Medicine and Health Sciences Commons^™

Quantifiying The Depth Of Oral Sedation Using Bispectral Index Monitoring, John Flowers

Theses and Dissertations

Purpose: To determine whether Bispectral Index Monitoring is an effective tool for quantifying sedation depth after the administration of oral drug regimens in children.Methods: This retrospective study reviewed the charts of 75 children who received oral conscious sedation for dental treatment. Data collected from the chart included; 1) BIS values at 5 minute intervals and at five critical events: pre-operative, local anesthesia delivery, rubber dam placement (if utilized), during operative treatment, and postoperatively, 2) behavior ratings at the five critical events and an overall behavior assessment, 3) treatment data, and 4) demographic data. Results: The mean BIS value for orally …

Assessment Of Seminary Education On End Of Life Issues, Stefan Hakon Pomrenke

Theses and Dissertations

Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in …

Effects Of Smoking And Gender On Tetrahydroisoquinolines And Beta-Carbolines In A Healthy Population And During Alcohol Detoxification, Satjit Singh Brar

Theses and Dissertations

The purpose of this investigation was to evaluate the effects of smoking and gender on 1) tetrahydroisoquinolines (TIQs) and beta-carbolines (BCs) in a population of healthy subjects and 2) TIQs in an alcohol-dependent population undergoing in-patient detoxification. Comparison in plasma TIQs between the populations was additionally conducted. To support the clinical investigations, a HPLC-FD method was developed and validated to assess plasma concentrations of BCs, harman and norharman, while a HPLC-ESI-MS/MS method was validated to quantify the TIQs, R/S-salsolinol along with dopamine. Forty-one young volunteers were recruited including 19 nonsmokers (NS), 11 light smokers (LS) and 11 heavy smokers (HS), …

Esthetic Posterior Stainless Steel Crowns And Their Relative Shear Strengths, Lonny Dale Carmichael

Theses and Dissertations

Purpose: The purpose of this study was to evaluate esthetic posterior stainless steel crowns (EP-SSC) and compare their relative shear strengths.Methods: Sixty EP-SSC were compared. 15 crowns from NuSmile® Primary Crowns, Kinder Krowns, and Dental Innovators 1UP and EC Crowns were studied. The crowns were cemented to a typodont tooth then thermally cycled in water baths to simulate oral conditions. Shear strengths were evaluated by subjecting these crowns to simulated forces of occlusion.Results: The force required to cause shearing of the esthetic facings was statistically significant. With the 1UP crown being significantly weaker than the other crowns tested. Conclusion: The …

How Well Does Spirituality Predict Health Status In People Living With Hiv-Disease?, Rachel Kidd Cobb

Theses and Dissertations

Problem: The United States of America has one of the highest number of HIV infections in the world; approximately 1.3 million people in North America were living with HIV in 2007. Factors influencing HIV survival are essential to disease management and care. Research findings suggest religion and spirituality may be essential components to health and well-being in individuals with HIV-Disease. Purpose: This study was designed to determine how well spirituality predicted health status in a convenience sample of 39 adults diagnosed with HIV-Disease. Procedure: A model building approach was used to explore relationships among the five variables of the Neuman …

Virginia Dental Journal (Vol. 85, No. 3, 2008)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 85, No. 2, 2008)

Virginia Dental Journal

No abstract provided.

Investigation Of Inosine And Hypoxanthine As Biomarkers Of Cardiac Ischemia In Plasma Of Non-Traumatic Chest Pain Patients And A Rapid Analytical System For Assessment, Don E. Farthing

Theses and Dissertations

Each year in the U.S., approximately 7-8 million patients with non-traumatic chest pain visit hospital emergency departments (ED) for medical evaluation. It is estimated that approximately 2-5% of these patients are experiencing acute cardiac ischemia, but due to the shortcomings of current test methods, they are incorrectly diagnosed and discharged without appropriate treatment provided, thus leading to poor patient outcome and potential medical malpractice litigation.The goals of this research were to evaluate plasma samples for potential biomarker(s) of acute cardiac ischemia prior to heart tissue necrosis, and to ultimately develop a rapid method for detection of the potential biomarker(s) in …

