Medicine and Health Sciences Commons^™

Effects Of Stem Cell Therapy On 6-Minute Walk Test Distance And Left Ventricular Ejection Fraction In Patients With Nonischemic Cardiomyopathy, Kayleigh Hunt, Alexa Maziuk

Physician Assistant Capstones, 2016 to 2019

Objective

To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.

Design

Systematic literature review

Methods

A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.

Results

Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

Diet-Induced Leukocyte Telomere Shortening In A Baboon Model For Early Stage Atherosclerosis, Genesio M. Karere, Michael C. Mahaney, Deborah E. Newman, Angelica M. Riojas, Clint Christensen, Shifra Birnbaum, John L. Vandeberg, Laura Cox

School of Medicine Publications and Presentations

Reported associations between leukocyte telomere length (LTL) attrition, diet and cardiovascular disease (CVD) are inconsistent. This study explores effects of prolonged exposure to a high cholesterol high fat (HCHF) diet on LTL in a baboon model of atherosclerosis. We measured LTL by qPCR in pedigreed baboons fed a chow (n = 105) or HCHF (n = 106) diet for 2 years, tested for effects of diet on LTL, and association between CVD risk factors and atherosclerotic lesions with LTL. Though not different at baseline, after 2 years median LTL is shorter in HCHF fed baboons (P < 0.0001). Diet predicts sex- and age-adjusted LTL and LTL attrition (P = 0.0009 and 0.0156, respectively). Serum concentrations of CVD biomarkers are associated with LTL at the 2-year endpoint and LTL accounts approximately 6% of the variance in aortic lesions (P = 0.04). Although heritable at baseline (h2 = 0.27, P = 0.027) and after 2 years (h2 = 0.46, P = 0.0038), baseline LTL does not predict lesion extent after 2 years. Atherogenic diet influences LTL, and LTL is a potential biomarker for early atherosclerosis. Prolonged exposure to an atherogenic diet decreases LTL and increases LTL attrition, and shortened LTL is associated with early-stage atherosclerosis in pedigreed baboons.

An In-Depth Review Of Retinitis Pigmentosa Development And Pathologies Overtime In Patients, Abdul Harris

Honors College Theses

Retinitis Pigmentosa is a disease which can cause blindness and affects around 2.5 million people worldwide. It is a disorder that has a multitude of ways of being inherited, such as autosomal dominant, autosomal recessive as well as X-linked and mitochondrial linked disorder. While some versions of RP may be syndromic (20%-30%), a majority of cases are in fact non-syndromic. The majority of non-syndromic cases inherited via autosomal dominant RP having RHO gene mutations, and X-linked means of inheritance having majority of patients with RPGR gene mutations. Ushers Syndrome, a syndromic version of retinitis pigmentosa and autosomal recessive RP having …

Impact Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Nasal Swab On Total Duration Of Mrsa Therapy For Pneumonia Patients, Darren D. Yum, Kayihura Manigaba, Danielle Gagne, Heather Ellis

Infectious Disease

Purpose: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program tool for avoiding unnecessary empiric anti-MRSA therapy for pneumonia. MRSA is an important cause of pneumonia and clinicians must determine when empiric antimicrobial therapy directed toward this pathogen is needed. Negative MRSA nasal swab has been shown to have a high negative predictive value ( >95%) across different types of pneumonia. The objective of this study is to assess the impact of negative MRSA nasal swabs on the duration of anti-MRSA therapy in a community hospital setting.

Methods: This study will be submitted to the institutional …

Impact Of Required Antibiotic Stop Dates And Indications On Length Of Treatment In Hospitalized Patients With Pneumonia, Amanda Haddad, Kathryn Hernando, Kayihura Manigaba, Abigail Antigua

Infectious Disease

Purpose: The CDC Core Elements of Hospital Antibiotic Stewardship Programs recommends implementing policies to support optimal antibiotic prescribing including documentation of dose, duration and indication. On January 31, 2017, the study institution implemented new physician order entry screens in the electronic health record requiring the input of indication and duration on all antibiotic orders. The objective of this study is to determine if implementation of mandatory indication and duration for antibiotic orders decreases antibiotic duration of therapy in hospitalized patients with pneumonia.

