Medicine and Health Sciences Commons^™

Investigating The Effects Of Excitotoxic Stimuli On The Suprachiasmatic Nucleus, Rachel A. Brandes

Chancellor’s Honors Program Projects

No abstract provided.

Neurodevelopmental Outcomes Of Infantile Hydrocephalus: An Fmri Case Study, Ikhlas Ahmed Hashi

Electronic Thesis and Dissertation Repository

Ventricle dilatation caused by infantile hydrocephalus may result in extensive damage of the posterior cortex (parietal and occipital lobes). We hypothesize that pathological changes in the development of the posterior cortex can be linked to non-verbal learning disabilities in children with previous infantile hydrocephalus. This case study will investigate the neurodevelopmental outcomes of 3 treated hydrocephalus patients, when compared to a group of healthy control children (n = 12). Within the hydrocephalus group, patients displayed differences in non-verbal test performance as well as parietal brain activation during an fMRI number comparison task. We associated these differences with clinical variables such …

Oxidative Phosphorylation: A Critical Feature And Novel Therapeutic Target In Melanoma Brain Metastases, Grant Fischer

Dissertations & Theses (Open Access)

We recently showed via RNA-sequencing (RNA-seq) analysis of clinical samples that melanoma brain metastases (MBMs) have higher expression of oxidative phosphorylation (OXPHOS) genes (including PPARGC1A or PGC1α) than patient-matched extracranial metastases (ECMs). Thus, the central hypothesis of this dissertation is that OXPHOS plays a critical role in the pathogenesis of MBMs.

RNA-seq analysis identified increased expression of OXPHOS genes in intracranial (ICr) vs. subcutaneous (SQ) xenografts of 4 different human melanoma cell lines. Increased OXPHOS in the ICr xenografts was confirmed by direct metabolite analysis and [U-¹³C]-glucose tracing analysis. Together, these studies indicate that the brain TME …

Improving The Assessment And Understanding Of Neurogenic Orthostatic Hypotension, Jacquie Baker

Electronic Thesis and Dissertation Repository

Neurogenic Orthostatic Hypotension (NOH) is a cardinal feature of autonomic failure. Patients with NOH experience a persistent and consistent drop in blood pressure when standing due to failure of the autonomic nervous system to reflexively increase sympathetic outflow. NOH affects individuals worldwide, presenting as both a primary feature (i.e. Multiple Systems Atrophy, Pure Autonomic Failure) and secondary to several common disorders including diabetes and Parkinson’s Disease. However, there are still several gaps in our overall understanding and assessment of patients with NOH. Therefore, the six studies presented in this thesis aimed to address some of these gaps in our current …

Dysphagia Screening To Prevent Hospital-Acquired Pneumonia Rates, Namneet Sekhon

Dissertations

Problem Pneumonia is a leading cause of death worldwide and affects all ages. Pneumonia may be acquired by aspiration and a bedside nursing dysphagia screen may reduce hospital acquired pneumonia (HAP) rates for stroke patients. The aim of this study was to evaluate use of the dysphagia screen for all patients receiving a computed tomography (CT) scan of the head in the emergency department (ED).

Method An observational, descriptive design for all patients who received a CT of the head in the ED and admitted over a 60-day period. The rate of dysphagia screening with the DePaul Hospital Swallow Screen …

Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard

Dissertations

Abstract Background: Delirium is associated with devastating outcomes, cognitive loss,

decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART- DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.

Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, …

The Correlation Between The Microbiome And Neurodegenerative Disorders Such As Alzheimer Disease, Aurora Mokris

Honors Theses

Recent studies suggest that there are 1.3 times as many microbial cells as human cells in the body (Abbot, 2016). Another study claims that the combined genomes of this microbiota is 150 times that of the human genome (Zhuang & Shen, 2018). If you have ever had the feeling that you are not alone in an empty room you are most certainly correct. Your body is teeming with millions of organisms living in mutualistic symbiosis with you and surrounding microbes, but at times, this seemingly harmonious relationship can be disturbed, resulting in serious physical and psychological changes to the human …

The Acute Effects Of Melatonin On Striatal Dopamine Release: Progressive Electrochemical Analysis In An Ex Vivo Mouse Model Utilizing Fast Scan Cyclic Voltammetry, Kevin D. Hughes

Masters Theses

The caudate putamen is a sub region of the basal ganglia, containing neural tracts important for cognition, reward learning, and voluntary motor function. Dopamine (DA) signaling received from the dopaminergic neurons of the substantia nigra pars compacta mediate locomotion, degradation of which is the characteristic neuropathology for Parkinson’s disease (PD). PD is an initially neurovegetative motor disorder but can progress to include cognitive impairments as well. Sundowner’s syndrome (SS) has been observed in patient populations with neurodegenerative diseases, characterized by the decline of cognition into evening hours. Due to the circadian influence which the hormone melatonin has on the sleep-wake …