The Influence Of Environmental Factors And Organizational Characteristics On Innovations In Family Medicine Practices In Virginia, Debora Goetz Goldberg

Theses and Dissertations

Family medicine practices are currently threatened by factors such as poor reimbursement, physician stress, shortage of providers, and difficulties in providing prompt access and reliable continuity of care. The external environment faced by family medicine practices is extremely complex and characterized by high pressure from regulatory sources, decreasing reimbursement levels, an increasing rate of change in technologies and care delivery processes, and increasing patient and community expectations. Over the last several years there have been many efforts in family medicine to respond to the challenges presented by the external environment. The majority of these efforts focus on redesigning the delivery …

Virginia Emergency Department Physician Knowledge Of The Emergent Treatment Of Avulsed Teeth, Joy Leatrice Barnes Phelps

Theses and Dissertations

Purpose: The purpose of this study was to determine the knowledge and treatment protocols for physicians in Virginia emergency departments in regards to the emergent treatment of avulsed teeth.Methods: Using a cross sectional survey design, an 8-item questionnaire regarding the treatment of avulsed teeth was emailed to 75 emergency department chairpersons in Virginia. After 30 days, a reminder paper copy of the questionnaire was mailed and an email reminder with the on-line link was sent. After 60 days the study was closed. Comparisons were made using chi-square analysis based on percentages to test for significance. Results: The response rate was …

Alternative Orthodontic Bonding Protocol Using Self Etching Primer, Rush-Baker Gaines Caldwell

Theses and Dissertations

The purpose of the current study was to develop a bonding method that can achieve clinically acceptable bond strength values while leaving a minimum amount of adhesive on the tooth surface during the debonding process. One hundred teeth were randomly assigned into groups. Five different enamel surface preparation protocols were tested (N = 20, each): Conventional acid etch, standard SEP, SEP applied with a light brush stroke (altered SEP 1), SEP applied directly to the composite of pre-coated bracket (altered SEP 2), and Primer Only groups. Brackets were debonded using an Instron universal testing machine (Instron, Canton, MA) in shear …

Endocannabinoid Modulation Of Spatial Memory In Aversively And Appetitively Motivated Barnes Maze Tasks, John Pinckney Harloe

Theses and Dissertations

Genetic deletion or pharmacological blockade of the CB1 receptor has been reported to impair extinction learning in aversive conditioning (i.e., conditioned fear and Morris water maze) paradigms, but not in operant procedures in which food reinforcement is earned. It is difficult to discern whether the differential effects caused by CB1 receptor disruption on extinction result from the hedonics (i.e., aversive vs. appetitive) or is related to the required responses associated with these disparate tasks. In order to evaluate whether the hedonics is the determining factor, we used either aversive (i.e., escape from bright lights and air turbulence) or appetitive (i.e., …

Comparison Of Emergence Behavior In Pediatric Dental Patients Undergoing General Anesthesia With Sevoflurane Versus Desflurane, Carla Lalande

Theses and Dissertations

Purpose: To determine which maintenance gas (sevoflurane versus desflurane) resulted in a faster emergence from general anesthesia and investigate the patient's emergence agitation. Methods: One group was maintained during general anesthesia with sevoflurane and the other with desflurane. Upon emergence the patient's behavior was evaluated.Results: The average emergence time for desflurane was 9.8; while the average for sevoflurane was 13.98 minutes. Patients who received premedication had an emergence time of 15.43 minutes, while patients who received no premedication emerged after 8.34 minutes.Zofran® was a significant predictor of purposeful actions. Patients were more aware of their surroundings when they received Zofran® …

Characterization Of Yeast 18s Rrna Dimethyl Transferase, Dim1p, Nagesh Pulicherla

Theses and Dissertations

Eukaryotic ribosome biogenesis, a dynamic and coordinated multistep process which requires more than 150 trans-acting factors, has been intensely studied in the yeast Saccharomyces cerevisiae. This evolutionarily conserved process involves numerous cleavages of pre-rRNA, modification of nucleotides, and concomitant assembly of the ribosomal proteins onto the rRNA. Considerable information is available about the importance of conserved pre-rRNA cleavage events in ribosome biogenesis; however, very little is known about the exact role of modified nucleotides, which cluster within the functionally important regions of the ribosome. One conserved group of modifications is the dimethylation of two adjacent adenosines at the 3´ end …

