Medicine and Health Sciences Commons^™

Self-Modulation Of Rectus Femoris Reflex Excitability In Humans, Kyoungsoon Kim, Tunc Akbas, Robert Lee, Kathleen Manella, James Sulzer

HPD Articles

Hyperreflexia is common after neurological injury such as stroke, yet clinical interventions have had mixed success. Our previous research has shown that hyperreflexia of the rectus femoris (RF) during pre-swing is closely associated with reduced swing phase knee flexion in those with post-stroke Stiff-Knee gait (SKG). Thus, reduction of RF hyperreflexia may improve walking function in those with post-stroke SKG. A non-pharmacological procedure for reducing hyperreflexia has emerged based on operant conditioning of H-reflex, an electrical analog of the spinal stretch reflex. It is currently unknown whether operant conditioning can be applied to the RF. This feasibility study trained 7 …

Dextromethorphan/Quinidine For The Treatment Of Bulbar Impairment In Amyotrophic Lateral Sclerosis., Lauren Tabor Gray, Eduardo Locatelli, Terrie Vasilopoulos, James Wymer, Emily K. Plowman

HPD Articles

OBJECTIVE: No efficacious treatments exist to improve or prolong bulbar functions of speech and swallowing in persons with amyotrophic lateral sclerosis (pALS). This study evaluated the short-term impact of dextromethorphan/quinidine (DMQ) treatment on speech and swallowing function in pALS.

METHODS: This was a cohort trial conducted between August 2019 to August 2021 in pALS with a confirmed diagnosis of probable-definite ALS (El-Escorial Criteria-revisited) and bulbar impairment (ALS Functional Rating Scale score ≤ 10 and speaking rate ≤ 140 words per minute) who were DMQ naïve. Efficacy of DMQ was assessed via pre-post change in the ALS Functional Rating Scale-Revised bulbar …

A Patient With Foot Pain Found To Have Leriche Syndrome: A Case Report And Brief Review Of The Literature., Moshe Bengio, Quan Ta, Glenn Goodwin, Megan De Kok, Alexander J. Scumpia

HPD Articles

Leriche syndrome, a rare and critical complication of peripheral arterial disease (PAD), affects the distal abdominal aorta (infrarenal) and, similar to PAD, is a result of plaque buildup in the arterial lumen. The Leriche syndrome triad includes claudication in the proximal lower extremity, decreased or absent femoral pulses, and, in some cases, impotence. This article presents a patient with an atypical presentation of foot pain who was subsequently found to have Leriche syndrome. The patient was a 59-year-old female, a former smoker, who presented to the emergency department (ED) with atraumatic, acute right foot pain. All right lower extremity pulses …

The Role Of Clock Genes In Maintaining Circadian Rhythm And Rheumatoid Arthritis Pathophysiology., Arathi Kulkarni, Michelle Demory-Beckler, Marc M. Kesselman

HPD Articles

Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that affects up to 1% of the world population and symmetrically affects the joints leading to joint stiffness and decreased mobility. RA patients present with increased pain and chronic inflammation within their joint spaces, which researchers have linked to poorer sleep patterns, including difficulty falling asleep and non-restorative sleep. As such, identifying mediators of poor sleep quality among RA patients may improve their long-term quality of life. More recently, researchers identified an association between chronic inflammation in RA patients and their circadian rhythm. Altered circadian rhythms negatively impact the hypothalamic-pituitary-adrenal (HPA) …

A Scoping Review On The Effects Of Covid-19 On Syringe Service Programs In The United States., Dylan Pietrantoni, Crystal Barroca, Sarah Lynch, Jonathan Byrne, Miranda Ortner, Roshni Kotwani, Kolin Limbrick, Paul Kaldas, Michael Moussa, Tatem Fredrickson, Jeffrey Schaefer, Robin J. Jacobs

