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Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley 2017 Aurora Health Care

Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley

Aurora Electrophysiology Fellows

Background: Catheter ablation of the cavotricuspid isthmus (CTI) is traditionally performed using fluoroscopy and electroanatomical mapping systems. Zero-fluoroscopy approaches have recently been studied, mostly using the EnSite® mapping system (St. Jude Medical Inc., St. Paul, MN). We studied the feasibility and efficacy of zero-fluoroscopic mapping and ablation of the CTI using the Carto® 3 system (Biosense Webster Inc., South Diamond Bar, CA).

Purpose: To evaluate the efficacy and safety of a zero-fluoroscopic approach to CTI ablation.

Methods: We included 9 patients with typical atrial flutter for whom mapping and ablation of the CTI was done using Carto mapping as the ...


Precision Study Of Stochastic Predictors For Dxa Scans, Raul Ramos 2016 University of Texas at Tyler

Precision Study Of Stochastic Predictors For Dxa Scans, Raul Ramos

Health and Kinesiology Theses

In this study, the in vivo reproducibility of stochastic predictors and BMD values from Dual- Energy X-ray Absorptiometry (DXA) were assessed at two different anatomic sites: hip and spine. Measurement of bone mineral density (BMD) derived from DXA has been widely used as a diagnostic tool for osteoporosis. BMD has been used as a representative value for bone strength and fracture risk, but only represents a part of both. In order to better understand fracture risk, the use of grayscale images from DXA scans has been implemented in enhancing the prediction of bone strength and fracture risk. The use of ...


Noise: Its Impact In The Operating Room, Brennon Wesley Sloan 2016 University of Southern Mississippi

Noise: Its Impact In The Operating Room, Brennon Wesley Sloan

Doctoral Nursing Capstone Projects

Orthopedic and neurologic cases routinely reach noise levels exceeding 120 decibels (Katz, 2014). Modern equipment and monitors used by anesthesia personnel only reach 85 decibels (Katz, 2014). These monitors can go undetected during peak noise levels creating a serious safety concern for patients that could lead to patient injury or death (Gawande, Zinner, Studdert, & Brennan, 2003). A clinical question was developed to determine if the education of noise levels in the operating room affects change in practice. For operating room managers and staff, does education of noise levels in the operating room compared to no education initiate a change in ...


A Multi-Channel 3d-Printed Bioreactor For Evaluation Of Growth And Production In The Microalga Dunaliella Sp, Cristian A. Cox Mr 2016 University of Maine

A Multi-Channel 3d-Printed Bioreactor For Evaluation Of Growth And Production In The Microalga Dunaliella Sp, Cristian A. Cox Mr

Electronic Theses and Dissertations

We explored the capabilities of additive manufacturing using a photo-cured jetted material 3D printer to manufacture a milli-microfluidic device with direct application in microalgae Dunaliella sp growth and intracellular compounds biosynthesis tests. A continuous microbioreactor for microalgae culture was CAD designed and successfully built in 1 hour and 49 minutes using black photopolymer cured by UV and a support material. The microreactor was made up of 2 parts including the bioreactor itself and a microchannel network for culture media fluids and microalgae. Both parts were assembled to form a single unit. Additional optical and auxiliar components were added. An external ...


Methylphenidate And Memory And Attention Adaptation Training For Persistent Cognitive Symptoms After Traumatic Brain Injury: A Randomized, Placebo-Controlled Trial, Brenna C. McDonald, Laura A. Flashman, David B. Arciniegas, Robert J. Ferguson, Li Xing, Jaroslaw Harezlak, Gwen C. Sprehn, Flora M. Hammond, Arthur C. Maerlender, Carrie L. Kruck, Karen L. Gillock, Kim Frey, Rachel N. Wall, Andrew J. Saykin, Thomas W. McAllister 2016 Indiana University School of Medicine

Methylphenidate And Memory And Attention Adaptation Training For Persistent Cognitive Symptoms After Traumatic Brain Injury: A Randomized, Placebo-Controlled Trial, Brenna C. Mcdonald, Laura A. Flashman, David B. Arciniegas, Robert J. Ferguson, Li Xing, Jaroslaw Harezlak, Gwen C. Sprehn, Flora M. Hammond, Arthur C. Maerlender, Carrie L. Kruck, Karen L. Gillock, Kim Frey, Rachel N. Wall, Andrew J. Saykin, Thomas W. Mcallister

