Diseases Commons^™

Examining The Efficacy Of Treatments For Complex Regional Pain Syndrome, Michael Podcasy

Capstone Showcase

Complex Regional Pain Syndrome (CRPS) is a disease that affects the sensory, motor, sudomotor, vasomotor and trophic systems of patients. The pathophysiology is currently unknown and the diagnostic criteria that is used, the Budapest criteria, has its own shortcomings. This had led to hurdles in the research of the disease and well as a lack of high-quality studies on the efficacy of the many treatments currently being used to treat CRPS today. This poster explores those concepts.

Emerging Unconventional Therapies For Glioblastoma Multiforme, Danielle Morang

Capstone Showcase

Glioblastoma multiforme (GBM) is the most prevalent and aggressive primary malignant brain tumor occurring in adults with a median survival of less than two years. It is a highly invasive tumor characterized by genetic heterogeneity, angiogenesis, and rapid proliferation. Patients undergo a multimodal treatment regimen consisting of surgical resection and chemoradiation therapy, yet GBM tumors almost always recur with a worsening prognosis. The molecular and genetic complexities of GBM pose a significant challenge for developing effective therapeutics. Thus, it is imperative to identify new therapeutic targets and explore novel treatment strategies to improve patients’ overall survival time and quality of …

Delivery Of The Immune System: Understanding The Development Of The Human Immune System Based On Birth Mode, Sara Abbas

Faculty Curated Undergraduate Works

The creation of the immune system starts from the womb. The expecting mother plays an immense role outside of the genetic influence in developing a neonate’s immune system. The mode of birth has a substantial impact, as the neonate’s initial moments can have lasting impacts on the making of a proper immune system. A mother should have the choice in choosing between a vaginal birth or a cesarean section and this paper looks to provide aid in the decision process by contrasting the two modes in terms of immunological impact, especially as the rate of c-sections climb (1,2). The approach …

Considerations In The Management Of Juvenile Absence Epilepsy In Pregnancy And In Females Of Childbearing Age, Casey Brew

Capstone Showcase

JAE is an epilepsy syndrome that typically requires lifelong AED treatment, and valproic acid or lamotrigine is considered first line to manage the spectrum of associated seizures. In females with JAE who become pregnant, there exist risks both from having uncontrolled seizures and from taking AEDs during the pregnancy. Valproic acid carries the highest risks to the fetus but is the most effective in controlling the seizure types seen with JAE. Folic acid supplementation has shown to mitigate some but not all of the fetal risks from valproic acid. Limited guidance from professional organizations exists for management of females of …

High Energy Blue Light Induces Oxidative Stress And Retinal Cell Apoptosis, Jessica Malinsky

Capstone Showcase

Blue light (BL) is a high energy, short wavelength spanning 400 to 500 nm. Found in technological and environmental forms, BL has been shown to induce photochemical damage of the retina by reactive oxygen species (ROS) production. Excess ROS leads to oxidative stress, which disrupts retinal mitochondrial structure and function. As mitochondria amply occupy photoreceptors, they also contribute to oxidative stress due to their selectively significant absorption of BL at 400 to 500 nm. ROS generation that induces oxidative stress subsequently promotes retinal mitochondrial apoptosis. BL filtering and preventative mechanisms have been suggested to improve or repair BL-induced retinal damage, …

Non-Pharmaceutical Symptom Management In Patients With Pcos, Allison Stern

Capstone Showcase

Polycystic Ovarian Syndrome (PCOS) is a relatively common diagnosis among biological females. There are many variations of presentations among patients with PCOS that require an individualized and tailored treatment plan for symptom management. Although there are pharmaceutical medications that can be used for PCOS symptoms, some patients’ symptoms might not be fully managed, or they might prefer to focus on non-pharmaceutical options for their symptoms instead. Therefore, it is important for clinicians to be familiar with alternatives to the mainstay of pharmaceutical treatment.

