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Session D-2: Don’T Overdose The Patient: A Unit Conversion Literacy Project, Gary M. Baker, David Anim-Addo, Patrick Young 2017 Northern Illinois University

Session D-2: Don’T Overdose The Patient: A Unit Conversion Literacy Project, Gary M. Baker, David Anim-Addo, Patrick Young

Professional Learning Day

General chemistry for non-science majors is often a prerequisite course for students pursuing degree programs in allied health fields, such as nursing. A core nursing skill is medicine management, which includes correctly calculating drug dosage volumes administered by I.V. or injection. Such calculations are nothing more than general chemistry problems involving concentration units and dilution. Our data show, however, that more than 90% of students lack this skill after taking a traditional general chemistry course. This presentation will focus on documenting this curricular gap and how we, as teachers, can address it.


Effect Of Immediate Initiation Of Antiretroviral Therapy On Risk Of Severe Bacterial Infections In Hiv-Positive People With Cd4 Cell Counts Of More Than 500 Cells Per Μl: Secondary Outcome Results From A Randomised Controlled Trial., Jemma O'Connor, Michael J Vjecha, Andrew N Phillips, Brian Angus, David Cooper, Fred Gordin, +several additional authors 2017 George Washington University

Effect Of Immediate Initiation Of Antiretroviral Therapy On Risk Of Severe Bacterial Infections In Hiv-Positive People With Cd4 Cell Counts Of More Than 500 Cells Per Μl: Secondary Outcome Results From A Randomised Controlled Trial., Jemma O'Connor, Michael J Vjecha, Andrew N Phillips, Brian Angus, David Cooper, Fred Gordin, +Several Additional Authors

Medicine Faculty Publications

BACKGROUND: The effects of antiretroviral therapy on risk of severe bacterial infections in people with high CD4 cell counts have not been well described. In this study, we aimed to quantify the effects of immediate versus deferred ART on the risk of severe bacterial infection in people with high CD4 cell counts in a preplanned analysis of the START trial.

METHODS: The START trial was a randomised controlled trial in ART-naive HIV-positive patients with CD4 cell count of more than 500 cells per μL assigned to immediate ART or deferral until their CD4 cell counts were lower than 350 cells ...


Risk Of Gastrointestinal Bleeding Among Dabigatran Users – A Self Controlled Case Series Analysis, Wenze Tang, Hsien-Yen Chang, Meijia Zhou, Sonal Singh 2017 George Washington University

Risk Of Gastrointestinal Bleeding Among Dabigatran Users – A Self Controlled Case Series Analysis, Wenze Tang, Hsien-Yen Chang, Meijia Zhou, Sonal Singh

Epidemiology and Biostatistics Faculty Publications

This article aims to evaluate the real world risk of gastrointestinal bleeding among users naïve to dabigatran. We adopted a self-controlled case series design. We sampled 1215 eligible adult participants who were continuous insured users between July 1, 2010 and March 31, 2012 with use of dabigatran and at least one gastrointestinal bleeding episode. We used a conditional Poisson regression to estimate incidence rate ratios. The population consisted of 64.69% of male and 60.25% patients equal to or greater than age 65 at start of observation. After adjustment for time-variant confounders, the incidence rate of gastrointestinal bleeding was ...


Unmasking Of Myoclonus By Lacosamide In Generalized Epilepsy, Daniel Birnbaum, Mohamad Z. Koubeissi 2017 George Washington University

Unmasking Of Myoclonus By Lacosamide In Generalized Epilepsy, Daniel Birnbaum, Mohamad Z. Koubeissi

Neurology Faculty Publications

Lacosamide is a new-generation antiseizure medication that is approved for use as an adjunctive treatment and monotherapy in focal epilepsy. Its use in generalized epilepsy, however, has not been adequately evaluated in controlled trials. We report a 67-year-old woman who experienced new-onset myoclonic seizures after initiation of lacosamide. We presume that she had an undiagnosed generalized epilepsy syndrome, likely juvenile myoclonic epilepsy. Myoclonic seizures were not reported before introducing lacosamide and completely resolved after lacosamide was discontinued. This suggests that lacosamide may have the potential to worsen myoclonus, similar to what has been reported with another sodium channel agent, lamotrigine ...


Characterization Of Physicochemical And Thermal Properties Of Biofield Treated Ethyl Cellulose And Methyl Cellulose, Mahendra Trivedi 2016 Trivedi Global Inc.

