Digital Commons Network^™

Is Metoclopramide Effective In Treating Symptoms In Diabetic Gastroparesis?, Prachi Patel

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not is metoclopramide effective in treating symptoms in diabetic gastroparesis?

Study Design: Systematic review of 1 controlled randomized double blinded study, 1 controlled randomized open label study, and 1 controlled open label case analysis published in peer reviewed journals between 2012-2014, all in English language.

Data Sources: 1 randomized double blinded study, 1 randomized open label study, and 1 case analysis comparing symptom reduction of gastroparesis after the intervention of nasal and oral metoclopramide compared to placebo controls. These sources were found using PubMed and OVID.

Outcomes …

Is Bovine Lactoferrin Effective In Preventing Diarrhea In Infants And Toddlers?, Kateryna Toganov

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence-based medicine (EBM) review is to determine whether bovine lactoferrin is effective in preventing diarrhea in infants and toddlers.

Study design: Review of three English-language primary randomized controlled trials published between 2007 and 2016.

Data sources: Three double-blind controlled trials comparing bovine lactoferrin to placebo were found using PubMed.

Outcomes measured: Incidence and incidence rate of diarrhea in episodes/child/year were measured using the information provided by the caregivers and the healthcare records obtained from a hospital or clinic.

Results: King et al. found that there was no statistically significant difference in incidence of diarrhea …

Does Secukinumab Improve Self-Reported Quality Of Life In Patients With Moderate-To-Severe Ankylosing Spondylitis When Taken Regularly?, Ryan Yenovkian

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not secukinumab improves self-reported quality of life in patients with moderate-to-severe ankylosing spondylitis when taken regularly.

Study design: A systematic review of three randomized placebo-controlled trials (RCTs), published in peer-reviewed journals between 2013 and 2015, all in the English language. Data sources: All three studies were found and accessed on PubMed.

Outcomes measured: Patient quality of life was assessed in all three studies using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and reported as mean change from baseline. ASQoL is scored from 0-18 with a higher …

Understanding The Utilization Of Community-Based Services In Late Old Age: A Participatory Approach For Connecting Through The Communication Ecology, Carrie Leach

Wayne State University Dissertations

As the pool of eligible recipients continues to grow, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. Mounting research demonstrates that investment in community-based services to ensure seniors remain independent translates to saved government dollars. As a contributing researcher of a multi-year county-wide older adult needs assessment in Monroe County, Michigan, data collected from 1,870 people revealed a communication disjuncture between seniors and service providers. In response, officials convened a post assessment working group that focused on communication and outreach. Along with members of the Community Advisory Group …

Effects Of Alpha-Gpc And Huperzine-A On Short Term Memory, Anaerobic Power Output, Post Exhaustion Compared To Caffeine And Placebo In Healthy College Age Students, John P. Isaacs

Online Theses and Dissertations

Introduction: The use of multi-ingredient pre-workout supplements has been steadily on the rise in the fitness industries. Companies make claims about improvements in performance both physically and cognitively for users but seldom provide research to back up the claims made about the ingredients or dosages. Purpose: To examine the effects of Huperzine-A and Alpha-GPC on short term memory and anaerobic power output, post exhaustion compared to caffeine and placebo in healthy college age students. Methods: The study was conducted as a double blind, placebo controlled, randomized design on 62 healthy adults (N=62 height 68.4 ± 3.5 in., weight 78.5 ± …

Protease-Mediated Growth Of Staphylococcus Aureus On Host Proteins Is Opp3 Dependent, Mckenzie K. Lehman, Austin S. Nuxoll, Kelsey J. Yamada, Tammy Kielian, Steven D. Carson, Paul D. Fey

Journal Articles: Pathology and Microbiology

Staphylococcus aureus has the ability to cause infections in multiple organ systems, suggesting an ability to rapidly adapt to changing carbon and nitrogen sources. Although there is little information about the nutrients available at specific sites of infection, a mature skin abscess has been characterized as glucose depleted, indicating that peptides and free amino acids are an important source of nutrients for the bacteria. Our studies have found that mutations in enzymes necessary for growth on amino acids, including pyruvate carboxykinase (ΔpckA) and glutamate dehydrogenase (ΔgudB), reduced the ability of the bacteria to proliferate within a …

