Diagnosis Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Determination Of Initial Hepatitis B Surface Antigen (Hbsag) Cutoff Index (Coi) Threshold For Reporting Hbsag Reactivity, Piya Wongchampa, Arkom Chaiwongkot, Rangsima Reantragoon

Chulalongkorn Medical Journal

Background: The Hepatitis B surface antigen (HBsAg) commercially-available screening test suggests a confirmatory testing in all cases that are reactive, but this will take a long time to reporting of results and increase the total test cost.

Objectives: To investigate the correlation between cutoff index (COI) values of initial HBsAg screening test and their corresponding confirmatory neutralization results in order to identify a COI value for distinguishing samples that truly need confirmatory neutralization testing.

Methods: A retrospective study of 72,496 HBsAg screening test results using the Elecsys HBsAg II kit of patients at King Chulalongkorn Memorial Hospital, the Thai Red …

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

The Impact Of Covid-19 On The Utilization Of Early Magnetic Resonance Imaging (Emri) In The Assessment Of Acute Uncomplicated Low Back Pain (Lbp) And The Subsequent Effect On Health Care Service Utilization And Patient Outcomes, Kimberly Radcliffe

MUSC Theses and Dissertations

OBJECTIVES: To examine changes in MRI rates between Pre-COVID-19 period (Feb-April 2019) and COVID-19 period (Feb-April 2020) among commercially insured patients aged 18-60 with a diagnosis of acute LBP, and to analyze differences in patient characteristics and outcomes between the time periods. Additionally, to examine the impact of eMRI on patient outcomes and health care costs for patients in the COVID-19 period.

DESIGN/METHODS: Using IBM® MarketScan® Commercial Database (MarketScan) we performed a quantitative pre-post comparative retrospective observational study of 117,150 total patients to examine adjusted differences in patient characteristics and rates of MRIs between time periods. We analyzed 49,020 patients …

Update On The Role Of Muc13 In Pancreatic Cancer: A Promising Early Detection Biomarker, Anupam Dhasmana, Swati Dhasmana, Sheema Khan, Meena Jaggi, Murali M. Yallapu, Subhash C. Chauhan

Research Symposium

Background: With the rise in pancreatic cancer (PanCa) prevalence and mortality rate, by 2030 it will secure second position among leading causes of cancer-related deaths. Due to poor prognosis of PanCa only 11% of PanCa patients have a 5-year survival rate, resulting in an equal mortality rate and incidence rate. 85% of PanCa are Pancreatic ductal adenocarcinoma (PDAC). The main clinical challenge with PanCa is poor treatment outcomes due the late diagnosis. Currently, there are traditional biomarkers panels available for diagnosis, however, these biomarkers do not have optimal sensitivity and specificity for PanCa. Considering this alarming unmet clinic need, our …

Diagnostic Accuracy Of The Passive Straight Leg Raise Test In Detecting Compression Of The Lower Lumbar Nerve Roots, Hisham Mohamed Hussein, Ehab Kamel, Mohamed Ragab, Ahmed Elerian

Internet Journal of Allied Health Sciences and Practice

Background: Lumbar nerve root compression is a pathological condition that occurs commonly in the low back pain population. Passive straight leg raise (SLR) is a clinical test widely used to confirm this pathological condition. Yet, its diagnostic accuracy needs further investigation. Objective: To assess the sensitivity and specificity of the passive SLR test in detecting compression of the lower lumbar nerve roots using magnetic resonance imaging as a reference standard. Design: This study is a prospective diagnostic-accuracy study. Methods: One hundred-and-twelve participants (82 males and 30 females) met the inclusion criteria and joined the study. Participants were recruited through direct …

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

A Potential Role Of Urinary P75ecd As A Biomarker For Amyotrophic Lateral Sclerosis In An American Cohort, Swati Dhasmana, Anupam Dhasmana, Sheema Khan, Acharan S. Narula, Murali Yallapu, Subhash Chauhan

Research Symposium

Background: Neurological disorders present a unique complexity compared to other diseases, involving multiple risk factors, causes, treatments, and outcomes. These disorders often exhibit various molecular and morphological changes indicative of disruptions in cellular plasticity and resilience. The pathogenesis of many neurological disorders remains unclear, necessitating ongoing investigations. Amyotrophic lateral sclerosis (ALS) exemplifies an idiopathic and fatal neurodegenerative disease marked by the degeneration of upper and lower motor neurons. The average life expectancy post-diagnosis is a mere 36 months, primarily attributed to respiratory muscle denervation.The persistent challenges in ALS clinical trials and the absence of effective therapeutic options have intensified interest …

