Medicine and Health Sciences Commons^™

Does Perioperative Angiotensin-Converting Enzyme Inhibitor Therapy Correlate With Increased Use Of Vasopressors During Posterior Lumbar Interbody Fusion Versus Those Not Receiving Angiotensin-Converting Enzyme Inhibitor Therapy: A Retrospective Study, Joshua Ross

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to evaluate if patients who took Angiotensin Converting Enzyme (ACE) inhibitors the morning of surgery for Posterior Lumbar Interbody Fusion (PLIF) required more treatment for intraoperative hypotension.

Introduction: PLIF is a surgical procedure used to correct spinal disorders that include compression, instability, pathological lesions, deformities, and pain. PLIF is completed utilizing the prone position for optimal access to the lumbar spine. Complications associated with prone position have included Post-Operative Vision Loss (POVL), compression of abdominal vessels, and head and neck venous compression resulting in neurologic injury. Currently, there are no set recommendations …

Intraoperative Administration Of Intravenous Acetaminophen At Induction Or End Of Surgery And Its Relationship With Opioid Consumption And Pain Scores, Spencer Davis Greenwood

Theses, Dissertations and Capstones

Obesity has become increasingly prevalent in the United States. Bariatric surgeries have increased as the prevalence of obesity has risen, providing an effective alternative to weight loss. Intravenous acetaminophen (IVA) is a safe and effective non-opioid medication that can be given without the risk of respiratory or cardiac complications. Research has shown that the use of IVA during surgery can improve postoperative pain scores, reduce opioid requirements, and improve patient satisfaction.

A retrospective cohort study of 200 patients (100 per group) undergoing laparoscopic bariatric surgery (LBS) was performed. Statistical analysis was used to determine the relationship between those who received …

The Association Between Intraoperative Single-Dose Dexamethasone And Postoperative Pain In Patients Undergoing Laparoscopic Cholecystectomy, Sara Hatfield

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to examine the association between a single dose of intraoperative dexamethasone in patients undergoing outpatient laparoscopic cholecystectomy surgery and postoperative pain scores and the amount of postoperative opioid administration.

Introduction: Pain is one of the most common complaints in the postoperative period and the days following a patient’s procedure. While opioids are commonly used for treating intraoperative and postoperative pain, anesthesia providers can lessen their use by adopting multimodal analgesia techniques. This study attempts to fill the research gap related to the association of a single dose of intravenous dexamethasone intraoperatively …

The Influence On Morbidity And Mortality When Blood Products Are Transfused Using Conventional Coagulation Tests Versus Teg Or Rotem In Trauma Patients Perioperatively, Teresa Diana Kelley

Theses, Dissertations and Capstones

Abstract: Coagulopathy in trauma patients occurs due to tissue injury, hemodilution (dilution of hematocrit and clotting factors), infusion of hypo-coagulable blood products (e.g., packed red blood cells), acidosis, hypothermia, continued blood loss, and depletion of clotting factors. The onset of coagulopathy begins with the initial tissue injury and evolves rapidly. Many factors need consideration when determining resuscitative treatment for the trauma victim. These factors include the amount of time for extraction from the field, transport time to a trauma center, associated weather, and treatment provided in route. This study compared two clinical laboratory pathways (Conventional Coagulation test and Rotational Thromboelastometry …

What Is The Relationship Of Increased Intraocular Pressure And Body Mass Index In Patients Undergoing Robotic Prostatectomy In Sleep Trendelenburg Position?, Seth Parsons

Theses, Dissertations and Capstones

Introduction: Robotic Prostatectomy is a common procedure performed in surgery centers all over the world, but these procedures can be long and difficult to manage for Anesthesia providers. This study examined the relationship between increased intraocular pressure (IOP) and Body Mass Index (BMI) during Robotic Prostatectomies in Steep Trendelenburg (ST) position. Other variables studied were length of procedure, age, and ASA physical classification.

Methodology: The study was a retrospective cross-sectional design of 100 patients with a BMI over 30 and 100 patients with a BMI under 30 who have undergone Robotic Prostatectomies at Charleston Area Medical Center (CAMC) between …

Does Rotem-Guided Therapy Influence Postoperative Chest Tube Output In On-Pump Cabg?, Preston Franklin Woodburn-Camp

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to identify the association between ROTEM-guided therapy and chest tube output in patients who have undergone elective on-pump CABG.