HPD Articles

The COVID-19 pandemic has had worldwide impacts, including disrupting community services. One interrupted service was syringe service programs (SSPs), community-established initiatives that provide sterile supplies and aid in overcoming addiction in drug-using participants. In the United States (U.S.), SSPs have been key in combating the recent opioid use crisis and associated infections such as the human immunodeficiency virus (HIV) and hepatitis C. While some published reports on the pandemic's overall impacts on SSPs exist, certain aspects such as operational changes and repercussions on staff and participants may still be lacking. Information about the impact of interrupted SSP services due to …

The Role Of Egfr Amplification In Deep Venous Thrombosis Occurrence In Idh Wild-Type Glioblastoma., Brandon Y. Kaye, Assad Ali, Raphael Augusto Correa Bastianon Santiago, Bilal Ibrahim, Julio Isidor, Hany Awad, Mohammadmahdi Sabahi, Michal Obrzut, Badih Adada, Surabhi Ranjan, Hamid Borghei-Razavi

HPD Articles

Introduction: Glioblastoma (GBM) patients have a 20-30 incidence of venous thromboembolic events. EGFR is a widely used prognostic marker for many cancers. Recent lung cancer studies have described relationships between EGFR amplification and an increased incidence of thromboembolic complications. We aim to explore this relationship in glioblastoma patients. Methods: Two hundred ninety-three consecutive patients with IDH wild-type GBM were included in the analysis. The amplification status of EGFR was measured using fluorescence in situ hybridization (FISH). Centromere 7 (CEP7) expression was recorded to calculate the EGFR-to-CEP7 ratio. All data were collected retrospectively through chart review. Molecular data were obtained …

E-Health Literacy Scale, Patient Attitudes, Medication Adherence, And Internal Locus Of Control., Donrie J Purcell, Gesulla Cavanaugh, Kamilah Thomas-Purcell, Joshua Caballero, Drenna Waldrop, Victoria Ayala, Rosemary Davenport, Raymond L Ownby

HPD Articles

BACKGROUND: Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related.

METHODS: Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed …

Artificial Intelligence Modelling To Assess The Risk Of Cardiovascular Disease In Oncology Patients., Samer S Al-Droubi, Eiman Jahangir, Karl M Kochendorfer, Marianna Krive, Michal Laufer-Perl, Dan Gilon, Tochukwu M Okwuosa, Christopher P Gans, Joshua H Arnold, Shakthi T Bhaskar, Hesham A Yasin, Jacob Krive

HPD Articles

AIMS: There are no comprehensive machine learning (ML) tools used by oncologists to assist with risk identification and referrals to cardio-oncology. This study applies ML algorithms to identify oncology patients at risk for cardiovascular disease for referrals to cardio-oncology and to generate risk scores to support quality of care.

METHODS AND RESULTS: De-identified patient data were obtained from Vanderbilt University Medical Center. Patients with breast, kidney, and B-cell lymphoma cancers were targeted. Additionally, the study included patients who received immunotherapy drugs for treatment of melanoma, lung cancer, or kidney cancer. Random forest (RF) and artificial neural network (ANN) ML models …

An Exploratory Qualitative Study Of Oncology Nurses’ Experience In Providing Care For Terminally Ill Patients In Salmaniya Medical Complex In Bahrain, Layla S. Turki, Leena Khonji, Magda Bayoumi

The Qualitative Report

Oncology nurses are essential in palliative care for cancer patients, especially at end-of-life stages. Caring for terminally ill cancer patients is stressful, accompanied by negative and positive feelings, but oncology nurses have an unavoidable responsibility. However, little is known about oncology nurses' experience in the Kingdom of Bahrain caring for terminally ill cancer patients in their final weeks or days. This study aimed to explore the experience of oncology staff nurses in providing care for terminally ill patients in the Kingdom of Bahrain, and the research answered those questions: (a) What is the experience of oncology staff nurses in providing …

Type I Spontaneous Coronary Artery Dissection In A 33-Year-Old Male With Clinically Suspected Myopericarditis., Cullen Nisson, Yeily Hernandez Mato, Nimisha Lingappa, James Abraham

