Medicine and Health Sciences Commons^™

Do Antibiotics Improve Outcomes For Patients Hospitalized With Copd Exacerbations?, Sagi Mathew, Deborah S. Zeitlin, Katherine Rickett

Deborah Zeitlin

EVIDENCE-BASED ANSWER YES. Antibiotic use reduced mortality and treatment failure in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD) (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Giving antibiotics early to hospitalized patients decreased the need for later ventilation and readmission within 30 days for exacerbation of COPD (SOR: B, a retrospective cohort study).

Do Antibiotics Improve Outcomes For Patients Hospitalized With Copd Exacerbations?, Sagi Mathew, Deborah S. Zeitlin, Katherine Rickett

Deborah Zeitlin

EVIDENCE-BASED ANSWER YES. Antibiotic use reduced mortality and treatment failure in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD) (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Giving antibiotics early to hospitalized patients decreased the need for later ventilation and readmission within 30 days for exacerbation of COPD (SOR: B, a retrospective cohort study).

Treatment For Vestibular Disorders: How Does Your Physical Therapist Treat Dizziness Related To Vestibular Problems?, Courtney D. Hall, Susan J. Herdman, Susan L. Whitney, Stephen P. Cass, Richard A. Clendaniel, Terry D. Fife

ETSU Faculty Works

Dizziness is very common, but it is never normal. Dizziness can make performing daily activities, work, and walking difficult. Many people get dizzy when they turn their head, which can cause problems with walking and makes people more likely to fall. Most of the time dizziness is not from a life-threatening disease. Often dizziness is because of a disorder of the vestibular (or inner ear balance) system. People can get vestibular disorders from infections in the ear, problems with the immune system, medications that harm the inner ear, and rarely from diabetes or stroke because of a lack of blood …

High-Altitude Pulmonary Hypertension: An Update On Disease Pathogenesis And Management, Aibek E. Mirrakhimov, Kingman P. Strohl

Internal Medicine Faculty Publications

High-altitude pulmonary hypertension (HAPH) affects individuals residing at altitudes of 2,500 meters and higher. Numerous pathogenic variables play a role in disease inception and progression and include low oxygen concentration in inspired air, vasculopathy, and metabolic abnormalities. Since HAPH affects only some people living at high altitude genetic factors play a significant role in its pathogenesis.

The clinical presentation of HAPH is nonspecific and includes fatigue, shortness of breath, cognitive deficits, cough, and in advanced cases hepatosplenomegaly and overt right-sided heart failure. A thorough history is important and should include a search for additional risk factors for lung disease and …

The Crisis Of Opiates In Appalachia, James B. Becker Md

Marshall Journal of Medicine

No abstract provided.

Ruptures Of The Quadriceps And Patellar Tendons Of The Extensor Mechanism: A Review, Judd R. Fitzgerald

UNM Orthopaedic Research Journal

Damage to the quadriceps and patellar tendons of the extensor mechanism can be devastating and often life-changing injuries that require prompt diagnosis and treatment. A sound understanding of anatomy, biomechanics, and degenerative changes of both tendons and the extensor mechanism of the knee can help guide surgical repair and postoperative rehabilitation of patients. Immediate primary repair has often resulted in improved postoperative results compared with delayed reconstruction, and the avoidance of gap formation by use of careful techniques and augmentation has been critical for successful treatment. Additionally, patients with extensor mechanism injuries frequently have medical comorbidities or notable tendon degeneration; …

Causes, Evaluation, And Treatment Of Instability Of The Patellofemoral Joint Of The Knee: A Review, Michael J. Hopson

UNM Orthopaedic Research Journal

Instability of the patellofemoral (PF) joint of the knee is typically caused by chronic atraumatic injuries and inciting traumatic events. Anatomically, bony and softtissue structures surrounding the PF joint and extensor mechanism contribute to overall stability of the area, which results in efficient kinematic function at the PF articulation. Furthermore, physiological, genetic, anatomical, and demographical factors may affect the development and progression of PF joint instability. Treatment techniques have varied owing to individual factors that may have influence on pathological features of the injury. Nonoperative treatment has predominantly focused on strengthening of the quadriceps and vastus medialis by coordinated, closed …

