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Reducing Benzodiazepine Use For The Treatment Of Insomnia And Supporting Nonpharmacological Therapies, UnChan Pyon 2019 University of Vermont

Reducing Benzodiazepine Use For The Treatment Of Insomnia And Supporting Nonpharmacological Therapies, Unchan Pyon

Family Medicine Clerkship Student Projects

Most medical organizations recommend against the use of benzodiazepine use for the treatment of insomnia, especially in the elderly. However, the percentage of the adult population on benzos increase with age: 7.5% in adults ages 51-64; 9% in adults over 65. Alternative therapies for insomnia, including online CBT, require more commitment than taking a medication so many patients opt for medication. This project aims to increase awareness of benzodiazepine use for insomnia and provide support for nonpharmacological therapies.


Master Of Science In Anesthesia Fort Lauderdale, Nova Southeastern University 2019 Nova Southeastern University

Master Of Science In Anesthesia Fort Lauderdale, Nova Southeastern University

Health Professions Divisions Course Catalogs

No abstract provided.


Dr. Kiran C. Patel College Of Osteopathic Medicine Graduate Programs, Nova Southeastern University 2019 Nova Southeastern University

Dr. Kiran C. Patel College Of Osteopathic Medicine Graduate Programs, Nova Southeastern University

Health Professions Divisions Course Catalogs

No abstract provided.


Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson 2018 University of San Francisco

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted ...


Surveillance, Prevention And Surgical Treatments For Hepatocellular Carcinoma, Kerui Xu 2018 University of Nebraska Medical Center

Surveillance, Prevention And Surgical Treatments For Hepatocellular Carcinoma, Kerui Xu

Theses & Dissertations

Liver cancer is the second-leading cause of cancer death, representing roughly 9.1% of all cancer mortality. Of all primary cancers of the liver, hepatocellular carcinoma (HCC) accounts for roughly 85%. HCC has been increasing in the U.S. and other countries. In particular, HCC places a huge burden on the Chinese population, as China alone consists of approximately 50% of the total HCC cases and deaths. In China, chronic hepatitis B virus (HBV) infection is the leading cause for developing HCC. The two challenges in prevention and control of HCC experienced in China are low rates of HCC screening ...


Student Registered Nurse Anesthetists’ Perception Of Simulation As A Positive Reinforcement To Classroom Lecture In Handling A Difficult Airway, Kayla Forbis 2018 The University of Southern Mississippi

Student Registered Nurse Anesthetists’ Perception Of Simulation As A Positive Reinforcement To Classroom Lecture In Handling A Difficult Airway, Kayla Forbis

Doctoral Projects

The management of a difficult airway by anesthesia providers is a core component of providing safe care. Simulation provides an opportunity for the student to manage uncommon clinical scenarios without harm to an actual patient. This project aimed to determine if the use of simulation may be useful in training Student Registered Nurse Anesthetist in the management skills of a difficult airway. The proposed intervention of this project was the addition of simulation experience to didactic lecture covering difficult airway management techniques. As supported in the Adult Learning Principles of Medical Learners, by allowing the SRNA to actively participate in ...


Ultrasound Use In Resource-Limited Settings: A Systematic Review, Ravindra Gopaul, Gonzalo Bearman, Michael P. Stevens 2018 Virginia Commonwealth University; Penn State Health Milton S. Hershey Medical Center

Ultrasound Use In Resource-Limited Settings: A Systematic Review, Ravindra Gopaul, Gonzalo Bearman, Michael P. Stevens

Journal of Global Radiology

Purpose: Over the past decade, ultrasound (US) machines have become smaller, less expensive, more reliable, durable and user-friendly, making ultrasonography an ideal imaging modality in resource-poor settings. We conducted a literature review to examine the use of ultrasound in resource-limited settings, with emphasis on common applications, barriers to implementation, and impact on clinical decision-making and patient disposition.

Methods and Materials: Literature review. We conducted a PubMed and Cochrane Central search on the clinical use of ultrasound in the developing world. Search terms included ultrasonography, developing countries, resource limited, remote setting, poverty, and low income. Articles from 2000 to 2015 that ...


