Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Open Surgery With Intraoperative Enteroscopy In Jejunoileal Massive Bleeding In Pediatric Patient: An Evidence-Based Case Report, Rini Y. Husni, Kshetra Rinaldhy

The New Ropanasuri Journal of Surgery

Introduction. A case report of surgical exploratory laparotomy with intraoperative enteroscopy (IOE) as a treatment in massive jejunoileal bleeding in children.

Method. We conducted a literature search on databases such as Cochrane, PubMed, ScienceDirect, and Google Scholar. Abstract and title screening was done based on exclusion criteria, inclusion criteria, and double filtering. The selected article then reviewed using critical appraisal tools based on its validity, importance, and applicability. Selected articles were benchmark to the discussion.

Results. The application of open surgery with IOE as the final treatment that can be recommended in the critical or life-threatening condition …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Publications

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Impact Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Nasal Swab On Total Duration Of Mrsa Therapy For Pneumonia Patients, Darren D. Yum, Kayihura Manigaba, Danielle Gagne, Heather Ellis

Infectious Disease

Purpose: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program tool for avoiding unnecessary empiric anti-MRSA therapy for pneumonia. MRSA is an important cause of pneumonia and clinicians must determine when empiric antimicrobial therapy directed toward this pathogen is needed. Negative MRSA nasal swab has been shown to have a high negative predictive value ( >95%) across different types of pneumonia. The objective of this study is to assess the impact of negative MRSA nasal swabs on the duration of anti-MRSA therapy in a community hospital setting.

Methods: This study will be submitted to the institutional …

Voice Analysis With Iphones: A Low Cost Experimental Solution, Benjamin Van Der Woerd

Electronic Thesis and Dissertation Repository

Background:

Acoustic voice analysis requires a resource intensive setup, including a soundproof booth. This project evaluates smartphone microphone and recording environment impacts on voice sample collection for acoustic voice analysis. A proprietary analysis algorithm is presented for validation.

Methods:

Microphone and recording environment were evaluated using previously collected voice samples presented in four conditions to test two microphones and two recording environments. Prospective samples were used to test the proprietary algorithm, whereby samples were analyzed using this and Praat.

Results:

Microphone and recording environment had small, clinically unimportant impacts on most measurements. The proprietary algorithm reliably analyzed sustained vowels, with …

Using Simple Ct Perfusion To Help Identify Ictal Vs. Interictal Lateralized Periodic Discharges (Lpds): A Case Report, Michelle Nunes, Aqsa Ullah, Amna Imran, Enrique Serrano

Neurology

No abstract provided.

Outbreak Of Ebola Virus Disease, Alexandra Dimit, Tiffany Kneuss, Joelle Farano, Haley Armstrong, Jodi Otte, Andrew M. Roecker

Pharmacy and Wellness Review

Ebola virus disease (EVD) has existed as a major health concern with devastating and, many times, fatal symptoms. The recent outbreaks of EVD in West Africa and the Democratic Republic of the Congo (DRC) have incited international concern. In this article, the implications of EVD will be discussed including the etiology, transmission, signs and symptoms, diagnosis and treatment of the disease. In addition to this discussion, the manner in which major health care organizations, including the World Health Organization (WHO), are dealing with treating infected patients and containing spread of the disease will be covered.

Management Of Breakthrough Pain In Cancer Patients: Traditional And Novel Approaches, Courtney Porter, Nathaniel Hedrick, Katherine Salay, Lacey Shumate, Caitlin Swann, Kelly Reilly Kroustos

Pharmacy and Wellness Review

Approximately 80 percent of career patients experience breakthrough pain (BTP) characterized by acute onset, short duration, and moderate-to-severe intensity. Treatment of BTP using current available medications is often insufficient, leading to the development of various novel approaches that focus on rapid onset of action and short duration of action. Most of these products are still in clinical trials, and future studies are needed to compare the novel approaches to currently available treatments. Non-medication related issues, which arise from a lack of communication and understanding between the patient, physician and pharmacist, are also barriers to adequate BTP management. By educating patients …

Polycystic Ovarian Syndrome And Hyperinsulinemia: Overview And Treatment, Amanda M. Meyer, Lauren D. Bajbus, Sarah E. Drake, Kristen M. Quertinmont, Ashley Overy, Anne Gentry

Pharmacy and Wellness Review

Polycystic ovary syndrome is a prevalent issue in women's health that is associated with hyperinsulinemia and insulin resistance and can lead to long-term health problems. The most highly recommended treatments are diet and lifestyle changes. If these changes alone are not enough, pharmacologic treatments may be employed which include metformin, spironolactone or thiazolidinediones, although more research is needed to fully realize their role. The role of the pharmacist in this disease state includes counseling patients on healthy lifestyle changes, consulting with the physician about prescribing the best medication for each patient, and monitoring therapy adherence in the patient.