Periprosthetic Fractures Of The Femur After Total Hip Arthroplasty And Hemiarthroplasty: A Review, Reilly R. Kuehn

UNM Orthopaedic Research Journal

Periprosthetic fractures of the femur after total hip arthroplasty (THA) and hemiarthroplasty represent relatively uncommon but challenging complications. The incidence of these types of fractures has been rising, owing to an increasing number of hip arthroplasties performed, aging population, and prevalent use of uncemented stems, which may have unsuccessful long-term results compared with use of cemented stems. Method of treatment has been generally based on the Vancouver classification system that describes radiographic characteristics of fractures and stability of the femoral stems in respect to placement in the bone. In particular, the presence of loose stems has often indicated the need …

Treatment Of Injuries And Conditions Of The Distal Clavicle: A Review, Heather M. Menzer

UNM Orthopaedic Research Journal

Several trauma-related injuries and degenerative conditions affect the distal end of the clavicle. Fractures of the distal clavicle and separations of the acromioclavicular (AC) joint are common, resulting from direct impact onto the shoulder region. Osteolysis and osteoarthritis of degenerative processes of the AC joint are caused by repetitive activity and overuse of the shoulder. To help identify options for treating the distal end of the clavicle, this review highlighted notable anatomical locations and biomechanics; findings of physical examinations; classification systems of injuries; and standard operative and nonoperative methods used for treatment. Although distal clavicle fractures, AC joint separations, osteolysis, …

Idiopathic Thrombocytopenic Purpura In A 21-Year-Old Collegiate Football Player: A Case Report, James A. Leinhart, Shane P. Cass, Matthew A. Tennison, Ronica A. Martinez, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Muscle cramps are commonly observed in collegiate athlete-patients; however, the condition may be a symptom of severe disorders. In particular, idiopathic thrombocytopenic purpura (ITP) may be a possible diagnosis and involves a decreased number of platelets in the bloodstream. We describe a 21-year-old collegiate player of American football with initially presented with cramping of the neck, abdomen, and forearms. Although findings of physical examination were normal, results of laboratory tests indicated ITP, and the patient was hospitalized for 3 days until the platelet count increased. Because the levels continued to decrease at 6-month followup, splenectomy and use of rituximab agents …

Spare-Parts Technique For Concurrent Treatment Of Ectrodactyly Of The Feet And Syndactyly Of The Hands In A 2-Year-Old Boy: A Case Report, Brielle K. Payne, Mary E. Logue, Selina R. Silva, Deana M. Mercer

UNM Orthopaedic Research Journal

Syndactyly is the most frequently occurring congenital malformation of the limbs. Although common, few studies have reported treating syndactyly using Z-plasty with and without full-thickness grafting. We present a 2-year-old boy who presented to our clinic with ectrodactyly of the feet and simple complete syndactyly of two fingers on each hand. After ectrodactyly reconstruction, we used the excess foot skin to cover finger defects. The patient recovered well postoperatively, with matching skin and no trouble with hair growth. Use of a spare-parts technique can help avoid complications associated with harvesting grafts from other donor sites. The results reinforce the importance …

Case No. 20 - Diagnosis And Treatment Of Meningitis In A 3 Week Old Child Who Sustained A Spinal Cord Infarct Following A Cardiac Arrest, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Diagnosis and Treatment of Meningitis in a 3 Week Old Child who Sustained a Spinal Cord Infarct Following a Cardiac Arrest

Case No. 22 - Paraplegia In A 12 Year Old With A Delayed Diagnosis And Treatment Of Transverse Myelitis, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Paraplegia in a 12 year old with a Delayed Diagnosis and Treatment of Transverse Myelitis

