Medicine and Health Sciences Commons^™

Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut

Journal of Patient-Centered Research and Reviews

Type 2 diabetes mellitus is an immense burden to the health of our population and to our current health care system, and the weight of this burden is only projected to multiply in coming years. A nutritious diet is an indispensable aspect of diabetes treatment, and the lack of access to food engenders poor disease-state control, which correlates with increased health care utilization. Interventions aimed at improving access to food through medically tailored meals (MTMs) have demonstrated effectiveness in improving the health of food-insecure type 2 diabetic patients and reducing health care costs. Further studies are necessary to increase the …

Improving Bronchiolitis Care Across Multiple Care Settings Using A Deimplementation Bundle, Amanda Nedved, Kathleen Berg, Troy Richardson, Amanda Montalbano, Matthew B. Johnson

Posters

Despite the availability of a bronchiolitis CPG; variation in care practices still existed at our institution. The aim of our quality improvement (QI) project was to increase overall adherence with our institutional CPG in patients 60 days to 24 months of age diagnosed with bronchiolitis in the urgent care centers (UCC), emergency departments (ED), and general inpatient units from a baseline of 40.9% to 60% by the end of two bronchiolitis seasons.

Gracilis Myocutaneous Flap For Perineal Defect Reconstruction After Left Hemivulvectomy For Locally Invasive Vulvar Cancer – A Case Report And A Literature Review, Nicolae Bacalbasa, Irina Balescu, Andreea Mereuta, Alina Tanase, Adriana Ghelmene, Mihaela Vilcu, Iulian Brezean

Journal of Mind and Medical Sciences

Performing radical surgery for locally advanced vulvar cancer is usually associated with the occurrence of large perineal defects. In order to provide a better healing process of the perineal wound, different reconstructive techniques have been proposed.

We present the case of a 63-year-old female patient diagnosed with locally advanced vulvar cancer for which a left hemivulvectomy with bilateral inguinal lymph node dissection was performed. After completion of the resection phase, the reconstruction with gracilis myocutaneous flap was performed. The patient developed a non-union of the flap. However, it slowly healed without any surgical re-intervention.

Gracilis myocutaneous flap seems to be …

Xanthogranulomatous Pyelonephritis: Presentation And Management, Răzvan C. Petca, Răzvan I. Popescu, Cristian Mareș, Claudia Mehedințu, Bogdan Mastalier, Dumitru Cristinel Badiu, Nicoleta Măru, Vlad D. Constantin, Aida Petca

Journal of Mind and Medical Sciences

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and …

Immune And Inflammatory Pathways In Non-Alcoholic Steatohepatitis (Nash). An Update, Sorina Cezara Coste, Ionela Popovici, Andreea Maria Stefan, Iulia Breaban, Adela Sitar Taut, Simina Tarmure Sarlea, Angela Cozma, Dorel Sampelean, Olga Hilda Orasan, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test …

The Relationship Between Gut Microbiota And Spontaneous Bacterial Peritonitis In Patients With Liver Cirrhosis - A Literature Review, Roxana-Emanuela Popoiag, Anca Mihaela Pantea Stoian, Adrian P. Suceveanu, Andra I. Suceveanu, Laura Mazilu, Irinel R. Parepa, Laura M. Serban, Mihai Paunica, Catalina Motofei, Carmen Fierbinteanu Braticevici

Journal of Mind and Medical Sciences

Gut microbiota is an essential component in the pathogenesis of liver cirrhosis and its complications. There is a direct relationship between the gut and the liver called the gutliver axis through which bacteria can reach the liver through the portal venous blood. However, it remains unclear how bacteria leave the intestine and reach the fluid collection in the abdomen. A series of mechanisms have been postulated to be involved in the pathogenesis of spontaneous bacterial peritonitis (SBP) and other complications of liver cirrhosis, including bacterial translocation, bacterial overgrowth, altered intestinal permeability and dysfunctional immunity. The hepatic function may also be …

Physical Exercise – The Friend Or The Enemy Of The Patient With Pulmonary Tuberculosis?, Victoria Maria Ruta, Teodora Gabriela Alexescu, Simina Tarmure, Vasile Negrean, Monica Carmen Pop, Nicoleta Motoc, Iulia Olimpia Pfingstgraf, Mirela Georgiana Perne, Lorena Ciumarnean, Simona Valeria Clichici, Adina Milena Man

Journal of Mind and Medical Sciences

Introduction. Tuberculosis, a major cause of morbidity and mortality, is the second cause of death from an infectious disease, after HIV/AIDS. Each second, a new infection occurs around the globe. Pulmonary tuberculosis can equally affect a performance athlete as well as an aspiring athlete. Physical exercise must be individualized and customized. Pulmonary rehabilitation guides 3 recommend types of exercises for patients with obstructive pathology: stretching, cardiovascular exercise or aerobics. Exercises must be started under medical supervision and must be interrupted if: the ventricular altitude increases above the maximum estimated level for the age, oxygen saturation (SaO2). Aim. The current review …