Methods: This study was submitted to the Institutional Review Committee for approval. The clinical pharmacy surveillance platform, …

Does Dispensing Naloxone Kits To High-Risk Patients At The Time Of Emergency Department (Ed) Discharge Reduce The Burden Of Subsequent Overdose-Related Care?, Steven D. Perry, Charleen Gnisci, Rachel Beham

Emergency Medicine

Purpose: The rates of opioid-related overdose and death have remained at or near historically high levels despite reform in pharmaceutical opioid prescribing trends. This study will determine if a recently implemented protocol which aims to provide high-risk patients with naloxone emergency kits at the time of ED discharge has reduced the need for subsequent overdose-related care to a greater degree than providing the same patients with written outpatient naloxone prescriptions. Patients currently receive either intervention upon discharge from the ED based on a protocolized, criteria-based, provider-implemented decision-making tree that identifies patients at high risk for subsequent overdose.

Methods: This study …

Air Pollution & Asthma Prevalence: Hotspot Analysis On Environmental Injustice In Buffalo, New York, Zuveria Shaguphta

Graduate Dissertations and Theses

This research aims to focus on the historical impacts of segregation in these communities (with Census Bureau data) and whether we see that these are the areas with continued segregation and a disproportionate number of TRI facilities. The third part of this research will be to investigate the presence of asthma in these neighborhoods as documented by the New York State Health Department. Asthma is a chronic disease in which the airways are inflamed due to some kind of external factor causing this reaction. Literature shows that there is a relationship between outdoor air pollution from combustion of fossil fuels …

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher

Ramucirumab: A New Agent For Advanced Or Metastatic Gastric Junction Adenocarcinoma, Adam Smith, Rebecca Worden, Jessica Hoffert, Brendon Rasor, Hannah Stewart, David Koh

Pharmacy and Wellness Review

Ramucirumab (Cyramza®), approved April 21, 2014, is a vascular endothelial growth factor receptor 2 (VEGFR2) antagonist with a U.S. Food and Drug Administration (FDA) indication for the treatment of advanced or metastatic gastric/gastroesophageal junction adenocarcinoma. Gastric cancer is a prevalent cancer in the United States with a poor prognosis. The phase 3 trial, REGARD, shows that ramucirumab, when used within four months after the last dose of first-line chemotherapy or six months after the last dose of adjuvant chemotherapy, increases overall survival. Also, ramucirumab has been included in combination therapy, such as in the RAINBOW trial, which demonstrated its effectiveness …

Outbreak Of Ebola Virus Disease, Alexandra Dimit, Tiffany Kneuss, Joelle Farano, Haley Armstrong, Jodi Otte, Andrew M. Roecker

Pharmacy and Wellness Review

Ebola virus disease (EVD) has existed as a major health concern with devastating and, many times, fatal symptoms. The recent outbreaks of EVD in West Africa and the Democratic Republic of the Congo (DRC) have incited international concern. In this article, the implications of EVD will be discussed including the etiology, transmission, signs and symptoms, diagnosis and treatment of the disease. In addition to this discussion, the manner in which major health care organizations, including the World Health Organization (WHO), are dealing with treating infected patients and containing spread of the disease will be covered.

Cannabinoids For The Treatment Of Chronic Headaches, Kevin Krivanek, Lucy K. Wagala, Brian Heilbronner, Kimberly Loughlin, David Kinder

Pharmacy and Wellness Review

Species of the Cannabis plant genus were among the earliest medicinal plants cultivated by man, with historical accounts of their medicinal uses dating back before the Common Era. Despite its current legal status, Cannabis has garnered nationwide attention as a therapeutic agent for various disease states, including chronic headaches, due to its medical indications as an antispastic, analgesic, antiemetic, neuroprotective and anti-inflammatory agent. Since headaches have a high prevalence in the American population and greatly impair simple daily aspects of living, chronic headaches have become a particular point of interest in regard to the therapeutic potential of Cannabis. Clinical trials …

Marijuana And Its Cardiovascular Implications, Albert Bui, Daniel Powell, Victoria Cho, Kelsey Lindsley, Lindsey Peters

Pharmacy and Wellness Review

As marijuana becomes legalized for medical use, it is important for prescribers and pharmacists to be knowledgeable about the important aspects of marijuana such as mechanism of action, indications and abuse potential. Although marijuana's medicinal benefits are frequently reported, the risks, namely cardiovascular risks, associated with its utilization are often overlooked. Use of marijuana has been reported to increase the risk of myocardial infarction, tachycardia and hypotension, among others. Health care providers must determine if marijuana's benefits outweigh such risks when marijuana therapy is an option. It is also important for pharmacists to understand how to successfully counsel patients using …

