Medicine and Health Sciences Commons^™

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

The Case For Using Composition Tomography To Evaluate Perirectal Necrotizing Fasciitis: Is It Really Necessary?, Tyler Bayliss, David Denning

Marshall Journal of Medicine

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if …

Perceptions Of Diabetes Distress And Counseling During The Pandemic - Rural Provider Perspectives, Ranjita Misra, Brenna O. Kirk, William D. Lewis

Marshall Journal of Medicine

Introduction

West Virginia is an Appalachian rural state that ranks highest in the nation in the prevalence of diabetes (16.2%). The COVID-19 pandemic impacted routine diabetes care. As a result, individuals experienced diabetes distress over the physical and psychological burdens of diabetes management. In rural and medically underserved counties (71%), diabetes care is often provided by primary care physicians. However, healthcare providers’ perspectives on diabetes distress and related counseling to address them are unclear. This cross-sectional study’s objective was to explore healthcare providers’ (HCP) perspectives regarding their patient’s diabetes distress and how it guided their counseling for diabetes self-care during …

Chronic Exertional Compartment Syndrome: A Case Report About Claudication In A Healthy Adult, Adrienne Mays-Kingston, Jeremy Eckels, Holly Farkosh, Austin Nichols, Paris Johnson, Adam M. Franks

Marshall Journal of Medicine

Claudication occurs when the blood supply is insufficient to service the musculature in the body with oxygen and metabolic waste management. A clinical complaint of claudication is commonly seen in primary care among older patients with vascular risk factors. A young and healthy patient presenting with claudication is less common and often results in delayed diagnosis with numerous extraneous diagnostic studies. This case discusses a young, healthy male patient with lower extremity symptoms that got worse with exercise and better with rest. He had normal physical exam findings leading to multiple diagnostic studies and over 12 months between the onset …

High Body Mass Index Changes Peri-Tumor Adipose Tissue Which In Turn Promotes Triple Negative Breast Cancer, Cora Elizabeth Miracle

Theses, Dissertations and Capstones

Cancer is one of the leading causes of death worldwide, responsible for over half a million deaths each year. There are multiple risk factors associated with the development of cancer. Some of these risks include genetics, smoking, and most recently, obesity (Lewandowska et al., 2019) (De Pergola & Silvestris, 2013). Research has shown that obesity is linked to the promotion of fourteen different cancers, including aggressive triple negative breast cancer (TNBC). Patients that are obese are more likely to develop cancer (Park et al., 2014). In addition, if the patient is obese at the time of a cancer diagnosis, they …

Elucidating The Impact Of Western Diet On Bone Marrow Cytokine Signatures: Understanding Poor Outcomes In Susceptibility To Infection And Progression Of Cancer, Lahari Kondeti

Theses, Dissertations and Capstones

Among other disease outcomes, obesity is associated with 1) reduction in long-lasting immune protection and 2) acquisition of cancer. Given our interest in hematopoietic stem and progenitor cell (HSPC) dynamics, we questioned if similar mechanisms in the bone marrow microenvironment contribute to obesity-induced HSPC alterations responsible for 1) decreased immune protection and 2) transformation of HSPCs in the pathogenesis of hematologic malignancies. The negative effects of obesity on immune protection are most notably established in influenza models. Influenza infection susceptibility is increased and influenza vaccine-induced immunity wains in obese individuals. Ongoing studies aim to define mechanisms for waning immunity at …

Benefits Of Medical Thc For Neurological Disorders In The U.S., Andrew Lester, Alexandria Gartin

Theses, Dissertations and Capstones

Introduction: The introduction of THC into the medical field has allowed medical professionals to offer a new treatment option to aid in their patients treatment plan by decreasing their symptoms of side effects of other medications used for their conditions.

Methodology: This study utilized a literature review. Five databases were used to collect 116 total sources. These sources were reviewed and reduced to 33 sources that were used in the written research. Of these, 16 sources were used in the results section.