Total And Free Plasma Bilirubin And Clinical Outcomes In Severe Hyperbilirubinemia, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, Tina Slusher, Fatima Abdullahi, Hafsat M. Suleiman, Victor C. Pam, Mamu B. Samuel, Christopher S. Yilgwan, Christian Isichei, Idris Y. Mohammed

Posters

Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) have become relatively uncommon in high income countries but remain a major cause of morbidity and mortality in low- and middle-income countries. To better understand the relationship between free (Bf) and total (TB) bilirubin levels and the development of ABE and KSD we followed infants born in three large tertiary centers in northern and central Nigeria (Jos, Kano and Zaria).

Weighted Pathway Genetic Load Analysis Of Hyperbilirubinemic Infants Indicates A Potential Genetic Component For Susceptibility To Bilirubin Neurotoxicity, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, John Cowden, Monica Villagullen, Laurence Thielemans, Dina Villanueva Garcia, Jesus Aguirre-Hernandez

Posters

Severe kernicterus spectrum disorder (KSD) is described as motor and auditory deficits resulting from brain damage caused by hyperbilirubinemia. The severity of HB does not always predict the severity of injury. The lack of a strong monogenetic link to susceptibility suggests bilirubin-induced brain damage may be due to impaired bilirubin response pathways. This poster describes work to use a modified pathway genetic load (mPGL) score method to perform a targeted genetic analysis of whole exome data from patients with various degrees of neonatal HB, with an ultimate goal of developing a neonatal screen to susceptibiltiy to bilirubin neurotoxicity.

Prevention Of Oral Mucositis In Cancer Patients, Patricia E. Biel

Evidence-Based Practice Project Reports

Oral mucositis [OM] is one of the most severe non-hematological problems related to cancer treatments and can impact quality of life. It is linked to poorer outcomes due to the associated weight loss, pain, dehydration, and risk of developing life-threatening infections. The purpose of this evidence-based practice project was to determine if OM is preventable with the use of an oral care protocol and zinc supplementation when compared to use of oral care protocols alone. The Johns Hopkins Nursing Evidence-Based Practice Model was used to guide project implementation in an outpatient oncology office. Recommendations were developed from an exhaustive review …

Direct Lung Sampling Indicates That Established Pathogens Dominate Early Infections In Children With Cystic Fibrosis., Peter Jorth, Zarmina Ehsan Md, Amir Rezayat, Ellen Caldwell, Christopher Pope, John J. Brewington, Christopher H. Goss, Dan Benscoter, John P. Clancy, Pradeep K. Singh

Manuscripts, Articles, Book Chapters and Other Papers

Culture and sequencing have produced divergent hypotheses about cystic fibrosis (CF) lung infections. Culturing suggests that CF lungs are uninfected before colonization by a limited group of CF pathogens. Sequencing suggests diverse communities of mostly oral bacteria inhabit lungs early on and diversity decreases as disease progresses. We studied the lung microbiota of CF children using bronchoscopy and sequencing, with measures to reduce contamination. We found no evidence for oral bacterial communities in lung lavages that lacked CF pathogens. Lavage microbial diversity varied widely, but decreases in diversity appeared to be driven by increased CF pathogen abundance, which reduced the …

Representing The Patient Experience Of Heart Failure Through Empathy, Journey And Stakeholder Mapping, Leanna Woods, Jed Duff, Erin Roehrer, Kim Walker, Elizabeth Cummings

Patient Experience Journal

Heart failure is a long-term condition requiring those affected to manage numerous self-care related activities. People with heart failure report multiple challenges accommodating self-care activities in their every-day life. The aim of this study is to (1) understand the experience of people with heart failure and their caregivers in the local patient population, and (2) visually represent these experiences to inform the design of a mobile health intervention supporting self-care. Seven patients and four family caregivers were interviewed using an empathic approach. Data was collected using rapid design methods including an empathy map to uncover patient and caregiver perspectives and …

Comedian Rod Man’S Heartfelt Speech, Ramona Johnston's Death Remind Us Of Urgent Need To Cure Huntington's Disease, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Iron-Containing Nanoparticles For The Treatment Of Chrionic Biofilm Infections In Cystic Fibrosis, Leisha M. A. Martin

