Medicine and Health Sciences Commons^™

Chronic Illness Management In Teams Of Urban Multidisciplinary Scholars (Cimtums) –– Part Ii, John R. Brill, Diane Ames, Christine B. Groth, Helen Yu

Journal of Patient-Centered Research and Reviews

Background: Diabetes is a major contributor to morbidity and mortality as well as the single most expensive health care condition in the world. Numerous interventions have attempted to improve control of this disorder and reduce its complications. Traditional care for diabetes centers on an individual clinician. More recently, recognition of the central role of the patient has come into vogue. Payors, including Medicare, now cover up to 13 hours of diabetes self-management and education programs annually. Patient-centered medical home efforts add an aspect of inclusiveness, but retain a medical focus and are being increasingly advocated and trained. To date, no …

In Vitro Growth Suppression Of Renal Carcinoma Cells By Curcumin, Santhi Konduri, Madhavi Latha Yadav Bangaru, Phu Thanh Do, Shenglin Chen, Jeffrey Woodliff, Sanjay Kansra

Journal of Patient-Centered Research and Reviews

Background: Malignant clear cell renal carcinoma (ccRCC) is an aggressive tumor that is highly resistant to chemotherapy and radiation. Current therapeutic approaches to management of ccRCC have not significantly improved patient survival, therefore novel therapies are needed. The von Hippel-Lindau tumor suppressor gene is frequently mutated in ccRCC resulting in unregulated transcriptional activity of hypoxia-inducible factors (HIF) 1α and 2α. HIF-mediated transcription leads to increased growth factor expression and growth factor receptor (GFR)-mediated signaling. NFκB and STAT3 are phosphorylated in response to GFR activation and modulate gene expression, which promotes cell growth and invasion. Activated NFκB and STAT3 expression is …

Reducing Readmission Rates In Acute Pancreatitis Through Patient Education And Risk Assessment, Jordan T. Vulcano

Journal of Patient-Centered Research and Reviews

Background: Early hospital readmissions are a direct burden on both our patients’ well-being and health care system as a whole. Acute pancreatitis is a top offender, with countless 30-day readmissions. Studies have showed a consistently higher than average 30-day readmission rates in acute pancreatitis, around 19%. This is significantly higher than the average all-cause readmission rate at Aurora Health Care hospitals. This quality improvement project aimed to reduce the rate of acute pancreatitis 30-day readmission rates at several Aurora hospitals through patient education and a readmission risk assessment tool.

Purpose: To clarify some of the risk factors associated with acute …

Tertiary Center Experience Of Catheter-Directed Thrombolysis For Immediately Threatened Acute Lower Limb Ischemia Of Native Vessels And Bypass Graft Thrombosis, Hani Hashim, M. Fuad Jan, Maharaj Singh, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Background: Catheter-directed thrombolysis (CDT) is an effective therapy and a class I indication for patients with acute limb ischemia (ALI, Rutherford categories I and IIa) of less than 14 days duration, and class IIb indication for ALI (Rutherford category IIb) with symptoms more than 14 days duration. However, there is no consensus on the initial management option for ALI (Rutherford category IIb) with symptoms less than 14 days duration.

Purpose: To evaluate the safety, efficacy and outcome of CDT, with or without bailout Angiojet mechanical thrombectomy, in patients with immediately threatened acute lower extremity ischemia (Rutherford category IIb) as a …

Practc: Practice Readiness Academic Clinical Training Collaborative –– Gap Analysis To Advance Clinical Training For Nurse Practitioner Students, Jennifer Hartlaub, Mary Ann Muzi, M. Jamie Cairo, John R. Brill, James Weese, Kristin Rivera, Susan Hafemann, Ann M. Rohrer, Julia Schumacher, Terri L. Vandenhouten

Journal of Patient-Centered Research and Reviews

Background: Multiple factors have created a perfect storm of health care provider shortages in the United States. Advanced practice registered nurses (APRNs), long established as high-quality, cost-effective health care providers, are meeting health care needs across the nation in a variety of settings, and in Wisconsin will be needed to augment the primary care workforce. With 5.7% of its registered nurses credentialed as APRNs, Wisconsin lags behind the national average of 8.7%. However, current capacity to educate this workforce is strained, requiring innovative data-driven clinical education models.

