Medicine and Health Sciences Commons^™

Inter- And Intra-Physician Variation In Quantifying Actinic Keratosis Skin Photodamage, Benjamin Schmeusser, Christina E. Borchers, Jeffrey B. Travers, Samia Borchers, Justin Trevino, Max Rubin, Heidi Donnelly, Karl Kellawan, Lydia Carpenter, Shalini Bahl, Craig A. Rohan, Elizabeth Muennich, Scott Guenthner, Holly Hahn, Ali Rkein, Marc Darst, Nico Mousdicas, Elizabeth E. Cates, Ulas Sunar, Trevor J. Bihl

Dermatology Faculty Publications

We investigated the variations in physician evaluation of skin photodamage based on a published photodamage scale. Of interest is the utility of a 10-level scale ranging from none and mild photodamage to actinic keratosis (AK). The dorsal forearms of 55 adult subjects with various amounts of photodamage were considered. Each forearm was independently evaluated by 15 board-certified dermatologists according to the Global Assessment Severity Scale ranging from 0 (less severe) to 9 (the most progressed stage of skin damage). Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion. Results show substantial disagreement amongst the dermatologists on …

Spotlight Commentary: Why We Need To Pay Attention To Toxicity Associated With Herbal Medicines, Elena Y. Enioutina, Kathleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

No abstract provided.

Renal Survival In Children With Glomerulonephritis With Crescents: A Pediatric Nephrology Research Consortium Cohort Study, Joseph G. Maliakkal, M. John Hicks, Mini Michael, David T. Selewski, Katherine Twombley, Michelle N. Rheault, Meredith Seamon, Jason M. Misurac, Cheryl L. Tran, Loretta Reyes, Joseph T. Flynn, Ali M. Onder, Alexandru R. Constantinescu, Vaishali Singh, Cynthia Pan, Abiodun Aderogba Omoloja, Qiang Wu, William E. Smoyer, Guillermo Hidalgo, Scott E. Wenderfer

Pediatrics Faculty Publications

There is no evidence-based definition for diagnosing crescentic glomerulonephritis. The prognostic implications of crescentic lesions on kidney biopsy have not been quantified. Our objective was to determine risk factors for end-stage kidney disease (ESKD) in patients with glomerulonephritis and crescents on kidney biopsy. A query of the Pediatric Nephrology Research Consortium’s Pediatric Glomerulonephritis with Crescents registry identified 305 patients from 15 centers. A retrospective cohort study was performed with ESKD as the primary outcome. Median age at biopsy was 11 years (range 1–21). The percentage of crescents was 3–100% (median 20%). Etiologies included IgA nephropathy (23%), lupus (21%), IgA vasculitis …

Trends In Cancer Prevalence In Punjab, Pakistan: A Systematic Study From 2010 To 2016, Sana Hafeez, Asmat Mahmood, Rizwan Ullah Khan, Naila Malkani

Journal of Bioresource Management

Cancer is the second leading cause of death globally. However, in Pakistan, in the absence of a national cancer registry, it is difficult to predict the current status of cancer incidence. Therefore, a need was felt to design a study that can give a depiction of the prevalence of common cancer types and their relevance to the local population in the absence of a proper cancer registry system. In view of this, data was collected from 2010 to 2016 for breast, prostate, head and neck, cervical and colorectal cancer from the cancer hospitals and centres located all over Punjab, Pakistan. …

The Perils Of Recreational Marijuana Use: Relationships With Mental Health Among Emergency Department Patients, Catherine A. Marco, John Paul Detherage Iii, Ashley Lafountain, Megan Hanna, Justin Anderson, Rachel Rhee, Jacqueline Ziegman, Dennis Mann

Emergency Medicine Faculty Publications

Abstract Introduction Marijuana is a commonly used drug in the United States. Many states have legalized the recreational use of marijuana. The effects of marijuana on mental health are unknown. Methods In this prospective survey study, eligible participants included ED patients age 18 and older, who had ever used recreational marijuana. A survey instrument was developed, piloted, and revised. Data collected included reasons for marijuana use, marijuana's perceived effectiveness, and history of mental health conditions, including depression, anxiety, and suicidal thoughts. Results Among 303 participants (86% response rate), the median age of first marijuana use was 16 ([IQR 14, 19], …

Vital Signs, Spring 2020, Boonshoft School Of Medicine

Vital Signs

A thirty-one page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Predictors Of New-Onset Atrial Fibrillation In Geriatric Trauma Patients, Catherine A. Marco, Jennifer Lynde, Blake Nelson, Joshua Madden, Adam Schaefer, Claire Hardman, Mary Mccarthy