Purpose of the Study: The purpose of this research was to analyze the prescription use of …

Spontaneous Pneumothorax: A Rare Complication Of Neurofibromatosis Type 1 Associated Diffuse Lung Disease, Emma I. Sherfinski, Mark H. Cooper Md, Phd

Marshall Journal of Medicine

The visually striking neurocutaneous findings of neurofibromatosis type 1 (NF1) are well recognized and have been well documented throughout scientific literature. While not uncommon, the pulmonary manifestations of NF1 are unknown to many physicians. Complications of NF1 associated diffuse lung disease (NF-DLD) include pulmonary hypertension, pulmonary artery stenosis, subpleural cysts, and spontaneous pneumothorax. We present a case of a 34-year-old male with NF-DLD found incidentally in adolescence with previous apical bleb repair, presenting nearly twenty years later with spontaneous pneumothorax. In NF1 patients with pulmonary complaints, NF-DLD should be assessed with computed tomography (CT) and physicians should be familiar with …

Chronic Cavitary Pulmonary Aspergillosis: An Unusual Cause Of Chronic Cough, Pleuritic Chest Pain, And Hemoptysis In A 24-Year-Old Coal Mine Worker, Emma I. Sherfinski, Emily J. Vore, Mark H. Cooper Md, Phd, Peimei He Md

Marshall Journal of Medicine

Pulmonary Aspergillus infections are caused by the ubiquitous fungus mold when spores found in compost, dust, and plant material are inhaled. Manifestation of the disease is represented by a delicate balance between host and pathogen interactions, making Aspergillus infection more commonly observed in immunocompromised individuals. Chronic cavitary pulmonary aspergillosis (CCPA) is a subtype of pulmonary Aspergillosis associated with history of chronic or prior lung disease. Here we present the case of a non-immunocompromised 24-year-old male with a history of intermittent asthma with chronic pulmonary symptoms and finding of a lung mass on imaging. We describe the diagnostic challenge and surgical …

Analysis Of Blood Borne Pathogen Exposure Monitoring Protocol Adherence In An Academic Medical Center: A Seven Year Analysis And Literature Review, Natavoot N. Chongswatdi Md, Callie Seaman Md, Diane Harman Rn, Bsn, William Rollyson Md, Adam M. Franks Md

Marshall Journal of Medicine

Introduction

Health care workers (HCW) are at risk for occupational blood borne pathogen exposures (BBPE). Effective prevention and management of BBPEs relies upon reporting and post-exposure follow-up protocol adherence. As post-exposure monitoring completion is largely unexplored, seven years of a university healthcare system’s BBPE exposure data was explored and compared to documented rates.

Methods

The Marshall Health Occupational Health and Wellness division collected seven years (2012-2018) of BBPE follow-up monitoring adherence rates and demographic data. Data for HCW occupation, exposure incident, and source patient disease status were evaluated. Differences were analyzed with Chi square, Fischer Exact and logistic regression tests. …

Adult Pulmonary Langerhans Cell Histiocytosis With Osseous Involvement: Understanding This Rare Mimic Of Malignancy, Samantha A. Smith Ms Iii, Adam M. Franks Md, William Rollyson Ms Iv, Doreen Griswold, Tammy Bannister Md

Marshall Journal of Medicine

Langerhans cells are dendritic cells that form the antigenic barrier of the human body. They occur in nearly any tissue but are most prevalent in the skin, submucosa of the bronchial tree, and other mucosae. Langerhans Cell Histiocytosis (LCH) develops when these cells damage the tissues in which they reside through a combination of inflammatory and monoclonal stimulation. The pulmonary variant of LCH involves the lung parenchyma and creates a wide variety of disturbances: pulmonary hypertension and both obstructive and restrictive lung disease. Osseous involvement, in addition to the pulmonary variant, presents with pulmonary masses and lytic bone lesions, which …

Current And Novel Neuroregenerative Therapies, Arrin Brooks

Theses, Dissertations and Capstones

Underlying the physical and cognitive deficits consequent of many neuropathologies is one common factor, the loss of neurons. While neurodegenerative diseases, stroke, and traumatic brain injury arise from a variety of etiologies, they all ultimately result in injury and/or death of neuronal cells and concomitant functional deficits. In the present work we primarily focus on current and potential treatments for localized lesions, particularly those in the striatum of Parkinson’s disease (PD) or the cortex as in stroke. First, we discuss a new surgical technique for deep brain stimulator (DBS) placement, as DBS is a mainstay treatment for movement disorders including …