P4ha1 Is A New Regulator Of The Hif-1 Pathway In Breast Cancer, Ren Xu

Markey Cancer Center Faculty Publications

Hypoxia-Inducible Factor (HIF)-1 is a transcription factor that plays the key role in response to low oxygen concentrations, or hypoxia. Activation of the HIF-1 pathway is not only crucial for normal tissue development and function, but also involved in disease progression, such as cancer. Cancer cells proliferate rapidly in solid tumors, and thus, solid tumors consume much more oxygen and nutrients than normal tissue and generate oxygen tension. It is well established that oxygen tension in solid tumor tissue induces the aberrant activation of the HIF-1 pathway, and subsequently promotes angiogenesis and tumor progression. Breast cancer is a heterogeneous disease …

Global Health Elective In Rural Guatemala, Kendall Burns

Posters

Describes pediatric resident's experience learning to translate evidence based medicine to resource-limited areas in rural Guatemala.

The Feasibility Of A Behavioral Group Intervention After Weight-Loss Surgery: A Randomized Pilot Trial, Michelle R. Lent, Laura K Campbell, Mackenzie C Kelly, Jessica L Lawson, Jessica M Murakami, Sasha Gorrell, G Craig Wood, Marianne M Yohn, Stephanie Ranck, Anthony T Petrick, Krystal Cunningham, Megan E Lamotte, Christopher D Still

PCOM Scholarly Works

BACKGROUND: Formal psychosocial support programs after weight-loss surgery are limited in scope and availability.

OBJECTIVE: This randomized pilot study evaluated the feasibility of a postoperative behavioral intervention program.

MATERIALS AND METHODS: Postoperative weight-loss surgery patients (N = 50) were recruited from February 2017-July 2017 and randomized to a four-month behavioral program or usual care wait-list. Outcomes evaluated in addition to feasibility included health-related quality of life (Short Form -36), psychosocial functioning and adherence. Secondary outcomes included within-group changes for each outcome.

RESULTS: Out of eight possible sessions, intervention participants attended a mean of 4.2 sessions. Intervention group participants experienced greater …

Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Review, Christopher T. Brindle

Theses and Dissertations

BACKGROUND

Cardiac surgery patients have some of the highest reported incidence and prevalence of pressure injuries (PI). A growing subset of cardiac surgery include patients with end-stage heart failure who undergo ventricular assist device (VAD) or total artificial heart (TAH) surgery. The risk of PI and their natural history of development in this population are unknown and the specific risk factors for PI development remain unexplored.

OBJECTIVES

To perform a systematic review of the literature to identify the incidence and risk factors of PI development in patients undergoing VAD-TAH surgery and thereby inform study design and variables in an eight-year …

Assessing Nutritional Status Of Critically Ill Patients Using Serum Prealbumin Levels, Khushbakht Arbab, Hafsa Majid, Lena Jafri, Aysha Habib, Ahmed Raheem, Bushra Jamil, Bushra Akram, Madiha Hashmi

Department of Pathology and Laboratory Medicine

Background: Malnutrition in hospitalized patients, contributes to poor outcomes. Biomarker serum prealbumin, can prevent the complications by commencement of nutritional support to improve clinical outcomes. This study was designed to assess the association between low serum prealbumin level (<18 mg/dl), with length of stay and all cause intensive care unit mortality.
Methods: This cross-sectional study was conducted from July 2016 to July 2017 at Aga Khan University Hospital Karachi Pakistan. All consecutive patients, aged between 18 to 70 years, admitted in medical or surgical intensive care unit were included. Demographic, clinical history and blood samples for analysing serum prealbumin were obtained on first day of admission. Patients were categorized into two groups …