Characterization Of Physicochemical And Thermal Properties Of Biofield Treated Ethyl Cellulose And Methyl Cellulose, Mahendra Trivedi

Mahendra Kumar Trivedi

Cellulose and its derivatives are used as potential matrices for biomaterials and tissue engineering applications. The objective of present research was to investigate the influence of biofield treatment on physical, chemical and thermal properties of ethyl cellulose (EC) and methyl cellulose (MC). The study was performed in two groups (control and treated). The control group remained as untreated, and biofield treatment was given to treated group. The biofield treated polymers are characterized by Fourier transform infrared spectroscopy (FT-IR), CHNSO analysis, X-ray diffraction study (XRD), Differential Scanning calorimetry (DSC), and thermogravimetric analysis (TGA). FT-IR analysis of treated EC showed downward shifting ...


Characterization Of Physicochemical And Thermal Properties Of Biofield Treated Ethyl Cellulose And Methyl Cellulose, Mahendra Trivedi, Dahryn Trivedi 2016 Trivedi Global Inc.

Characterization Of Physicochemical And Thermal Properties Of Biofield Treated Ethyl Cellulose And Methyl Cellulose, Mahendra Trivedi, Dahryn Trivedi

Mahendra Kumar Trivedi

Cellulose and its derivatives are used as potential matrices for biomaterials and tissue engineering applications. The objective of present research was to investigate the influence of biofield treatment on physical, chemical and thermal properties of ethyl cellulose (EC) and methyl cellulose (MC). The study was performed in two groups (control and treated). The control group remained as untreated, and biofield treatment was given to treated group. The biofield treated polymers are characterized by Fourier transform infrared spectroscopy (FT-IR), CHNSO analysis, X-ray diffraction study (XRD), Differential Scanning calorimetry (DSC), and thermogravimetric analysis (TGA). FT-IR analysis of treated EC showed downward shifting ...


A New Sv2a Ligand For Epilepsy, Michael A. Rogawski 2016 University of California - Davis

A New Sv2a Ligand For Epilepsy, Michael A. Rogawski

Michael A. Rogawski

Since the 1970s, racetams have been in use as cognitive enhancers. Levetiracetam was discovered to have antiseizure activity in animal models and was then found to bind to SV2A in synaptic and endocrine vesicles. Brivaracetam, an analog of levetiracetam, was identified in a medicinal chemistry campaign with the objective of discovering analogs with higher affinity at racetam-binding sites and greater antiseizure potency.


Profile Interview With Faculty Mentor Jane Krause, Elizabeth J. Dowell, Ashley M. Schinker 2016 Purdue University

Profile Interview With Faculty Mentor Jane Krause, Elizabeth J. Dowell, Ashley M. Schinker

Purdue Journal of Service-Learning and International Engagement

No abstract provided.


There Is A Trend Favoring Vancomycin Vs. Metronidazole In Treating Severe C. Difficile Infection, Dean D. Fouchia 2016 Wayne State University School of Medicine

There Is A Trend Favoring Vancomycin Vs. Metronidazole In Treating Severe C. Difficile Infection, Dean D. Fouchia

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Johnson S, Louie TJ, Gerding DN, et al. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345-354. doi: 10.1093/cid/ciu313


Synthesis And Development Of Long-Acting Abacavir Prodrug Nanoformulations, Dhirender Singh 2016 University of Nebraska Medical Center

Synthesis And Development Of Long-Acting Abacavir Prodrug Nanoformulations, Dhirender Singh

Theses & Dissertations

Over the past decade, work from our laboratory has demonstrated the potential of targeted nanoformulated antiretroviral therapy (nanoART) to produce sustained high plasma and tissue drug concentrations for weeks following a single intramuscular (IM) administration that can suppress ongoing viral replication and mitigate dose associated viral resistance. While progress has occurred towards developing long-acting nanoformulations for protease and nonnucleoside reverse transcriptase (RT) inhibitors, development of nanoformulations of hydrophilic nucleoside RT inhibitor drugs have remained elusive. Abacavir (ABC); a hydrophilic molecule exhibited limited utilities to develop into long-acting nanoformulation platform. Furthermore, inefficient conversion of ABC to its biological active metabolites; carbovir ...


Novel Ph-Sensitive Cyclic Peptides, Dhammika Weerakkody, Anna Moshnikova, Naglaa Salem El-Sayed, Ramona-Cosima Adochite, Gregory Slaybaugh, Jovana Golijanin, Rakesh Tiwari, Oleg A. Andreev, Keykavous Parang, Yana K. Reshetnyak 2016 University of Rhode Island

Novel Ph-Sensitive Cyclic Peptides, Dhammika Weerakkody, Anna Moshnikova, Naglaa Salem El-Sayed, Ramona-Cosima Adochite, Gregory Slaybaugh, Jovana Golijanin, Rakesh Tiwari, Oleg A. Andreev, Keykavous Parang, Yana K. Reshetnyak

Pharmacy Faculty Articles and Research

A series of cyclic peptides containing a number of tryptophan (W) and glutamic acid (E) residues were synthesized and evaluated as pH-sensitive agents for targeting of acidic tissue and pH-dependent cytoplasmic delivery of molecules. Biophysical studies revealed the molecular mechanism of peptides action and localization within the lipid bilayer of the membrane at high and low pHs. The symmetric, c[(WE)4WC], and asymmetric, c[E4W5C], cyclic peptides translocated amanitin, a polar cargo molecule of similar size, across the lipid bilayer and induced cell death in a pH- and concentration-dependent manner. Fluorescently-labelled peptides were evaluated for targeting of acidic 4T1 ...