Updated Efficacy Of First Or Second-Line Pembrolizumab Plus In Metastatic Triple Negative Breast Cancer And Correlations With Baseline Lymphocyte And Naïve Cd4+ T-Cell Count, David Page, Joanna Pucilowska, Laura Bennetts, I Kim, Katherine Sanchez, Maritza Martel, Alison Conlin, Nikki Moxon, Staci Mellinger, Anupama Acheson, K Kemmer, Z Mitri, J Vuky, J Ahn, C Abaya, T Manigault, R Basho, Walter Urba, HL McArthur 2018 Earle A. Chiles Research Institute, Portland, OR; Providence Cancer Institute, Portland OR

Updated Efficacy Of First Or Second-Line Pembrolizumab Plus In Metastatic Triple Negative Breast Cancer And Correlations With Baseline Lymphocyte And Naïve Cd4+ T-Cell Count, David Page, Joanna Pucilowska, Laura Bennetts, I Kim, Katherine Sanchez, Maritza Martel, Alison Conlin, Nikki Moxon, Staci Mellinger, Anupama Acheson, K Kemmer, Z Mitri, J Vuky, J Ahn, C Abaya, T Manigault, R Basho, Walter Urba, Hl Mcarthur

Other Publications

Background: In mTNBC, anti-PD-1/L1 monotherapy is most effective when administered early in the course of disease, with recent trials demonstrating overall response rates (ORR) of 23-26% in the first-line setting and 5-6% in later lines. This may reflect iatrogenic lymphopenia from preceding cytotoxic chemotherapy. Furthermore, curative-intent chemotherapy is associated with prolonged suppression of naïve CD4+ cells, a T-cell subset that may play a critical role in the generation of de novo anti-tumor immune responses. We present the final clinical results of a pilot study evaluating the safety and efficacy of combining pembrolizumab plus standard-of-care capecitabine in the first/second-line ...


Perilymphatic Irx-2 Cytokine Therapy To Enhance Tumor Infiltrating Lymphocytes And Pd-L1 Expression Preceding Curative-Intent Therapy In Early Stage Breast Cancer, Joanna Pucilowska, Venkatesh Rajamanickam, Katherine Sanchez, Valerie Conrad, Alison Conlin, Shagheyegh Aliabadi-Wahle, Shu-Ching Chang, Gary Grunkemeier, Nikki Moxon, Staci Mellinger, Maritza Martel, James Egan, Monil Shah, David B Page 2018 Earle A. Chiles Research Institute, Portland, OR; Providence Cancer Institute, Portland, OR

Perilymphatic Irx-2 Cytokine Therapy To Enhance Tumor Infiltrating Lymphocytes And Pd-L1 Expression Preceding Curative-Intent Therapy In Early Stage Breast Cancer, Joanna Pucilowska, Venkatesh Rajamanickam, Katherine Sanchez, Valerie Conrad, Alison Conlin, Shagheyegh Aliabadi-Wahle, Shu-Ching Chang, Gary Grunkemeier, Nikki Moxon, Staci Mellinger, Maritza Martel, James Egan, Monil Shah, David B Page

Other Publications

Background: Cytokines are being explored as a therapeutic strategy to modulate the tumor microenvironment and facilitate immunotherapy benefit in breast cancer. Here, we investigate a locoregional therapeutic approach whereby cytokines (IRX-2) are administered into the subcutaneous peri-areolar tissue (in an anatomic distribution similar to sentinel lymph node mapping) to facilitate immune cell recruitment/activation within the draining lymph nodes and tumor in ESBC. IRX-2 is derived from ex vivo phytohemagglutinin-stimulated lymphocytes and contains multiple cytokines including IL-1β, IL-2, TNF-α, IFN-γ, IL-6, IL-8, and GM-CSF, with stable concentrations from lot to lot. Preclinically, IRX-2 activates T-cells and natural killer (NK) cells ...


The Utilization Of Venous-Venous Extracorporeal Membrane Oxygenation Membrane For The Management Of Status Asthmaticus, Kenneth Miller MSRT, MEd, RRT-ACCS, FAARC,, Jennifer Strow DO, Alison N. Bedekovich MSN, RN 2018 Lehigh Valley Health Network

The Utilization Of Venous-Venous Extracorporeal Membrane Oxygenation Membrane For The Management Of Status Asthmaticus, Kenneth Miller Msrt, Med, Rrt-Accs, Faarc,, Jennifer Strow Do, Alison N. Bedekovich Msn, Rn

Patient Care Services / Nursing

No abstract provided.


