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Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Assessment Of Chronic Disease To Determine Appropriateness Of Implantable Cardioverter-Defibrillator Therapy, Bilal M. Omery, Maharaj Singh, Randy S. Turkel, Robyn Shearer, Arshad Jahangir, M. Eyman Mortada, Jasbir S. Sra, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Implantable cardioverter-defibrillator (ICD) therapy is considered appropriate when a patient is felt to have a reasonable expectation of 1-year survival. Chronic diseases have been estimated to be associated with greater than 10% annual mortality and may reduce benefits of ICD therapy. Frailty has been estimated to be associated with greater than 20% annual mortality and has been suggested to contraindicate ICD therapy.

Purpose: Determine a risk score that may identify patients in whom ICD implantation may not be appropriate.

Methods: Patients who received an ICD for primary and secondary prevention from 2008 through 2013 at the Aurora Health Care …

Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker

Journal of Patient-Centered Research and Reviews

Background: Metabolic syndrome (MetS) is a constellation of metabolic conditions, including abdominal obesity, high blood pressure, high triglyceride level, low high-density-lipoprotein level and high fasting blood glucose level, that increase the risk of developing chronic health conditions. Various combinations of diagnostic criteria have been proposed, including those by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Foundation (IDF), among others. However, inconsistent use of diagnostic criteria and inadequate scientific evidence supporting use of specific criteria are current problems in health care.

Purpose: Quantify the prevalence of MetS diagnosis within the …

Decreasing Time To Broad Spectrum Antibiotics For Septic Patients In The Emergency Department, Joseph J. Zieminski, Emily E. Bryant

Journal of Patient-Centered Research and Reviews

Background: Timely administration of broad spectrum antibiotics has been shown to be directly correlated with decreased mortality for patients with severe sepsis and septic shock. As such, both the Surviving Sepsis Campaign and the SEP-1 CMS measure recognize timely antibiotic administration as a cornerstone of therapy for patients with severe sepsis or septic shock.

Purpose: Decrease time to broad spectrum antibiotic administration for septic patients in the emergency department (ED) of Aurora St. Luke’s Medical Center.

Methods: An alert within the electronic medical record was created to more rapidly identify potentially septic patients in the ED. After receiving the alert, …

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting likely occurs …

Relative Associations Of Age, Height, And Weight On Sinus Of Valsalva And Mid-Ascending Aorta: An Imaging And Epidemiology Study, Mirza Nubair Ahmad, Syed Haris Pir, Mirza Mujadil Ahmad, Sharmeen Hussaini, Bijoy K. Khandheria, A. Jamil Tajik, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Background: Prior studies show ascending aorta diameter varies with age, height and weight, but they did not evaluate relative influence of these variables on aortic diameter. Since height is genetically determined, and genetic disorders like Marfan syndrome are predominantly associated with sinus of Valsalva (SOV) dilation, we hypothesized height may have stronger association with SOV.

Purpose: Based on anecdotal observation, since age, weight and obesity are acquired attributes, we hypothesized age, weight and body mass index may have greater association with mid-ascending aorta (MAA) diameter, even in normal patients.

Methods: We evaluated echocardiographic studies of patients ≥ 15 years old …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Journal of Patient-Centered Research and Reviews

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Therapeutic Drug Monitoring And Methods Of Quantitation For Carbamazepine, Cristian Tuchila, Daniela Luiza Baconi, Cristina Dinu Pirvu, Denisa O. Balalau, Ana Maria Vlasceanu, Miriana Stan, Cristian Balalau

Journal of Mind and Medical Sciences

Carbamazepine is an early anticonvulsant still used today in the treatment of several forms of epilepsy. An active metabolite in the human body contributes to its pharmacological effect. Carbamazepine metabolism has high inter-individual variability, such that it is relatively difficult to establish a direct link between dose and concentration, or between concentration and pharmacological effect. Carbamazepine is thus a good candidate for therapeutic drug monitoring (TDM). Good UV specific absorbance and high plasmatic concentrations allow for the use of UV detection, which is often more accessible than other methods of detection. This paper presents several methods used for the detection …

Rehabilitation Of An Injured Golden Eagle (Aquila Chrysaetos): A Case Study, Fida Muhammad Khan, Fakhar-I- Abbas, Abu Ul Hassan Faiz

Journal of Bioresource Management

Habitat destruction and anthropogenic activities cause wild birds to migrate towards urban areas in search of food and sometimes nesting in high-roof buildings, where they are caught by local people using different techniques and are further used for hunting or recreational purposes. An injured Golden Eagle (Aquila chrysaetos) was found entangled in bushes near the vicinity of Balkasar Research Complex, Chakwal, Pakistan. After complete physical examination, a wound on the right wing and closed leg fracture was diagnosed. The successful treatment was done by anti-parasitic and anti-bacterial drugs with careful monitoring. Splint was adjusted after aligning the fractured …