Emergency Medicine Faculty Publications

Geriatric patients (age >65) comprise a growing segment of the trauma population. New-onset atrial fibrillation may occur after injury, complicating clinical management and resulting in significant morbidity and mortality. This study was undertaken to identify clinical and demographic factors associated with new-onset atrial fibrillation among geriatric trauma patients . Methods: In this case control study, eligible participants included admitted trauma patients age 65 and older who developed new-onset atrial fibrillation during the hospitalization. Controls were admitted trauma patients who were matched for age and injury severity score, who did not develop atrial fibrillation. We evaluated the associations between new-onset atrial …

Investigation Into The Reproducibility Of The Association Of Cord Blood Magnesium Concentration And Cerebral Palsy Or Death In Children, Christopher Luke Dixon, Xiaoxi Liu, Alfred Balch, Maged Costantine, Catherine M. Sherwin

Pediatrics Faculty Publications

Objective: To evaluate the association of cord blood magnesium concentrations at the time of birth with cerebral palsy (CP) and neonatal death. Study Design: A secondary analysis of a randomized controlled trial that randomized women at imminent risk of delivery between 24 and 31 weeks of gestation to receive magnesium sulfate or placebo. This ‘study’s primary outcome was a composite of either moderate to severe CP or death. Secondary outcomes included CP, moderate to severe CP, neonatal death, and neonatal head ultrasound findings. We used a logistic regression model to evaluate the relationship between the concentration of magnesium in cord …

The Reliability Of Histamine Pharmacodynamic Response Phenotype Classification In Children With Allergic Disease., Kumar Ss, Liu X, Sherwin Cm, Jones Bl

Pediatrics Faculty Publications

We have identified distinct histamine pharmacodynamic response phenotypes in children with allergic disease utilizing histamine iontophoresis with laser Doppler (HILD). These response phenotypes may be relevant in guiding therapeutic decision making for agents targeting the allergic response pathways. However, the reliability of these response phenotypes has not been assessed. Therefore, we performed HILD in children with allergic rhinitis and/or asthma on two to three separate occasions. HILD response-time data were analyzed in NONMEM using a linked effect PKPD model. Examination of observed vs. classified response phenotypes predicted response plots and the sum of residuals. The intraclass correlation coefficient (ICC) was …

Therapeutic Potential Of Citrulline As An Arginine Supplement: A Clinical Pharmacology Review, Jahidur Rashid, Shaun S. Kumar, Kathleen M. Job, Xiaoxi Liu, Candice D. Fike, Catherine M. T. Sherwin

Pediatrics Faculty Publications

Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction. L-arginine, an endogenous amino acid, was reported in clinical studies in adults to improve cardiovascular function in hypertension, pulmonary hypertension, pre-eclampsia, angina, and mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome. L-citrulline, a natural precursor of L-arginine, is more bioavailable than L-arginine because of hepatic first-pass metabolism avoidance and longer circulation time. Although not yet well studied, arginine/citrulline has immense therapeutic potential in some life-threatening diseases of children. However, optimal clinical development of arginine or …

Mandatory And Permissive Reporting Laws: Obligations, Challenges, Moral Dilemmas, And Opportunities, Joel M. Geiderman, Catherine A. Marco

Emergency Medicine Faculty Publications

The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm. In an open society, others, such as teachers, clergy, police officers, or simply neighbors, share the responsibility of protecting individuals at risk, often by reporting them to authorities. The emergency physician and others in the emergency department are uniquely positioned to identify people at risk or who pose a risk, and to report them as required or allowed under the law. In some circumstances, …

A Comparison Between The Teg 6s And Teg 5000 Analyzers To Assess Coagulation In Trauma Patients, Matthew D. Neal, Ernest E. Moore, Mark Walsh, Scott Thomas, Rachael A. Callcut, Lucy Z. Kornbilth, Martin Schreiber, Akpofure Peter Ekeh, Adam J. Singer, Lawrence Lottenberg, Michael Foreman, Susan Evans, Robert D. Winfield, Michael D. Goodman, Carl Freeman, David Milia, Noelle Saillant, Jan Hartmann, Hardean E. Achneck

Department of Surgery Faculty Publications

BACKGROUND

Trauma-induced coagulopathy is a major driver of mortality following severe injury. Viscoelastic goal-directed resuscitation can reduce mortality after injury. The TEG 5000 system is widely used for viscoelastic testing. However, the TEG 6s system incorporates newer technology, with encouraging results in cardiovascular interventions. The purpose of this study was to validate the TEG 6s system for use in trauma patients.