Evidence-Based Intervention To Improve Assessment Of Headache Pain And Its Functional Capacity, Mavjuda Saydazamova

Doctoral Projects

Introduction: Headache is a chronic pain that is challenging to properly assess in clinical practice, as it is based almost entirely on the ability of the clinician and patient to communicate. This communication is based on pain scale tools. To assess patients’ disability and pain intensity, the selected organization uses the Migraine Disability Assessment (MIDAS) screening tool. Pain intensity is measured with a Numeric Pain Scale within the MIDAS. Measuring chronic headache pain accurately, while using a very subjective and inadequate pain scale to measure chronic pain was an issue. The literature review supported replacing the Numeric Pain Scale with …

Analysis Of Gene Transcription Changes Following Chlamydia Pneumoniae Infection Of Thpl Monocytes May Have Relevance To Alzheimer's Disease, Desiré Guthier

PCOM Biomedical Studies Student Scholarship

There is increasing evidence that neuroinflammation caused by infectious agents is an important etiologic factor in neurodegenerative diseases including Alzheimer's disease (AD). One infectious agent that has been associated with AD is Chlamydia pneumoniae (Cpn). Cpn DNA can be detected within peripherally circulating mononuclear cells and there is evidence that infected mononuclear cells could be involved in chronic infection and contribute to inflammation at numerous anatomical sites, including the brain. Understanding Cpn genetic changes progressing from an acute to a chronic infection within monocytes may help to further elucidate. the role of Cpn infected monocytes with regard to …

Is Cannabis Effective In Reducing Muscle Spasticity And Body Pain Amongst Patients With Multiple Sclerosis?, William E. Johnson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cannabis is effective in reducing muscle spasticity and body pain amongst patients with Multiple Sclerosis (MS).

STUDY DESIGN: A systematic review of three peer-reviewed studies published between the years of 2003 and 2012.

DATA SOURCES: Three randomized control trials (RCTs) evaluating if cannabis can reduce muscle spasticity and body pain for patients diagnosed with Multiple Sclerosis. All three sources were selected from PubMed and examined for outcomes that were patient oriented.

OUTCOMES MEASURED: The two primary outcomes measured include: muscle spasticity measured by the Ashworth scale, …

Is The Use Of Methylcobalamin Alone Or In Combination With Lidocaine Clinically More Effective Than Lidocaine Alone In Relieving Herpes Zoster Related Neuropathic Pain With Subcutaneous Injections?, Rachel N. Todd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Methylcobalamin alone or in combination with Lidocaine is clinically more effective than Lidocaine alone in relieving Herpes Zoster related neuropathic pain with subcutaneous injections.

STUDY DESIGN: This is a systematic review of three peer-reviewed primary studies. All were randomized, controlled trials published between the years of 2014 and 2016.

DATA SOURCES: Data sources obtained for this review were published in peer reviewed journals and selected from PubMed Database.

OUTCOME MEASURED: The outcomes measured reflected the effectiveness of incorporating subcutaneous Methylcobalamin in the treatment regimen for neuropathic …

Does Sertraline Decrease Depression In Patients Who Suffered A Traumatic Brain Injury (Tbi)?, Christina Costantino

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does sertraline decrease depression in patients who suffered a traumatic brain injury (TBI)?”

STUDY DESIGN: Review of three randomized controlled trials (RCTs) published in English between 2009-2016.

DATA SOURCES: One RCT and two double-blind, placebo-controlled, RCTs found via PubMed evaluated the benefit of the antidepressant drug, sertraline (Zoloft), in decreasing depression in patients who suffered a TBI.

OUTCOMES MEASURED: Main outcomes were measured using the DSM-IV, Hamilton Rating Score for Depression (HAM-D)6 , Beck Anxiety Inventory (BAI)6 , and the Life-3 quality of life (QOL)6 , …

Is Treadmill Training Effective In Improving Postural Instability, Balance, And Gait In Patients With Parkinson Disease?, Katelyn A. Matekovic

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not treadmill training is effective in improving postural instability, balance, and gait in patients with Parkinson disease.

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between the years of 2013 and 2017.

DATA SOURCES: Three randomized controlled trials comparing the efficacy of treadmill training for improving postural instability, balance, and gait for patients with Parkinson Disease. Sources were selected from PubMed based off of the relevance to the clinical question and if they include patient oriented outcome measures.

OUTCOMES MEASURED: The outcomes measured in …

Does Transcutaneous Vagal Nerve Stimulation (T-Vns) Reduce Seizure Frequency In Adult Patients With Pharmacoresistent Epilepsy?, Scott Poirier

PCOM Physician Assistant Studies Student Scholarship

Objective The objective of this selective EBM review is to determine whether or not transcutaneous vagal nerve stimulation is an effective measure in reducing seizure frequency in adult patients with pharmacoresistant epilepsy.