Characterization Of Different Molecular Markers For Identification Of Salmonella Enterica Serovar Typhi In Pakistani Population, Faizan Muttiullah, Fida Muhammad Khan, Fakhar-I- Abbas, Sabiha Shamim

Journal of Bioresource Management

Typhoid is caused by Salmonella enterica serovar Typhi that is usually diagnosed by using serologic and immuno-chromatographic techniques in developing counties including Pakistan, which is thought to be an unreliable diagnostic method. For accurate diagnosis we used molecular techniques to amplify 204 bp StyR-36 and 498 bp flagellin gene for the identification of Salmonella enterica serovar Typhi. This study was done on 58 individuals diagnosed positive of typhoid via serologic tests and 50 healthy individuals as a control group. Success rate of amplification for flagellin gene was 77.58% while that for StyR-36 gene was 68.97% showing that flagellin gene primer …

Reframing Outcome Measures For Thrombolytics In Acute Ischemic Stroke, Brandon Baker, Charles W. Kropf, Nicholus Yee, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation examining relevant research and discussing the potential benefits and harms of thrombolytic therapy in acute stroke.

Anticoagulation Increases Survival In Patients With Idiopathic Pulmonary Arterial Hypertension, Marvin L. Kajy

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Olsson KM, Delcroix M, Ghofrani HA, et al. Anticoagulation and survival in pulmonary arterial hypertension: Results from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). Circulation, 2014;129(1):57-65. doi: 10.1161/CIRCULATIONAHA.113.004526

Influence Of Differential Calcification In The Descending Thoracic Aorta On Aortic Pulse Pressure, Mirza Mujadil Ahmad, Syed Haris Ahmed Pir, Mustafa Noor Muhammad, Sharmeen Hussaini, Immad Arif Kiani, Mirza Nubair Ahmad, Imaad Razzaque, Muhammad Nabeel Syed, Rafath Ullah, Suhail Allaqaband, Anjan Gupta, Steven C. Port, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Purpose: Multiple studies have shown pulse pressure (PP) to be a strong predictor of aortic calcification. However, no studies are available that correlate PP with aortic calcification at the segmental level.

Methods: We identified 37 patients with aortic PP measured during cardiac catheterization. Their noncontrast chest computed tomography scans were evaluated for the presence of calcium in different segments (ascending aorta, arch of aorta [arch], descending aorta) and quantified. Patients with calcification (Calcified Group A) were compared against patients without calcification (Noncalcified Group B) in terms of PP, calcification and compliance.

Results: The mean of the total calcium score was …

Convolutional Neural Networks In Medical Imaging, Mitchell Finzel

Scholarly Horizons: University of Minnesota, Morris Undergraduate Journal

Over the past 5 years there has been an increase in the use of convolutional neural networks in a broad variety of medical imaging applications. This is due in part to the increase in their popularity since their success in the 2012 ImageNet competition, but is also due to their adaptability across a range of medical imaging applications. These applications vary greatly; from the segmentation of knee cartilage to the detection of Alzheimer's disease in MRIs and much more. In this paper we will go over some of the cutting edge techniques being used specifically for the tasks of brain …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Analysis Of The Local And Systemic Cytokine Response Profiles In Patients With Community-Acquired Pneumonia. Relationship With Disease Severity And Outcomes., Rafael Fernandez-Botran, Timothy Lee Wiemken, Robert R. Kelley, Paula Peyrani, Jose Bordon, Rodrigo Cavallazzi, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

The goals of this study were to investigate the relationship of systemic and local cytokine responses with time to clinical stability (TCS) in patients with community-acquired pneumonia (CAP) and to develop a model to integrate multiple cytokine data into “cytokine response profiles” based on local vs. systemic and pro- vs. anti-inflammatory cytokine patterns in order to better understand their relationships with measures of CAP severity and outcomes. Forty hospitalized patients enrolled through the Community Acquired Pneumonia Inflammatory Study Group (CAPISG) were analyzed. Based on the ranked distribution of the levels of eight different pro-inflammatory cytokines and chemokines (IL-1b, IL-6, IL-8, …

Venoarterial Extracorporeal Membrane Oxygenation For Cardiogenic Shock: A Retrospective Analysis Based On The Etiology Of Shock, Andrew Burchett, Thomas Tribble, Richard Charnigo, Susan Smyth, Maya Guglin

The VAD Journal

Abstract:

Background: We performed a retrospective analysis to evaluate the efficacy of VA-ECMO support in cardiogenic shock based on various etiologies.