Acute Otitis Media: Management And Recurrence In The Pediatric Population, Sydney Klaiman

Capstone Showcase

Acute otitis media (AOM) is one the the most common condition that affects the pediatric population. AOM place burden on affected children, caregivers, the healthcare system, and also contributes to antibiotic resistance. In many cases, AOM is not just a one-time occurrence and is the most common reason that kids receive oral antibiotics and undergo surgery. Relative to the number of articles available, there is a large gap in the research that does not thoroughly address recurrent AOM (rAOM) and the importance of its management and prevention. Therefore, the goal of this poster is to discuss different modalities used to …

Vitamin D Enhanced Vitamin D Receptor (Vdr) Inhibition Of Nlrp3 Inflammasome Activation Can Attenuate The Development Of Autoimmune Thyroiditis, Alexzon Mandac

Capstone Showcase

Autoimmune Thyroiditis (AIT) is a prevalent autoimmune disease affecting approximately 2% of the population. Characterized by the gradual loss of thyroid function through an autoimmune attack on the thyroid gland, the disease manifests symptoms that negatively affect one’s quality of life. The mechanisms behind the disease’s pathophysiology are not fully understood; however, researchers are examining the involvement of the NLRP3 inflammasome in the disease. This thesis will address the question of whether Vitamin D can act as an inhibitor of the NLRP3 inflammasome and attenuate the progression of AIT in mouse model. Current investigations explore the effects of NLRP3 inhibition …

Treatment Of Hypothyroidism: Desiccated Thyroid Extract, Aimee Fong

Capstone Showcase

The treatment of hypothyroidism with Levothyroxine (T4) has been well studied and FDA approved. However, many patients continue to have signs and symptoms of hypothyroidism while on Levothyroxine treatment despite reaching appropriate thyroid levels. An additional thyroid treatment known as desiccated thyroid extract (DTE) is made from dried pig thyroid glands and is advertised as a “natural” alternative to Levothyroxine. Despite lack of FDA approval and studies surrounding DTE, clinicians have prescribed DTE to patients, many of whom reported relief of their symptoms. The following poster highlights the approach to the treatment of hypothyroidism with Levothyroxine and DTE and outlines …

Continuing Medical Education On Immunothombosis In Sepsis, Vivienne Van Nguyen

Capstone Showcase

In the past decades, the incidence of sepsis complicated by immunothrombosis has increased in critically ill patients, especially those with sepsis and septic shock. Despite intensive surveillance and prevention of the underlying causes, these disease syndromes are frequently fatal. The increased incidence of immunothrombosis in sepsis has been accompanied by many critical issues and concerns regarding current diagnostic and treatment protocols. This paper offers a concise critical assessment of the current state of knowledge about sepsis and immunothrombosis among clinicians in the ICU as well as problem concerning the recognition of sepsis and immunothrombosis and their management.

Management Of Adult Growth Hormone Deficiency Related To Hypopituitarism, Kellie Jamin

Capstone Showcase

The treatment of growth hormone deficiency (GHD) is well-established in childhood but less understood in adults, given the more complex role that growth hormone (GH) assumes in this population. Decreased functionality of the pituitary gland, otherwise known as hypopituitarism, can present with an isolated GHD in adulthood, which may result from a number of factors including neoplasm, ischemia, infection, traumatic injury, or systemic disease. Adult GHD may be definitively diagnosed with a stimulation test, the insulin tolerance test (ITT) being the study of choice. With a positive ITT, the disorder can be treated with growth hormone replacement therapy (GHRT), which …

Complex Regional Pain Syndrome: Not A Catch-All, Amanda Shulski

Capstone Showcase

Complex Regional Pain Syndrome (CRPS) is prolonged and disproportionate neuropathic pain and inflammation which presents after surgery, fracture, or trauma to a limb. This phenomenon has been recognized in the literature since the civil war but the pathophysiology has only become clear over the last 20 years. There are no diagnostic tests for CRPS and it is a relatively rare condition with only about 20 cases in 100,000 people per year. CRPS is then under-recognized by some providers but over-diagnosed by others. Occasionally, providers use CRPS as a catch-all for unexplained pain rather than a recognized condition with specific diagnostic …