Study Design This systematic review comprises a randomized controlled trial and an observational pilot study, both published in 2014, as well as a double-blind randomized control trial published in 2016.

Data Sources All articles were published and displayed in English. The articles were obtained via the PubMed database.

Outcomes Measured Reductions in average seizure frequency were analyzed based on data from patient seizure diaries. Secondary outcomes, including quality …

Is Methylphenidate Effective In Reducing Apathy Among Alzheimer’S Disease Patients?, Jeremy Rinaldi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE The objective of this selective EBM review is to determine whether or not “Is methylphenidate effective in reducing apathy among Alzheimer’s disease patients?”

STUDY DESIGN Systematic review of two randomized controlled trials published in 2008 and 2013 and one open label study published in 2010.

DATA SOURCES Two randomized controlled trials and one open label study were obtained using PubMed and Medline.

OUTCOMES MEASURED The focus of this review is to determine the efficacy of methylphenidate in decreasing symptoms of apathy in Alzheimer’s disease patients. The efficacy of methylphenidate was assessed in all three studies by using the Apathy …

Does Yoga Improve Symptoms In Patients With Parkinson’S Disease?, Victoria L. Starner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not yoga improved symptoms in patients with Parkinson’s disease.

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between 2014 and 2018.

DATA SOURCES: Two randomized control trials and one before and after case study evaluating if yoga can improve symptoms for patients who are diagnosed with Parkinson’s disease.

OUTCOMES MEASURES: The outcomes that were measured were balance and movement speed. Balance was measured using single leg balance test, single leg stance, and Berg Balance Scale. Movement speed, bradykinesia, was measured using the Unified Parkinson’s …

Understanding The Contributions Of Alzheimer’S Disease & Cardiovascular Risks To Cerebral Small Vessel Disease Manifest As White Matter Hyperintensities On Magnetic Resonance Imaging (Mri), Omar M. Al-Janabi

Theses and Dissertations--Clinical and Translational Science

Introduction: Alzheimer’s Diseases (AD) & cerebral small vessel disease associated with cardiovascular risk factors (cSVD) frequently coexist, differentially affecting both imaging and clinical features associated with aging and dementia. We hypothesized that Magnetic Resonance Imaging (MRI) can be used in novel ways to identify relative contributions of AD & cardiovascular risks to cSVD and brain atrophy, generating new biomarkers & insights into mixed disease states associated with cognitive decline and dementia.

Methods: Three experiments were conducted to address the overarching hypothesis. First, we visually rated the clinical MRI of 325 participants from a community-based cross-sectional sample to elucidate the relative …

The Effects Of Matrix Metalloproteinase-9 On Cx3cl1 Shedding And Axon Retraction, Lauren A. Dobrie

Honors Undergraduate Theses

Spinal cord injury (SCI) often leads to irreversible damage, and permanent paralysis inferior to the injury is common (Leibinger et al., 2013). Injury to the spinal cord occurs in two phases. In the first phase, components of the spinal cord are subject to mechanical trauma causing direct damage. In the second phase, damage spreads from the area of injury through molecular processes. Several studies have linked M1 "pro-inflammatory" macrophages to exacerbation of damage by inducing dieback of dystrophic axons, but not healthy axons, through direct cellular contact. Several studies have identified the presence of macrophage subtypes at specific time. A …

Role Of Amyloid Precursor Protein In Neuroregeneration On An In Vitro Model In Alzheimer's Patient-Specific Cell Lines, Lina S. Bedoya Martinez

Honors Undergraduate Theses

Alzheimer's disease (AD) leads to neurodegeneration resulting in cognitive and physical impairments. AD is denoted by accumulation of intracellular neurofibrillary tangles, known as tau, and extracellular plaques of the amyloid beta protein (Aβ). Aβ results from the proteolytic cleavage of the amyloid precursor protein (APP) by β- and gamma-secretases in the amyloidogenic pathway. Although, Aβ has been widely studied for neurodegeneration, the role of APP in both, the healthy and diseased conditions, has not yet been entirely understood. The function that APP has in neural stem cell (NSC) proliferation, differentiation, and migration during adult neurogenesis has been previously studied. Additionally, …

Autologous Peripheral Nerve Grafts To The Brain For The Treatment Of Parkinson's Disease, Andrew Welleford

Theses and Dissertations--Neuroscience

Parkinson’s disease (PD) is a disorder of the nervous system that causes problems with movement (motor symptoms) as well as other problems such as mood disorders, cognitive changes, sleep disorders, constipation, pain, and other non-motor symptoms. The severity of PD symptoms worsens over time as the disease progresses, and while there are treatments for the motor and some non-motor symptoms there is no known cure for PD. Thus there is a high demand for therapies to slow the progressive neurodegeneration observed in PD. Two clinical trials at the University of Kentucky College of Medicine (NCT02369003, NCT01833364) are currently underway that …