Current Assessment And Intervention Strategies For Childhood Obesity Used By Pediatric Care Providers, Jennifer Bivins

DNP Projects

Childhood obesity rates in the United States have tripled since the 1970s in the U.S. (CDC, 2018). Due to the persistent rise in obesity rate sin children and the possible health risks associated with obesity, it is important for pediatric providers to appropriately assess and treat childhood obesity. There is limited data on what pediatric providers in the primary care setting are doing to address this growing health problem. PURPOSE: The purpose of this study was to determine current assessment and intervention strategies for childhood obesity used by pediatric health care providers at the University of Kentucky, General Pediatric clinic. …

Patient Care In High-Level Containment Care Units: In A Resourced Setting, Angela M. Vasa, Kate C. Boulter, Jolene M. Horihan, David S. Cates, Craig A. Piquette, James N. Sullivan, Daniel W. Johnson, Angela L. Hewlett

Books and Book Chapters: Nebraska Medicine

Vasa, A., Boulter, K., Horihan, Cates, D., Piquette, C., Sullivan, J., Johnson, D, & Hewlett, A. (2019). Patient Care in High-Level Containment Care Units. In T. Cieslak, M. Kortepeter, C. Kratochvil, & J. Lawler (Eds.), Nebraska Isolation and Quarantine Manual (pp. 87-101). Lincoln, NE: University of Nebraska Press.

Organizational Models In Athletic Training And The Effect On The Quality Of Care Delivered, Matthew Ferreira

Graduate Theses, Dissertations, and Problem Reports (ETD)

Context: Quality of care is an ethical priority to all healthcare professionals. Healthcare fields such as nursing and physical therapy have made changes in staff size and focus that have increased the quality of care provided to patients. The athletic training field has not made changes to the organizational structure. Thus, the quality of care delivered by athletic trainers is an understudied topic. Likewise, the organizational models have just recently been explored in the literature. Objective: Identify differences in the three models of organization (academic, athletic, and medical) related to quality of care delivered and coverage versus care. Design: This …

Vital Signs, Winter 2019, Boonshoft School Of Medicine

Vital Signs

A thirty-two page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Effect Of Neoadjuvant Chemoradiation On Preoperative Pulmonary Physiology, Postoperative Respiratory Complications And Quality Of Life In Patients With Oesophageal Cancer, J. A. Elliott, L. O'Byrne, G. Foley, C. F. Murphy, Suzanne Doyle, S. King, E. M. Guinan, N. Ravi, V. Reynolds

Articles

Background: It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer.

Methods: Consecutive patients treated between 2010 and 2016 were included. Three-dimensional conformal radiation was standard, with a lung dose–volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41⋅4Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

A Double Humanized Blt-Mice Model Featuring A Stable Human-Like Gut Microbiome And Human Immune System, Lance Daharsh, Jianshui Zhang, Amanda E. Ramer-Tait, Qingsheng Li

Nebraska Center for Virology: Faculty Publications

Humanized mice (hu-mice) that feature a functional human immune system have fundamentally changed the study of human pathogens and disease. They can be used to model diseases that are otherwise difficult or impossible to study in humans or other animal models. The gut microbiome can have a profound impact on human health and disease. However, the murine gut microbiome is very different than the one found in humans. There is a need for improved pre-clinical hu-mice models that have an engrafted human gut microbiome. Therefore, we created double hu-mice that feature both a human immune system and stable human-like gut …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …

Subjective And Objective Assessment Of Taste And Smell Sensation In Advanced Cancer, Niamh Mcgettigan, Pauline Uí Dhuibhir, Michelle Barrett, Jessica Sui, Lucy Balding, Stephen Higgins, Norma O'Leary, Aileen Kennedy, Declan Walsh