Cme: Ischemic Stroke Recognition And Management, Mae Missana

Capstone Showcase

Stroke is defined as a sudden onset of neurologic deficit caused by interrupted blood flow. Stroke is divided into two subtypes: ischemic and hemorrhagic. Roughly 87% of all strokes are ischemic with infarcts caused by obstruction to carotid artery circulation or vertebrobasilar artery circulation. Symptoms of ischemic and hemorrhagic stroke are similar on physical exam;therefore use of imaging is essential to determine treatment pathway. Asstroke is one of the leading causes of death in the United States, it is important to recognize the signs and symptoms, employ the necessary tools to evaluate and identity stroke, and deliver timely treatment to …

The Safety Of Covid-19 Vaccines In Pregnancy, Lauren Zacharias

Capstone Showcase

SARS-CoV-2 has caused over 800,000 deaths in the United States since it was first detected here in 2020. Despite there being 3 available COVID-19 vaccines in the US, and recommendations by the CDC and countless other public health agencies that any potential risks are outweighed by the benefit of the vaccines, only 31% of pregnant women in the US are vaccinated against COVID-19 due to unfounded claims by an anti-vaccination movement that COVID mRNA vaccines cause infertility. This presentation explores where these claims originated, why they are untrue, the risks of COVID-19 infections in pregnancy, and the potential benefits of …

Non-Pharmacological Management Of Idiopathic/Persistent Dyspareunia, Iveshia Ford

Capstone Showcase

Painful sexual intercourse, or dyspareunia, is a condition numerous women experience. An unknown, but still important, number of those affected find no relief with medication or surgery. Yet, it can be difficult for patients to discuss concerns with their provider. In addition, many providers do not have an adequate comfort level to discuss such topics. This paper aims to equip providers with non-pharmacological treatment options which include pelvic floor physical therapy, sex therapy and lifestyle changes. With the cultural shifts and changing ideas of sexuality in today’s age, it is important that clinicians remain versed in sexual health and patient …

A Case Of Protein Losing Enteropathy After Fontan Operation, Gina Kim

Capstone Showcase

Protein Losing Enteropathy (PLE) is a condition in which an excessive amount of proteins are lost through the gastrointestinal tract leading to hypoproteinemia and manifesting as edema, ascites, and diarrhea. While in most cases PLE is a treatable disorder with good outcomes, the morbidity and mortality of the disorder is significantly elevated in patients with a history of Fontan surgery–an operation used to palliate patients born with a single ventricle by rerouting venous blood return directly to pulmonary circulation. After failure of first-line therapeutics of diuretics and steroids, this case study explores the successful treatment of a 5-year-old patient with …

The Benefit Of Bdnf Modification In The Treatment Of Post-Stroke Depression, Christine Gordynskiy-Ageyev

Capstone Showcase

Neuroplasticity has been a rapidly expanding area of research, and its findings have elucidated the potential of taking advantage of some of its components for the treatment of various neural pathologies. Stroke is the most common cause of long-term disability, and it is a disease process that affects many people. There are many rehabilitation programs that seek to restore a patient’s motor and cognitive functions after stroke; if not fully, then at least partially. Unfortunately, mental health changes contribute in large part to the overall disability of a patient, but these changes are not always targeted in these programs. In …

Vulvodynia: Making The Diagnosis And Improving Treatment Outcomes, Sophia Campbell

Capstone Showcase

Vulvodynia is an underdiagnosed condition that affects about 25% of women1. Patients report frustration and a lack of knowledge in the medical community regarding their symptoms of vulvar pain. Painful penetration makes performing an internal pelvic exam difficult, and patients may avoid annual gynecological appointments due to fear. It is imperative for providers to understand and implement the correct approach for accurate diagnosis. Once the diagnosis of vulvodynia has been identified, the multimodal treatment plan should be implemented to include pharmacological therapy, referral to physical therapy, and psychotherapy. With continued research and the use of evidence-based practice, the gap in …

Case Report: Fournier's Gangrene, Abigail Groos

Capstone Showcase

•Fournier’s gangrene is a rare manifestation of the already sparse skin infection known as necrotizing fasciitis, specifically of the scrotal and perineal region. This case illustrates a patient in the emergency department with a severe necrotizing skin infection who quickly progressed to sepsis and multiorgan damage. It is important to understand the common presentation, complications, and ideal management of patients with necrotizing fasciitis.