HPD Articles

We report a 33-year-old male with uncontrolled type II diabetes, and tobacco and marijuana use who presented with chest pain after a night of binge drinking and vomiting. ECG changes were consistent with acute pericarditis. Troponin levels were found to be significantly elevated and rising. The patient was immediately treated with acetylsalicylic acid (ASA), morphine, nitroglycerin drip, and heparin drip. Echocardiogram showed preserved ejection fraction (EF) without effusion. Coronary angiography demonstrated a type I spontaneous coronary artery dissection (SCAD) of the mid-left anterior descending artery (LAD) without significant coronary artery disease. Diagnostic intravenous ultrasound (IVUS) confirmed a type I SCAD …

Benefits And Risks Of Sun Exposure To Maintain Adequate Vitamin D Levels., Jonathan Raymond-Lezman, Suzanne Riskin M.D.

HPD Articles

Vitamin D is a hormone that can be generated in the skin upon ultraviolet light exposure or ingested through supplementation. Vitamin D deficiency may have numerous deleterious effects on health. Sun avoidance strategies should be avoided due to the unwanted health risks associated with hypovitaminosis D. We present an objective investigation of the benefits and risks of using sun exposure to increase vitamin D levels and how it impacts human health. A review of the literature was conducted using Embase and PubMed to examine the relationship between UV exposure, vitamin D levels, health benefits, and risks. UV exposure is the …

Gender And Ethnic Disparities In Students' Perceptions Of How Different Groups Of Persons Suspected Of Possessing And/Or Selling Illegal Drugs Are Treated In The Criminal Justice System., Manuel J. Carvajal, Assma Twahir, Ioana Popovici

HPD Articles

Ethnic minorities and individuals of low socioeconomics status are disproportionately more likely to be detained, arrested, and convicted and receive longer sentences for drug offenses. This article explores gender and ethnic differentials among college students' perceptions on the criminal justice treatment of different gender, ethnic, and income groups applied to alleged drug offenders. It uses survey data provided by students at a large public university in South Florida. A two-way classification model examines the nature of disparities in perceptions. Students perceive widespread ethnic inequalities and female and Black students perceive greater disparities in the criminal justice system for all disadvantaged …

Variation In Leg Tissue Dielectric Constant Values Of Healthy Young Adult Females With And Without Compression Bandaging., Suzie Ehmann, Harvey N. Mayrovitz

HPD Articles

Background The clinical efficacy of a compression application has been often limited to the assessment of the change in limb volume, change in clinical symptoms (i.e., wound size, pain, range of motion, incidence of cellulitis), or vascular hemodynamics of the whole limb. Assessing compression-related biophysical changes of a localized area, such as around a wound, or in an area outside of an extremity cannot be objectively assessed by these measurements. Tissue dielectric constant (TDC) values, which provide a measure of the local tissue water (LTW) content, offer an alternative method to document variation in the LTW content of the skin …

Disparities In Women With Endometriosis Regarding Access To Care, Diagnosis, Treatment, And Management In The United States: A Scoping Review., Shannon Westwood, Mackenzie Fannin, Fadumo Ali, Justice Thigpen, Rachel Tatro, Amanda Hernandez, Cadynce Peltzer, Mariah Hildebrand, Alexnys Fernandez-Pacheco, Jonathan Raymond-Lezman, Robin J. Jacobs

HPD Articles

Endometriosis is a benign gynecological condition that elicits chronic pain in 2-10% of reproductive-age women in the United States and exists in approximately 50% of women with infertility. It creates complications such as hemorrhage and uterine rupture. Historically, the gynecologic symptoms of endometriosis have been associated with economic strain and inferior quality of life. It is suspected that endometriosis diagnosis and treatment are affected by health disparities throughout gynecological care. The goal of this review was to collate and report the current evidence on potential healthcare disparities related to endometriosis diagnosis, treatment, and care across race, ethnicity, and socioeconomic status. …

A Case Of Syringocystadenocarcinoma Papilliferum: Not Your Usual Suspect., Alena Bashinskaya, Lucas Shapiro, Conner Thompson, Artis P. Truett, Patricia Moody