Nanoscience and Microsystems ETDs

Cystic fibrosis (CF) is the most common genetic disease resulting in the morbidity and mortality of Caucasian children and adults worldwide. Due to a genetic mutation resulting in malfunction of the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) protein, CF patients produce highly viscous mucus in their respiratory tract. This leads to impairment of the mucociliary clearance of inhaled microbes. In addition to reduced microbial clearance, anoxic environmental conditions in the lungs promote biofilm-mode growth of the pathogenic bacterial species Pseudomonas aeruginosa. Chronic infections of P. aeruginosa begin in early childhood and typically persist until respiratory failure and death result. The …

Mortality Influenced By Sepsis Bundle Compliance And Initial Lactic Acid In Severe Sepsis And Septic Shock, Evelyn George

DNP Projects

Sepsis, a life-threatening infection killing 270,000 yearly, is a concern to health care providers, policy makers, and patients due to its high volume and increasing cost. Patients older than 64 years have a higher occurrence of sepsis and greater mortality risk. The Surviving Sepsis Guidelines (SSG) recommends the use of the three-hour bundle that standardizes care to decrease cost, morbidity, and mortality. The three-hour bundle includes two treatments, intravenous fluids and antibiotics, and two tests, blood cultures and lactic acid level. One bundle element, lactic acid level, is associated with higher mortality rates, although only a few studies exist. The …

2018 Guide Summer Research - Breast Cancer, Qur'annah Jones, Delawnia Comer-Hagans

Research Days

This research poster details the relationship between cancer treatments and alternative approaches, such as mindfulness. The purpose of this study was to determine the methodology used by doctors to treat breast cancer and their willingness to try a holistic approach. This study was conducted on site at the UIC Cancer Center as well as remotely within hospitals around the Chicagoland area. We determined that mindfulness is in fact a worthwhile asset to breast cancer patients and that the field of oncology could support further research.

Prognosis Of Patients With Aki After Percutaneous Mechanical Thrombectomy: A Retrospective Cohort Analysis, Hongchuan H. Coville Md, Tien-Min Lee Md, Hong Liang, Paul Alfino Md, Christopher Bray Md, Matthew Calestino Md

Internal Medicine

Percutaneous Mechanical Thrombectomy (PMT) is an endovascular procedure utilized in both arterial and venous thrombosis. Acute kidney injury (AKI) has been recognized as one undesired sequela of PMT. There is no study to investigate the outcomes in this specific patient population.

An Anatomical And Functional Analysis Of Digital Arteries, Katie Highsmith

Student Scholar Showcase

Blood flow to the tissue of the hands and digits is efficiently regulated by vasoconstriction and vasodilation. Through a series of cadaveric dissection, we examined arteries in the hands and digits, including ulnar artery, radial artery, palmar arteries, and digital arteries, for their distribution (branching) patterns and morphological parameters (e.g., thickness, length between branches, external and internal diameters). Using data directly collected from three female cadavers as input variables to our mathematical model, we simulated vasoconstriction (-20% and -10% diameter) and vasodilation (+10% and +20 diameter) to evaluate the extent of changes in blood volume and flow within the arteries. …

Exploration Of Prostate Cancer Cells: The Significance Of Active Herv, Dakota Shepherd

Student Scholar Showcase

The second most common cancer in men is prostate cancer. Prostate cancer is traditionally diagnosed by a digital rectal exam. Blood tests can also be used to test for PSA (prostate-specific antigen). These two methods can be used together but can sometimes provide both false negative and false positive results. A new method of testing for prostate cancer could prove to be beneficial. Previous studies have shown that active HERV sequences have been identified in some cancers, including prostate cancer. We hypothesize that the presence of active HERV in prostate cancer lines is significant. In this study, rabbit polyclonal antibodies …

Body Mass Index In Multiple Sclerosis Modulates Ceramide-Induced Dna Methylation And Disease Course, Kamilah Castro, Achilles Ntranos, Mario Amatruda, Maria Petracca, Peter Kosa, Emily Y. Chen, Johannes Morstein, Dirk Trauner, Corey T. Watson, Michael A. Kiebish, Bibiana Bielekova, Matilde Inglese, Ilana Katz Sand, Patricia Casaccia

Advanced Science Research Center

Background: Multiple Sclerosis (MS) results from genetic predisposition and environmental variables, including elevated Body Mass Index (BMI) in early life. This study addresses the effect of BMI on the epigenome of monocytes and disease course in MS.