The Use Of Implants Vs. Endodontics: Practitioner Attitudes In 2007, Gardiner Mckay Packer

Theses and Dissertations

The purpose of this study was to determine what factors influence dentists when deciding whether to place an implant or perform endodontic retreatment. Null hypothesis: Dentists today are no more likely to place an implant than to perform endodontic retreatment. A twelve-item questionnaire was mailed to 525 general dentists and specialists who are members of the Richmond Dental Society. Response rate was 61.9%. The questionnaire included items on demographics, practice profile and cases of failing endodontic therapy which participants were asked to consider and chose between endodontic retreatment or implant placement. The relationship between the treatment choices and the characteristics …

Examining The Behavioral And Molecular Aspects Of Adolescent Nicotine Dependence: Implications For Vulnerability To Drugs Of Abuse, Dena Heath Kota

Theses and Dissertations

Approximately 200 million men and 100 million women smoke worldwide. In the United States, an estimated 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) are smokers. The commencement of smoking at a young age is thought to increase addiction liability, decrease the probability of successful cessation, and correlate with a higher number of cigarettes smoked per day. Studies from the World Health Organization indicate that between 80,000 and 100,000 children start smoking every day worldwide. These statistics suggest that adolescence is a critical phase for developing nicotine dependence. The work in this dissertation contributes to the further …

5-Ht3 Receptor Ligands And Their Effect On Psychomotor Stimulants, Jessica Nicole Worsham

Theses and Dissertations

Drug abuse and addiction are considered to be a result, at least in part, of the rewarding effects produced by increasing dopamine levels. 5-HT3 serotonin receptors have been shown to indirectly affect dopamine levels. Therefore, the effect of the 5-HT3 receptor partial agonist, MD-354, on the actions of psychomotor stimulants was analyzed in mouse locomotor activity assays to determine whether MD-354 is working through a 5-HT3 receptor agonist or antagonist mode of action. Studies with (+)amphetamine and (+)methamphetamine in combination with MD-354 indicated MD-354 is either devoid of action or is behaving similar to the 5-HT3 receptor antagonist, ondansetron. This …

The Psychosocial Influence Of Dental Esthetics In Adolescents As Judged By Peers, Scott Thomas Henson

Theses and Dissertations

The purpose of this study was to determine if dental esthetics affects the perception of adolescents regarding their peer's social aptitude in specific areas such as athletics, popularity, leadership, and academics. Ten patient photographs (4 males, 6 females) from a private orthodontic practice in Richmond, VA were selected for inclusion in this study. The frontal smiling photographs were digitally modified with insertion of either an ideal smile (straight) or a non-ideal smile (crooked) to create an image identical to the original except for an altered dental complex. Laypersons rated the straight and crooked patient photographs for athletic performance, socialization skills …

A Capillary-Based Microfluidic System For Immunoaffinity Separations In Biological Matrices, Michael Peoples

Theses and Dissertations

The analysis of biological samples in clinical or research settings often requires measurement of analytes from complex and limited matrices. Immunoaffinity separations in miniaturized formats offer selective isolation of target analytes with minimal reagent consumption and reduced analysis times. A prototype capillary-based microfluidic system has been developed for immunoaffinity separations in biological matrices with laser-induced fluorescence detection of labeled antigens or antibodies. The laboratory-constructed device was assembled from two micro syringe pumps, a microchip mixer, a micro-injector, a diode laser with fused-silica capillary flow cell, and a separation capillary column. The columns were prepared from polymer tubing and packed under …

Enzymology And Molecular Biology Of Bile Acid 7alpha- And 7beta- Dehydroxylation By The Intestinal Bacteria Clostridium Scindens And Clostridium Hylemonae, Jason Michael Ridlon