HPD Articles

Syringocystadenocarcinoma papilliferum (SCACP) is an exceptionally rare cutaneous adnexal tumor that is infrequently encountered by clinicians worldwide. The tumor typically appears in the older population, affecting patients in their fifth and sixth decades of life without male or female predominance. Patients frequently present with a variable-sized hyperpigmented ulcerative lesion containing an exudate that has a long-standing course of progression from its benign counterpart, Syringocystadenoma papilliferum (SCAP). Additionally, the clinical presentation and morphology of the neoplasm can be easily confused with a variety of other skin cancers, such as squamous cell carcinoma (SCC), basal cell carcinoma (BCC), cutaneous lymphoma, and cutaneous …

The Implications Of Pharmacogenomics In Oncology, Jean J. Latimer

HPD Articles

No abstract provided.

Scalp, Oral, And Nail Pemphigus Vulgaris: Clinical Characteristics And A Review Of The Literature., Emily Eachus, Lauren E Delamielleure, Samrah Mitha, Taha F Rasul, Arfa Faiz

HPD Articles

Pemphigus vulgaris (PV) is a rare disease that affects the skin and mucous membranes, causing blistering and erosions. Identifying and effectively managing atypical presentations of pemphigus vulgaris can be challenging due to its rarity. We describe a 32-year-old male patient with a medical history including prediabetes, moderate asthma, hyperlipidemia, coccidioidomycosis, and respiratory infections. He was evaluated via telehealth in the allergy and immunology clinic for uncontrolled asthma. Initially, he complained of a whitish film in the mouth while on treatment with fluticasone and salmeterol. He also noted new vesicular lesions on his scalp and body. When evaluated later in the …

The Overlap Of Diabetes And Osteoarthritis In American Populations., Harshita Nadella, Allan W. Bloom, Michelle Demory Beckler, Marc M. Kesselman

HPD Articles

Diabetes mellitus, a condition in which the body's ability to produce insulin is impaired, and osteoarthritis (OA), a painful degeneration of joint cartilage, are both serious conditions that affect millions of people in the United States (U.S.). Osteoarthritis is a chronic degenerative condition of the joint cartilage, affecting mainly the older population. The purpose of this paper is to find a connection, if any, between diabetes and osteoarthritis and if either condition can predispose an individual to the other. Not only can this review help to explain the co-existence of these two diseases, but it can also be used to …

Dichorionic-Diamniotic Twin Pregnancy In A Bicornuate Uterus With Twin A Affected By Ebstein's Anomaly., Colleen N. Gorman, Spencer A. Grabois, Shreya Mathur, Evan P. Grabois, Allen Silanee

HPD Articles

Congenital Mullerian anomalies are rare developmental defects that result in malformation of the fallopian tubes, uterus, cervix, and vagina. The bicornuate uterus is one of the many variants of Mullerian anomalies, defined as having an external fundal indentation of greater than one centimeter. Pelvic ultrasound has a sensitivity of 99% for identifying bicornuate uteruses and is the predominant imaging device used for diagnosis. The cervical and uterine cavity anatomy in patients with a bicornuate uterus varies. The effect of maternal uterine structure on offspring development has been poorly documented. This report details a rare case of dichorionic-diamniotic twin pregnancy in …

Ventricular Fibrillation In An Afebrile Covid-19 Patient Presenting With Transient Type-I Brugada Pattern., Judah A. Kreinbrook, Annalia Foster, Luis Paulino, Fabio Leonelli

HPD Articles

COVID-19 has been associated with an increased risk of both atrial and ventricular arrhythmias. Brugada syndrome (BrS), an inherited sodium channelopathy presenting with a characteristic ECG morphology, confers a baseline risk of ventricular arrhythmias such as ventricular fibrillation (VF), especially during febrile illnesses. However, mimics of BrS, termed Brugada phenocopies (BrP), have been noted in association with fever, electrolyte abnormalities, and toxidromes outside of viral illness. Such presentations manifest the same ECG pattern, the type-I Brugada pattern (type-I BP). Thus, the acute stage of an illness such as COVID-19, when accompanied by a first-time presentation of type-I BP, may not …