Articles

Context: Taste and smell abnormalities (TSA) occur throughout the cancer trajectory regardless of cancer primary site and contribute to cancer-associated malnutrition. TSA etiology is poorly understood. Tumor-related inflammation is a possible cause. Objective: This study examined the prevalence, characteristics, and severity of TSA in advanced cancer and explored the relationship between TSA and nutritional status. No previous study combined subjective and objective measures for both taste and smell assessment in this population. Method: Consecutive advanced cancer hospice patients were recruited. A modified version of the “Taste and Smell Survey” assessed subjective TSA. Validated taste strips and “Sniffin’ …

Inclusion Body Myositis In A Middle-Aged Woman With Knee Pain And Weakness: A Case Report, Jacob Christensen, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Weakness and osteoarthritis are common concerns for orthopaedic and primary care physicians when caring for aging adults. We describe a 58-year-old woman with a history of Sjogren syndrome and knee osteoarthritis. She presented to our clinic for injection of viscosupplementation in her left knee, and review of her medical records revealed right hand weakness at 7 years after the onset of symptoms. Findings of muscle biopsy and multiple electromyograms revealed inclusion body myositis, primarily affecting the deep finger flexors and quadriceps muscles. On the basis of this diagnosis, physical therapy and supportive care were recommended. The results of the current …

Elevated Homeostatic Model Assessment Of Insulin Resistance Level Increases The Risk Of Acne, Stefani Nurhadi, Igaa Praharsini, Aagp Wiraguna

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Insulin resistance and high carbohydrate diets are currently considered to be influential in acne aetiology. Insulin is a hormone that does not only regulate the concentration of blood glucose but also affects the production of sebum and through the Insulin Growth Factor-1 (IGF-1) receptor stimulates androgen synthesis which will increase the proliferation of keratinocytes duct and the production of sebum in acne of the pilosebaceous.

Methods: This is a cross sectional observational analytic study involving 38 acne patients and 38 controls. This study aims to determine whether the increase in Homeostatic Model Assessment of Insulin Resistance …

Effects Of Iron-Deficiency Anemia On Auditory Function In School-Aged Children, Eman Soliman Abd El-Gaffar, Gehan M. S. Abd El-Salam, Hala M. Abd El-Samad

Journal of Medicine in Scientific Research

Introduction Iron is important for proper myelination of spinal cord and white matter of cerebellar folds in brain and is a cofactor for a number of enzymes involved in neurotransmitter synthesis. Auditory brainstem evoked response (ABR) represents the progressive activation of different levels of the auditory pathway from the acoustic nerve (wave I) to the lateral lemniscuses (wave V). Otoacoustic emissions (OAEs) are sounds measured in the external ear canal that reflect movement of the outer hair cells in the cochlea. Patients and methods A total of 40 children, of both sexes, with age ranging from 6–12 years old, were …

Assessment Of Inequalities In Coverage Of Essential Reproductive, Maternal, Newborn, Child, And Adolescent Health Interventions In Kenya, Emily Catherine Keats, Nadia Akseer, Zaid Bhatt, William Macharia, Anthony Ngugi, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Paediatrics and Child Health, East Africa

Importance: Previous work has underscored subnational inequalities that could impede additional health gains in Kenya.

Objective: To provide a comprehensive assessment of the burden, distribution, and change in inequalities in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) interventions in Kenya from 2003 to 2014.

Design, Setting, and Participants: This population-based cross-sectional study used data from the 2003, 2008, and 2014 Kenya Demographic and Health Surveys. The study included women of reproductive age (ages 15-49 years) and children younger than years, with national, regional, county, and subcounty level representation. Data analysis was conducted from April 2018 to November 2018.