Methods: We retrospectively analyzed 99 patients supported with VA-ECMO from January 1, 2012 to January 1, 2015. Outcomes included survival to discontinuation of VA-ECMO support and survival to hospital discharge. The etiologies of cardiogenic shock included cardiac arrest (CPR), acute myocardial infarction (AMI), decompensated congestive heart failure (CHF), pulmonary embolism (PE), right ventricular failure (RVF) not secondary to an acute pulmonary embolism, and post-cardiotomy syndrome (PCS). The PCS group was used as a reference group; odds ratios were estimated …

It Is Reasonable To Recommended Intrapleural Alteplase For Loculated Pleural Effusions, Tricia Fernandez

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Thommi G, Shehan J, Robison K, Christensen M, Backemeyer L, McLeay M. A double blind randomized cross over trial comparing rate of decortication and efficacy of intrapleural instillation of alteplase vs placebo in patients with empyemas and complicated parapneumonic effusions. Respir Med. 2012;17(2):716-723. doi: 10.1016/j.rmed.2012.02.005

Manage Terminal Ileum Diverticulitis Comparably To Diverticulitis Elsewhere, James Yip

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Park HC, Lee BH. The management of terminal ileum diverticulitis. Am Surg. 2009 Dec;75(12):1199-202.

Are Contact Lenses An Effective Vehicle For Ocular-Disease Drug Delivery?, Chana Haimowitz

The Science Journal of the Lander College of Arts and Sciences

Due to numerous drawbacks with current modes of treatment for various ocular diseases, researchers are synthesizing drug dispensing contact lenses. The lenses will contribute to greater bioavailability of the drug, the minimization of negative side effects, and increased patient compliance. As treatment for glaucoma, in vivo studies have been conducted with latanoprost, timolol maleate, and brimonidine tartrate-eluting lenses, and have succeeded in reducing intraocular pressure to desired values (Ciolino et al., 2016), (Schultz and Mint, 2002). As treatment for fungal keratitis, in vitro studies prove that econazole and natamycin-eluting contact lenses have been successful in killing 100% of fungi for …

Do Antibiotics In Early Life Contribute To Obesity?, Shimon Kadosh

The Science Journal of the Lander College of Arts and Sciences

In recent years, science has made great strides in its understanding of the microbiome, discovering that it plays a role in regulating many body processes. One area of study is the microbiomes interaction and influence on host metabolic processes. Studies using both mice and humans have established a clear correlation between obesity and the composition of the microbiome, identifying a microbiome unique to obese individuals. Furthermore, experiments with germ-free mice have shown that the microbiome effects host metabolism, causing germ free mice to increase in mass when inoculated with normal microbiota. Inoculation with microbiota from obese mice yielded greater increases …

Repurposing Diabetes Drugs To Treat Insulin Resistance In Alzheimer’S Disease‌, Yael Lazarus

The Science Journal of the Lander College of Arts and Sciences

Alzheimer’s disease is a neurodegenerative condition which results in a significant decline in cognitive status. Novel treatment approaches for Alzheimer’s are sorely needed, as current medications for the disease offer only marginal clinical benefit. Research has discovered a connection between the pathology of Alzheimer’s and Type 2 Diabetes, two serious and seemingly unrelated disorders. Clinical studies have shown that Alzheimer’s disease is associated with brain insulin resistance similar to the pathology of Type 2 Diabetes. This observation has led to the notion that drugs developed for the treatment of Type 2 Diabetes may be beneficial in modifying the cognitive function …

Contribuciones De La Salud Y La Seguridad En El Trabajo A La Calidad De La Vida Laboral: Una Reflexión Analítica, Ivonne Constanza Valero Pacheco, Martha Isabel Riaño-Casallas

Ciencia y Tecnología para la Salud Visual y Ocular

La finalidad de la Calidad de Vida Laboral (CVL) y la Seguridad y Salud en el Trabajo (SST) es el bienestar, la productividad y la protección del trabajador en su medio laboral. Por tal razón, el objetivo del presente trabajo es comprender la relación entre estos dos conceptos y, por ende, deducir la significancia de tal nexo. El estudio se realiza bajo un enfoque cualitativo-descriptivo, por su carácter interpretativo-inductivo, y con diseño hermenéutico mediante, cual pretende comprender, explicar e interpretar las teorías propuestas para CVL y sus relaciones con la SST como factor determinante de esta. Resultado de dicho análisis …

La Calidad De Vida Relacionada Con La Salud En Pacientes Con Degeneración Macular Asociada Con La Edad, Gerardo Andrés Dussán Torres

Ciencia y Tecnología para la Salud Visual y Ocular

La degeneración macular asociada con la edad (DMAE) es una enfermedad de la retina que no solo afecta la función visual, sino que influye en la salud general del paciente y en su calidad de vida por esta razón, la medición de la salud visual típicamente efectuada con los indicadores clínicos debe, además, abarcar una evaluación que permita obtener un valor numérico que represente la enfermedad dentro del estado funcional del paciente. Objetivo establecer diferencias estadísticamente significativas de la calidad de vida relacionada con la salud (CVRS) en los participantes diagnosticados con DMAE y en pacientes sanos. Metodología: estudio observacional …