Fda Approves New Inhaled Insulin: Afrezza® (Technosphere® Insulin), Benjamin Finley, Christina Ciccone, Kimberly Loughlin, Michelle Musser

Pharmacy and Wellness Review

Diabetes is an endocrine disease caused by deficiency or malfunction of insulin that results in high blood glucose levels and places patients at higher risk for a number of complications. This chronic disease is difficult to manage and affects millions of people in the United States, costing the health care system billions of dollars a year. Of a variety of antidiabetic agents used to control blood glucose, insulin is perhaps the most effective, but until recently it was only available in injectable form. As of June 27, 2014, a new inhaled insulin called Afrezza® (Technosphere® insulin) was approved by the …

Prevention Of Cytomegalovirus Lntection In Pregnant Mothers And Neonates, Aisha Oliver, Taylor Gauthier, Breanne Rizzo, Alison Huet, Natalie Dipietro

Pharmacy and Wellness Review

Congenital cytomegalovirus (CMV) is the most common virus spread in utero from mother to fetus, leading to more long-term problems and childhood deaths than other conditions such as Down syndrome, fetal alcohol syndrome, pediatric HIV/AIDS, or neural tube defects. The majority of congenital CMV infections are primary infections in which the mother acquires the infection during pregnancy. Current treatment options for CMV infection are available, but there is limited data on safety and effectiveness in pregnant mothers and neonates. Prevention by screening for CMV is associated with a high cost, and vaccines are currently unavailable. Studies show that education and …

Polycystic Ovarian Syndrome And Hyperinsulinemia: Overview And Treatment, Amanda M. Meyer, Lauren D. Bajbus, Sarah E. Drake, Kristen M. Quertinmont, Ashley Overy, Anne Gentry

Pharmacy and Wellness Review

Polycystic ovary syndrome is a prevalent issue in women's health that is associated with hyperinsulinemia and insulin resistance and can lead to long-term health problems. The most highly recommended treatments are diet and lifestyle changes. If these changes alone are not enough, pharmacologic treatments may be employed which include metformin, spironolactone or thiazolidinediones, although more research is needed to fully realize their role. The role of the pharmacist in this disease state includes counseling patients on healthy lifestyle changes, consulting with the physician about prescribing the best medication for each patient, and monitoring therapy adherence in the patient.

Role Of Non-Nutritive Sweeteners In Obesity And Diabetes, Erica Schoenberger, Ellen Hazelet, Kaitlin Sanders, Lindsey Hallman, David Bright, Amy Stockert

Pharmacy and Wellness Review

Artificial sweeteners have become a central component of the Western diet in order to facilitate weight loss and enhance glucose control. Despite their popularity, evidence supporting the benefits of artificial sweeteners remains contradictory; different trials have shown weight loss, weight gain or no change with artificial sweetener consumption. Multiple trials have correlated artificial sweetener usage, in the form of diet soda, with an increased risk of obesity, diabetes and/or metabolic syndrome. Hypotheses speculate that individuals who consume larger loads of artificial sweeteners may be more likely to make unhealthy lifestyle choices, putting them at an increased risk for the development …

Management Of Hypertensive Emergencies In Pediatrics, Jennifer L. Bauer, Jamie L. Amero, Amanda C. Mcdavid, Ryan A. Fischer, Alison L. Huet, Karen L. Kier

Pharmacy and Wellness Review

As hypertension becomes more prevalent in the pediatric population, clinicians are more likely to encounter hypertensive emergencies in children, which require pharmacists and physicians to be educated on the therapeutic options for these emergencies. However, the strict governmental requirements on the testing of these drugs in pediatric patients have limited the amount of available evidence on which to base clinical decisions. This review will highlight the available evidence and preferred treatment options for the management of pediatric hypertensive emergencies.

