or history of shoulder/neck surgery ...


Predicting Falls In Community-Dwelling Older Adults Using The Repetitive Step Test, Harold L. Merriman, Kurt Jackson, Jamie Wynk, Megan Gordon, Kathryn Quinn, Sarah Welsh May 2020

Predicting Falls In Community-Dwelling Older Adults Using The Repetitive Step Test, Harold L. Merriman, Kurt Jackson, Jamie Wynk, Megan Gordon, Kathryn Quinn, Sarah Welsh

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: The Repetitive Step Test (RST) is a newly developed dynamic balance test that requires stepping in multiple directions. It has previously demonstrated excellent test-retest and inter-rater reliability, along with ability to retrospectively classify individuals who had fallen more than once in 12 months though its ability to predict falls has not been evaluated. This study aimed to determine the capability of the RST to identify individuals likely to fall prospectively over 12 months.

Methods: 63 community-dwelling adults >65 years old were tested using the following balance and mobility measures: RST, 10 Meter Walk Test (10MWT), Activities-specific Balance Confidence ...


The Association Between Y-Balance And The Delos Postural Proprioceptive System In Professional Basketball Players, Philip A. Anloague, Shawn Windle, Grady Garno, Mike Lewandowski, Caleb Norton, Ryan Smerke, Sierra Speck, Jenna Stoner, Aaron Strausbaugh May 2020

The Association Between Y-Balance And The Delos Postural Proprioceptive System In Professional Basketball Players, Philip A. Anloague, Shawn Windle, Grady Garno, Mike Lewandowski, Caleb Norton, Ryan Smerke, Sierra Speck, Jenna Stoner, Aaron Strausbaugh

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Lower extremity injury is common in professional basketball. The Y-Balance Test (YBT) and the Delos Postural Proprioceptive System (DPPS) have been purported to assess dynamic postural control and balance, which has been associated with injury in elite athletics. It has been reported that performance on balance assessments is influenced by many factors that include mobility, strength, and proprioception. The purpose of this exploratory study was to investigate the relationship between DPPS and YBT performance in professional basketball players.

Methods: 13 professional basketball players (age=25.5 yrs +/- 3.9, height = 2.00 m +/- .079 weight = 99.89 kg ...


The Relationship Between Knee Valgus And Clinical Measures In Professional Basketball: A Cart Analysis, Philip A. Anloague, Donald S. Strack, Carl Eaton, Joshua David Corbeil, Steven Michael Short, Paul John Insana, Stephanie Lynn Nazario May 2020

The Relationship Between Knee Valgus And Clinical Measures In Professional Basketball: A Cart Analysis, Philip A. Anloague, Donald S. Strack, Carl Eaton, Joshua David Corbeil, Steven Michael Short, Paul John Insana, Stephanie Lynn Nazario

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Background/Purpose: Lower extremity injuries occur at an amplified rate in professional basketball. Evidence suggests that knee frontal plane valgus may be associated with risk of injury. The Landing Error Scoring System includes the assessment of maximum knee valgus during a countermovement jump. The investigation of interactions among linear and non-linear factors may help the understanding of the interdependence of various measures and poor performance on the knee valgus displacement (KVD) component of the LESS in professional basketball players. The purpose of this study was to investigate predictors of knee valgus displacement on the LESS. We hypothesize that a positive ...


Prevalence Of Iron Deficiency In Division Iii Female Athletes, Cassandra Sterbens May 2020

Prevalence Of Iron Deficiency In Division Iii Female Athletes, Cassandra Sterbens

Transformations: Presentation Slides

Iron deficiency is known to affect many female athletes, but there is a lack of research on its prevalence amongst cheerleaders. Iron deficiency is known to cause fatigue, which is likely to impair an athlete’s performance. Hence, the purpose of this study was to provide insight into the iron levels of cheerleaders that could guide both athletes and coaches, creating positive dietary changes. It may be necessary to increase awareness of this condition amongst female athletes, as it is preventable. The online tool, MyDietAnalysis, was used to examine each participant’s actual nutrient intake relative to their Recommended Dietary ...


Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda May 2020

Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda

Student Research Posters

In the United States, patients who have Limited English Proficiency (LEP) report having more problems communicating with their children’s doctors (Eneriz-Wieme et al., 2014) and experiencing more discrimination (Zhang et al., 2012) which can lead to increased psychological distress (Torres et al., 2012). The goal of this study was to determine if level of English Proficiency is related to stress levels and discrimination among Latinx parents. Participants consisted of 22 Latinx parents (86.4% Mexican and 90.9% female) in the San Francisco Bay Area. The Acute Stress Appraisals scale (Mendes, et al., 2007) measured parents' stress levels before ...


The Scoop, Vol. 7 Issue 2, May 2020, Health Sciences Library May 2020

The Scoop, Vol. 7 Issue 2, May 2020, Health Sciences Library

Volume 7

Reporting the latest from your Health Sciences Library.


What’S The Word? Defining Community Pharmacy Interventions, Elizabeth Laughlin, Bsps, Danielle C. Mayer, Pharmd, Bcacp, Sarah Lynch, Pharmd, Bcacp May 2020

What’S The Word? Defining Community Pharmacy Interventions, Elizabeth Laughlin, Bsps, Danielle C. Mayer, Pharmd, Bcacp, Sarah Lynch, Pharmd, Bcacp

College of Pharmacy Posters

Primary Objective: Determine whether student pharmacists & licensed pharmacists are consistently able to categorize interventions

Secondary Objective: Evaluate trends in themes for situations that are not easily categorized


A Perplexing Case Of Episodic Abdominal Pain And The Role Of Mast Cells Gastroenteritis, Hayden Smith, Mari Kai Apr 2020

A Perplexing Case Of Episodic Abdominal Pain And The Role Of Mast Cells Gastroenteritis, Hayden Smith, Mari Kai

Providence Portland Medical Center Internal Medicine

Here we present a case of chronic intractable vomiting and diarrhea of unknown cause, and introduce the relatively new entity of mast cell gastroenteritis.

Our patient is a 38-year old female with PMH of seronegative rheumatoid arthritis, mixed connective tissue disorder, and several recent hospitalizations over the past 4 months at outside hospitals for suspected colitis with associated vomiting and diarrhea. Current symptoms include 4 days of nausea with intractable vomiting, and 2 days of rectal fullness with mucoid rectal discharge. Previous workup at outside hospitals included multiple abdominal CT scans, flexible sigmoidoscopy, colonoscopy, and exploratory laparotomy. Prior to admission ...


Battling The Stigma: Hiv Screening In Resident Primary Care Clinic, Garrett Spencer, Laura Loertscher, Shelley Sanders Apr 2020

Battling The Stigma: Hiv Screening In Resident Primary Care Clinic, Garrett Spencer, Laura Loertscher, Shelley Sanders

Providence St. Vincent Internal Medicine

INTRODUCTION: HIV affects ~1.2 million in the US, with 25% unaware of their statusand annual incidence of 50,000. Early detection and treatment reduces risk of AIDS-related deaths and transmission. Both the CDC and the US Preventative Service Task Force recommend routine HIV screening. The Providence Medical Group at St Vincent (PMG-STV) resident clinic has no routine screening protocol. • 24% (757/3139) of all clinic patients have ever been screened. • Of active clinic patients seen quarterly, 5% are offered screening with only 3% completing screening. We implemented and measured a clinic-wide HIV screening protocol leveraging existing clinic workflows. We ...


Clinical Impact Of An Hiv Specialist Pharmacist Collaborative Practice Agreement: A 1-Year Retrospective Review Of Interventions, Rebekah Bartholomew, Geoffrey L'Heureux, Brent Footer Apr 2020

Clinical Impact Of An Hiv Specialist Pharmacist Collaborative Practice Agreement: A 1-Year Retrospective Review Of Interventions, Rebekah Bartholomew, Geoffrey L'Heureux, Brent Footer

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers

Title: Clinical Impact of an HIV Specialist Pharmacist Collaborative Practice Agreement: a 1-year Retrospective Review of Interventions

Purpose/Background:

HIV continues to be one of the most complex disease states for patients and providers to manage. With new medications and guidelines being routinely updated, ensuring that patients are on optimal anti-retroviral therapy (ART) throughout their lives can be difficult. Previous studies on pharmacist-led HIV services have shown that utilizing a pharmacist to manage ART is beneficial. The purpose of this study is to add to that body of evidence by analyzing the clinical impact of a nascent collaborative practice agreement ...