Experiences In Remote Learning: Perceptions Of West Virginia Educators During The Covid-19 Pandemic, Craig Edward Arch

Theses, Dissertations and Capstones

In March 2020, the threat of illness caused by Covid-19 prompted West Virginia Governor Jim Justice to abruptly close public schools statewide. Instruction was delivered remotely for the remainder of the 2019 – 2020 school year and sporadically across the state during the 2020-2021 school year with educators holding class meetings and delivering instruction where technology and a reliable internet connection were available. Gaining understanding as it relates to a teacher’s remote learning experience may provide insight into how administrators can prepare for future interruptions in in-person instruction. Identifying specific areas teachers felt were challenging or stressful may provide a …

Utility And Yield Of Genetic Testing Leading To A Definitive Neuromuscular Or Neuropathic Diagnosis At A Rural Outpatient Neurology Clinic Affiliated With A University Health Center In West Virginia Over 4 Years., Holly Farkosh, Dominika Lozowska

Marshall Journal of Medicine

Introduction

Clinicians are increasingly relying on genetic testing to pinpoint definite diagnoses. A more general diagnosis of neuropathy or neuromuscular disease like myopathy can be narrowed down substantially using genetic testing. Because carrier status is of utmost importance in reproductive matters, pathogenic results can prognosticate the future course of the illness and help plan ahead for treatment and social supports. Given the expense of genetic testing, it is important to assess the cost-benefit ratio to determine whether it is worthwhile to collect genetic samples. The purpose of the study was to determine the likelihood of obtaining a conclusive confirmatory diagnosis …

Alpha-Gal Allergy: A New Threat To Appalachia, Adam M. Franks Md, Makala Murphy Bs, Madison Griffis Md, Rebekah Franks Ba, Cwr, Colin M. Franks, Gary Petty Md

Marshall Journal of Medicine

Abstract

Alpha-gal allergy, or mammalian meat allergy, is described as the development of IgE antibodies to the oligosaccharide galactose-a-1,3-galactose following a bite from the tick species Amblyomma americanum (Lone Star tick) or Dermacentor variabillis (Wood tick). Dermatologic or gastrointestinal symptoms are usually delayed by four to six hours after exposure, making the diagnosis difficult. Due to the use of mammalian proteins in many common medications, surgical equipment and prosthesis, unexpected reactions can occur. In the United States, this pathology is predominately seen in the southeast, but has been associated with other tick species on every continent except Antarctica. As the …

Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Diagnosis Obscured By Concomitant Recreational Drug Use, Paige Lester Ms Ii, Adam M. Franks Md, William Rollyson Ms Iv, Jenna K. Barbour Md, Matthew B. Curry Md

Marshall Journal of Medicine

Anti-NMDA receptor encephalitis (aNMDAre) is a relatively newly discovered autoimmune and inflammatory disorder affecting the limbic system. It has a clinical course that includes Prodromal, Psychiatric, Unresponsive and Hyperkinetic stages. These stages are often confused with mental health issues in the medical literature, but they also share symptoms of various drug intoxication and withdrawal states. Implicit bias in physicians regarding substance use disorder and patient demographics can impair delivery of care and outcomes in patients with aNMDAre, especially in an environment of recreational drug use. When clinical presentation aligns, this diagnosis should be investigated as soon as possible, even in …

Non-Selective Primary Human Tumor Cell Line Generation From Surgical Resections To Be Paired With Flash Frozen And Paraffin Embedded Tissue: Advancements In Democratizing Translational Research Materials To Rural Institutions, Jennifer Hawkins, Rebecca Russell, Logan M. Lawrence, Amrita Valluri, Jessica Wellman, Krista Denning

Marshall Journal of Medicine

Translational cancer research relies on the availability of human patient tissue demonstrating the specific disease process under investigation. Biobanks of human tissue have historically been and remain to date the primary access point for cancer research samples. Biorepositories routinely supply researchers with varying sample types for use in biomedical studies; most commonly formalin-fixed and paraffin-embedded (FFPE) tissue, or fresh snap-frozen tissue. In conjunction with preserved tissue samples, viable tumor cell lines derived from patient tissue have emerged to be a new gold standard in cancer research particularly in drug discovery and functional prognostic assays. Tissue banks providing these samples are …

Leveraging A Public-Private-Academic Collaborative Partnership To Confront Challenges In The Covid-19 Pandemic., James Denvir

Marshall Journal of Medicine

Like all viruses, the SARS-CoV-2 virus mutates over time, creating new viral variants that have the potential to transmit more rapidly, cause more severe disease, or avoid treatment and prevention strategies. A critical component of the public health response to COVID-19 is identifying and tracking emergence of SARS-CoV-2 variants. In West Virginia, this effort is coordinated via a public-private-academic collaboration.