Introduction: In open heart surgery, there are a variety of ways that coagulation disturbances occur, such as hemodilution of coagulation factors and platelets, a reduction in coagulation factors due to the use of cardiopulmonary bypass the administration of the anticoagulant heparin, and altered temperature. Severe bleeding is frequently associated with open-heart surgery, especially on-pump coronary artery bypass grafting (CABG). Thromboelastometry using rotational thromboelastometry (ROTEM) is a point-of-care testing that can show specific defects in …

Tenofovir Induced Nephrotoxicity: A Mechanistic Study, Rachel A. Murphy

Theses, Dissertations and Capstones

Tenofovir (TFV) is a reverse transcriptase inhibitor that is approved by the United States Food and Drug Administration (FDA) to treat HIV and chronic Hepatitis B. It has a long half-life, allowing for once a day dosing and is effective in treatment of both naive and experienced patients. It is administered orally as tenofovir disoproxil fumarate (TDF) and is deesterified in plasma to the active drug TFV. However, renal impairment is associated with its use; TFV can induce decreased glomerular filtration rate (GFR) and free calcitriol, renal failure, and Fanconi Syndrome. The exact mechanism of toxicity currently remains unknown, largely …

The Assessment Of Medial Stability Of The Elbow Using Sonography And Three Clinical Tests, Andrew Michael Demoss

Theses, Dissertations and Capstones

Introduction: Injuries to the Ulnar Collateral Ligament of the elbow are a common occurrence in overhead throwing athletes. Clinical assessment of the medial elbow can be assisted using Sonography. Ultrasound imaging can be used to determine the width of the medial joint space. This study will determine whether altering the joint angle in the elbow during various clinical tests has an effect on the width of the medial joint space.

Methods: Ultrasound images of the non-dominant elbow were collected during three clinical tests of medial elbow stability; valgus stress test, weighted valgus test and the milking maneuver. The …

The Effects Of Flexor Pronator Mass Fatigue On Medial Elbow Stability, Nathaniel Harvey Millard

Theses, Dissertations and Capstones

Introduction: The medial elbow is supported from valgus loading with the ulnar collateral ligament (UCL), the flexor pronator mass (FPM), and the radial head. Fatigue of muscle can lead to a decrease in force production. The decrease in force production can lead to a decrease in joint stability. This study tested the effect of fatigue of the FPM muscles on the width of the medial joint space.

Methods: Thirty-one participants volunteered for this study (18 female and 12 male, 1 excluded; mean height 170.2±10.1 cm, mean weight 71.2±15.6 kg, mean age 21.53±1.87 years old). Ultrasound images of the width of …

The Effects Of Rape Myth Acceptance, Benevolent Sexism, Characterological Self-Blame, And Behavioral Self-Blame On Posttraumatic Stress Disorder Symptom Severity, Jacob Whitaker Camp

Theses, Dissertations and Capstones

Roughly 35 to 50 percent of victims of sexual assault begin to suffer from posttraumatic stress disorder (PTSD) relatively early after the assault (Elklit, Due, & Christiansen, 2009). Many victims of sexual assault who are diagnosed with PTSD continue to experience symptoms long after the incident occurred (Peter-Hagene & Ullman, 2015). Rape has serious effects on the psychological health of the victims. Although no study had been done directly examining the relationship between rape myth acceptance and PTSD symptom severity, studies have shown that benevolent sexism affects rape myth acceptance and that rape myth acceptance affects how individuals attribute blame …

Employing The Enzyme Cofactor Function Of Ascorbic Acid To Affect Oncogenic Pathways In Human Melanoma: Modulating Hypoxia Inducible Factor-1Α And Dna Demethylation To Reduce Malignant Potential, Adam Patrick Fischer

Theses, Dissertations and Capstones

Dioxygenase enzymes such as the HIF hydroxylases (PHD1-3, FIH) and the Ten-eleven translocation (TET1-3) enzymes regulate the activity of the hypoxia inducible factor-1_a (HIF1_a) transcription factor and the DNA methylation status of cells, respectively. Aberrant accumulation and activation of HIF-1_a can allow malignant cells to acquire attributes that promote progression, chemotherapy resistance, and survival, while aberrant hypermethylation of gene promoters can silence the expression of tumor suppressor genes essential to preventing tumorigenesis. Inadequate levels of intracellular ascorbic acid (AA), a necessary cofactor for optimal dioxygenase enzyme function, could potentiate these tumorigenic conditions. In fact, plasma levels …

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

Balance Score Card In Health Care Organization, Vani Pathuri, Huanyu Wang

Theses, Dissertations and Capstones

Balance Score Card is a strategic planning and management system and it helps in observing organizational business activities. This approach has improved the organizational performances. It has four perspectives of vision and strategy listed as financial, internal business, learning and growth, and customer perspective. A semi structured interview has been taken with Tanya Morton, who is ‎an Assistant Director of Nursing at Cabell Huntington hospital. Hospital graphs have shown that the utilization of BSC with Nurse Department have become more satisfied during the eight years, and the remaining three departments also showed satisfactory report with BSC.

Is Interoperability A Hindrance To The Nationwide Health Information Exchange (Nhie)?, Nitesh Patil, Sruthi Katamneni

Theses, Dissertations and Capstones

Introduction: HIE is the exchange of clinical data as well as healthcare data among the providers, healthcare institutions, and data repositories. Nationwide Health Information Network (NHIN), was adopted in the year 2004, under the Office of the National Coordinator for Health Information Technology (ONCHIT) with an objective to share the files electronically securely and in a safe manner.

Methodology: The literature review included 40 references in which information relevant to the purpose of this study was scrutinized; these references met the inclusion criterion. The methodology for this study was an extensive and thorough literature review. The sources utilized in this …

Perceptions Of The Athletic Training Profession By A Collegiate Athlete Patient Population, Bethany Estelle Beuhring

Theses, Dissertations and Capstones

Patient satisfaction is an advancing topic amongst health care professions, but athletic training has not kept up with these advances. The purpose of this study was to assess patient satisfaction and perception of the athletic training profession as related to their exposure to athletic training services over the course of an athletic career. Four hundred one student-athletes from a single institution were sent an email containing a link to the online-questionnaire, 93 student-athletes submitted the questionnaire. Weak negative correlations were found between questions regarding patient satisfaction with athletic training care and patient perception of the athletic training profession. Results imply, …

Local Sensitivity Analysis Of Acute Inflammation, James Martin

Theses, Dissertations and Capstones

The inflammatory response is the body's response to some pathogen or foreign invader. When infected by a pathogen, a healthy individual will mount a response with immunological factors to eliminate it. An inflammatory response that is either too strong or too weak can be detrimental to the individual's health. We will look at a qualitative mathematical model of the inflammatory response, in scenarios that represent varying disorders of the immune system. Using sensitivity analysis we determine which parameters of this model are most influential in the different scenarios. By determining which parameters are most influential we can suggest possible targets …

"We're Human": An Analysis Of Formal And Informal Training Methods For Direct Care Staff Working With Dual-Diagnosis Populations, Adam Clay Stephenson

Theses, Dissertations and Capstones

Direct care staff, or DCS, are individuals tasked with providing a number of care services to individuals with disabilities in various settings. This study focuses on a group of direct care staff working at a day habilitation program in central West Virginia. Training techniques used to prepare these workers for a diverse array of roles are reviewed comparatively and through a sociological theoretical lens utilizing perspectives from Bandura (1977), Laubach (2005), Marx (1964), and Wolfensberger (1983). Semi-structured interview results indicate that formal training is driven by a less valorous view of disabled individuals as a class than informal training; that …

Doxorubicin Cytotoxicity In A Human Proximal Tubular Epithelial Cell Line Was Attenuated By The Natural Product Resveratrol, Morghan Schuyler Getty

Theses, Dissertations and Capstones

The cancer chemotherapeutic agent doxorubicin (DOX), Adriamycin, is part of the treatment regimen for breast, ovarian, small cell lung cancer and acute/chronic lymphoid leukemia. Adverse effects associated with DOX are cardiotoxicity and nephrotoxicity. Interventions are needed to reduce DOX nephrotoxicity. Resveratrol (RES) is a phytochemical contained in grapes, berries and nuts, which possesses antioxidant and anticancer properties. This study tested the hypothesis that RES will attenuate DOX renal cytotoxicity in human noncancerous renal proximal tubular epithelial (HK-2) cells and that RES will reduce DOX mediated changes in mitochondrial function. HK-2 cells were plated and grown for 48 hours (h). Cells …

Career Paths, Barriers, And Professional Experiences: A Comparison Study Of Physical Therapy Program Directors In The United States, Tamara Nancy Gravano

Theses, Dissertations and Capstones

The entry-level degree for physical therapists today is a professional doctoral degree. It is similar to a medical degree program where the expected outcome of its graduates is clinical practice, and there is no formal training in academic teaching or administration. The purpose of this study was to determine the leadership characteristics, styles, and behaviors of accredited Doctor of Physical Therapy (DPT) program directors (PD) and to gain a better understanding of their preparation and path to program leadership. The survey instrument was sent electronically to all program directors of accredited DPT programs in the United States (N=233) and the …

Telemedicine And Its Utilization In The Management Of Chronic Heart Failure Patients, Adejoke Sotome, Chirra Pooja

Theses, Dissertations and Capstones

Introduction: Telemedicine is well developed and very useful for heart failure patients in emergencies. Many cases of heart failures are due to inability of reaching the physicians on time and failure of assessing the patient disease condition at earlier stage.

Methodology: The methodology for this study was a literature review. Electronic databases used included EBSCO Host, Google Scholar, Academic Search Premier, PubMed, ProQuest, and Marshall Digital Scholar. A total of 32 sources were referenced.

Results: This literature review examined several studies and research articles on the significance of Telemedicine in the treatment of chronic heart failure patients with …