Management Of Hypertensive Emergencies In Pediatrics, Jennifer L. Bauer, Jamie L. Amero, Amanda C. Mcdavid, Ryan A. Fischer, Alison L. Huet, Karen L. Kier

Pharmacy and Wellness Review

As hypertension becomes more prevalent in the pediatric population, clinicians are more likely to encounter hypertensive emergencies in children, which require pharmacists and physicians to be educated on the therapeutic options for these emergencies. However, the strict governmental requirements on the testing of these drugs in pediatric patients have limited the amount of available evidence on which to base clinical decisions. This review will highlight the available evidence and preferred treatment options for the management of pediatric hypertensive emergencies.

Recent Advances Spark Significant Guideline Change: Antiretroviral Therapy (Art) At High Cd4+ Counts In The Treatment Naïve Patient, Joshua Ilenin, Kelly Fargo, Lisa Berni, Kristen Thatcher, Caitlin Swann, Andrew Roecker

Pharmacy and Wellness Review

Human immunodeficiency virus (HIV) targets CD4+ lymphocytes, a critical component to proper functioning of the human immune system. HIV is a significant public health concern, having resulted in over 27 million deaths since its discovery. Currently, several different treatment options exist, with combination antiretroviral therapy (ART) at the forefront. Despite the success of ART therapy, there are number of problems, including poor patient compliance. Due to this, the appropriate time to initiate therapy in the treatment naïve patient is under continuous scrutiny. Recently, several trials have demonstrated evidence suggesting that initiating ART at high CD4+ counts in the treatment naïve …

Evolution Of Acute Ischemic Stroke Treatment As Supported By Clinical Trials, Savya S. Shukla, Brian F. Baigorri Md, Roberto I. Fourzali Md, Yafell Serulle Md

Radiology

No abstract provided.

Role Of The Pharmacist In Improving Treatment For Children With Concurrent Gastrointestinal And Autism Spectrum Disorders, Whitney R. Henry, Kaitlin A. Sanders, Jenna L. Schaffner, Leslie M. Hart, Whitney N. Detillion, Anne F. Gentry

Pharmacy and Wellness Review

Over the last several years, a noteworthy association between gastrointestinal (GI) disorders and autism spectrum disorders (ASD) has been documented, although no large population-based studies exist. GI disorders in ASD children may stem from the underlying behavioral, communication, sensory or neurological issues intrinsic to the autistic disorder itself; therefore, the incorporation of alternative therapies, including behavioral modification, may be compelling treatment additions to the GI care traditionally recommended in children. To improve GI symptoms and quality of life in ASD children, a multidisciplinary approach is optimal, with pharmacists playing an active role in determining appropriate pharmacotherapy. Although there is a …

Options For Breast Cancer Prevention In High-Risk Patients, Ashley M. Overy, Lacey A. Shumate, Sarah M. Webb, Ashley E. Lehnert, Monica A. Weisenberger, Whitney N. Detillion, Andrew M. Roecker

Pharmacy and Wellness Review

Breast cancer is the most frequently diagnosed non-skin cancer in women, and one in eight women will develop breast cancer within their Iifetimes. Unfortunately, the strongest risk factors for breast cancer (i.e. age, family history, hormonal factors) are not easily modified. There is some evidence that chemopreventative drugs may be able to prevent breast cancer in high-risk patients. Tamoxifen and raloxifene have been shown to reduce the risk of breast cancer in high-risk women but may be associated with several serious adverse events. Clinical trials are currently in progress to determine if aromatase inhibitors are a viable alternative for breast …