Alzheimer's Disease: Knowledge Of Early Detection, Risk Factors, And Treatment, Anna H. Smith, Katlyn S. Spadino

All Electronic Theses and Dissertations

Alzheimer's disease causes a progressive and irreversible decline in cognitive functioning. There are many people living with this disease, and the prevalence is expected to triple between 2010 and 2050. Many members of society are affected through either a personal diagnosis or the diagnosis of a family member. There have been numerous studies outlining risk factors, signs and symptoms, and treatments for this disease, but it is unknown if this has translated to greater public awareness. This study aims to assess the general adult population's knowledge of Alzheimer's disease. The participants are 35 to 70 years old and live in …

Most Efficient Methods To Treat Breast Cancer, Esther Ehrman

The Science Journal of the Lander College of Arts and Sciences

Breast cancer is rampant in today’s world. Because there are many different cases and so many different ways to classify breast cancer, a multidisciplinary approach must be taken. Many patients undergo breast conserving surgery which creates a need for the eradication of any remaining tumor residue through radiation. Fifty Gy of radiation should be applied to the breast with an additional 16 Gy as a boost. If a mastectomy is performed to remove a large tumor and 4 or more positive lymph nodes were present, radiation should be applied as well. If the tumor expresses HER2 protein, Trastuzumab should be …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

Analyzing Tuberculosis Diagnosis And Treatment In Kasungu, Malawi, Andrew Currier

Honors Theses

Despite Tuberculosis (TB) being a highly curable disease, it continues to result in over 5% of deaths in the Sub-Saharan African country of Malawi. Coupled with HIV, the disease remains one of the leading causes of death in Malawi. In the summer of 2015, I joined a research team from Partners in Hope to conduct a survey evaluating the health centers that provide TB care in the Kasungu region of Malawi. After visiting 23 health centers, the results of the 47-question survey were compiled and analyzed to provide information on the capabilities and practices at each health center. The results …

Epidemiology And Cost Of Drug Treatment Of Cancer In Northern Cyprus, Ayşe Gökyi̇ği̇t, Seyi̇de Rumeysa Demi̇rdamar

Turkish Journal of Medical Sciences

Background/aim: To determine the epidemiology, the sociodemographic features, the incidence and prevalence rate of cancer, and the cost of drug treatment in Northern Cyprus. Materials and methods: All of the oncology prescriptions, cancer pathology reports, and cancer referrals to overseas for 2011 were collected from the state hospitals, the only private university hospital that provides oncology services, and the Ministry of Health to prepare an epidemiological database. The total cost of drug treatment at the state hospitals and cost of the most frequent five cancer types were also calculated using the therapy protocols and the expense of the drugs. Results: …

How To Manage Knee Arthritis: Best Practices For Treatment Prior To Orthopaedic Referral, Ali Oliashirazi Md, Alex Caughran Md, Zain Quazi Md, Grant Buchanan Md, Akash Sharma, Franklin D. Shuler Md, Phd

Orthopaedics

Osteoarthritis (OA) of the knee is a debilitating disease in which degeneration of the joint space cartilage can lead to life-altering pain and stiffness. The prevalence of OA has a strong correlation with age, with evidence of radiographic knee OA found in 37.4% of persons older than 60 years of age. According to the Agency for Healthcare Research and Quality’s (AHRQ) 2013 report, osteoarthritis was ranked the second most expensive condition for Medicare and private insurers, with over 90% of the hospitalizations for OA involving a knee or hip replacement. It is projected that by 2030 the number of primary …

Is Yoga An Effective Treatment For Post-Traumatic Stress Disorder (Ptsd)?, Marissa Ionna

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is Yoga An Effective Treatment For Post-Traumatic Stress Disorder (PTSD)?”

Study Design: Systematic review of three randomized controlled trials (RCTs) published in peer reviewed journals between 2010-2014, all English language.

Data Sources: Three randomized controlled trials were found using PubMed.