Recent Progress In Micro And Nano-Encapsulation Techniques For Environmental Applications: A Review, Sefeera Sadik Ayyaril, Abdallah Shanableh, Sourjya Bhattacharjee, Mutasem Rawas-Qalaji, Roberta Cagliani, Ahmad Ghassan Shabib, Muhammad Imran Khan

HPD Articles

In recent years, micro- and nano-encapsulation methods have received considerable interest in the field of environmental research. These simple coating approaches retain the active material of interest inside a semipermeable membrane or carrier matrix, which allows the transfer of materials between the matrix and the reaction medium. This enables the development of particles with a controlled or triggered-release mechanism. The use of pH, temperature and pressure-responsive agents is commonly employed to regulate the release of core material from encapsulated particles. Diverse applications, from water treatment to energy storage and agricultural practices, have seen the use of encapsulated materials especially in …

Exploring Sex As A Moderator Of Other Prognostic Variables In Whiplash Associated Disorder: An Observational Study., Bradford Callan, David M. Walton, Joshua Cleland, Morey J. Kolber, James M. Elliott

HPD Articles

BACKGROUND: Prognostic variables for assessing people with whiplash associated disorder (WAD) following a motor vehicle collision (MVC) have been evaluated in numerous studies. However, there is minimal evidence assessing how these variables may differ between males and females.

QUESTION/PURPOSE: 1) To assess if the sex of a person interacts with known prognostic variables within the development of chronic WAD. 2) To determine if commonly used outcome measures used in the assessment of chronic WAD differ between sexes.

METHODS: The study was a secondary analysis of an observational study with an inception cohort immediately following an MVC in an emergency department …

Nutrition Intervention Through A Social Media Platform On Nutrition Knowledge And Cvd Risk Factors Amongst Firefighters, Katie Emerson, Douglas Kalman, Michael Downing

HPD Articles

Introduction: Cardiovascular disease (CVD) is the number one cause of on-duty death for firefighters. Risk factors such as hypertension, obesity, and elevated cholesterol can be used as predictors in the prevention and intervention of CVD. Social media(SM)has become a popular platform for delivering health and wellness information. The aims of this study were to examine the utility of nutrition education through a dedicated social media platform (Instagram) for supporting and enhancing nutrition knowledge and in reducing CVD risk factors amongst firefighters. Methods: In a pilot study, firefighters (n=53) were exposed to a private IG account for 6 weeks. The intervention …

Creatine Supplementation And Endurance Performance: Surges And Sprints To Win The Race., Scott C. Forbes, Darren G. Candow, Joao Henrique Falk Neto, Michael D. Kennedy, Jennifer L. Forbes, Marco Machado, Erik Bustillo, Jose Gomez-Lopez, Andres Zapata, Jose Antonio

HPD Articles

Creatine supplementation is an effective ergogenic aid to augment resistance training and improve intense, short duration, intermittent performance. The effects on endurance performance are less known. The purpose of this brief narrative review is to discuss the potential mechanisms of how creatine can affect endurance performance, defined as large muscle mass activities that are cyclical in nature and are >~3 min in duration, and to highlight specific nuances within the literature. Mechanistically, creatine supplementation elevates skeletal muscle phosphocreatine (PCr) stores facilitating a greater capacity to rapidly resynthesize ATP and buffer hydrogen ion accumulation. When co-ingested with carbohydrates, creatine enhances glycogen …

Venous, Arterial, And Neuropathic Leg Ulcers With Emphasis On The Geriatric Population., Harvey N. Mayrovitz, Summer Wong, Camilla Mancuso

HPD Articles

Leg ulcers are a common and often serious problem in older adults. Underlying conditions that increase risk include age-related increases in chronic venous insufficiency, peripheral artery disease, connective tissue and autoimmune conditions, reduced mobility, and diabetes mellitus (DM). Geriatric patients have a higher risk of multiple wound-related complications including infection, cellulitis, ischemia, and gangrene, any of which may lead to further complications including amputation. The very presence of these lower extremity ulcers in the elderly negatively impacts their quality of life and ability to function. Understanding and early identification of the underlying conditions and wound features are important for effective …

