Medicine and Health Sciences Commons^™

The Role Of Primary Care Providers In Maintaining Weight Loss By Preventing Behavioral Relapse, Hayden R. Blanchard

Capstone Showcase

Supporting patients in optimizing health by treating obesity remains a relevant goal for primary care providers. While weight loss is frequently achieved with behavioral modification, maintaining weight loss by avoiding behavioral relapse is much more difficult. Patient may lose weight by reducing overall energy intake, incorporating intensive behavior change programs, utilizing pharmacotherapy as needed and, in certain cases, undergoing bariatric surgery. With a focus on behavior change and maintenance, primary care providers can support patients by planning more frequent follow up appointments, at least every one to three months. In these visits, PCPs can: focus on reenforcing lifestyle change principles …

Student Perceptions Of The Effectiveness Of Collegiate Recovery Programs And Collegiate Recovery Communities, Michael Anthony Herold

Theses and Dissertations

Research on the objective effectiveness of Collegiate Recovery Programs and Collegiate Recovery Communities (CRPs / CRCs) has shown success in maintaining recovery and improving academic outcomes for college students in recovery, but research on the experiences of this population is starting to emerge. This study used a mixed-method design to investigate the perceptions of members of CRPs / CRCs regarding the impact of participation on their recovery from substance abuse and their overall quality of life. Thirty-one participants completed the Drug Avoidance Self-Efficacy Scale (DASES) and the Quality of Life Index – Generic Version iii (QLI). Paired samples t-tests were …

Editorial: Sex Differences In The Neurobiology Of Drug Relapse Vulnerability, Daniel F Manvich, Jessica A Loweth, Wendy J Lynch, Jayme R Mcreynolds

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Augmenting Addiction Management: The Potential Efficacy Of Combining Rtms With Cbt, Dylan Schroeder

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Abstract

Non-substance and substance related addictive disorders contribute a high global disease burden with relatively poor treatment options with poor craving control and high relapse rates. CBT is a well-documented treatment modality which is the cornerstone for top-down behavioral management of cravings and preventing relapse, but its clinical efficacy is limited. Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment method which may reduce cravings and relapse rates through a bottom-up neurochemical approach.

There is potential that the rTMS reduction of bottom-up cravings may synergistically enhance the top-down control of cravings established with CBT. Existing primary research demonstrates that a …

Sakurabonsai: Protocol Design Of A Novel, Prospective Study To Explore Clinical, Imaging, And Biomarker Outcomes In Patients With Aqp4-Igg-Seropositive Neuromyelitis Optica Spectrum Disorder Receiving Open-Label Satralizumab, Jeffrey L Bennett, Kazuo Fujihara, Ho Jin Kim, Romain Marignier, Kevin C O'Connor, Robert C Sergott, Anthony Traboulsee, Heinz Wiendl, Jens Wuerfel, Scott S Zamvil, Veronica G Anania, Regine Buffels, Thomas Künzel, Annemarie N Lekkerkerker, Siân Lennon-Chrimes, Sean J Pittock

Wills Eye Hospital Papers

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune disease of the central nervous system that produces acute, unpredictable relapses causing cumulative neurological disability. Satralizumab, a humanized, monoclonal recycling antibody that targets the interleukin-6 receptor, reduced NMOSD relapse risk vs. placebo in two Phase 3 trials: SAkuraSky (satralizumab ± immunosuppressive therapy; NCT02028884) and SAkuraStar (satralizumab monotherapy; NCT02073279). Satralizumab is approved to treat aquaporin-4 IgG-seropositive (AQP4-IgG+) NMOSD. SAkuraBONSAI (NCT05269667) will explore fluid and imaging biomarkers to better understand the mechanism of action of satralizumab and the neuronal and immunological changes following treatment in AQP4-IgG+ NMOSD.

Objectives: …

Evaluation Of Pattern Of Relapse In Luminal Breast Cancer, Mohamed Ahmed Abdelaziz, Eslam Mohamed Ebrahim, Mohsen Salah El-Din Zikry

Al-Azhar International Medical Journal

Background: The most common molecular subtype of breast cancer worldwide is luminal breast cancer. It has shown a good prognostic profile compared to other types. Despite the immense development of adjuvant treatment in the past years, around 20% of patients with early-stage disease relapse. Aim of the study: To evaluate the relapse pattern in luminal breast cancer and the correlation between luminal types and (AJCC 8th edition). Subject and Methods: A total of 230 luminal breast cancer patients treated at Al-Hussein University Hospital between 2013 and 2018 were analyzed. Patients have been divided into the following groups: luminal A (31%) …