The U-Net-Based Active Learning Framework For Enhancing Cancer Immunotherapy, Vishwanshi Joshi

Theses, Dissertations and Capstones

Breast cancer is the most common cancer in the world. According to the U.S. Breast Cancer Statistics, about 281,000 new cases of invasive breast cancer are expected to be diagnosed in 2021 (Smith et al., 2019). The death rate of breast cancer is higher than any other cancer type. Early detection and treatment of breast cancer have been challenging over the last few decades. Meanwhile, deep learning algorithms using Convolutional Neural Networks to segment images have achieved considerable success in recent years. These algorithms have continued to assist in exploring the quantitative measurement of cancer cells in the tumor microenvironment. …

Drug Delivery Systems: Exploring Rheological Properties And Therapeutic Effect Of 5-Fu Chitosan Gel For Topical Wound Healing, Samuel Tetteh-Quarshie

Theses, Dissertations and Capstones

Diabetic skin wound is a common complication of diabetes that occurs in about 15% of diabetic patients and often requires prolonged hospitalization for its management and treatment. Natural polymers are used for wound dressing due to their biological adhesiveness, non-toxicity, and biodegradable nature. 5-Fluorouracil (FU) has been shown to alter adipokine expression which is implicated in cutaneous wound repair. Thus, our overall objective was to investigate the utility of chitosan (CS) gel for topical delivery of 5-FU to treat diabetic wounds. We prepared chitosan gel (2% w/w) in serial dilutions of 5-FU (25μg/mL, 2.5μg/mL, 0.25μg/mL, and 0.025μg/mL) and evaluated their …

Role Of Thymidine Phosphorylase In Type 2 Diabetes-Associated High-Risk Of Thrombosis, Adam Belcher

Theses, Dissertations and Capstones

Cardiovascular diseases (CVDs), such as ischemic heart disease and stroke, are the leading causes of death globally that disproportionally affects patients with type 2 diabetes mellitus (T2DM) at a 2-4-fold rate compared to non-diabetic patients. These CVDs result from a blood clot, also known as a thrombus, formed in arteries that can block blood flow resulting in tissue damage and death. Antiplatelet drugs, such as aspirin and clopidogrel, used to prevent thrombosis have been found to be less effective in diabetics and increase the risk of hemorrhagic events. The T2DM epidemic has made it imperative to find therapies that decrease …

Do Needle Exchange Programs Cause More Harm To Injection Drug Users And Compromise The Safety Of The Communities In Which They Are In Place?, Amber L. Payne

Theses, Dissertations and Capstones

Needle Exchange Programs (NEP) are put in place in regions in the US, where illegal injectable drug use is prevalent, in order to decrease the amount of blood borne diseases by at least 10%, such as Hepatitis C and Human Immunodeficiency Virus (HIV), being spread throughout the drug-using community. People and Healthcare Professionals in these communities have questioned if NEPs have caused more harm to the drug users and if they have compromised public safety due to incorrect disposal of syringes.

During a study in 2011, the spread of blood borne diseases in areas where NEPs were present, decreased among …

Effects Of The Needle Exchange Program Implemented In West Virginia, Amber Graves, Anthony B. Uriarte, Katherine Duty

Theses, Dissertations and Capstones

Introduction: West Virginia has had a recent spike in infectious diseases such as HIV and hepatitis due to increased rates of injectable drug use. The rising costs associated with such diseases have been a cause for concern in the sector of healthcare and public health. In the state, the exchanging of dirty needles has resulted in the spread of bloodborne pathogens, however, the implementation of needle exchange programs has sought to decrease the rates of infection, improve health outcomes, and lower healthcare costs. However, there is a question as to the effectiveness of such programs.