Theses and Dissertations

The collective microbial genomes within our gut(microbiome) represent a powerful metabolic force, leading many authors to call our GI flora an "organ within an organ", and the metagenomic sequencing of our microbiome, "the second human genome project". Bile acids, endogenously produced by the host liver, represent both a strong selective pressure for potential colonizers, aswell as substrates for microbial metabolism. Indeed, microbes have evolved enzymes to deconjugate bile salts, epimerize bile acid hydroxyl groups, and 7alpha-dehydroxylateprimary bile acids. The products of microbial 7alpha-dehydroxylation, secondary bile acids, are suggested by numerous lines of evidence to be involved in promoting colon carcinogenesis. …

Fluoride Varnish Use Among Dentists In Virginia, Amanda Bowen Kuhn

Theses and Dissertations

Purpose: The purpose of this study was to asses fluoride varnish use by dental practitioners in Virginia. Methods: Using a cross sectional survey design, all dentists in Virginia who are members of the Virginia Dental Association (VDA) were sent an online survey about usage and knowledge of fluoride varnish. Results: The majority of the respondents were general dentists (79%) followed by pediatric dentists (12%). Fluoride varnish use increased with year of graduation from dental school. Dentists who thought fluoride varnish was more effective and less time consuming use it more than other topical fluorides. Dentists who thought their patients prefer …

Frontal Plane Pelvic Drop In Runners: Causes And Clinical Implications, Evie Neff Burnet

Theses and Dissertations

Running is becoming an increasingly popular sport; however, runners have a high rate of injury and are therefore often treated in the orthopedic or sports medicine setting. One current focus of these patients' treatment is gluteus medius muscle (GM) strengthening and gait retraining, with the goal of decreasing frontal plane pelvic drop. Unfortunately, there is a research void assessing the role of GM function on pelvic drop, and the effect of an increased pelvic drop on running performance. The specific aims of this research were to investigate a link between frontal plane pelvic drop and (1) isometric GM torque, (2) …

Exploring The Experience Of Benefit Finding In Parents Of Children With Cancer: A Grounded Theory Study, Carol E. Zogran

Theses and Dissertations

The diagnosis of cancer in a child is one of the most significant stressors a parent can experience, and research in the area of stress-related effects of illness on parents has emerged in many areas. The majority of studies have focused on the potential or actual negative impact on parents during and after treatment of their child's illness. However, studies that initially set out to explore the difficulties associated with coping with childhood cancer found that parents often reported positive aspects about the experience. There is now increasing interest and support for the study of "positive-health" factors that contribute to …

The Effects Of Atomoxetine On Cognitive Performace And Neuroplasticity After Traumatic Brain Injury, Wendy Reid

Theses and Dissertations

Catecholaminergic neurotransmission is regionally altered following injury, and drugs aimed at these systems offer promising avenues for post-TBI pharmacotherapies. Atomoxetine is a selective norepinephrine transporter (NET) inhibitor currently indicated for treatment of attention-deficit hyperactivity disorder (ADHD). The studies in this dissertation were designed to test the efficacy of atomoxetine for treating cognitive deficits following experimental TBI and the potential mechanism for any beneficial effect. The first part of the study focused on behavioral recovery following atomoxetine treatment. Several important questions of dose, therapeutic window, and duration of treatment were addressed in these studies. Sprague-Dawley rats were subjected to lateral fluid-percussion …

Treatment Outcomes And Retention In Medicaid And Non-Medicaid Orthodontic Patients, Ashkan Ghaffari

Theses and Dissertations

Medicaid orthodontic patients have been shown to miss more appointments and break more appliances than self-pay patients, indicating a greater tendency toward non-compliance. Lack of compliance during the post-treatment phase can be detrimental to retention. The purpose of this study was to determine whether there is a difference in PAR score changes between Medicaid and non-Medicaid patients during and after orthodontic treatment. PAR scores were determined using study models of 43 Medicaid and 39 non-Medicaid patients before and at the end of active treatment, and 24 Medicaid and 42 non-Medicaid patients at the end of treatment and at an average …

Interaction Of Glycolysis And Mitochondrial Respiration In Metabolic Oscillations Of Pancreatic Islets, Richard Bertram, Leslie S. Satin, Morten Gram Pedersen, Dan S. Luciani, Arthur Sherman