Genomic Epidemiology And Transmission Dynamics Of Recurrent Clostridioides Difficile Infection In Western Australia, Daniel R. Knight, Korakrit Imwattana, Deirdre A. Collins, Su-Chen Lim, Stacey Hong, Papanin Putsathit, Thomas V. Riley

Research outputs 2022 to 2026

Recurrent cases of Clostridioides difficile infection (rCDI) remain one of the most common and serious challenges faced in the management of CDI. The accurate distinction between a relapse (caused by infection with the same strain) and reinfection (caused by a new strain) has implications for infection control and prevention, and patient therapy. Here, we used whole-genome sequencing to investigate the epidemiology of 94 C. difficile isolates from 38 patients with rCDI in Western Australia. The C. difficile strain population comprised 13 sequence types (STs) led by ST2 (PCR ribotype (RT) 014, 36.2 %), ST8 (RT002, 19.1 %) and ST34 (RT056, …

Impact Of Covid - 19 Pandemic On The Clinical Course Of Inflammatory Bowel Disease In Egyptian Tertiary Centers, Alaa Alsawak, Omar Abdallah, Ali Madian, Hassan Atalla, Ramadan Eldamarawy, Ahmed Eliwa, Ahmed Khamiss, Ashraf El Sharkawy, Sadek Mostafa, Alshimaa Alaboudy, Maha M. Maher, Ashraf Elbahrawy

Mansoura Medical Journal

Abstract

Background/Aim: The coronavirus disease 2019 (Covid-19) pandemic have a major impact on the clinical course of chronic diseases including inflammatory bowel disease (IBD). In the current study we aimed to evaluate the clinical relapse and worsening of IBD activity during Covid-19 pandemic.

Methods: 125 patients included and followed for one year. Of them, 98 and 27 patients had inactive and active IBD before the study, respectively. The clinical activity of IBD assessed by Crohn’s disease activity index (CDAI) and simplified colitis clinical activity index (SCCAI). Severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection detected by real-time polymerase chain …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Cell-Free Dna Sequencing In Multiple Myeloma, Russell Irwin

Dissertations & Theses (Open Access)

Multiple myeloma (MM) is an incurable plasma cell dyscrasia. Recent advances in MM therapy, including CAR-T therapy, have increased survival and shown the value of assessing treatment response with great sensitivity, both in acute and long-term settings. Cell-free DNA, DNA fragments which are released into circulation as a part of normal cellular turnover, is a useful and dynamic biomarker in cancer patients due to the presence of circulating tumor DNA (ctDNA), which is readily identified using next generation sequencing. Here we report the analytical sensitivity, applicability, consistency, and prognostic ability of M5Seq, a novel hybrid capture panel designed for MM …

Assessment Of Fibroblast Growth Factor-23 In Children With Nephrotic Syndrome Treated With Glucocorticosteroids, Fahima M. Hassan, Mahmoud M. K. Ahmed, Mohamed S. Elharoun, Noran T. Aboelkhair

Menoufia Medical Journal

Objectives To evaluate fibroblast growth factor-23 (FGF-23) levels in children with nephrotic syndrome treated with glucocorticosteroids in comparison with existing markers of bone metabolism. Background Nephrotic syndrome is a frequent chronic illness defined by changes of permselectivity at the capillary wall of renal glomeruli, resulting in the glomerular inability to limit protein loss in urine. FGF-23 is an effective phosphaturic hormone secreted by osteocytes, which has a vital role in vitamin D and phosphate homeostasis. Patients and methods This case–control study included 80 children of which 40 children with idiopathic nephrotic syndrome were subdivided into three groups: steroid-dependent, steroid-resistant, and …

Ride The Wave (The Wave Of Recovery): Leisure Time Activities, Donald R. Martin Sr.