A Case Of Siadh After Bowel Preparation For Routine Colonoscopy, Joseph C. Rath, Allison M. Hemmer, Kennedy A. Forest, Kahlen R. Morris, Mary E. Watson

Aesculapius Journal (Health Sciences & Medicine)

Electrolyte abnormalities, including hyponatremia, are a known outcome of bowel preparations used for colonoscopy. Severe and symptomatic hyponatremia after bowel preparation is uncommon and occurs due to excessive release of ADH among other contributing factors. Risk factors for developing hyponatremia after bowel preparation include increased age, female gender, kidney disease, heart failure, and use of various medications. We present the case of a 78-year-old female who presented with altered mental status and possible seizures after completing bowel preparation with polyethylene glycol for a colonoscopy. Serum and urine studies were consistent with SIADH. She required fluid restriction, hypertonic saline, and sodium …

Evaluation Of Nursing Approach To Assessment Of Post-Operative Respiratory Depression Using A Simulation Model, Natalia Tarasova, Usha Asirvatham, Robin D. Goetz, Mariela Riveria, Juraj Sprung, Toby N. Weingarten

Journal of Perioperative Nursing

Introduction: Assessments of post-operative patients that have been carried out by health care providers before critical opioid-induced respiratory events often do not detect respiratory depression. We hypothesise that opioidinduced respiratory patterns present during sleep may not be properly recognised as providers typically awaken patients for vital sign checks, and awake state assessment is recorded. We used a simulation manikin model to test this hypothesis.

Methods: Nurses who work on a standard post-operative hospital ward volunteered to participate in a study designed to record vital signs on an adult male manikin. None of the nurses had formal critical care or postoperative …

Correlation Enhanced Distribution Adaptation For Prediction Of Fall Risk, Ziqi Guo, Teresa Wu, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon

Physical Therapy Faculty Articles and Research

With technological advancements in diagnostic imaging, smart sensing, and wearables, a multitude of heterogeneous sources or modalities are available to proactively monitor the health of the elderly. Due to the increasing risks of falls among older adults, an early diagnosis tool is crucial to prevent future falls. However, during the early stage of diagnosis, there is often limited or no labeled data (expert-confirmed diagnostic information) available in the target domain (new cohort) to determine the proper treatment for older adults. Instead, there are multiple related but non-identical domain data with labels from the existing cohort or different institutions. Integrating different …

Device-Assisted Enteroscopy In The Surveillance Of Intestinal Hamartomas In Peutz-Jeghers Syndrome, Omar Wahid Mohamed Elfeky, Suraj Panjwani, David Cave, Daniel Wild, Daniel Raines

School of Medicine Faculty Publications

Background: PJS is an autosomal dominant, genetic disorder characterized by the formation of hamartomatous polyps in the gastrointestinal tract. These polyps result in significant morbidity due to adverse events including intestinal obstruction, bleeding, and malignancy. The aim of this study was to describe the role of DAE in monitoring and prophylactic polypectomy within the small bowel. Methods: Electronic medical records were surveyed to identify all DAE procedures performed in patients with PJS within three U.S. referral centers between Jan 1st 2007 and January 1st 2020. Individual charts were reviewed to collect and analyze specific data points. Primary end points included …

Promises And Risks Of Applying Ai Medical Imaging To Early Detection Of Cancers, And Regulation For Ai Medical Imaging, Yiyao Zhang

The Journal of Purdue Undergraduate Research

No abstract provided.

The Impact Of Simulated Image Acquisition Time Reduction On Image Quality And Parameters Of Myocardial Perfusion Imaging Using A Dedicated Cardiac Camera, Alireza Khatami

Electronic Thesis and Dissertation Repository

Heart disease is the second leading cause of death in Canada, highlighting the crucial role of early diagnosis in disease management. Myocardial perfusion imaging (MPI), is widely employed for this purpose, involves injecting a radiopharmaceutical into the body, imaging its distribution with a gamma camera, and revealing cardiac blood flow patterns. A significant challenge in MPI is the lengthy 8 to 10 minutes required for stress and rest imaging, potentially causing patient discomfort and compromising image quality due to movement. In a clinical study with 26 patients, post-processed data manipulation simulated a reduction in MPI imaging time. The findings indicated …

Classification Of Colorectal Cancer Using Resnet And Efficientnet Models, Abhishek Ranjan, Priyanshu Srivastva, B Prabadevi, R Sivakumar, Rahul Soangra, Shamala K. Subramaniam

Physical Therapy Faculty Articles and Research

Introduction:

Cancer is one of the most prevalent diseases from children to elderly adults. This will be deadly if not detected at an earlier stage of the cancerous cell formation, thereby increasing the mortality rate. One such cancer is colorectal cancer, caused due to abnormal growth in the rectum or colon. Early screening of colorectal cancer helps to identify these abnormal growth and can exterminate them before they turn into cancerous cells.