Outcomes Measured: All three studies measured improvement in PTSD symptoms through yoga therapy using self-reported patient questionnaires, visual analog scales, and vital signs.

Results: Studies by Telles et al. and van der Kolk et al. found that yoga therapy significantly improved symptoms in patients with Post-Traumatic …

Does The Use Of Oral Amphetamines Reduce Cocaine Use In Cocaine-Dependent Individuals?, Kevin M. Strate

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the use of oral amphetamines reduces cocaine use in cocaine-dependent individuals.

Study Design: Review of three English language randomized control trials (RCTs) published in 2001, 2003 and 2004.

Data Sources: 3 randomized controlled trials published after 1999 were obtained using PubMed, OVID, and Medline.

Outcomes Measured: The efficacy of using d-amphetamine to promote cocaine use cessation in cocaine-dependent individuals, determined using immunoassay and mass spectrometric analysis to identify cocaine metabolites in the participant’s urine.

Results: Grabowski et al (2004) found a significant reduction in the use …

Neurodevelopmental Expression Profile Of Dimeric And Monomeric Group 1 Mglurs: Relevance To Schizophrenia Pathogenesis And Treatment, Jeremy Lum, Francesca Fernandez-Enright, Natalie Matosin, Jessica L. Andrews, Xu-Feng Huang, Lezanne Ooi, Kelly A. Newell

Illawarra Health and Medical Research Institute

Group 1 metabotropic glutamate receptors (mGluR1/mGluR5) play an integral role in neurodevelopment and are implicated in psychiatric disorders, such as schizophrenia. mGluR1 and mGluR5 are expressed as homodimers, which is important for their functionality and pharmacology. We examined the protein expression of dimeric and monomeric mGluR1α and mGluR5 in the prefrontal cortex (PFC) and hippocampus throughout development (juvenile/adolescence/adulthood) and in the perinatal phencyclidine (PCP) model of schizophrenia. Under control conditions, mGluR1α dimer expression increased between juvenile and adolescence (209-328%), while monomeric levels remained consistent. Dimeric mGluR5 was steadily expressed across all time points; monomeric mGluR5 was present in juveniles, dramatically …

Reconceptualizing Involuntary Outpatient Psychiatric Treatment From "Capacity" To "Capability", Edwina M. Light, Michael D. Robertson, Ian Kerridge, Philip Boyce, Terry Carney, Alan Rosen, Michelle Cleary, Glenn E. Hunt, Nick O'Connor

Illawarra Health and Medical Research Institute

Justifying involuntary psychiatric treatment on the basis of a judgment that a person lacks capacity is controversial because there are questions about the meaning and utility of the concept in this context. There are complexities to using capacity in this way, which are further amplified in the community outpatient setting compared with acute inpatient care. A richer account of capacity, its meanings, and practical applications in context, is required. This qualitative study sought to build inductively a model of capacity in the context of involuntary outpatient psychiatric treatment, based on 38 interviews with stakeholders from New South Wales, Australia. The …

Early Antipsychotic Treatment In Juvenile Rats Elicits Long-Term Alterations To The Dopamine Neurotransmitter System, Michael De Santis, Jiamei Lian, Xu-Feng Huang, Chao Deng

Illawarra Health and Medical Research Institute

Prescription of antipsychotic drugs (APDs) to children has substantially increased in recent years. Whilst current investigations into potential long-term effects have uncovered some alterations to adult behaviours, further investigations into potential changes to neurotransmitter systems are required. The current study investigated potential long-term changes to the adult dopamine (DA) system following aripiprazole, olanzapine and risperidone treatment in female and male juvenile rats. Levels of tyrosine hydroxylase (TH), phosphorylated-TH (p-TH), dopamine active transporter (DAT), and D₁ and D₂ receptors were measured via Western blot and/or receptor autoradiography. Aripiprazole decreased TH and D₁ receptor levels in the ventral tegmental …

Neurovascular Disorders: Novel Perspectives On Pathogenesis, Diagnosis, And Treatment., David Hasan, Nohra Chalouhi, Md, Aaron S Dumont, Robert M Starke, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

No abstract provided.