The Use Of Milrinone In Neonates With Persistent Pulmonary Hypertension Of The Newborn - A Randomised Controlled Trial Pilot Study (Mint 1): Study Protocol And Review Of Literature., Afif F. El-Khuffash, Patrick J. McNamara, Colm Breatnach, Neidin Bussmann, Aisling Smith, Oliver Feeney, Elizabeth Tully, Joanna Griffin, Willem P. de Boode, Brian Cleary, Orla Franklin, Eugene Dempsey 2018 Royal College of Surgeons in Ireland

The Use Of Milrinone In Neonates With Persistent Pulmonary Hypertension Of The Newborn - A Randomised Controlled Trial Pilot Study (Mint 1): Study Protocol And Review Of Literature., Afif F. El-Khuffash, Patrick J. Mcnamara, Colm Breatnach, Neidin Bussmann, Aisling Smith, Oliver Feeney, Elizabeth Tully, Joanna Griffin, Willem P. De Boode, Brian Cleary, Orla Franklin, Eugene Dempsey

Department of Paediatrics Articles

Persistent pulmonary hypertension of the newborn (PPHN) is a relatively common condition which results in a mortality of up to 33%. Up to 40% of infants treated with nitric oxide (iNO) either have a transient response or fail to demonstrate an improvement in oxygenation. Milrinone, a selective phosphodiesterase 3 (PDE3) inhibitor with inotropic and lusitropic properties may have potential benefit in PPHN. This pilot study was developed to assess the impact of milrinone administration on time spent on iNO in infants with PPHN. This is a multicentre, randomized, double-blind, two arm pilot study, with a balanced (1:1) allocation of ...


Pharmacist Interventions Involving Patient Outreach: Early Findings Of Patient Outcomes In Older Adults, Matthew Fair BS, PharmD, BCPS, BCGP,, Michelle Omari-Okyere BS, PharmD, BCPS, BCGP, Elie Jabbour PharmD, MBA,, Brenda Frutos MPH, CHES, Nyann Biery MS 2018 Lehigh Valley Health Network

Pharmacist Interventions Involving Patient Outreach: Early Findings Of Patient Outcomes In Older Adults, Matthew Fair Bs, Pharmd, Bcps, Bcgp,, Michelle Omari-Okyere Bs, Pharmd, Bcps, Bcgp, Elie Jabbour Pharmd, Mba,, Brenda Frutos Mph, Ches, Nyann Biery Ms

Department of Pharmacy

No abstract provided.


Resilience Training For Va Primary Care Providers, Elizabeth A. Recupero 2018 University of Massachusetts Boston

Resilience Training For Va Primary Care Providers, Elizabeth A. Recupero

Instructional Design Capstones Collection

Physician burnout syndrome is epidemic within the U.S. healthcare system. Burnout is defined by three main criteria: emotional exhaustion, depersonalization, and a low sense of personal accomplishment, and its prevalence is highest among primary care providers. The VA’s All Employee Survey (AES) demonstrates that more than 50% of physicians working for the VA Healthcare System exhibit at least one of these symptoms. The literature discusses that this syndrome can be improved by increasing physician resilience. This capstone project first analyzed the need for resiliency training among VA primary care providers. After the needs analysis, an online training that ...


Effect Of Differences In Metabolic Activity Of Melanoma Models On Response To Lonidamine Plus Doxorubicin., Kavindra Nath, Jeffrey Roman, David S. Nelson, Lili Guo, Seung-Cheol Lee, Stepan Orlovskiy, Kevin Muriuki, Daniel F. Heitjan, Stephen Pickup, Dennis B. Leeper, Ian A. Blair, Mary E. Putt, Jerry D. Glickson 2018 University of Pennsylvania

Effect Of Differences In Metabolic Activity Of Melanoma Models On Response To Lonidamine Plus Doxorubicin., Kavindra Nath, Jeffrey Roman, David S. Nelson, Lili Guo, Seung-Cheol Lee, Stepan Orlovskiy, Kevin Muriuki, Daniel F. Heitjan, Stephen Pickup, Dennis B. Leeper, Ian A. Blair, Mary E. Putt, Jerry D. Glickson