Aim:

Therefore, this study aims to develop a robust and efficient classification system for colorectal cancer through Convolutional Neural Networks (CNNs) on histological images.

Methods:

Despite challenges in …

Machine Learning As A Tool For Early Detection: A Focus On Late-Stage Colorectal Cancer Across Socioeconomic Spectrums, Hadiza Galadima, Rexford Anson-Dwamena, Ashley Johnson, Ghalib Bello, Georges Adunlin, James Blando

Community & Environmental Health Faculty Publications

Purpose: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. Methods: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. Results: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, …

Association Of Maternal Prenatal Copper Concentration With Gestational Duration And Preterm Birth: A Multicountry Meta-Analysis Author Links Open Overlay Panel., Nagendra Monangi, Huan Xu, Yue-Mei Fan, Rasheeda Khanam, Waqasuddin Khan, Saikat Deb, Jesmin Pervin, Joan Price, Lovejeet Kaur, R. Ochieng

Paediatrics and Child Health, East Africa

Background: Copper (Cu), an essential trace mineral regulating multiple actions of inflammation and oxidative stress, has been implicated in risk for preterm birth (PTB).

Objectives: This study aimed to determine the association of maternal Cu concentration during pregnancy with PTB risk and gestational duration in a large multicohort study including diverse populations.

Methods: Maternal plasma or serum samples of 10,449 singleton live births were obtained from 18 geographically diverse study cohorts. Maternal Cu concentrations were determined using inductively coupled plasma mass spectrometry. The associations of maternal Cu with PTB and gestational duration were analyzed using …

Delays In Chest Compressions During Ems Cpr: A Retrospective Review Of Cardiac Ultrasound Vs Carotid Views During Ohca, Himanshu Gupta, Ryan Richardson, Casey Patrick, James Seek, Nick Smith, Kevin Crocker, Josh Rasco, Robert Dickson

Gulf Coast Division Research Day 2024

No abstract provided.

Colon Adenocarcinoma Mimicking Acute Appendicitis In A 28-Year-Old, Bridget Kowalczyk, Edward Pingenot, Vivek Bansal

Gulf Coast Division Research Day 2024

No abstract provided.

Development And Validation Of A Novel Skin Pigment Scale, Christina Guo, Henry Lim, Christopher Wong, Christian Scheufele, Michael Carletti, Michele L. Mccarroll, Stephen Weis

North Texas Research Forum 2024

Background: Precise description of the skin is a pillar of dermatology. For dermatologists, skin pigment is akin to a ‘vital sign’ in that it represents a basic, yet illuminating, piece of information for each patient. The current method used to describe skin color is the Fitzpatrick scale. The Fitzpatrick scale was designed to measure skin burning and the scale is inadequate for precise measurement of skin color in a diverse population. The prevalence of its use perpetuates harmful and outdated structures and contributes to health disparity. For those reasons, there is a critical need for initiatives that evaluate the current …

Partial Anomalous Pulmonary Venous Return: To Fix Or Not To Fix?, Akshaj Pole, Jennifer Austin, Amnah Andrabi

North Texas Research Forum 2024

Patient is a 56-year-old male with a past medical history of type 2 diabetes, hypertension, prior MVA with chest trauma, and coronary artery disease with 2 prior stents in the obtuse marginal and right coronary artery who was brought to the ED for severe chest pain. Patient was immediately taken to the cath lab for cardiac intervention. Patient was identified to have 90-95% stenosis of his left circumflex but was unable to be stented due to tortuosity of the vessel and tight lesion. Due to patient’s multivessel coronary artery disease and newly diagnosed diabetes, patient was referred to cardiothoracic surgery …

Comparing Large Language Models Accuracy In Following Interval Surveillance Colonoscopy Guidelines, Olufemi Osikoya, Gregory Brennan