Tolerability Of Induction Chemotherapy Dosing Practices In Acute Myeloid Leukemia Patients, Kaylene M. Peric, David J. Reeves 2016 Butler University

Tolerability Of Induction Chemotherapy Dosing Practices In Acute Myeloid Leukemia Patients, Kaylene M. Peric, David J. Reeves

David Reeves

For patients with high body surface areas (BSA), differing chemotherapy dosing strategies have been utilized in attempts to reduce toxicity. In a retrospective evaluation, we compared the effects of chemotherapy dosing in acute myeloid leukemia patients with high BSA (>2 m2) who received capped doses (n = 12) to those who received uncapped doses (n = 24), and to patients with BSA ≤ 2 m2 (n = 42). There were no statistically significant differences among groups (BSA ≤ 2 m2, BSA > 2 m2 capped, and BSA > 2 m2 uncapped) in the incidences of febrile neutropenia (85.7, 66.7, and ...


Drug-Drug Interaction Between Methotrexate And Levetiracetam Resulting In Delayed Methotrexate Elimination, Emily Bain, Ruemu E. Birhiray, David J. Reeves 2016 Butler University

Drug-Drug Interaction Between Methotrexate And Levetiracetam Resulting In Delayed Methotrexate Elimination, Emily Bain, Ruemu E. Birhiray, David J. Reeves

David Reeves

Objective: To report a case of delayed methotrexate (MTX) elimination while receiving concomitant levetiracetam. Case Report: A 46-year-old man with relapsed osteosarcoma of the base of the skull receiving high-dose MTX tolerated his first cycle of MTX with elimination to nontoxic MTX levels (≤0.1 µmol/L) within 90 hours. After hospital discharge, the patient experienced seizures secondary to brain metastasis and started on levetiracetam, which was continued as maintenance therapy. The patient experienced delayed MTX elimination during cycles 2, 3, and 4 while receiving levetiracetam. On average, elimination to nontoxic MTX levels took 130 hours (106-144 hours). Before the ...


Bone Health Management In Prostate Cancer Patients Receiving Androgen Deprivation Therapy, Vishnuprabha Dhanapal, David J. Reeves 2016 Butler University

Bone Health Management In Prostate Cancer Patients Receiving Androgen Deprivation Therapy, Vishnuprabha Dhanapal, David J. Reeves

David Reeves

Purpose. Patients receiving androgen deprivation therapy undergo a rapid decline in bone mineral density during the first 6 to 12 months of initiating therapy. The World Health Organization has developed and implemented the Fracture Risk Assessment Tool (FRAX) to predict the ten year risk of a major fracture & hip fracture. Additionally, the National Comprehensive Cancer Network and the National Osteoporosis Foundation have developed osteoporosis guidelines. This study aims to characterize the fracture risk (based on the FRAX tool) and the current management of bone health based on national guidelines compliance.

Methods. A retrospective chart review of patients receiving a LHRH ...


Successful Desensitization To Docetaxel After Severe Hypersensitivity Reactions In Two Patients, David J. Reeves, Michael J. Callahan, Gregory P. Sutton 2016 Butler University

Successful Desensitization To Docetaxel After Severe Hypersensitivity Reactions In Two Patients, David J. Reeves, Michael J. Callahan, Gregory P. Sutton

David Reeves

Purpose Two cases of successful desensitization to docetaxel after severe hypersensitivity reactions are reported.

Summary Two patients with gynecological malignancies (uterine leiomyosarcoma and ovarian adenocarcinoma) experienced severe hypersensitivity reactions with docetaxel, including flushing, numbness, sharp radiating pain, severe nausea and vomiting, apnea, and unresponsiveness. Both patients received ondansetron before docetaxel. One patient received dexamethasone, diphenhydramine, and famotidine premedication before docetaxel, as she had previously reacted to paclitaxel. Docetaxel infusions were stopped, and the reactions were treated with diphenhydramine and dexamethasone (one patient also received famotidine). After resolution of symptoms, the docetaxel was not reinitiated due to the nature of the ...