Pharmacology and Toxicology Publications

Abstract

Insulin secretion from pancreatic β-cells is oscillatory, with a typical period of 2–7 min, reflecting oscillations in membrane potential and the cytosolic Ca²⁺ concentration. Our central hypothesis is that the slow 2–7 min oscillations are due to glycolytic oscillations, whereas faster oscillations that are superimposed are due to Ca²⁺ feedback onto metabolism or ion channels. We extend a previous mathematical model based on this hypothesis to include a more detailed description of mitochondrial metabolism. We demonstrate that this model can account for typical oscillatory patterns of membrane potential and Ca²⁺ concentration in islets. It also …

Biophysical Characterization Of Anticoagulant Hemextin Ab Complex From The Venom Of Snake Hemachatus Haemachatus, Yajnavalka Banerjee, Rajamani Lakshminarayanan, Subramanian Vivekanandan, Ganesh Srinivasan Anand, Suresh Valiyaveettil, R. Manjunatha Kini

Biochemistry and Molecular Biology Publications

Abstract

Hemextin AB complex from the venom of Hemachatus haemachatus is the first known natural anticoagulant that specifically inhibits the enzymatic activity of blood coagulation factor VIIa in the absence of factor Xa. It is also the only known heterotetrameric complex of two three-finger toxins. Individually only hemextin A has mild anticoagulant activity, whereas hemextin B is inactive. However, hemextin B synergistically enhances the anticoagulant activity of hemextin A and their complex exhibits potent anticoagulant activity. In this study we characterized the nature of molecular interactions leading to the complex formation. Circular dichroism studies indicate the stabilization of β-sheet …

Peginterferon Alfa-2a And Ribavirin For 16 Or 24 Weeks In Hcv Genotype 2 Or 3, Mitchell L. Shiffman, Fredy Suter, Bruce R. Bacon, David Nelson, Hugh Harley, Richard Sola, Stephen D. Shafran, Karl Barange, Amy Lin, Ash Soman, Stefan Zeuzem

VCU Health Publications

Background

Patients infected with hepatitis C virus (HCV) genotype 2 or 3 have sustained virologic response rates of approximately 80% after receiving treatment with peginterferon and ribavirin for 24 weeks. We conducted a large, randomized, multinational, noninferiority trial to determine whether similar efficacy could be achieved with only 16 weeks of treatment with peginterferon alfa-2a and ribavirin.

Methods

We randomly assigned 1469 patients with HCV genotype 2 or 3 to receive 180 μg of peginterferon alfa-2a weekly, plus 800 mg of ribavirin daily, for either 16 or 24 weeks. A sustained virologic response was defined as an undetectable serum HCV …

Eltrombopag For Thrombocytopenia In Patients With Cirrhosis Associated With Hepatitis C, John G. Mchutchison, Geoffrey Dusheiko, Mitchell L. Shiffman, Maribel Rodriguez-Torres, Samuel Sigal, Marc Bourliere, Thomas Berg, Stuart C. Gordon, Fiona M. Campbell, Dickens Theodore, Nicole Blackman, Julian Jenkins, Nezam H. Afdhal

VCU Health Publications

Background

Eltrombopag is a new, orally active thrombopoietin-receptor agonist that stimulates thrombopoiesis. We evaluated its ability to increase platelet counts and facilitate treatment for hepatitis C virus (HCV) infection in patients with thrombocytopenia associated with HCV-related cirrhosis.

Methods

Seventy-four patients with HCV-related cirrhosis and platelet counts of 20,000 to less than 70,000 per cubic millimeter were randomly assigned to receive eltrombopag (30, 50, or 75 mg daily) or placebo daily for 4 weeks. The primary end point was a platelet count of 100,000 per cubic millimeter or more at week 4. Peginterferon and ribavirin could then be initiated, with continuation …

Enhanced Care Assistant Training To Address The Workforce Crisis In Home Care: Changes Related To Job Satisfaction And Career Commitment, Constance L. Coogle, Iris A. Parham, Rita Jablonski, Jason A. Rachel

Virginia Center on Aging Publications

Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically signifi cant increase in Intrinsic Job Satisfaction scores for participants 18–39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically signifi cant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily …