Medicine and Health Sciences Commons^™

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

Hiv-1 Integrase Multimerization By Quinoline Based Drugs, Samer Beauti

Honors Theses

Human Immunodeficiency Virus Type 1 (HIV-1), a single stranded RNA retrovirus, affects over 30,000,000 people world-wide1. The virus works by infecting and promoting destruction of CD4 immune cells. and thus, suppressing proper immune functions2. Contrary to DNA viruses, the absence of extensive proofreading mechanisms in RNA viruses makes HIV latency a major obstacle in the discovery of long-term, effective treatments. Moreover, the importance of exploring novel therapeutic targets and designing complimentary inhibitory molecules remains steadfast in HIV research3 Recently, HIV-1 Integrase (IN) multimerization, the core enzyme used for integration of the viral DNA into an invaded host chromosome, has been …

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified registered nurse …

The Design Of An Instrument To Assess Clinical Laboratories Efficacy Post Implementation Of The Patient Protection Affordable Care Act, Harry Mcdonald Jr.

Dissertations

The healthcare system in the United States has undergone substantial changes in support of the Patient Protection and Affordable Care Act (PPACA). On March 23, 2010, the implementation of the new healthcare law brought universal healthcare access to all Americans, while attempting to increase quality and decrease medical costs. The new law promotes more of a quality-focused, outcome-based model rather than a pay-for-fee service model; thus, moving the paradigm from infrequent to preemptive healthcare. The PPACA postulates as the only way to achieve cost savings while increasing quality and access. Never before has there been such an extensive change to …

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

Oral Carbohydrate Administration Prior To Colorectal Surgery: Practice Change Outcomes And Economic Analysis, Joshua Kendrick Ezelle

Doctoral Projects

Difference in recovery times has been an interest of mine for many years. I observed that an open heart surgery routinely recovered and discharged on the third post-op day, while a colorectal patient often required a hospital stay of five to ten days. I began researching recovery methods of colorectal patients. I found enhanced recovery techniques like decreased narcotic, use of NSAID’s, early ambulation, and the use of medications that assist with bowel peristalsis are being employed nationally. Other techniques are now starting to be used with positive results. One of these is Carb-loading. Carb-loading is the oral intake of …

Effects Of Prebiotics On Gut Bacterial Communities And Healing Of Induced Colitis In Mice, Krystyn Elizabeth Davis

Master's Theses

Inflammatory Bowel Diseases (IBD) cause chronic inflammation of the gastrointestinal tract and debilitating symptoms in those suffering from the diseases. After inducing colitis in a mouse model using Dextran Sulfate Sodium (DSS), prebiotics inulin and oligofructose enriched inulin (OEI) were used as treatments to determine their effects on the gut microbial community, physiological healing process, and immune response in the mice after initial inflammation and before subsequent inflammation, or relapse. The treatment with inulin led to an increase in regulatory T cell number, but this increase was not as significant as the increase induced by the OEI. Inulin increased the …

The Effect Of Increased Exposure Of Uvc Light On Human Skin Microbiota, T'Kylia S. Moss

Honors Theses

Many methods have been employed to prevent infections from opportunistic pathogens in immunocompromised individuals. Among these are the use of ultraviolet light (UV). In this study, UVC light, was found to have a deleterious effect on specific skin flora. Organisms tested included Acinetobacter baumanii, Candida albicans, Candida kefyr, Corynebacterium renale, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes. Nutrient agar was used to cultivate most organisms. Blood agar was used for the cultivation of Streptococcus pyogenes and Enterococcus faecalis. Bacterial suspensions were made and utilized to plate each organism onto a set of 7 nutrient agar or …

Preparation Of Myod Mrna For The Differentiation Of Stem Cells Into Muscle Cells, Stephanie A. Ye

Honors Theses

Embryonic stem cells (ESCs) are characterized by their two special properties: pluripotency and self-renewal. Pluripotency is the ability of ESCs to differentiate into any cell type upon expression of specific proteins called transcription factors. In order to induce differentiation, transcription factors specific for the particular cell type have to be introduced and expressed in the ESCs. The introduction of transcription factors can be achieved by using either DNA, RNA, or protein. According to the Central Dogma of Molecular Biology, DNA is first transcribed into messenger RNA (mRNA), which is then translated to make a functional protein molecule. Among the available …

The Incidence Of Early Stage Postoperative Nausea And Vomiting Following The Use Of Nitrous Oxide And Prophylactic Antiemetic Therapy: Implications For Clinical Practice, James Sullivan

Doctoral Projects

Nitrous oxide (N₂O) is a volatile agent currently used during the induction and maintenance of general anesthesia. Since it’s discovery in 1786 by Dr. Priestly, it is the oldest volatile agent to find continued use in current practice (Kossick, 2014). In conjunction with its extensive history is the debate regarding its emetic properties. Numerous studies have investigated the effect of nitrous oxide to produce postoperative nausea and vomiting (PONV) with varying and often conflicting results. Generally speaking, nitrous oxide is theoretically an emetic and is believed to be associated with PONV (Tramer, Moore, & McQuay, 1996). This has …

The Effectiveness Of A Preoperative Multimodal Antiemetic Regimen On Reducing Early Postoperative Nausea And Vomiting In Total Joint Arthroplasty Patients, Jerry Mosley

Doctoral Projects

Postoperative nausea and vomiting (PONV) occurs frequently in all types of surgeries including after total joint orthopedic procedures. The resulting PONV can lead to many unwanted occurrences including immobilization, distress, and many serious adverse health complications. These unwanted occurrences may then lead to increased cost to the patient and healthcare facility. Administration of a preoperative multimodal regimen known to reduce PONV has the potential to reduce such unwanted anesthetic side effects influencing a reduction in overall healthcare cost. The purpose of this study is to determine the effectiveness of the preoperative kit which includes the administration of metoclopramide, famotidine, ondansetron, …

Self-Assembled Gold Nanoplexes For Cancer-Targeted Sirna Delivery, Yongliang Shi

Master's Theses

Through layer-by-layer method, the authors have constructed three Au nanoplexes: AuPEI/RNA/PEI, AuPEI/RNA/PEI-mPEG, and AuPEI/NA/PEI-PEG-FA. All the nanoplexes are characterized by UV-vis spectrometry, DLS, and zeta potential. The surface density of the first layer PEI and second layer RNA were also determined. Moreover, the Au nanoplexes can protect siRNA from RNase degradation and are stable in cell culture medium.

siGLuc-ppp, ssRNA₈₀, and siF17 were delivered by the assembled Au nanoplexes, and the results were analyzed by GLuc assay, TB assay, and Luciferase assay. In terms of RNA delivery, the Au nanoplexes AuPEI/RNA/PEI exhibited excellent gene silencing efficiency (or causing …

Dispositional Optimism: Modeling Cardiovascular Disease Mortality With Traditional Risk Factors And A Psychosocial Personality Trait, Kiana Ramisi Luckett Robinson

Dissertations

Despite increased awareness of clinical risk factors for cardiovascular disease (CVD), heart disease remains a physical and economic burden to African Americans. The aim of this study was to investigate the relationship between dispositional optimism, a psychosocial personality trait, and CVD mortality, based on immediate cause of death. A cross-sectional design was used to examine the predictive value of dispositional optimism in CVD mortality concomitant with traditional CVD risk factors. The traditional CVD risk factors of interest consisted of body mass index, waist circumference, systolic and diastolic blood pressures, total cholesterol, and C-reactive protein. Also, aggregated mortality data for optimists …

Propagation Of Oligomeric Α-Synuclein And Amyloid-Β: Implications For Parkinson's And Alzheimer's Diseases, Matthew Stephen Planchard

Master's Theses

The aggregation of amyloidogenic proteins is a critical event in the pathology of a variety of neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). The proteins α-synuclein (αS) and amyloid-β (Aβ) are involved in the formation of amyloid lesions observed in PD and AD, respectively. Both PD and AD exhibit a significant amount of co-pathology in clinical settings, and the αS and Aβ proteins have been shown to interact in vitro. Recent experimental consensus has shown oligomeric species to be significant, if not primary, sources of toxicity in these diseases. …

Role Of Msa In Immune Evasion, Persistence, And Protease Regulation In The Human Pathogenic Strains Of Staphylococcus Aureus, Maria Deepa Basco

Dissertations

Opportunistic pathogens like Staphylococcus aureus on entering the host can stay colonized at the foci of infection or evade the immune system to disseminate to other sites. In this study we investigated the regulatory influence of the modulator of sarA (msa) on immune evasion and host persistence, employing the hospital-acquired strain S. aureus UAMS-1 and community-acquired strain S. aureus USA300 LAC. In the murine sepsis model, mutation of the msa gene in LAC showed no change in dissemination of infection; however, in UAMS-1 a decrease in microbial load was observed in the lungs. Differential regulation by the msa gene was …

Biophysical Understanding Of Novel Synthetic Amyloid-Β (Aβ) Prions In Alzheimer's Disease, Amit Kumar

Dissertations

Oligomers of amyloid-β (Aβ) peptide are the primary toxic agents that play a pivotal role in the pathogenesis of Alzheimer’s disease (AD). Oligomers are the intermediates formed during the Aβ aggregation process leading up to insoluble fibrils. It is important to know that oligomers can also be formed via pathways that do not lead to fibril formation. Such ‘off-pathway’ oligomers would have significantly longer half-lives than the ‘on-pathway’ ones, which may result in prolonged toxicity to neuronal cells. Furthermore, neither the mechanism of neurotoxicity nor the potential mechanisms of propagation and proliferation to neighboring cells are well understood. Moreover, recent …