Ascorbic Acid For The Treatment Of Rasburicase Induced Methemoglobinemia In The Setting Of Acute Renal Failure, David J. Reeves, Lindsay Saum, Ruemu Birhiray 2016 Butler University

Ascorbic Acid For The Treatment Of Rasburicase Induced Methemoglobinemia In The Setting Of Acute Renal Failure, David J. Reeves, Lindsay Saum, Ruemu Birhiray

David Reeves

Purpose A case of apparent rasburicase-induced methemoglobinemia and acute kidney injury treated with i.v. ascorbic acid because of suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is reported.

Summary A 46-year-old African-American man with a recent diagnosis of multiple myeloma and renal insufficiency was admitted to the hospital with a cough, hemoptysis, and fatigue. His medical history included hypertrophic cardiomyopathy, ventricular tachycardia, attention deficit/hyperactivity disorder, and pleural effusion. No treatments for multiple myeloma were started before hospital admission. Levofloxacin 750 mg orally daily for possible pneumonia, lenalidomide 10 mg orally daily, and dexamethasone 20 mg orally weekly were administered. Plasmapheresis was ...


Real-Time Temperature And Heat Flux Measurements For Lyophilization Process Design And Monitoring: Part 1, Evan T. Liechty, Nicholas J. Huls, Andrew D. Strongrich, Alina A. Alexeenko 2016 Purdue University

Real-Time Temperature And Heat Flux Measurements For Lyophilization Process Design And Monitoring: Part 1, Evan T. Liechty, Nicholas J. Huls, Andrew D. Strongrich, Alina A. Alexeenko

The Summer Undergraduate Research Fellowship (SURF) Symposium

Lyophilization is a common method used to preserve pharmaceutical and biological products. Accurately measuring temperature during the three stages of lyophilization: freezing, primary drying, and secondary drying, is important to ensure product consistency and to reduce operating costs. Wireless temperature sensors were evaluated to determine if temperature is monitored accurately and to determine if wireless temperature sensors offer advantages over traditional temperature measurement technologies. These sensors contain three capacitors to monitor temperature as the solvent is sublimated. A Millrock Technology REVO lyophilizer was used for testing. Water and 5% w/v sucrose solution were distributed in 3 mL fill volume ...


Antibiotic Drug Discovery With An Eye Towards Overcoming Drug Resistance, Daniel Towner Hoagland 2016 University of Tennessee Health Science Center

Antibiotic Drug Discovery With An Eye Towards Overcoming Drug Resistance, Daniel Towner Hoagland

Theses and Dissertations (ETD)

As a species, humans have become ever reliant on the use of antibiotics to facilitate our everyday lives. The widespread emergence of resistance to currently used antibiotics is commonly attributed to an over use in our society. Such resistance, coupled with a lack of innovation and production of novel antibiotic drugs, threatens to return humanity to an era similar to one before the discovery of the first antibiotics. The need to find new agents to be used in this fight is paramount, as well as learning from our recent failures to produce such compounds. This document will highlight my efforts ...


Neonatal Pain Management: Still In Search For The Holy Grail., Karel Allegaert, John N. van den Anker 2016 George Washington University

Neonatal Pain Management: Still In Search For The Holy Grail., Karel Allegaert, John N. Van Den Anker

Pediatrics Faculty Publications

Inadequate pain management but also inappropriate use of analgesics in early infancy has negative effects on neurodevelopmental outcome. As a consequence, neonatal pain management is still in search for the Holy Grail. At best, effective pain management is based on prevention, assessment, and treatment followed by a re-assessment of the pain to determine if additional treatment is still necessary. Unfortunately, epidemiological observations suggest that neonates are undergoing painful procedures very frequently, unveiling the need for effective preventive, non-pharmacological strategies. In addition, assessment is still based on validated, multimodal, but subjective pain assessment tools. Finally, in neonatal intensive care units, there ...


Emergency Medicine Providers Systematically Underestimate Their Opioid Prescribing Practices, Sean S. Michael, Kavita Babu, Christopher Androskl Jr., Martin A. Reznek 2016 University of Massachusettts Medical School

Emergency Medicine Providers Systematically Underestimate Their Opioid Prescribing Practices, Sean S. Michael, Kavita Babu, Christopher Androskl Jr., Martin A. Reznek

UMass Center for Clinical and Translational Science Research Retreat

Background: Opioid misuse is a known public health problem, nationwide and in Massachusetts. The Massachusetts Hospital Association (MHA) developed recommendations to address opioid prescribing in the ED setting, and UMassMemorial Health Care recently implemented a system-wide opioid practice guideline mirroring the MHA policy. Little is known about methods to influence behavior change among ED providers related to opioid prescribing practices. Guideline implementation provided a unique opportunity for a natural experiment related to prescribing patterns, and we hypothesized that a simultaneous experimental intervention to provide clinicians with their individual prescribing data would alter their practices beyond any effect achieved solely by ...


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