Center for Brain, Biology and Behavior: Papers & Publications

The purpose of this multicenter, prospective, randomized, placebo-controlled study was to evaluate and compare the efficacy of two cognitive rehabilitation interventions (Memory and Attention Adaptation Training (MAAT) and Attention Builders Training (ABT)), with and without pharmacologic enhancement (i.e., with methylphenidate (MPH) or placebo), for treating persistent cognitive problems after traumatic brain injury (TBI). Adults with a history of TBI at least four months prior to study enrollment with either objective cognitive deficits or subjective cognitive complaints were randomized to receive MPH or placebo and MAAT or ABT, yielding four treatment combinations: MAAT/MPH (N=17), ABT/MPH (N=19 ...


Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley 2016 Aurora Health Care

Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley

Journal of Patient-Centered Research and Reviews

Background: Catheter ablation of the cavotricuspid isthmus (CTI) is traditionally performed using fluoroscopy and electroanatomical mapping systems. Zero-fluoroscopy approaches have recently been studied, mostly using the EnSite® mapping system (St. Jude Medical Inc., St. Paul, MN). We studied the feasibility and efficacy of zero-fluoroscopic mapping and ablation of the CTI using the Carto® 3 system (Biosense Webster Inc., South Diamond Bar, CA).

Purpose: To evaluate the efficacy and safety of a zero-fluoroscopic approach to CTI ablation.

Methods: We included 9 patients with typical atrial flutter for whom mapping and ablation of the CTI was done using Carto mapping as the ...


Endoscopic Ultrasound Guided Drainage Of Peri-Rectal Collections: A Salvage Approach, Yana Cavanagh, Kevin Hosein, Nihar Shah, Edward Milman, Sohail N. Shaikh 2016 Trinitas Regional Medical Center

Endoscopic Ultrasound Guided Drainage Of Peri-Rectal Collections: A Salvage Approach, Yana Cavanagh, Kevin Hosein, Nihar Shah, Edward Milman, Sohail N. Shaikh

Nihar Shah

Abdominal and pelvic abscesses can occur as a consequence of surgery and are associated with significant morbidity and mortality. It is well accepted that the primary treatment is antibiotic therapy and minimally invasive drainage. Surgical measures are typically reserved for patients with luminal perforations or those who do not respond to conservative measures. Previously available modalities of drainage involved percutaneous and computed tomography guided access. Recently, endoscopic ultrasound guided aspiration has emerged as a safe alternative for management of intra-abdominal abscesses. Since its first application for peripancreatic drainage, endoscopic ultrasound techniques and technologies have significantly evolved. Endoscopic ultrasound interventions can ...


A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, MD, Grant S. Buchanan, MD, Franklin D. Shuler, MD, PhD 2016 Marshall University, Joan C. Edwards School of Medicine

A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, Md, Grant S. Buchanan, Md, Franklin D. Shuler, Md, Phd

Franklin D. Shuler

Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from Pubmed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors ...


Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani 2016 Marshall University school of Medicine

Retrograde Pedal Access For Revascularization Of Infrapopliteal Arterial Occlusive Disease In Critical Limb Ischemia (Cli) Patients As A Primary Approach., Ahmed Amro, Alaa Gabi, Shahed Elhamdani, Haytham Aljoudi, Mehiar El-Hamdani

Marshall Journal of Medicine

Introduction:

We are presenting three cases (out of similar several cases) where tibio-pedal approach was performed as an initial primary approach for limb salvage in patients with CLI secondary to Infra-popliteal (IP) disease. We consider this approach to be a necessary evolution in endovascular intervention.

Discussion:

Retrograde pedal access is safe, feasible with high technical success rate and a relatively low procedural complication rate, with low 30 days mortality and low rate of major adverse cardiac events. Freedom from major adverse limb events and limb salvage are both high at 1 year follow up. It allows quick therapy and short ...