Recent Advances Spark Significant Guideline Change: Antiretroviral Therapy (Art) At High Cd4+ Counts In The Treatment Naïve Patient, Joshua Ilenin, Kelly Fargo, Lisa Berni, Kristen Thatcher, Caitlin Swann, Andrew Roecker

Pharmacy and Wellness Review

Human immunodeficiency virus (HIV) targets CD4+ lymphocytes, a critical component to proper functioning of the human immune system. HIV is a significant public health concern, having resulted in over 27 million deaths since its discovery. Currently, several different treatment options exist, with combination antiretroviral therapy (ART) at the forefront. Despite the success of ART therapy, there are number of problems, including poor patient compliance. Due to this, the appropriate time to initiate therapy in the treatment naïve patient is under continuous scrutiny. Recently, several trials have demonstrated evidence suggesting that initiating ART at high CD4+ counts in the treatment naïve …

Evolution Of Acute Ischemic Stroke Treatment As Supported By Clinical Trials, Savya S. Shukla, Brian F. Baigorri Md, Roberto I. Fourzali Md, Yafell Serulle Md

Radiology

No abstract provided.

The Hiv Vaccine: Learning From Failure And Building On Success, Lindsey Mcclish, Kimberly Gathers, Katie Salay, Lisa Vranekovic, Kristin Seaman, Kelly M. Shields

Pharmacy and Wellness Review

An effective vaccine for acquired immune deficiency syndrome (AIDS) has eluded researchers since the identification of the HIV virus. There are many challenges in developing an effective HIV vaccine, including the lack of knowledge regarding the immune response to the virus and its diverse nature. Ethical concerns further complicate research. A recent phase III trial was performed in Thailand and showed that a significant reduction in HIV infection is possible. Pharmacists need to stay informed of these important breakthroughs in AIDS research in order to provide quality health information to patients in their community. This paper aims to evaluate the …

Role Of The Pharmacist In Improving Treatment For Children With Concurrent Gastrointestinal And Autism Spectrum Disorders, Whitney R. Henry, Kaitlin A. Sanders, Jenna L. Schaffner, Leslie M. Hart, Whitney N. Detillion, Anne F. Gentry

Pharmacy and Wellness Review

Over the last several years, a noteworthy association between gastrointestinal (GI) disorders and autism spectrum disorders (ASD) has been documented, although no large population-based studies exist. GI disorders in ASD children may stem from the underlying behavioral, communication, sensory or neurological issues intrinsic to the autistic disorder itself; therefore, the incorporation of alternative therapies, including behavioral modification, may be compelling treatment additions to the GI care traditionally recommended in children. To improve GI symptoms and quality of life in ASD children, a multidisciplinary approach is optimal, with pharmacists playing an active role in determining appropriate pharmacotherapy. Although there is a …

A Review Of Dabigatran, An Oral Anticoagulant, Lindsey A. Hallman, Chad A. Rounds, Rebecca A. Carey, Nicole R. Hume, Karen L. Kier, James Spicer

Pharmacy and Wellness Review

Serious clinical complications associated with venous thrombotic embolism (VTE) necessitate prophylaxis in patient groups who are at high risk of VTE, specifically those recovering from orthopedic surgery with atrial fibrillation, with mechanical heart valves, at increased risk for stroke, or recovering post-MI. Currently, prophylaxis with warfarin, enoxaparin, or fondaparinux has been the standard of therapy, but these therapies each have their limitations. Dabigatran etexilate is an orally available pro-drug of dabigatran, a competitive, reversible, direct inhibitor thrombin (Factor lla). The agent is converted by esterases, and, thus, not associated with the complications of the CYP enzyme system. Dabigatran follows a …

Evaluation Of Tumor Necrosis Factor Alpha In Sleep-Deprived Menopausal- Induced Rats And The Impact On Bone Health, Nicole Ellsworth, Dwight Curry Iii, Cj Deleon, Frank Frisch

Student Scholar Symposium Abstracts and Posters

Post-menopausal osteoporosis as a consequence of estrogen depletion is a growing concern for women in the United States. As more women take on executive positions and experience sleep deprivation, there is the potential for up regulation of pro-inflammatory cytokines, such as tumor necrosis factor alpha. It follows that the homeostatic imbalance of osteoclastic and osteoblastic activity leads to a greater risk of disease. Bisphosphonates generally, and Zolendronate specifically works by decreasing the number of osteoclasts. This current study investigated the impact of Zolendronate on the concentrations of tumor necrosis factor alpha-type (TNFɑ) in 32 ovariectomized Wistar rats. Throughout a five …

Bone Strength And Distal Femur Trabecular Thickness In Sleep Deprived Ovariectomized Rats Treated With Zoledronate, Erin Nolte, Frank Frisch