METHODS

Multicenter noninvasive observational study for method comparison conducted at 12 US Levels I and II trauma centers. Agreement between the TEG 6s and TEG 5000 systems was examined using citrated kaolin reaction time (CK.R), citrated functional fibrinogen maximum …

Effect Of Hiv Prevalence And Gender On Cardiovascular Disease Deaths, Tanjeev Ahmad

Scholarship in Medicine - All Papers

Cardiovascular disease is a widely diagnosed condition that can have many etiologies and factors that changes its prognosis. This project was aimed at investigating two potential factors that changes its prognosis: HIV status and gender. Data on HIV status was collected from NCHHSTP AtlasPlus for all US states and territories and data on cardiovascular disease deaths and corresponding gender was collected from Interactive Atlas of Heart Disease and Stroke for all US states and territories. Using a linear regression test, a correlation was tested for between HIV status and cardiovascular disease deaths for every US state/territory followed by a test …

Incidence Of Female Breast Cancer In The United States By Race And Region, Tiffany Le

Scholarship in Medicine - All Papers

Objective: Assess the distribution and incidence of female breast cancer in the United States in different races and regions of the United States. Methods: Collect and analyze CDC WONDER data from the Center for Disease and Control to see if there are varying rates of female breast cancer incidence between races and in different regions of the United States. Results: The results are expected to show a significant difference in female breast cancer incidence between races and a non-significant difference in female breast cancer incidence among different regions of the United States.

Marijuana Use And Mental Health Among Emergency Department Patients, Megan Hanna

Scholarship in Medicine - All Papers

Background: According to the Centers for Disease Control and Prevention (CDC), marijuana is the most commonly used illicit drug in the U.S. with an increasing number of users in recent years.

Objective: This study was undertaken to identify common reasons for marijuana use and any relationship between its use and mental health among Emergency Department (ED) patients. Methods: A total of 303 ED patients participated from the Miami Valley Hospital Emergency Department. Eligible participants included those with any marijuana use. Subjects were administered a survey which identified age of first use, reasons for use, and presence of anxiety and depression …

Long-Term Survival Of Bladder Cancer Metastatic To Femoral Neck Treated With Chemotherapy, Radiation, And Arthroplasty: A Case Report, John Defant, Scott Huff, Joseph D. Henningsen, Anil Krishnamurthy

Scholarship in Medicine - All Papers

Case: A 64-year-old male suffered a pathologic left femoral neck fracture. Biopsy demonstrated metastatic urothelial cancer with a non-muscle invasive bladder cancer primary confirmed by cystoscopy. Patient underwent hemiarthroplasty, chemotherapy, radiation, and eventually, a conversion to total hip arthroplasty. Today, over a decade from initial surgery, the patient remains alive and highly functional. To our knowledge, this is the only report of bone metastatic bladder cancer with over 10-year survival. Conclusion: Bladder cancer metastatic to bone has a 5-year survival rate of 3%. Surgical resection of metastasis with reconstruction may confer a survival benefit in bony oligometastatic bladder cancer.

The Verbal Numeric Pain Scale: Ed Patient Understanding And Perspectives, Bracey Bayonnet

Scholarship in Medicine - All Papers

Objective: The objective of this study is to identify patient self-reported pain scores and understanding and perspectives of the Verbal Numeric Pain Scale. Methods: In this prospective survey study, eligible participants were interviewed by research assistants. Data collected included ED patients self-reported pain scores, previous painful experiences, and their understanding of the Verbal Numeric Pain Scale,

Results: Among 164 participants (92% response rate), the mean triage pain score was 6.4 (95% CI 6.0-6.9). Many participants had experienced significant painful experiences in the past, including major surgery (N = 113), broken bone (N = 102), childbirth (N = 89) and kidney …

Quality Improvement: Patient Education For Management Of Hypertension In Pregnancy, Kriti Goel

Scholarship in Medicine - All Papers

Objective: We introduced maternal hypertension education tools that address illiteracy in underserved populations. Through these tools, we aim to improve patients’ knowledge of their conditions. We also aim to determine if healthcare providers perceive a benefit to the use of the tools. Ultimately, we hope these changes will lead to better short- and long-term health outcomes for mother and child.

Methods: Pregnant women with any form of hypertension at Five Rivers Center for Women’s Health (FRHC) were surveyed during OB visits. The Patient Questionnaire includes objective knowledge questions on their condition and self-reported comprehension questions. Forty-five women were surveyed during …

Refusal Of Care In The Emergency Department: Self-Reported Reasons For Leaving Without Completing Treatment, Brenden Drerup

Scholarship in Medicine - All Papers

Objective: Emergency department (ED) patients may choose to leave prior to physician evaluation, elope during treatment, or leave against medical advice during treatment. This study was performed to identify the reasons why patients left the ED before completing treatment. Methods: This prospective study was conducted at Miami Valley Hospital, an urban level 1 trauma center. This study identified ED patients who left before completing treatment, including those who left without being seen (LWBS), eloped during treatment, or left against medical advice (AMA), from September to December of 2018. This project included a chart review and a prospective patient telephone survey. …