IPS/BAS 495 Undergraduate Capstone Projects

Ride the Wave (The Wave of Recovery) Leisure Time Activities is the title of a leisure time activities booklet that was created by Donnie Martin in partnership with Recovery in Motion (RIM, non-profit organization), as a resource to help reduce occurrences of addiction relapses in the Twin Falls community. The hope is that more recovering addicts will be successful in their recovery and transition into a recovery lifestyle becoming productive members of the Twin Falls community. The leisure time activities booklet is being distributed and edified to recovering addicts in recovery support groups by RIM support group facilitators and by …

Clinical Impact Of A Highly Sensitive Next-Generation Sequencing Measurable Residual Disease Assay In Patients With Acute Lymphoblastic Leukemia, Nicholas Short

Dissertations & Theses (Open Access)

Measurable residual disease (MRD) is highly prognostic for relapse and overall survival (OS) in acute lymphoblastic leukemia (ALL), although many patients with apparent “MRD negativity” by standard assays still relapse. We evaluated the clinical impact of a highly sensitive next-generation sequencing (NGS) MRD assay in 74 adults with ALL undergoing frontline therapy. Among remission samples that were MRD negative by multiparameter flow cytometry (MFC), 46% were MRD positive by the NGS assay. At the time of complete remission (CR), MRD negativity by MFC at a sensitivity of 1x10^-4 and NGS at a sensitivity of 1x10^-6 was achieved in …

Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield

Walden Dissertations and Doctoral Studies

AbstractOpioid use accounts for many deaths each day in the United States. Although research has shown that retention in medication assisted treatment (MAT) programs increases quality of life for those individuals with opioid use disorder (OUD) and decreases premature death, there has been limited research on the perspectives of individuals with OUD in MAT programs and why they remained in or left the programs. The purpose of this qualitative phenomenological study, guided by Merleau-Ponty’s theory of perception, was to explore the lived experiences of those with OUD treated in a MAT program. An algorithm type interview was conducted to ask …

Substance Abuse Relapse Is Not About Willpower But Is The Culmination Of Psychological And Socioeconomic Stress, Paul A. Steffes

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the impact of non-judgmental listening on patient care outcomes.

Mindfulness-Based Intervention And Relapse Rates In Adults With A History Of Substance Use Disorder, Tamieko Ross-Anyaso

Student Scholarly Projects

Practice Problem: Substance abuse disorder (SUD) has become an increasingly prevalent community health problem worldwide, affecting individuals in all geographical regions regardless of age, race, sex, and socioeconomic status, despite decades of efforts to find a solution (Bowen et al., 2014). A lack of treatment engagement and substance‐misuse crisis calls attention to the effectiveness of relapse‐sensitive care and treatments.

PICOT: The question addressed in this evidence-based project was “ In adults over 18 years of age with substance use disorder (P), how does the effect of mindfulness-based treatment (I), compared with no mindfulness-based treatment (C), reduce the risk of relapse …

Survival Following Relapse In Children With Acute Myeloid Leukemia: A Report From Aml-Bfm And Cog., Mareike Rasche, Martin Zimmermann, Emma Steidel, Todd Alonzo, Richard Aplenc, Jean-Pierre Bourquin, Heidrun Boztug, Todd Cooper, A S. Gamis, Robert B. Gerbing, Iveta Janotova, Jan-Henning Klusmann, Thomas Lehrnbecher, Nora Mühlegger, Nils V. Neuhoff, Naghmeh Niktoreh, Lucie Sramkova, Jan Stary, Katharina Waack, Christiane Walter, Ursula Creutzig, Michael Dworzak, Gertjan Kaspers, Edward Anders Kolb, Dirk Reinhardt

Manuscripts, Articles, Book Chapters and Other Papers

Post-relapse therapy remains critical for survival in children with acute myeloid leukemia (AML). We evaluated survival, response and prognostic variables following relapse in independent cooperative group studies conducted by COG and the population-based AML-BFM study group. BFM included 197 patients who relapsed after closure of the last I-BFM relapse trial until 2017, while COG included 852 patients who relapsed on the last Phase 3 trials (AAML0531, AAML1031). Overall survival at 5 years (OS) was 42 ± 4% (BFM) and 35 ± 2% (COG). Initial high-risk features (BFM 32 ± 6%, COG 26 ± 4%) and short time to relapse (BFM …

Female Rats Display Higher Methamphetamine-Primed Reinstatement And C-Fos Immunoreactivity Than Male Rats, Steven T. Pittenger, Shinnyi Chou, Nathan J. Murawski, Scott T. Barrett, Olivia Loh, Juan F. Duque, Ming Li, Rick A. Bevins

Department of Psychology: Faculty Publications

Methamphetamine (meth) dependence is often characterized by persistent and chronic relapse (i.e., return to drug use). Previous work suggests females may be at greater risk to relapse. In this study, we extended this limited evidence and identified sex-dependent neural substrates related to meth-triggered reinstatement. Male and female Sprague-Dawley rats were implanted with indwelling jugular catheters. Half of the rats were then trained to self-administer meth (0.05 mg/kg/inf); the other half self-administered saline during 21 daily sessions (2 h). Rats were then given 12 extinction sessions. Twenty-four hours after the last extinction session, rats received reinstatement testing. Half of the rats …