Purpura Fulminans Due To Mssa Toxic Shock Syndrome, Leah Grant, Rachel Plotinsky Apr 2020

Purpura Fulminans Due To Mssa Toxic Shock Syndrome, Leah Grant, Rachel Plotinsky

Providence St. Vincent Internal Medicine

Introduction: Purpurafulminansis a rare and serious complication of anacute infectious process, characterized by large purpuricskin lesions, fever, hypotension, and DIC. The mostcommon infectious cause of purpurafulminansismeningococcal disease, though few case reports in theliterature describe Staph aureusas a causative organism.

Case Report: •A 53 year-old woman with a history of heart blocks/ppacemaker placement in 2002 presented to the ED withnausea, vomiting, fevers, chills, diffuse muscle pain and asyncopalepisode. •She was found to have multi-organ dysfunction on labs,including AKI and thrombocytopenia.On hospital day 2, shedeveloped acrocyanosis. She became febrile & hypotensive requiring transfer tothe ICU for vasopressor support. Blood cultures ...


Sola Dosis Facit Venenum: Understanding Severity Of Tca Intoxication, Sean Brachvogel, Justin Osborn, Tanya Page Apr 2020

Sola Dosis Facit Venenum: Understanding Severity Of Tca Intoxication, Sean Brachvogel, Justin Osborn, Tanya Page

Milwaukie Family Medicine

The Dose Makes the Poison, or does it? Judicious Management of TCA Intoxication.

Author(s): Sean Brachvogel, MD, MPH; Justin Osborn, MD; Tanya Page, MD

Context/background: Tricyclic antidepressants (TCAs) have been mostly supplanted by SSRIs in the treatment of depression, however they remain a mainstay of chronic pain management.1 Untreated suicide attempts with a TCAs carry a 70% fatality rate, which drops dramatically to 3% with hospitalization.2 As such, maintaining healthcare provider recognition and management of TCA toxicity is of lifesaving importance.

Objective: Here we describe a case report in which alcohol ingestion masked the severity of ...


Unpainfully Sweet, Khoi Nguyen, Alex Schafir Apr 2020

Unpainfully Sweet, Khoi Nguyen, Alex Schafir

Providence St. Vincent Internal Medicine

Introduction: Sweet's syndrome (ss), or acute febrile neutrophilic dermatosis, is characterized by sudden onset of fever, leukocytosis and erythematous plaques or nodules infiltrated by neutrophils. There are three main clinical settings in which Sweet's syndrome has been described: The diagnosis of Sweet’s syndrome often has a temporal association with the discovery or relapse of cancer as reported in this case.

Case Report: A 64-year-old woman with recurrent breast cancer on targeted and hormonal therapy presented to the ED with acute onset of fever and diffuse non-tender body rash. Vitals suggested sepsis and she was treated with broad ...


Evaluation Of A Two-Way, Hipaa-Compliant Text-Messaging Platform In A Health System Specialty Pharmacy, Dj Clark, Adam Saulles, Tara Berkson Apr 2020

Evaluation Of A Two-Way, Hipaa-Compliant Text-Messaging Platform In A Health System Specialty Pharmacy, Dj Clark, Adam Saulles, Tara Berkson

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers

PDJ Clark, PharmD, PGY1 Pharmacy Practice Resident
Adam Saulles, PharmD, CSP, BCACP; Tara Berkson, PharmD, BCACP

Providence Health and Services, Portland, Oregon

Evaluation of a two-way, HIPAA-compliant text-messaging platform in a health system specialty pharmacy

Specialty medications, including those used to treat Multiple Sclerosis (MS), represent a growing proportion of prescription drug expenditures in the United States. MS is a chronic, progressive condition that requires maintenance therapy with disease-modifying medications. Many patients with MS rely on specialty pharmacies to obtain, dispense, and perform the necessary monitoring for these complex medication regimens. A study performed in 2017 by Munsell et al ...