The Clinician’S Approach To Primary Dysmenorrhea: Nutrient And Supplement Modifications, Rachel Albert

Capstone Showcase

As evidence-based practice on health topics and standards continually evolves, it remains the responsibility of the clinicians to seek out data and newly discovered information that may pertain to patient populations. A longstanding issue that clinicians must address is the approach to primary dysmenorrhea. Currently it is estimated that 50% to 90% of the female population in the reproductive age group experiences this condition, making it the most prevalent health related problem among women of these ages. While this number represents a wide range of the population, many women still accept the symptoms of dysmenorrhea as commonplace and therefore do …

Non-Pharmacological Management Of Idiopathic/Persistent Dyspareunia, Iveshia Ford

Capstone Showcase

Painful sexual intercourse, or dyspareunia, is a condition numerous women experience. An unknown, but still important, number of those affected find no relief with medication or surgery. Yet, it can be difficult for patients to discuss concerns with their provider. In addition, many providers do not have an adequate comfort level to discuss such topics. This paper aims to equip providers with non-pharmacological treatment options which include pelvic floor physical therapy, sex therapy and lifestyle changes. With the cultural shifts and changing ideas of sexuality in today’s age, it is important that clinicians remain versed in sexual health and patient …

Primary Aortic Valve Replacement In Adults From Age 45 To 65 And How Their Survivability, Post Replacement, May Be Affected By Opting For A Bioprosthetic Or Mechanical Valve., Chandler Hutchinson

Capstone Showcase

Abstract:

Introduction: Aortic valve replacement in middle-aged adults is a procedure done when the aortic valve becomes so incompetent, that replacement is the only viable option for the patient. A bioprosthetic or a mechanical valve is then chosen and replaces the patients’ native aortic valve. For these adults, this procedure is life-extending and the only option for prolonged survival. This paper will address whether a bioprosthetic or mechanical valve would be the better option for prolonging a middle-aged patients’ life.

Methods: A literature search was completed in November of 2019 using PubMed and Google Scholar. Seven articles were chosen based …

Management Of Refractory Ventricular Fibrillation With Double Sequential Defibrillation, Kaitlyn A. Brown

Capstone Showcase

Patients experiencing cardiac arrest are treated according to ACLS protocols, however current protocols lack recommendations for the treatment of refractory Ventricular Fibrillation which persists after more than 3 cycles of CPR and defibrillation. One potential intervention for these cases that is being researched is the use of simultaneous or sequential activation of two defibrillators. This literature review analyzed the results of several studies to determine if double sequential defibrillation (DSD) is a viable treatment to achieve return of spontaneous circulation (ROSC) and improved patient survival. The results of the studies were mixed with some showing positive outcomes, and others showing …

Therapeutical Studies Of The Disrupted Cftr Gene In Affected Sheep And Rabbit Models Produced By Genome Editor Crispr/Cas9, Nicole Teberio

Capstone Showcase

Cystic Fibrosis (CF) is a life-threatening, autosomal recessive disorder caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. Patients with CF have a decreased lifespan due to complications with lung infections/disease, decreased airway function, and persistent cough with phlegm. Over the past few decades, scientists have contributed to CF research by using animal models to understand the pathology of the disease. The models selected have similar pathogenesis to humans, so they are key insights for understanding the effects of CFTR gene malfunctions. More recently, animal models, such as CRISPR generated sheep and rabbits used in the two current …

Comparing Melatonin Use To Bright Light Therapy In Mitigating Cardiovascular Effects Due To Shift Work Disorder In Shift Working Adults, Alexandra Hirt