Department of Radiation Oncology Faculty Papers

Lonidamine (LND), a metabolic modulator, sensitizes DB-1 human melanoma to doxorubicin (DOX) chemotherapy by acidifying and de-energizing the tumor. This report compares the effects of LND on two human melanoma lines, DB-1 and WM983B, which exhibit different metabolic properties. Using liquid chromatography mass spectrometry and Seahorse analysis, we show that DB-1 was more glycolytic than WM983B in vitro. 31P magnetic resonance spectroscopy (MRS) indicates that LND (100 mg/kg, i.p.) induces similar selective acidification and de-energization of WM983B xenografts in immunosuppressed mice. Over three hours, intracellular pH (pHi) of WM983B decreased from 6.91 ± 0.03 to 6 ...


Levels Of Par-1 Kinase Determine The Localization Of Bruchpilot At The Drosophila Neuromuscular Junction Synapses., Kara R. Barber, Martin Hruska, Keegan M. Bush, Jade A. Martinez, Hong Fei, Irwin B. Levitan, Matthew B. Dalva, Yogesh P. Wairkar 2018 University of Texas Medical Branch, Galveston

Levels Of Par-1 Kinase Determine The Localization Of Bruchpilot At The Drosophila Neuromuscular Junction Synapses., Kara R. Barber, Martin Hruska, Keegan M. Bush, Jade A. Martinez, Hong Fei, Irwin B. Levitan, Matthew B. Dalva, Yogesh P. Wairkar

Farber Institute for Neurosciences Faculty Papers

Functional synaptic networks are compromised in many neurodevelopmental and neurodegenerative diseases. While the mechanisms of axonal transport and localization of synaptic vesicles and mitochondria are relatively well studied, little is known about the mechanisms that regulate the localization of proteins that localize to active zones. Recent finding suggests that mechanisms involved in transporting proteins destined to active zones are distinct from those that transport synaptic vesicles or mitochondria. Here we report that localization of BRP-an essential active zone scaffolding protein in Drosophila, depends on the precise balance of neuronal Par-1 kinase. Disruption of Par-1 levels leads to excess accumulation of ...


Is Radiofrequency Energy A Safe And Effective Treatment For Reducing Symptoms Of Gastroesophageal Reflux Disease In Patients 18 Years Or Older?, Kristen L. Schaffer 2018 Philadelphia College of Osteopathic Medicine

Is Radiofrequency Energy A Safe And Effective Treatment For Reducing Symptoms Of Gastroesophageal Reflux Disease In Patients 18 Years Or Older?, Kristen L. Schaffer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not “Is radiofrequency energy a safe and effective treatment for reducing symptoms of gastroesophageal reflux disease in patients 18 years or older?”

STUDY DESIGN: Review of two double-blind, randomized control trials and one double-blind, randomized cross-over study published between 2003 and 2012. All studies were published in the English language in peer reviewed journals.

DATA SOURCES: Two randomized control trials and one randomized cross-over study were found using PubMed.

OUTCOMES MEASURED: The outcomes measured include changes in GERD symptom scores for fourteen symptoms, improvement of ...


Characterization Of Antibiotic Use For Acute Otitis Media In Pediatric Physician Practices, Jasica N. Truong PharmD, Kristin M. Held PharmD, BCOP, Jennifer E. Macfarlan MPH, Tibisay Villalobos MD, FAAP 2018 Lehigh Valley Health Network

Characterization Of Antibiotic Use For Acute Otitis Media In Pediatric Physician Practices, Jasica N. Truong Pharmd, Kristin M. Held Pharmd, Bcop, Jennifer E. Macfarlan Mph, Tibisay Villalobos Md, Faap

Department of Pharmacy

No abstract provided.