Evaluation Of Transitional Care Interventions From A Decentralized Clinical Pharmacist In A Small Inpatient Geriatric Psychiatry Unit, Nathan Wong, Michael Brown Apr 2020

Evaluation Of Transitional Care Interventions From A Decentralized Clinical Pharmacist In A Small Inpatient Geriatric Psychiatry Unit, Nathan Wong, Michael Brown

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers

Evaluation of Transitional Care Interventions from a Decentralized Clinical Pharmacist in a Small Inpatient Geriatric Psychiatry Unit

Nathan Wong, PharmD; Michael Brown, RPh, BCPS, BCPP

Background: Transitioning between healthcare settings increases the risk for medication errors. A systematic review of 26 studies comparing various medication reconciliation interventions demonstrated consistent reductions in adverse drug events. Intensive pharmacist involvement and focus on high risk populations were the most successful. 1 Geriatric and behavioral health populations are especially vulnerable with polypharmacy and cognitive impairment often complicating the picture. Providence Milwaukie Hospital (PMH) houses a small unit tailored to provide mental health care for ...


Diabetes Education With A Teaching Kitchen Intervention Can Improve Hemoglobin A1c For Type 2 Diabetics Compared To Traditional Diabetes Education, Jill Christensen, Heidi Davis, Charlotte Navarre, Hsin-Fang Li, Kathy Schwab, Richard O'Neil, Justin Ferley Apr 2020

Diabetes Education With A Teaching Kitchen Intervention Can Improve Hemoglobin A1c For Type 2 Diabetics Compared To Traditional Diabetes Education, Jill Christensen, Heidi Davis, Charlotte Navarre, Hsin-Fang Li, Kathy Schwab, Richard O'Neil, Justin Ferley

Milwaukie Family Medicine

Authors
Jill Christensen MD MPH Providence Milwaukie Hospital
Heidi Davis MSW Providence Milwaukie Hospital
Charlotte Navarre RN Providence Milwaukie Hospital
Hsin-Fang Li PHD Providence Medical Data Research Center
Kathy Schwab MPH RDN Providence Health Education
Richard O’Neil MBA Providence Planning Analyst

Title Diabetes Education with a Teaching Kitchen Intervention Can Improve Hemoglobin A1c for Type 2 Diabetics Compared to Traditional Diabetes Education

Purpose The Providence Milwaukie Community Teaching Kitchen offers health-focused, budget friendly cooking classes for patients. In 2019, we piloted diabetes education classes with an added hands-on culinary session. This study compares the change in hemoglobin A1c for ...


A Case Of Gluten-Induced Delirium: Using Capsule Endoscopy To Diagnose Occult Gi Bleeding, Rachael Starcher, Lisa Sanders Apr 2020

A Case Of Gluten-Induced Delirium: Using Capsule Endoscopy To Diagnose Occult Gi Bleeding, Rachael Starcher, Lisa Sanders

Providence Portland Medical Center Internal Medicine

A Case Of Gluten-Induced Delirium:

Using Capsule Endoscopy To Diagnose Occult GI Bleeding

Rachael Starcher, MD

Providence Portland Medical Center – Portland, OR

Additional Authors: Lisa Sanders, MD

Introduction: Despite an increasing prevalence of celiac disease worldwide, many patients remain undiagnosed, putting them at risk for late stage complications of unidentified and untreated celiac disease. Ulcerative jejunoileitis is a rare cause of occult GI bleeding seen only in refractory celiac disease or in atypical celiac disease at the time of diagnosis. When left untreated, ulcerative jejunoileitis can lead to bowel perforation, blood loss anemia, and T-cell lymphoma.

Case Presentation: An 81-year-old ...