Exposures: …

Mechanical Suppression Of Osteolytic Bone Metastases In Advanced Breast Cancer Patients: A Randomised Controlled Study Protocol Evaluating Safety, Feasibility And Preliminary Efficacy Of Exercise As A Targeted Medicine, Nicolas H. Hart, Daniel A. Galvão, Christobel Saunders, Dennis R. Taaffe, Kynan T. Feeney, Nigel A. Spry, Daphne Tsoi, Hilary Martin, Raphael Chee, Tim Clay, Andrew D. Redfern, Robert U. Newton

Research outputs 2014 to 2021

BACKGROUND: Skeletal metastases present a major challenge for clinicians, representing an advanced and typically incurable stage of cancer. Bone is also the most common location for metastatic breast carcinoma, with skeletal lesions identified in over 80% of patients with advanced breast cancer. Preclinical models have demonstrated the ability of mechanical stimulation to suppress tumour formation and promote skeletal preservation at bone sites with osteolytic lesions, generating modulatory interference of tumour-driven bone remodelling. Preclinical studies have also demonstrated anti-cancer effects through exercise by minimising tumour hypoxia, normalising tumour vasculature and increasing tumoural blood perfusion. This study proposes to explore the promising …

Prenatal Risk For Autism Spectrum Disorder (Asd): Fetal Cortisol Exposure Predicts Child Asd Symptoms, Sheena Ram, Mariann A. Howland, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

The etiology of autism spectrum disorder (ASD) is multifactorial, complex, and likely involves interactions among genetic, epigenetic, and environmental factors. With respect to environmental influences, a growing literature implicates intrauterine experiences in the origin of this pervasive developmental disorder. In this prospective longitudinal study, we examined the hypothesis that fetal exposure to maternal cortisol may confer ASD risk. In addition, because ASD is four times more prevalent in males than in females, and because sexually dimorphic responses to intrauterine experiences are commonly observed, we examined whether or not any associations differ by fetal sex. Maternal plasma cortisol was measured at …

Strategies And Challenges Associated With Recruiting Retirement Village Communities And Residents Into A Group Exercise Intervention, Rachel L. Duckham, Jamie L. Tait, Caryl A. Nowson, Kerrie M. Sanders, Dennis R. Taaffe, Keith D. Hill, Robin M. Daly

Research outputs 2014 to 2021

BACKGROUND: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function.

METHODS: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via …

Prenatal Risk For Asd: Fetal Cortisol Exposure Predicts Child Autism-Spectrum-Disorder Symptoms, Sheena Ram, Mariann A. Howland, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

The etiology of autism spectrum disorder (ASD) is multifactorial, complex, and likely involves interactions among genetic, epigenetic, and environmental factors. With respect to environmental influences, a growing literature implicates intrauterine experiences in the origin of this pervasive developmental disorder. In this prospective longitudinal study, we examined the hypothesis that fetal exposure to maternal cortisol may confer ASD risk. In addition, because ASD is four times more prevalent in males than in females, and because sexually dimorphic responses to intrauterine experiences are commonly observed, we examined whether or not any associations differ by fetal sex. Maternal plasma cortisol was measured at …

Retinopathy Of Prematurity: A Major Review And Situation Analysis In Egypt, Ihab S. Othman

Journal of Medicine in Scientific Research

Retinopathy of prematurity (ROP) remains a major cause of childhood blindness in developing countries. As childhood and neonatal mortality in Egypt has shown tremendous improvement over the past two decades, it is expected to encounter an increasing number of cases of blindness from ROP in surviving infants unless strict guidelines and cooperation between different involved departments are explicitly set. In this review article, the author highlights the studies conducted and published risk factors, recommends protocols for early diagnosis, and describes management strategies to lessen or prevent blindness related to ROP.

The Role Of Urinary Hepcidin In Early Detection Of Iron Deficiency Anemia, Aisha El Sheimy, Azza Omran, Fify Helmy, Hala I. Mouhamed, Sohaila Ali, Youssof Mohamed

Journal of Medicine in Scientific Research

Iron deficiency anemia (IDA) is one of the most severe and important nutritional deficiencies, especially in children all over the world. Iron deficiency may occur because of inadequate dietary intake, increase in physiological needs of the nutrient, and/or increased losses, which may lead to anemia. IDA has been associated with cognitive, motor, and behavioral impairment in children. The most commonly used tests to determine iron status include serum iron levels, ferritin, and others. However, these test have limited role in diagnosis of IDA. For this reason, there is great interest in investigating effective method for the diagnosis of IDA. The …