Retrospective Analysis Of Guideline Recommended Antiretroviral Regimens And Vaccination Schedules For Adult Patients With Human Immunodeficiency Virus (Hiv) In An Infectious Diseases Clinic, Jose A. Roman PharmD, Jarrod W. Kile RPh, BCPS, Amy Slenker MD, Hope Kincaid MPH, CPH 2018 Lehigh Valley Health Network

Retrospective Analysis Of Guideline Recommended Antiretroviral Regimens And Vaccination Schedules For Adult Patients With Human Immunodeficiency Virus (Hiv) In An Infectious Diseases Clinic, Jose A. Roman Pharmd, Jarrod W. Kile Rph, Bcps, Amy Slenker Md, Hope Kincaid Mph, Cph

Department of Pharmacy

No abstract provided.


Loss-Of-Function Mutations In Atp6ap1 And Atp6ap2 In Granular Cell Tumors., Fresia Pareja, Alissa H. Brandes, Thais Basili, Pier Selenica, Felipe C. Geyer, Dan Fan, Arnaud Da Cruz Paula, Rahul Kumar, David N. Brown, Rodrigo Gularte-Mérida, Barbara Alemar, Rui Bi, Raymond S. Lim, Ino de Bruijn, Sho Fujisawa, Rui Gardner, Elvin Feng, Anqi Li, Edaise M. da Silva, John R. Lozada, Pedro Blecua, Leona Cohen-Gould, Achim A. Jungbluth, Emad A. Rakha, Ian O. Ellis, Maria I.A. Edelweiss, Juan P. Palazzo, Larry Norton, Travis Hollmann, Marcia Edelweiss, Brian P. Rubin, Britta Weigelt, Jorge S. Reis-Filho 2018 Memorial Sloan Kettering Cancer Center

Loss-Of-Function Mutations In Atp6ap1 And Atp6ap2 In Granular Cell Tumors., Fresia Pareja, Alissa H. Brandes, Thais Basili, Pier Selenica, Felipe C. Geyer, Dan Fan, Arnaud Da Cruz Paula, Rahul Kumar, David N. Brown, Rodrigo Gularte-Mérida, Barbara Alemar, Rui Bi, Raymond S. Lim, Ino De Bruijn, Sho Fujisawa, Rui Gardner, Elvin Feng, Anqi Li, Edaise M. Da Silva, John R. Lozada, Pedro Blecua, Leona Cohen-Gould, Achim A. Jungbluth, Emad A. Rakha, Ian O. Ellis, Maria I.A. Edelweiss, Juan P. Palazzo, Larry Norton, Travis Hollmann, Marcia Edelweiss, Brian P. Rubin, Britta Weigelt, Jorge S. Reis-Filho

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Granular cell tumors (GCTs) are rare tumors that can arise in multiple anatomical locations, and are characterized by abundant intracytoplasmic granules. The genetic drivers of GCTs are currently unknown. Here, we apply whole-exome sequencing and targeted sequencing analysis to reveal mutually exclusive, clonal, inactivating somatic mutations in the endosomal pH regulators ATP6AP1 or ATP6AP2 in 72% of GCTs. Silencing of these genes in vitro results in impaired vesicle acidification, redistribution of endosomal compartments, and accumulation of intracytoplasmic granules, recapitulating the cardinal phenotypic characteristics of GCTs and providing a novel genotypic-phenotypic correlation. In addition, depletion of ATP6AP1 or ATP6AP2 results in ...


A Learning Community Approach To Identifying Interventions In Health Systems To Reduce Colorectal Cancer Screening Disparities., Lillian C. Man, Melissa DiCarlo, Emily Lambert, Randa Sifri, Martha Romney, Linda Fleisher, Ronald Myers 2018 Thomas Jefferson University

A Learning Community Approach To Identifying Interventions In Health Systems To Reduce Colorectal Cancer Screening Disparities., Lillian C. Man, Melissa Dicarlo, Emily Lambert, Randa Sifri, Martha Romney, Linda Fleisher, Ronald Myers

Department of Medical Oncology Faculty Papers

Although colorectal cancer (CRC) screening in the United States has been increasing, screening rates are not optimal, and there are persistent disparities in CRC screening and mortality, particularly among minority patients. As most CRC screening takes place in primary care, health systems are well-positioned to address this important population health problem. However, most health systems have not actively engaged in identifying and implementing effective evidence-based intervention strategies that can raise CRC screening rates and reduce disparities. Drawing on the Collective Impact Model and the Interactive Systems Framework for Dissemination and Implementation, our project team applied a learning community strategy to ...


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