Implementing A Simplified Targeted Feedback Method To Reduce Fluoroquinolone Prescriptions In Emergency Departments, Minh Le, Alyssa Christensen, Brent Footer Apr 2020

Implementing A Simplified Targeted Feedback Method To Reduce Fluoroquinolone Prescriptions In Emergency Departments, Minh Le, Alyssa Christensen, Brent Footer

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers

Minh Le, PharmD

Alyssa Christensen, PharmD, BCIDP, Brent Footer, PharmD, BCPS

Providence Health System, Oregon

Implementing a simplified targeted feedback method to reduce fluoroquinolone prescriptions in emergency departments

Background: The CDC has proclaimed antibiotic resistance to be one of the biggest public health challenges of our time. Although fluoroquinolones (FQs) are among the most widely prescribed antibiotics in the ambulatory setting, there have been recent efforts to reduce their usage due to mounting concerns regarding their safety profile and resistance patterns. Provider audit-and-feedback has been shown to be among the most effective antimicrobial stewardship interventions, but the auditing process requires ...


Evaluation Of Guideline-Directed Medication Therapy For Heart Failure With Reduced Ejection Fraction Patients At Discharge On 30-Day Readmission Rates At Two Tertiary Healthcare Centers, Jacqueline Hesse, Yan Xu, Meri Slavica, James E. Watkins, Alan Rankin, Joshua Remick Apr 2020

Evaluation Of Guideline-Directed Medication Therapy For Heart Failure With Reduced Ejection Fraction Patients At Discharge On 30-Day Readmission Rates At Two Tertiary Healthcare Centers, Jacqueline Hesse, Yan Xu, Meri Slavica, James E. Watkins, Alan Rankin, Joshua Remick

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers

Evaluation of Guideline-Directed Medication Therapy for Heart Failure with Reduced Ejection Fraction Patients at Discharge on 30-Day Readmission Rates at Two Tertiary Healthcare Centers

Principal Investigator: Jacqueline Hesse, Pharm.D.

Preceptors: Yan Xu, Pharm.D., BCPS, BCCP; Meri Slavica, Ph.D., BCPS

Pharmacy Student: James Watkins, 2020 Pharm.D. Candidate

Sub-Investigators: Alan Rankin, MD; Joshua Remick, MD

Background:

Heart failure with reduced ejection fraction (HFrEF) is a chronic, progressive disease leading to symptoms such as dyspnea, cough, edema, fatigue, and exercise intolerance. The use of anangiotensin converting enzyme inhibitor (ACEi), angiotensin II receptor blocker (ARB), or angiotensin receptor-neprilysin inhibitor (ARNI ...


Be Careful What You Screen For: An Incidental Finding Of Tracheobronchial Amyloidosis, Emma White, Tricia James, Vikram Sahni, Jesse Powell Apr 2020

Be Careful What You Screen For: An Incidental Finding Of Tracheobronchial Amyloidosis, Emma White, Tricia James, Vikram Sahni, Jesse Powell

Providence Portland Medical Center Internal Medicine

Introduction: The 2011 National Lung Screening Trial (NLST) demonstrated a reduction in morbidity and mortality with LDCT compared to CXR. In 2013 the USPSTF began recommending CT scan for lung cancer screening in appropriate patients but, the 2015 National Health Interview Survey (NHIS) demonstrated that less than 5% of eligible patients received screening. The NLST also demonstrated a high rate of false positives, incidental findings, and the need for further invasive testing. When deciding to screen, patients and providers are tasked with reconciling these risks and benefits. In this case, we explore one patient’s incidental findings, and the work-up ...


The Dangers Of Gardening – Nocardia Infection In An Immunocompromised Patient, Gerald Hutfles, Justin Jin Apr 2020

The Dangers Of Gardening – Nocardia Infection In An Immunocompromised Patient, Gerald Hutfles, Justin Jin

Providence Portland Medical Center Internal Medicine

The Dangers Of Gardening –

Nocardia Infection In An Immunocompromised Patient

Gerald Hutfles, DO

Providence Portland Medical Center – Portland, OR

Additional Authors: Justin Jin, MD

Introduction: Nocardia is a gram-positive, partially-acid fast, aerobic, branching bacillus that can be found in soil and water. It is typically an opportunistic pathogen, with most infections occurring in the immunocompromised. Disease can be localized or disseminated, preferring pulmonary, nervous, and cutaneous tissues. Optimal antimicrobial therapy depends on speciation of the isolate, as Nocardia may exhibit variable antimicrobial susceptibility. A high clinical suspicion and appropriate empiric antimicrobial therapy is necessary. This clinical case highlights the importance ...