Accumbens Cholinergic Interneurons Mediate Cue-Induced Nicotine Seeking And Associated Glutamatergic Plasticity, Jonna M. Leyrer-Jackson, Michael Holter, Paula F. Overby, Jason M. Newbern, Michael D. Scofield, M. Foster Olive, Cassandra D. Gipson

Family and Community Medicine Faculty Publications

Nicotine, the primary addictive substance in tobacco, is widely abused. Relapse to cues associated with nicotine results in increased glutamate release within nucleus accumbens core (NAcore), modifying synaptic plasticity of medium spiny neurons (MSNs), which contributes to reinstatement of nicotine seeking. However, the role of cholinergic interneurons (ChIs) within the NAcore in mediating these neurobehavioral processes is unknown. ChIs represent less than 1% of the accumbens neuronal population and are activated during drug seeking and reward-predicting events. Thus, we hypothesized that ChIs may play a significant role in mediating glutamatergic plasticity that underlies nicotine-seeking behavior. Using chemogenetics in transgenic rats …

Factors Affecting Relapse In Patients With Granulomatosis Polyangiitis: A Single-Centerretrospective Cohort Study, Müge Aydin Tufan, Ni̇han Tekkarişmaz, Ahmet Eftal Yücel

Turkish Journal of Medical Sciences

Background and aim: This study aimed to determine the frequency of relapse, the risk factors for relapse, and the correlation of relapse with immunosuppressive regimens in patients with granulomatosis polyangiitis (GPA). Materials and methods: The demographic characteristics, the clinical, laboratory, and radiological findings, the immunosuppressive treatment regimens, and the remission and relapse rates of 50 patients with GPA were obtained retrospectively from medical records. Results: The mean relapse-free survival rates at years 1, 3, and 5 were 82%, 60%, and 50%, respectively. Increased relapse rates were observed in patients who had cavitary lung lesions (52.2% vs. 22.2%, p = 0.04) …

Genetic Relationships And Therapeutic Options For Relapsed Acute Lymphoblastic Leukemia, Hailie Shertzer

Senior Honors Theses

Acute lymphoblastic leukemia (ALL) is the most common form of cancer among children and can be lethal to the adult population. Though 80% of patients with ALL reach complete remission after treatment, about 20% of those diagnosed fail to remain cancer-free. Genetic rearrangements are the hallmark of relapsed ALL, but the mechanism by which these rearrangements occur is still unclear. Recent research suggests these mutations may be detectable during initial diagnosis. If researchers are able to accurately assess the probability of relapse during diagnosis by analyzing the genome of the leukemic cells, the likelihood of administering effective therapy would increase. …

Selecting The Optimal Unrelated Hematopoietic Stem Cell Transplant Donor For Relapse Prevention In Acute Myeloid Leukemia, Elizabeth Krieger, Rehan Qayyum, Amir Toor

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction/Background

Hematopoietic cell transplantation (HCT) provides

a cure for patients with acute myeloid leukemia.

Natural killer cells (NK) play an important role

in graft versus leukemia (GVL) effect after HCT,

through killer immunoglobulin-like receptor (KIR)

interaction with HLA ligands. This study is

undertaken to validate our previously published

mathematical model accounting for the KIR-KIRL

interactions in a post HCT setting.

Methods

Retrospective data were obtained from the Center

for International Blood and Marrow Transplant

Registry for 2317 donor recipient pairs (DRP) who

underwent 7/8 or 8/8 HLA allelic matched

unrelated donor (URD) HCT for AML. KIR-HLA

interaction scores were calculated …

Dual Therapy Treatment Of Pediatric Acute Lymphoblastic Leukemia With Blinotumomab And A Standard Chemotherapy Regimen, Tori I. Scheffler

Selected Honors Theses

Leukemia is the number one cancer affecting children in the nation, with acute lymphoblastic leukemia being the most prevalent classification.1 While new and innovative treatment protocols have greatly increased the success rate of primary cancer patients, those who face relapse receive a much more dismal prognosis. Recent studies have shown that patients who relapse quite frequently have developed drug-resistant clones of the original cancer cells, leading to a need for various secondary treatment options. The drug-resistance is due to clonal mutations that take place within the cancer cell, most often because of an outside pressure or stress within the environment …

Polysubstance Opioid Use In A Justice-Involved Population: An Analysis Of Patterns And Reentry Outcomes, Amanda Marie Bunting