Rangos De Referencia De Heteroforias Y Reservas Fusionales Entre Los 6 Y Los 60 Años De Edad, Alejandro León Álvarez, Sandra Milena Medrano Muñoz, Mónica Marlene Márquez Galvis

Ciencia y Tecnología para la Salud Visual y Ocular

Objetivo describir los valores de referencia para la heteroforia medida con el prisma cover test, las reservas fusionales negativas (RFN) y las positivas (RFP) a 3 m y 0,4 m y el punto próximo de convergencia (PPC), en una población colombiana entre los 6 y los 60 años de edad. Materiales y métodos se incluyeron 632 personas de Pereira, Colombia, en este estudio. Se les practicó un examen optométrico rutinario que incluyó la evaluación de la heteroforia con PCT, RFN y RFP con barra de prismas, PPC con una tarjeta acomodativa (OR) y luz más filtro rojo (FR). Resultados la …

Perfil De La Salud Visual Y Ocular De Los Niños De Dos Centros De Desarrollo Infantil De Pereira, Colombia, Mónica Marlene Márquez Galvis, Mayra Catalina Cáceres Díaz

Ciencia y Tecnología para la Salud Visual y Ocular

La detección de alteraciones en el desarrollo visual de los niños es una de las misiones del optómetra, para prevenir la aparición y complicación de los problemas visuales. Objetivo identificar el estado refractivo, motor y patológico del segmento anterior y posterior en los niños de dos centros de desarrollo infantil (CDI) de Pereira, Colombia. Materiales y métodos: estudio descriptivo retrospectivo, de corte transversal, en el cual se describen las características sociodemográficas y la morbilidad visual y ocular de los niños, de estrato socioeconómico 0 y 1, según las historias clínicas de exámenes efectuados en los años 2012 y 2013 y …

Asociación Del Virus Del Papiloma Humano Con Enfermedades Oculares Del Segmento Anterior Y Los Párpados, Paola Andrea Abello Tapias, Henry Herrera

Ciencia y Tecnología para la Salud Visual y Ocular

Este artículo se basa en la revisión y profundización de los conceptos relacionados con la virulencia del virus del papiloma humano (VPH) en el segmento anterior ocular, coexistente con papilomas múltiples palpebrales. Objetivo conocer las características clínicas, terapéuticas y epidemiológicas de la infección del VPH en el segmento anterior ocular y los párpados, así como sus diagnósticos diferenciales. Metodología: revisión sistematizada y exhaustiva de literatura científica relevante que evidencia objetividad en su comprensión y reproductividad en su conclusión la búsqueda se limitó a una revisión sistemática de metanálisis y ensayos clínicos, en idioma inglés y español, a partir del año …

Diagnóstico Diferencial De Conjuntivitis Alérgica Crónica En Rinitis Alérgica, Nancy Mariana Chaclán Delgado, Ruth Eva Hernández Carbajal, Óscar Antonio Ramos Montes

Ciencia y Tecnología para la Salud Visual y Ocular

Introducción en la clínica de optometría de la Facultad de Estudios Superiores (FES) Iztacala, de la Universidad Nacional Autónoma de México, se presentó un caso clínico de rinoconjuntivitis alérgica persistente monocular en un paciente de 13 años de edad, diagnosticado y tratado como conjuntivitis bacteriana por varias instancias médicas previas a nuestra consulta. Se analizó el caso al considerar los signos y síntomas, así como la evolución de la patología. Objetivo desarrollar un diagnóstico diferencial entre conjuntivitis alérgica crónica con rinoconjuntivitis alérgica persistente, a partir de un proceso diagnosticado como infeccioso. Método valoración a través de biomicroscopia, revisión de fosas …

Habilidades Visoperceptuales En Niños Escolarizados De 7 A 12 Años Con Ambliopía Refractiva, Tomás Cristóbal Jadue Jadue, Luisa Fernanda Figueroa O.

Ciencia y Tecnología para la Salud Visual y Ocular

La percepción visual es una habilidad que involucra una serie de subhabilidades relacionadas, que interactúan entre sí para analizar, integrar y sintetizar la información visual de manera eficiente. Objetivo general: determinar el estado de las habilidades visoperceptuales en niños escolarizados entre 7 y 12 años con ambliopía refractiva, residentes de Bogotá. Materiales y métodos: se desarrolló un estudio observacional descriptivo así mismo, se contribuyó en la obtención de la muestra al efectuar tamizaje visual a los estudiantes del grupo de edad seleccionado (examen completo, incluida cicloplejia, a los estudiantes positivos posibles ambliopes en el tamizaje) y al aplicar la prueba …