Measuring Energy Expenditure And Heart Rate During Maximum Aerobic Testing With The Apple Watch Series 7, Flavia Rusterholz, Corey A. Peacock, Andrew Rodriguez, Victoria Ortiz

HPD Articles

Introduction: Wrist-worn devices such as the Apple Watch have emerged as technology for tracking physical activity. The aim of this research study is to analyze the Apple Watch Series 7 (AW7) with measurements of the maximum heart rate (MHR) and maximum energy expenditure (MEE) during a maximal aerobic capacity test on the treadmill. AW7 measurements will be compared to the Polar Heart Rate Monitor (Polar) and the PARVO Metabolic Cart (PARVO). Methods: 22 healthy and active subjects (mean ± SD: age 23.8 ± 4.0 years; BMI 23.0 ± 5.9 kg/m2 ) volunteered for the study. The subjects confirmed their activity, …

Comparison Of Home-Blenderized Formula And Commercial Enteral Formulas For Gastrostomy Tube-Fed Children: A Retrospective, Prospective Cohort Study., Sebastian Shrager, Ayoola Adigun, Sonia Motolongo, Cristhiane S. Santos, Patricia Rowe-King, Debora Duro

HPD Articles

Background Blenderized gastrostomy tube feedings (BGTFs) consist of pureed table foods and liquids that are administered as enteral tube feedings. Compared to commercial enteral formulas (CEFs), BGTF has been shown to have fewer side effects. Despite these results, apprehensions have been raised about microbial contamination, nutritional deficiencies or surplus, risk of gastrostomy tube (GT) blockages, and lack of consistency in clinical outcomes. The goal of this retrospective, prospective, 18-month-long study is to report the clinical and nutritional outcomes of GT-dependent pediatric patients who attended a multidisciplinary feeding clinic. Methodology After Institutional Review Board (IRB) approval and consent were obtained, 25 …

Appendiceal Endometriosis Presenting As Chronic Appendicitis: A Case Report., Sarah Klein, Raeann Tourangeau-Young, Alejandro Biglione

HPD Articles

The origin of endometriosis has multiple theories, with controversy over which may demonstrate the prominent pathophysiology. The most common extra-pelvic organ system affected by endometriosis is the gastrointestinal tract. Gastrointestinal endometriosis (GE) accounts for 3 to 37% of all endometriosis cases, and appendiceal endometriosis is present in around 3% of GE cases, therefore constituting less than 1% of all endometriosis cases. In this report, we present a 24-year-old female with a past medical history significant for endometriosis status post two excisional laparoscopies who presented with eight months' duration of right lower quadrant pain, constant and stabbing, with rebound tenderness. Appendectomy …

Individual Characteristics That Promote Or Prevent Psychological Safety And Error Reporting In Healthcare: A Systematic Review., Dawn M. Wawersik, Emile R. Boutin, Teresa Gore, Janice C. Palaganas

HPD Articles

BACKGROUND: Healthcare errors continue to be a safety issue and an economic burden that causes death, increased length of stays, and emotional trauma to families and the person who commits the error.  Speaking up and error reporting within a safety culture can reduce the incidence of error; however, this is complex and multifaceted.

AIM: This systematic review investigates individual characteristics that support or prevent speaking up behaviors when adverse events occur.  This study further explores how organizational interventions designed to promote error reporting correlate to individual characteristics and perceptions of psychological safety.  .

METHODS: A systematic review of peer-reviewed articles …

Syndeep: A Deep Learning Approach For The Prediction Of Cancer Drugs Synergy., Anna Torkamannia, Yadollah Omidi, Reza Ferdousi

HPD Articles

Drug combinations can be the prime strategy for increasing the initial treatment options in cancer therapy. However, identifying the combinations through experimental approaches is very laborious and costly. Notably, in vitro and/or in vivo examination of all the possible combinations might not be plausible. This study presented a novel computational approach to predicting synergistic drug combinations. Specifically, the deep neural network-based binary classification was utilized to develop the model. Various physicochemical, genomic, protein-protein interaction and protein-metabolite interaction information were used to predict the synergy effects of the combinations of different drugs. The performance of the constructed model was compared with …