North Texas Research Forum 2024

Introduction: Providing pathology results and appropriate recommendations after resection of colon polyps is mandatory. Large language models (LLMs) such as ChatGPT and Google Bard, have shown promise in clinical workflows such as pathology results letters. We tested whether LLMs could provide appropriate surveillance recommendations based on current guidelines from the US multi-society task force for post-colonoscopy follow-up. Methods: Our aim was to compare the accuracy of ChatGPT 3.5, ChatGPT 4, and Google Bard in providing appropriate interval surveillance recommendations. An example prompt being “Write a patient pathology result letter after a colonoscopy with one tubular adenoma polyp (< 10mm) resected. Include recommendations for when the next surveillance colonoscopy should be completed.” Seventeen different post polypectomy surveillance queries and responses were analyzed (correct, partially correct, incorrect) compared to USMSTF guidelines. Results: When …

Disseminated Coccidioidomycosis Discovered Through Skin Biopsy In A Pregnant Patient From Mexico, Henry Lim, Christina Guo, Marshall Hall, Christian Scheufele, Christopher M. Wong

North Texas Research Forum 2024

Introduction: Coccidioidomycosis is an infection caused by the organism Coccidioides immitis, a fungus endemic to the southwestern United States, Mexico, Central and South America. The presentation of coccidioidomycosis can range from symptoms resembling a simple upper respiratory infection, such as cough, to more severe systemic symptoms including fever, malaise, and chills. Cutaneous lesions of coccidioidomycosis demonstrate a large heterogeneity of clinical manifestations but are significant as they may be the presenting sign of disseminated disease. While usually confined to the lungs, extrapulmonary coccidioidomycosis can occur in about 1 in 200 patients, most commonly associated with immunocompromised status. Pregnancy is an …

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen

North Texas Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …

Focused Assessment With Sonography Exams Vs Ct Scan, Anne Kresge, Charlotte Mueller, Briar Tures

Physician Assistant Capstones, 2020-current

Blunt trauma is a common reason patients present to the emergency department. Providers must evaluate these patients quickly to get them the correct treatment, especially for intra-abdominal bleeding. Focused assessment with sonography for trauma (FAST) exams are growing in use to evaluate trauma patients for free fluid in the abdomen. To be valuable to emergency providers, it must be known how FAST exams compare to the gold standard evaluation, computed tomography (CT) scans. Searches were done on Pubmed and Scopus databases using terms “focused assessment with sonography for trauma” and “FAST exam CT blunt abdominal trauma.” Limits were added to …

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

Variability In Provider Assessment Of Sepsis And Potential Of Host Response Technology To Address This Dilemma—Results Of An Online Delphi Study, Chadd K. Kraus, Hollis R. O’Neal, Nathan A. Ledeboer, Todd W. Rice, Wesley H. Self, Richard E. Rothman

School of Medicine Faculty Publications

Potentially septic patients have a huge clinical and economic impact on hospitals and often present to the emergency department (ED) with undifferentiated symptoms. The triage of these patients is complex and has historically relied heavily upon provider judgment. This study aims to evaluate the consistency of provider judgment and the potential of a new host response sepsis test to aid in the triage process. A modified Delphi study involving 26 participants from multiple specialties was conducted to evaluate provider agreement about sepsis risk and to test proposed actions based on the results of a sepsis test. The participants considered case …

Raman Spectroscopic Analysis Of Human Serum Samples Of Convalescing Covid-19 Positive Patients, Hugh Byrne, Naomi Jackson, Jaythoon Hassan

Articles

Rapid screening, detection and monitoring of viral infection is of critical importance, as exemplified by the rapid spread of SARS-CoV-2, leading to the worldwide pandemic of COVID-19. This is equally the case for the stages of patient convalescence as for the initial stages of infection, to understand the medium and long terms effects, as well as the efficacy of therapeutic interventions. Optical spectroscopic techniques potentially offer an alternative to currently employed techniques of screening for the presence, or the response to infection. In this study, the ability of Raman spectroscopy to distinguish between samples of the serum of convalescent COVID-19 …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Validity And Test-Retest Reliability Of A Digital Dynamic Visual Acuity Test Of Vestibular Function, Lydia F. Grunstra, Courtney D. Hall, Kara D. Stressman

Undergraduate Honors Theses

The vestibular system senses head motion and facilitates gaze stabilization, allowing for clear vision during movement. The vestibulo-ocular reflex (VOR) causes the eyes to move opposite head motion, thus maintaining focus on a target. Consequently, uncompensated loss of vestibular function leads to reduced VOR function resulting in dizziness, nausea, and visual disturbance. Different testing methods have been developed to measure VOR loss. These tests generally require bulky, expensive equipment, and must be performed by a trained examiner. A newly developed digital form of the dynamic visual acuity (DVA) test requires less equipment, is cost-effective, and may be performed at home …