Theses and Dissertations--Sociology

The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by …

Recurrence Of Clostridium Difficile Infection In The Western Australian Population, M. Alfayyadh, Deirdre A. Collins, S. Tempone, R. Mccann, P. K. Armstrong, Thomas V. Riley, A. Cook

Research outputs 2014 to 2021

Clostridium difficile, the most common cause of hospital-associated diarrhoea in developed countries, presents major public health challenges. The high clinical and economic burden from C. difficile infection (CDI) relates to the high frequency of recurrent infections caused by either the same or different strains of C. difficile. An interval of 8 weeks after index infection is commonly used to classify recurrent CDI episodes. We assessed strains of C. difficile in a sample of patients with recurrent CDI in Western Australia from October 2011 to July 2017. The performance of different intervals between initial and subsequent episodes of CDI was investigated. …

The Efficacy Of Meditation-Based Treatments In Relapse Prevention For Persons With Substance Use Disorders, Florence C. Bates

Honors Undergraduate Theses

Substance abuse is a global problem that has contributed to a variety of societal, financial, health, and familial strains. An increasing prevalence of illicit drug, prescription opioids, and alcohol abuse has created a need for re-evaluation of recovery and relapse treatments. This literature review examines the efficacy of meditation-based treatments for relapse prevention in persons recovering from Substance Use Disorders (SUDs). A comparative analysis of Mindfulness Based Relapse Programs (MBRP), an adapted MBRP-W program, and a Transcendental Meditation (TM) intervention was used to examine the success of meditation-based interventions. Research supports improvements associated with the meditation-based interventions including significant reductions …

A Real-World Comparison Of Relapse Rates, Healthcare Costs And Resource Use Among Patients With Multiple Sclerosis Newly Initiating Subcutaneous Interferon Beta-1a Versus Oral Disease-Modifying Drugs., James D Bowen, Chris M Kozma, Megan M Grosso, Amy L Phillips

Articles, Abstracts, and Reports

Background: Administrative-claims data enable comparative effectiveness assessment using large numbers of patients treated in real-world settings.

Objective: To evaluate real-world relapses, healthcare costs and resource use in patients with MS newly initiating subcutaneous interferon beta-1a (sc IFNβ-1a) v. oral disease-modifying drugs (DMDs: dimethyl fumarate, fingolimod, teriflunomide).

Methods: Patients from an administrative claims database (1 Jan 2012-31 Dec 2015) were selected if they: were 18-63 years old; had an MS diagnosis; had newly initiated sc IFNβ-1a, dimethyl fumarate, fingolimod, or teriflunomide (first claim = index); had no evidence of DMD 12-months pre-index; and had 12-month eligibility pre- and post-index. Relapse was …

Ssri Maintenance Therapy Reduces Rate Of Recurrence For Elderly Patients With First Episode Of Major Depression, Blake J. Arthurs

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Reynolds CF 3rd, Dew MA, Pollock BG, et al. Maintenance treatment of major depression in old age. N Engl J Med. 2006 Mar 16;354(11):1130-8. doi: 10.1056/NEJMoa052619. Based on the appraisal, long term SSRI maintenance therapy is recommended for elderly patients suffering from first episode of major depression.

Coping Strategies For Recovering Alcoholics And Addicts To Prevent Relapse, Heather Carr, Kristan Rigdon, Margaret Price, Hannah Fortner, Adam Herring

Heather Carr

Adding Psychotherapy To The Naltrexone Treatment Of Alcohol Use Disorder: Metaanalytic Review, Rizwan A. Ahmed, Vijaya P. Kotapati, Ali M. Khan, Nuzhat Hussain, Mudasar Hussain, Sara Dar, Jeevan Kumar, Gulshan A. Begum, Michael Esang, Navjot Brainch, Saeed Ahmed

School of Medicine Publications and Presentations

Background

It remains unclear if naltrexone combined with psychotherapy is superior to naltrexone alone in treating alcohol use disorders (AUD). The current meta-analysis examined the hypothesis that psychotherapy is a significant moderator that influences AUD-related outcomes and that naltrexone combined with psychotherapy is associated with significantly better AUD-related outcomes than naltrexone alone.

Methods

A total of 30 studies (Nnaltrexone = 2317; Nplacebo = 2056) were included. Random effects model meta-analyses were carried out for each of the studied outcomes. Subsequently, the random effects model pooled estimates from studies with and without psychotherapy were compared using a Wald test. A mixed-effect …