Purpose of Study: …

Targeting Epigenetic Mechanisms In Endometriosis, Sarah Elizabeth Brunty

Theses, Dissertations and Capstones

Endometriosis is a complex and elusive gynecological disease in which the inner lining of the uterus grows in locations outside of the uterus and forms lesions. It is known to affect 1 in 9 women of reproductive age worldwide. Symptoms of endometriosis include severe pain, heavy periods, and infertility. While multiple theories of origin exist, none fully encompass all aspects of the disease, although all theories agree that this is an inflammation-driven disease. Due to this, many researchers are turning towards epigenetics to explain the initiation and progression of endometriosis. However, what is causing these epigenetic changes is still a …

The Epigenetic Effects Of Omega-3 Fatty Acids In Diffuse Large B-Cell Lymphoma, Tanner Jeffrey Bakhshi

Theses, Dissertations and Capstones

Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma. It is an aggressive cancer, with 50-70% of patients diagnosed at an advanced stage and 30-50% of patients not cured by chemoimmunotherapy. DLBCL is almost always caused by genetic damage sustained during the germinal center (GC) reaction. The mechanisms that govern the GC reaction bear a striking resemblance to those that drive DLBCL. Genomic studies have shown that some of its most common mutations occur in genes that encode epigenetic modifiers, including the lysine (histone) acetyltransferases CREBBP and p300. These mutations prevent the acetylation of multiple histone residues, …

Beyond The Skin: A Case Report Of Vaginal Melanoma, Brittany Gilbert, Wm Tanner Gilbert, Ardeshir Hakam, Lynne J. Goebel

Marshall Journal of Medicine

Mucosal melanomas are rare, accounting for only 1.4% of all melanomas. Only 18% of mucosal melanomas are vulvovaginal in origin, making it exceedingly rare. Mucosal melanomas typically carry a worse prognosis than those arising from cutaneous sites with a higher risk of recurrence and disseminated disease. We report a rare case of vaginal melanoma presenting as postmenopausal bleeding and discuss management of this disease.

Acute Marjolin Ulcer From A Dog Bite, Brandon S. Henderson, Katalin Z. Kovacs, Lynne J. Goebel

Marshall Journal of Medicine

Marjolin ulcers are cancers, usually of squamous cell carcinoma pathology, that occur in scars or wounds. They are classically described in burn victims but can occur with other types of trauma and are rarely seen in association with bite wounds. Marjolin ulcers typically have a latent period of many years post-injury until the development of malignancy, but there are a few case reports of an exceedingly rare acute form. We present a case of a 78-year-old female who developed a Marjolin ulcer one month after sustaining a dog bite to the left index finger.

Chronic Inflammatory Demyelinating Polyneuropathy (Cidp) In A Patient With Diabetes: A Primary Care Perspective, Jordan Dever, Adam M. Franks, Laura M. Given, William Rollyson, Adrienne Mays-Kingston

Marshall Journal of Medicine

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a recurrent and progressive disease that causes proximal, symmetrical extremity weakness. The disease is diagnosed using clinical features, electrophysiologic testing, albumino-cytological disassociation in the cerebrospinal fluid, and sural nerve plexus biopsy. However, because of the low sensitivity of diagnostic criteria and other similar neuropathies, including diabetic polyneuropathy (DPN), accurate diagnosis is difficult. Differentiating between these diseases is especially important as CIDP’s changes are reversible and DPN’s are not. Making this differentiation allows for symptomatic improvement in a patient’s quality of life that would not be achieved otherwise. Early recognition and treatment, with modalities including …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Chronic Abdominal Pain In A Geriatric Patient: A Rare Case Of A Spigelian Hernia, Thomas D. Wright, Olumayowa Dayo, Lynne J. Goebel

Marshall Journal of Medicine

We present a case of Spigelian hernia in a 77-year-old patient to highlight the difficulty in making this diagnosis and to raise awareness of this rare condition among physicians who care for geriatric patients with chronic bouts of abdominal pain. The patient presented to the emergency department with a two-day complaint of abdominal pain after three years of similar recurrent attacks. Results of the physical examination and computed tomography (CT) of the abdomen were consistent with a left-sided Spigelian hernia. Operative repair was performed using robotic-assisted reduction and the patient recovered without any complications.