Development And Feasibility Testing Of Prompt-Care, An Ehealth System For Collection And Use Of Patient-Reported Outcome Measures For Personalized Treatment And Care: A Study Protocol, Afaf Girgis, Geoff P. Delaney, Anthony Arnold, Andrew Alexis Miller, Janelle V. Levesque, Nasreen Kaadan, Martin G. Carolan, Nicole Cook, Kenneth Masters, Thomas T. Tran, Tiffany Sandell, Ivana Durcinoska, Martha Gerges, Sandra Avery, Weng Ng, Stephen Della-Fiorentina, Haryana M. Dhillon, Ashley M. Maher

Illawarra Health and Medical Research Institute

Background: Patient-reported outcome (PRO) measures have been used widely to screen for depression, anxiety, and symptoms in cancer patients. Computer-based applications that collect patients' responses and transfer them to the treating health professional in real time have the potential to improve patient well-being and cancer outcomes.

Objective: This study will test the feasibility and acceptability of a newly developed eHealth system which facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research.

Methods: The eHealth system is being developed in consultation with …

Nursing Management And Mirror Therapy For Phantom Limb Pain, Bridget Henry

Honors Undergraduate Theses

Phantom limb pain may occur after the accidental removal or surgical amputation of a limb. Phantom limb pain is the experience of pain in the limb that is no longer present. The clinical management of phantom limb pain is essential in the overall reduction of patient rehabilitation and poor patient outcomes. A patient’s degree of phantom limb pain is influenced by their personal response to loss and pain and can have devastating effects to a person’s social performance, occupational role, family role, relationships, and involvement in activities or hobbies. Like most chronic pain, phantom limb pain decreases the quality of …

Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel

Walden Dissertations and Doctoral Studies

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral …

Serum Procalcitonin And C-Reactive Protein Kinetics As Indicators Of Treatmentoutcome In Hospitalized Patients With Community-Acquired Pneumonia, Mehmet Sezai̇ Taşbakan, Canan Gündüz, Abdullah Sayiner, Aykut Çi̇lli̇, Burcu Çelenk Karaboğa, Ayşin Şakar Coşkun, Feri̇de Durmaz Yaman, Oğuz Kilinç, Öznur Kiliç Soylar

Turkish Journal of Medical Sciences

Background/aim: There has been growing interest in the use of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with community-acquired pneumonia (CAP). The aim of this study was to investigate whether an assessment of fever, leukocyte count, and serum CRP and PCT levels on admission and during follow-up (day 3) provides any information about the clinical outcome in hospitalized patients with CAP. Materials and methods: Patients with a diagnosis of CAP who were admitted to and followed at four university hospitals were evaluated retrospectively using the Turkish Thoracic Society Pneumonia Database. Results: A total of 103 hospitalized CAP patients …

An Unusual Pathology With An Undefined Etiology:Solitary Fibrous Tumors Of The Pleura, Kutsal Turhan, Ali̇ Özdi̇l, Ayşe Gül Ergönül, Deni̇z Nart, Alpaslan Çakan, Ufuk Çağirici

Turkish Journal of Medical Sciences

Background/aim: The aim of the present study was to evaluate the etiology and clinical and pathological behavior of solitary fibrous tumors of the pleura (SFTPs), as well as the most appropriate surgical approach and the results of long-term follow-up of this condition. Materials and methods: Clinical and long-term follow-up records of 14 patients who had surgery for SFTP between 2001 and 2014 were reviewed retrospectively. Etiological factors, diagnostic procedures, and clinical courses and outcomes for these patients were studied. Results: Of the 14 patients, 8 were male (57%) and 6 were female (43%) patients. The mean age was 54.14 ± …