Image Restoration Using Automatic Damaged Regions Detection And Machine Learning-Based Inpainting Technique, Chloe Martin-King

Computational and Data Sciences (PhD) Dissertations

In this dissertation we propose two novel image restoration schemes. The first pertains to automatic detection of damaged regions in old photographs and digital images of cracked paintings. In cases when inpainting mask generation cannot be completely automatic, our detection algorithm facilitates precise mask creation, particularly useful for images containing damage that is tedious to annotate or difficult to geometrically define. The main contribution of this dissertation is the development and utilization of a new inpainting technique, region hiding, to repair a single image by training a convolutional neural network on various transformations of that image. Region hiding is also …

Standardized Reporting In Pancreatic Protocol Ct: Implementation Across 3 Community Hospitals, Jacob L. Miller, Kevin Carr, James Banks, Nisha Mani

Radiology

No abstract provided.

Identification And Molecular Analysis Of Dna In Exosomes, Jena Tavormina

Dissertations & Theses (Open Access)

Exosomes are heterogeneous nanoparticles 50-150nm in diameter. Exosomes contain many functional cargo components, such as protein, DNA, and RNA. While protein and RNA exosome content has been extensively studied, very little work has been done to characterize exosomal DNA. Here, we demonstrate that exosomal DNA is heterogeneous and its packaging into exosomes is dependent on the cell of origin. Furthermore, through a rigorous assessment of various isolation methods, we identify Size Exclusion Chromatography (SEC) as the best method for the isolation of exosomal DNA for downstream applications. Additionally, we evaluate the methylation status of exosomal DNA and demonstrate that exosomal …

A Multiple Comparison Study That Test The Validity Of Varian’S Rapidplan For Prostate Cancer Cases Based On Models Built From Outside Institution., La'rone Reid

Culminating Experience Projects

In radiation oncology treatment planning techniques and outcomes can differ from one institution to the next. With knowledge-based planning (KBP) the experience of larger institutions could help smaller institutions who may not have the opportunity to encounter certain types of cancer cases. However, this scenario is only true if the KBP software is consistent with its algorithmic output. Varian's KBP software called Rapid Plan (RP) will be analyzed for algorithmic consistency. This study investigates the validity and consistency of RP models from two different radiation oncology institutions, and compare data to determine RP quality, and consistency when planning prostate cancer …

Rapidly Recurrent Basilar Artery Thrombosis Treated With Emergent Mechanical Thrombectomies And Stenting, Mark Cohen, Amna Imran, Ankur Garg

Neurology

Acute basilar artery thrombosis (BAT) is a life-threatening condition that can be treated by emergent mechanical thrombectomy (EMT). Recurrent acute BAT is a rare phenomenon. Here we describe a case of rapid recurrent acute BAT that was treated each time by EMT and finally by emergent basilar artery stenting with good outcome

Creutzfeldt Jakob Disease: Progressive Neurological Decline, Christine Fayad Md, Scott J. Anderson, H. Alex Akhondi Md

Internal Medicine

No abstract provided.

Availability Of Pain Medications For Npo Patients, Anna Augustin Do, Kyle Borodunovich Do, Sean Quinonez Do, Furqan Haq, My Myers Md

Family Medicine

In recent years, the opioid epidemic has been a key catalyst in changing the medical standards for treating both acute and chronic pain. Instead of relying heavily on narcotics for pain management, practitioners are not encouraged to adapt a non-pharmacologic, non-opioid approach to analgesia. While many guidelines have been set to standardize outpatient pain management, the rules surrounding inpatient analgesia are limited or lacking.

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Prediction Of Anal Cancer Recurrence After Chemoradiotherapy Using Quantitative Image Features Extracted From Serial (18)F-Fdg Pet/Ct, Michael Chuong

Michael Chuong

No abstract provided.