Capstone Showcase

Introduction: Circadian Misalignment is a term used to describe a mismatch in one’s physiologically determined sleep patters and their actual sleep wake behaviors. Shift workers often end up in a vicious cycle of being in a state of chronic circadian misalignment, which then can lead to health problems, extreme fatigue, and insomnia, known as Shift Work Disorder (SWD).This has been studied in night shift workers who, when compared to daytime workers, have an increased risk of developing metabolic syndrome, type 2 diabetes, and coronary heart disease.These results are not dependent on any behavioral risk factors, such as smoking and poor …

The Efficacy Of Mirnas As A Diagnostic Tool For Endometriosis, Maura Franey

Capstone Showcase

Abstract

Introduction: Endometriosis is a chronic inflammatory gynecological condition. Laparoscopic abdominopelvic exploration is the gold standard of diagnosis, but is not performed until patients experience severe symptoms. This review analyzes the levels of circulating micro-RNAs (miRNAs) (I) for diagnosis of endometriosis (O) in women diagnosed with endometriosis (P) compared to laparoscopic exploration (C).

Methods: A literature search was conducted through PubMed and Cochrane Library in November 2019. A total of nine articles consisting of case-control or systematic reviews were selected based on publication date, main outcome, and the use of miRNAs or laparoscopy for diagnosis of endometriosis.

Results: The eight …

Land-Based Exercise Versus Hydrotherapy In Osteoarthritis, Alyson Rivers

Capstone Showcase

Introduction: Osteoarthritis is the most common form of arthritis. It results in joint pain, stiffness, reduced mobility, and decreased quality of life. While NSAIDs are the cornerstone of treatment, exercise is one of the safest and least expensive treatments. Exercise can be completed on land or in water. Hydrotherapy is hypothesized to produce more beneficial outcomes compared to land-based exercise.

Methods: The database, PubMed, was used to acquire articles that compare hydrotherapy to land-based therapy in individuals with large-joint OA. Outcomes of interest included pain relief, joint mobility, and quality of life.

Results: Based collectively on four articles, there was …

Efficacy Of Anti-Mullerian Hormone In The Diagnosis Of Polycystic Ovarian Syndrome, Cassidy Prewitt

Capstone Showcase

Introduction: Polycystic ovarian syndrome (PCOS) is a complex condition that presents with a wide variety of symptoms. The PCOS diagnosis standard is the Rotterdam criteria, which includes hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology (PCOM). Transvaginal ultrasounds have traditionally been used to evaluate PCOM, however, they are highly dependent on technician skill. This paper will evaluate research regarding the use of anti-Mullerian (AMH) in PCOS diagnosis as an alternative to transvaginal ultrasound.

Methods: A literature search was conducted using PubMed and Academic Search Ultimate in January 2020. A total of eight articles were selected based on relevance to the research topic …

Biometric Prognosticators Of Future Myocardial Infarction: Bmi Vs. Waist To Hip Ratio, Christopher Hover

Capstone Showcase

Introduction: Myocardial Infarction (MI), better known as a heart attack, occurs when one or more of the coronary arteries becomes blocked or clogged to the point of being unable to perfuse myocardial tissue. Standard biometric measurements when visiting an outpatient care provider include height and weight which are converted into body mass index (BMI). BMI can sometimes be misleading in judging future health outcomes such as heart attacks. Therefore, this review analyzes the use of waist to hip ratio (I) to predict future myocardial infarctions (P) subsequently to prevent such events (O) compared to the traditionally used metric of BMI …

Efficacy Of Sublingual Immunotherapy In The Treatment Of House-Dust Mite Induced Allergic Rhinitis, Sirena Saleet

Capstone Showcase

Introduction: House-dust mite (HDM) induced allergic rhinitis (AR) is a chronic condition associated with rhinorrhea, nasal obstruction, nasal pruritus and sneezing. The current mainstay of treatment is intranasal corticosteroids, which have shown variable degrees of symptom control among patients. Chronic use is typically required to achieve continued relief. Immunotherapy works to increase peripheral immune tolerance by administration of the allergen itself. Not only does it have the potential to decrease acute symptoms of allergic rhinitis, but it is also the sole treatment offering disease-modifying potential with long-term use. Immunotherapy is an option which can eliminate both the chronic administration …