The Physiological Responses To Cycling Stress., Moriah Larsen 2016 Northern Arizona University

The Physiological Responses To Cycling Stress., Moriah Larsen

Skyline - The Big Sky Undergraduate Journal

Background: As the intensity of exercise increases, the risk of incidences for exertional heat illness (EHI) continues to climb. The National Athletic Trainers Association (NATA) has set an official position statement; stating a “gold standard” for obtaining core body temperature is via rectal thermometry. It has been reported that other field-expedient methods of obtaining core body temperature (oral, axillary, tympanic, temporal) are invalid or unreliable sources after intense exercise in hot temperature regions. Purpose: To determine if a relationship exists between rectal temperature measurements and tympanic temperature measurements during intensive long bouts of exercise. Design: Controlled Laboratory Study. Setting: Human ...


Characterization And Personalization Of Botulinum Toxin Type A Therapy For Upper Limb Tremor In Parkinson Disease And Essential Tremor Patients Using Multi-Sensor Kinematic Technology, Olivia Samotus 2016 The University of Western Ontario

Characterization And Personalization Of Botulinum Toxin Type A Therapy For Upper Limb Tremor In Parkinson Disease And Essential Tremor Patients Using Multi-Sensor Kinematic Technology, Olivia Samotus

Electronic Thesis and Dissertation Repository

Tremor commonly affects the upper extremities in essential tremor (ET) and Parkinson disease (PD) patients where many experience functional disability and ultimately seek therapy. As ET and PD tremor features overlap and clinical assessment is challenging due to its highly complex nature, misdiagnosis is common resulting in unsuitable therapies and prognosis. Current treatment options for ET and PD tremor include pharmacotherapy, focal therapy with botulinum toxin type A (BoNT-A) injections, and surgical interventions which provide modest relief of tremor. However, such therapies are commonly associated with significant adverse events and lack long-term efficacy and tolerability. Hence lack of standardized, objective ...


Effect Of Taste Stimuli On Swallowing Function In Persons With Traumatic Injuries, Megan Asselin, Angela M. Dietsch 2016 University of Nebraska-Lincoln

Effect Of Taste Stimuli On Swallowing Function In Persons With Traumatic Injuries, Megan Asselin, Angela M. Dietsch

UCARE Research Products

Background

Swallowing disorders are prevalent and costly. As of now, there are limited therapeutic options available to treat them. Extant research in limited populations has suggested that swallowing mechanics can be improved by extremely sour liquids, but this has not been tested in traumatically injured populations. However, sour tastants are unpleasant, and more palatable taste mixtures have not been tested.

Methods

The quantitative data were extracted from an existing pool of de-identified video fluoroscopic swallowing studies (moving radiographs) obtained from traumatically injured young adults under another research protocol. Each participant completed swallows of custom-mixed plain, sour, and sweet-sour boluses. Positions ...


A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, MD, Grant S. Buchanan, MD, Franklin D. Shuler, MD, PhD 2016 Marshall University, Joan C. Edwards School of Medicine

A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, Md, Grant S. Buchanan, Md, Franklin D. Shuler, Md, Phd

Marshall Journal of Medicine

Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from Pubmed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors ...


Developing A Data Repository Of Standard Concussion Assessment Clinical Data For Research Involving College Athletes, Arthur C. Maerlender, Jennifer Mize Nelson, Julie A. Honaker 2016 University of Nebraska-Lincoln

Developing A Data Repository Of Standard Concussion Assessment Clinical Data For Research Involving College Athletes, Arthur C. Maerlender, Jennifer Mize Nelson, Julie A. Honaker

Center for Brain, Biology and Behavior: Papers & Publications

In sports concussion research, obtaining quality data from a sufficient number of participants to reach statistical power has been a particular problem. In addition, the necessary requirements of accessibility, informed consent, and confidentiality must be met. There is need to develop more efficient and controlled methods for collecting data to answer research questions in this realm, but the ability to collect and store these data in an efficient manner at the local level is limited. By virtue of their training, neuropsychologists can play a key role in improving data collection quality. The purpose of this paper is to describe a ...


Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri 2016 Aurora Health Care

Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri

Indrajit Choudhuri

Background: Electrocardiography (ECG) QT interval (QTI) prolongation independently predicts sudden death. Hospitalized patients are commonly exposed to multiple QT-prolonging drugs, and manual measurement of ECG QTI based on identifying the intersection of isoelectricity with the tangent to the terminal phase T-wave slope (QTTTT) is advocated due to inaccuracies in automated detection algorithms that may imprecisely identify QT duration.

Purpose: We evaluated the performance of QTTTT compared to a standard automated (12SL, GE Healthcare) method (QT-12SL).

Methods: Consecutively obtained ECGs of 250 hospitalized patients were reviewed. The QTI in leads II, aVR, V5 and V6 determined by QT-12SL and QTTTT were ...


Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan 2016 Aurora Research Institute, Aurora Health Care

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Omar M. Cheema, MD

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We ...


1st Place: The Effectiveness Of Yoga Therapy On An Adult, Post-Stroke Population: A Systematic Review (Final Research Paper), Baylor E. Hogan 2016 Chapman University

1st Place: The Effectiveness Of Yoga Therapy On An Adult, Post-Stroke Population: A Systematic Review (Final Research Paper), Baylor E. Hogan

Kevin and Tam Ross Undergraduate Research Prize

Objectives: The objectives of this paper are to (1) give a brief overview of stroke pathophysiology (2) outline yoga as a therapeutic strategy (3) present the current research on yoga rehabilitation for stroke (4) discuss the efficacy of yoga for chronic stroke.

Methods: Relevant terms were searched in PubMed, Web of Science, Academic OneFile, ScienceDirect, and Google Scholar electronic databases. Studies were excluded if they contained pediatric stroke, non-stroke neurological diseases, or subjects with comorbidities. Statistically significant data was extracted for the primary measures of nine trials.

Results: Four studies measured statistically significant outcomes (p<0.05). These included improvements in balance, independence, endurance, trait anxiety, fear of falling, self-efficacy, pain, strength, range of motion (ROM), activity, participation, and quality of life (QoL). Discussion: Lack of statistical significance in post-stroke depression (PSD) measures may be due to inadequate intervention length or a psychosocial cause of depression. Improvements in balance, flexibility, and strength from yoga participation permitted progress in disability and functionality. Finally, overall health-related quality of life (HRQL) is affected by the severity of mental disorders and physical disability. Yoga can have a positive effect in both domains and therefore, may improve HRQL.

Conclusion: Preliminary evidence suggests the ...


Reliability Of Clinical Evaluators Of Spasticity In Patients With Stroke, Tiffany Alvino, Shiney David, Chelsea Gendvil 2016 Graduate Center, City University of New York

Reliability Of Clinical Evaluators Of Spasticity In Patients With Stroke, Tiffany Alvino, Shiney David, Chelsea Gendvil

All Graduate Works by Year: Dissertations, Theses, and Capstone Projects

Spasticity is characterized by hyperexcitable stretch reflexes with amplitude increases in response to velocity dependent passive movement and resistance. Spasticity is the result of abnormal function of segmental and suprasegmental neuronal circuits. The objective of this study was to determine any positive correlation between three clinical evaluators of spasticity (i.e., the pendulum test, the patellar tendon tap test (PTT), and the Modified Ashworth scale) in their reliability to assess spasticity in people post-stroke. It was hypothesized that the use of force movement sensors along with surface electromyography increases the reliability of the standardized clinical tests. The results show that ...


Estimating The Impact Of Lost To Follow-Up On Breast Cancer Patients' Five-Year Disease-Free Survival, Megan Whitworth 2016 California Polytechnic State University, San Luis Obispo

Estimating The Impact Of Lost To Follow-Up On Breast Cancer Patients' Five-Year Disease-Free Survival, Megan Whitworth

Statistics

Abstract

Background Nationally, the 5-year survival rate for patients with breast cancer is relatively higher than patients diagnosed with other types of cancer. In addition to the higher survival rates, breast cancer patients also tend to have increased rates of lost to follow-up as compared to other cancers. When a patient becomes lost, the occurrence of distant metastasis cannot be reliably ascertained, unless the patient had a breast cancer-specific death. As a consequence of the missing information from lost patients, results from statistical analyses that contain lost patients may not adequately reflect the actual recurrence and disease-free survival rates. The ...


Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu 2016 Chapman University

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review ...


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