Creating An Interprofessional Collaborative Research Opportunity For Physical And Occupational Therapy Students, Anne Fleischer, Mary Insana Fisher, Shirley P. O'Brien

Physical Therapy Faculty Publications

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional …

Safe And Effective Use Of A Hands-Free Intracorporeal Retractor For Suture-Based Liver Retraction During Minimally Invasive Bariatric Procedures: Results Of A Large Case Series, Roger De La Torre, Matthew Sappington, Tom Smith, Jeremy Bryner, David Mantilla, J Stephen Scott

General Surgery

Background

Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate operative view and working space. Conventional approaches utilize a mechanical retractor that requires a dedicated incision, may cause liver damage, and often requires an assistant. This study evaluated the safety and efficacy of hands-free intracorporeal retractors in a large series of subjects undergoing laparoscopic bariatric surgery. This method eliminates the need for a subxiphoid incision, enables full surgeon autonomy, and allows for adjustments throughout the procedure.

Methods

Retrospective chart review identified all subjects at a single hospital undergoing bariatric surgery between September 2017-March 2019 …

A Novel Polyelectrolyte Multilayer Nanofilm-Based Synthetic Bioresorbable Antimicrobial Matrix Accelerated Healing Of Chronic Wounds In A Prospective Clinical Evaluation, Sarah Waterman Manning Md, David A. Humphrey, Michael J. Schurr, Eric C. Crawford, Gaurav Pranami, William Shillinglaw, Lorinda K. Baker, Michael J. Schurr

General Surgery

No abstract provided.

Double Pylorus: Case Report Of Atypical Presentation, Christopher Lozano Orpiano Do, Gurjeet Kang Do, Michael Quinn Do, Lakshminarasimhan Venu Md, Joseph Staffetti Md

Gastroenterology

Introduction: Double pylorus is a rare endoscopic finding that has been reported in 0.001% to 0.4% of upper gastrointestinal endoscopies, consisting of a gastroduodenal fistula extending from the prepyloric gastric antrum to the duodenal bulb through an accessory channel. In the majority of cases, it is a complication when peptic ulcers erode and create a fistula between the duodenal bulb and the distal stomach. It usually presents on the lessor curvature of the gastric antrum and on a superior wall of the duodenal bulb. It is commonly an endoscopic finding, since clinical presentation is similar to other peptic diseases.

Case …

Iron Pill-Induced Gastropathy In Elderly Patients: A Case Series Report, Isin Y. Comba Md, Richard Henriquez, Sundeep Kumar, Ruthvik Srinvasa-Murthy, Maria Wallis-Crespo, Lakhinder Bhatia Md, Joshua Shultz

Gastroenterology

Introduction: Iron deficiency anemia is a global health problem with an estimated two billion cases worldwide. Oral iron supplementation is considered the first line treatment. However, recent studies favor the use of short-term IV iron especially in patients with drug tolerance and efficacy concerns. In this report, we present three cases of iron pill gastropathy in patient's whose clinical courses were complicated by gastric erosion, ulcer or gastrointestinal (GI) bleeding. All of our patients had a history of iron deficiency anemia and were being treated with oral ferrous sulfate.

Case Description/Methods: The first case involved a 72-year-old male with multiple …

Size Matters: A Case Of Recurrent Proximal Esophageal Stenoses Treated With A Biliary Self Expanding Metal Stent (Sems), Sahityan Viswanathan, Timothy Dobin, Long T. Hoang

Gastroenterology

Esophageal stenosis after radiotherapy occurs in up to 15% of patients within three months of treatment. Endoscopic dilation remains the standard of care for cervical esophageal stenosis with refractory cases requiring stenting. Proximal stenosis poses a challenge as standard esophageal stents can cause cervicalgia and globus sensation due to their size and expansive force. We report on the usage of a biliary SEMS for a severe-recurrent stricture at the level of the proximal esophageal sphincter.

Not Just A Cyst: A Rare Presentation Of Luq Pain, Richard Henriquez, Isin Y. Comba Md, Sundeep Kumar Md, Khawaja Arsalan Bashir, Maria Wallis-Crespo Md, Lakhinder Bhatia Md

Gastroenterology

Lymphangioma is a benign congenital malformation of the lymphatic system that is relatively common in juvenile population. Rarely, it can be seen in adults and majority of the cases are reported in the head and neck region (70-75%). Typically, these malformations are asymptomatic. In this report, we present a rare case of splenic lymphangioma presenting with severe, intractable abdominal pain.

A Unique Presentation Of Scurvy In The Modern Era, Anita Bhagavathula Do, Joanna Linsteadt Md, Sonam Jaggi Md

Internal Medicine

No abstract provided.