Student Scholar Symposium Abstracts and Posters

Osteoporosis is a disease that causes the density and quality of bone to be decreased, which can increase the risk of fracture by 40%. 1 in 3 women over the age of 50 will be affected by osteoporosis. This study aimed to show how bone strength and distal femur trabecular thickness might be affected by Zoledronate and sleep-deprivation in estrogen-deficient rats. Wistar female rats were ovariectomized to contrive postmenopausal estrogen-deficiency. The rats were separated into 4 groups. The control group (C, n=4) was given an intraperitoneal (IP) injection of 0.45 mL of 0.9% saline, were housed in standard conditions permitting …

Junctophilin-2 Protects Cardiomyocytes Against Palmitate-Induced Injury, Xiaoyun Ji

Electronic Thesis and Dissertation Repository

Cardiac lipotoxicity may induce cardiomyocyte apoptosis, eventually leading to myocardial dysfunction and heart failure. This study investigated whether and how junctophilin-2 (JPH2) plays a role in palmitate-induced apoptosis in cardiomyocytes. Here, we found palmitate incubation reduced JPH2 protein levels, increased cytosolic Ca²⁺ and induced apoptosis in cardiomyocytes. JPH2 over-expression prevented the increased cytosolic Ca²⁺ and apoptosis in palmitate-stimulated cardiomyocytes. JPH2 over-expression also attenuated palmitate-induced CCAAT-enhancer-binding protein homologous protein (CHOP) expression and CHOP deletion alleviated palmitate-induced apoptosis. Furthermore, blocking Ca²⁺ release from ryanodine receptor-2 (RyR2) prevented palmitate-stimulated CHOP induction and apoptosis. Additionally, JPH2 silencing elevated cytosolic Ca^{2+ …}

Alzheimer's And Amyloid Beta: Amyloidogenicity And Tauopathy Via Dyshomeostatic Interactions Of Amyloid Beta, Jordan Tillinghast

Senior Honors Theses

This paper reviews functions of Amyloid-β (Aβ) in healthy individuals compared to the consequences of aberrant Aβ in Alzheimer’s disease (AD). As extraneuronal Aβ accumulation and plaque formation are characteristics of AD, it is reasonable to infer a pivotal role for Aβ in AD pathogenesis. Establishing progress of the disease as well as the mechanism of neurodegeneration from AD have proven difficult (Selkoe, 1994). This thesis provides evidence suggesting the pathogenesis of AD is due to dysfunctional neuronal processes involving Aβ’s synaptic malfunction, abnormal interaction with tau, and disruption of neuronal homeostasis. Significant evidence demonstrates that AD symptoms are partially …

Effectiveness Of Individual Nutrition Education Compared To Group Education, In Improving Anthropometric And Biochemical Indices Among Hypertensive Adults With Excessive Body Weight: A Randomized Controlled Trial, Danuta Gajewska, Alicja Kucharska, Marcin Kozak, Shahla M. Wunderlich, Joanna Niegowska

Department of Nutrition and Food Studies Scholarship and Creative Works

Objective: The study aims to compare the effectiveness of individual and group nutrition education methods in improving key anthropometric and biochemical markers in drug-treated, overweight-obese hypertensive adults. Methods: The randomized trial included 170 patients with pharmacologically well-controlled primary hypertension and body mass index (BMI) ≥ 25 kg/m². For six months, the patients received six sessions, either one-to-one individual nutrition education (IE, n = 89) or group education (GE, n= 81), developed by dietitians. Anthropometric measurements, body composition, and fasting measures of biochemical parameters were obtained at baseline and after six months of intervention. Results: 150 patients completed the …

A Cross-Sectional Analysis Of Factors Associated With Detection Of Oncogenic Human Papillomavirus In Human Immunodeficiency Virus-Infected And Uninfected Kenyan Women, Aaron Ermel, P. Tonui, M. Titus, Y. Tong, N. Wong, J. Ong’Echa, Kapten Muthoka, Stephen Kiptoo, A. Moormann, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer is caused by oncogenic human papillomaviruses (HPV) and is one of the most common malignancies in women living in sub-Saharan Africa. Women infected with the human immunodeficiency virus (HIV) have a higher incidence of cervical cancer, but the full impact on HPV detection is not well understood, and associations of biological and behavioral factors with oncogenic HPV detection have not been fully examined. Therefore, a study was initiated to investigate factors that are associated with oncogenic HPV detection in Kenyan women.

Methods: Women without cervical dysplasia were enrolled in a longitudinal study. Data from enrollment are presented …