Methods: Fifty-four therapy-naive Relapsing Remitting (RR) MS patients with high and normal BMI received clinical and MRI evaluation. Blood samples were immunophenotyped, and processed for unbiased plasma lipidomic profiling and genome-wide DNA methylation analysis of circulating monocytes. The main findings at baseline were validated in an independent cohort of 91 therapy-naïve RRMS patients. Disease course was evaluated by a two-year longitudinal follow up …

Quadricuspid Aortic Valve: Report Of Two Cases And Brief Review., Oreoluwa Oladiran, Ifeanyi Nwosu, Rashmi Dhital, Gbujie Ezioma

Reading Hospital Internal Medicine Residency

Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect characterized by the presence of four aortic valve leaflets of equal or varying sizes. Even rarer is its clinical presentation with aortic stenosis. Diagnosis of QAV could be challenging but is of great importance as patients often present with progressive aortic regurgitation. We present 2 cases of QAV presenting differently: one with aortic stenosis requiring valve replacement and the other with aortic regurgitation requiring close monitoring.

Childhood Oral Infections And Subclinical Atherosclerosis In Adulthood: Should We Wait For Causality Or Just Treat?, Anwar T. Merchant, Salim S. Virani

Office of the Provost

No abstract provided.

The Validity Of Medicare Claims-Based Codes To Identify Nontuberculous Mycobacterial Infection In Patients With Bronchiectasis, Jennifer Ku

OHSU-PSU School of Public Health Annual Conference

Background: Nontuberculous mycobacteria (NTM) is a disease of increasing incidence, causing permanent airway damage leading to destructive pulmonary disease. Medicare claims-based codes have been used to identify NTM infection and to evaluate trends in diagnosis and disease outcomes. However, claims-based codes to identify NTM infection have not been validated.

Methods: We linked patients with a bronchiectasis diagnosis (ICD-9-CM 494.0 or 494.1) excluding cystic fibrosis from the national 2006-2014 Centers for Medicare and Medicaid (Medicare) data to the U.S. Bronchiectasis Research Registry (BRR). The BRR is a national prospective cohort of patients with bronchiectasis, that collects detailed clinical, laboratory, microbiology and …

Validity Of An Atopic Dermatitis Outcome Measure For Real-World Clinical Practice, Christina Topham, Dylan Haynes, Molly Brazil, Eric Simpson

OHSU-PSU School of Public Health Annual Conference

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the United States. AD is associated with reduced quality of life and substantial financial costs, making it burdensome at an individual and population level. Disease severity outcome measures are validated tools to assess severity and therapeutic response. Recent consensus statements have identified gold-standard outcome measures for AD in clinical trials, but further work is needed evaluating outcome measures feasible for clinical practice.

Objective: To investigate the validity and feasibility of the product of investigator global assessment and body surface area (IGA x BSA) as an outcome measure …

Preventing Infectious Hematopoietic Necrosis In Salmonid Fish Along The Columbia River Basin, Whitney L. Wright

OHSU-PSU School of Public Health Annual Conference

Infectious hematopoietic necrosis virus (IHNV) is a member of the Rhabdoviridae family and causes infectious hematopoietic necrosis (IHN) disease in many salmonid species during the juvenile or “fry” stage of life. IHNV is endemic to Western North America and occurs in the Columbia River Basin, where Steelhead and Chinook salmon are the most abundant IHNV-vulnerable species. IHNV can cause an epidemic in wild or farmed stocks, killing 90-95 percent of the fish it infects. Transmission is currently understood to occur by direct exposure through the gills, and the virus is shed typically from asymptomatic or clinically ill carrier adults at …

Assessing The Criteria For Definition Of Perimembranous Ventricular Septal Defects In Light Of The Search For Consensus, Justin T. Tretter, Vi-Hue Tran, Seth Gray, Hieu Ta, Rohit S. Loomba, William O'Connor, Diane E. Spicer, Andrew C. Cook, Robert H. Anderson

Pathology and Laboratory Medicine Faculty Publications

Background: Discussions continue as to whether ventricular septal defects are best categorized according to their right ventricular geography or their borders. This is especially true when considering the perimembranous defect. Our aim, therefore, was to establish the phenotypic feature of the perimembranous defect, and to establish the ease of distinguishing its geographical variants.

Methods and results: We assessed unrepaired isolated perimembranous ventricular defects from six historic archives, subcategorizing them using the ICD-11 coding system. We identified 365 defects, of which 94 (26%) were deemed to open centrally, 168 (46%) to open to the outlet, and 84 (23%) to the inlet …

Association Of Lowering Low-Density Lipoprotein Cholesterol With Contemporary Lipid-Lowering Therapies And Risk Of Diabetes Mellitus: A Systematic Review And Meta-Analysis, Victor Okunrintemi

All Publications

No abstract provided.

Aortic Stenosis, Tony Un '19

Human Diseases Graphic Novels

No abstract provided.

Cushing's And Confusion, Diana Gonzalez '20, Grace Yue '20, Amy Churchill '20, Trinity Coates '20, Annie Xu '19

Human Diseases Graphic Novels

No abstract provided.

Lights Out, Charlotte Graves '20

Human Diseases Graphic Novels

No abstract provided.