Purpose: To identify gaps in the current clinical educational framework for nurse practitioner …

Mailed At-Home Fit Intervention To Increase Colorectal Screenings At Sixteenth Street Community Health Centers, Alexander V. Herrera, Brian Hilgeman, Michelle Buelow, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Background: Mailed at-home FIT intervention kits to increase colorectal cancer screenings at Sixteenth Street Community Health Centers (SSCHC).

Purpose: It is our goal to increase the current SSCHC colorectal cancer baseline screening rate of 23% to 50% within three years of full at-home FIT kit implementation.

Methods: Colon cancer is the second and third most common cause of cancer death in the United States in Hispanic men and women, respectively. Colonoscopy is the most common method of colon cancer screening, even among low-income patients. However, it has been shown in community health centers that mailed FIT kits are a more …

Maternal Intuition Of Fetal Gender, Michael P. Mcfadzen, David P. Dielentheis, Ronda Kasten

Journal of Patient-Centered Research and Reviews

Background: Many pregnant mothers feel they have a perception or intuition as to the gender of their unborn baby. There is very little published scientific literature regarding this topic. The study’s goal is to determine accuracy of mothers’ perceptions as to gender of their unborn babies. Many scientists believe a pregnant woman could not determine her baby’s gender by intuition, with a 50% probability of correctly determining the gender. This study should be considered fun science.

Purpose: To objectively measure a pregnant mother’s perception as to the gender of her unborn baby and compare to sonographically proved gender. The study …

Real-World Relevance Of Manual Electrocardiography Qt Interval Measurement, Satish Velagapudi, Zahra Nur Khaled, Bilal Omery, Firas Zahwe, Michael Anigbogu, Sarah Zukkoor, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Electrocardiography (ECG) QT interval (QTI) prolongation independently predicts sudden death. Hospitalized patients are commonly exposed to multiple QT-prolonging drugs, and manual measurement of ECG QTI based on identifying the intersection of isoelectricity with the tangent to the terminal phase T-wave slope (QTTTT) is advocated due to inaccuracies in automated detection algorithms that may imprecisely identify QT duration.

Purpose: We evaluated the performance of QTTTT compared to a standard automated (12SL, GE Healthcare) method (QT-12SL).

Methods: Consecutively obtained ECGs of 250 hospitalized patients were reviewed. The QTI in leads II, aVR, V5 and V6 determined by QT-12SL and QTTTT were …

Incidence Of Breast, Colorectal And Lung Cancers And Mortality Among Women Within Midwestern States, Ruth M. Perez, Matthew Rappelt, Kathryn Kossow, Maharaj Singh

Journal of Patient-Centered Research and Reviews

Background: Breast, colorectal and lung cancers have been shown to be the most common cancers as well as the leading causes of cancer death among women. Previous studies suggest that the Northeast had significantly higher rates in incidence and mortality than the Midwest, South and Western regions. However, new data indicates that the Midwest now harbors the highest mortality rates. In Wisconsin, the sixth largest state in the Midwest, cancer is the leading cause of death. Differences in incidence and mortality of breast, colorectal and lung cancers have been observed between Wisconsin, other Midwestern states and national data, warranting further …

Feasibility Of Atrial Delivery And Tracking Of Stem Cells In A Porcine Model, Nina Garlie, Timothy Hacker, Eric G. Schmuck, Jill Koch, Jayant Khitha, Amish Raval, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Many patients undergoing open heart surgery have sinus node dysfunction and atrial fibrillation, leading to adverse outcomes. Mesenchymal stem cells (MSC) delivered at the time of surgery may have a reparative effect on atrial tissue, thereby improving sinus node function and reducing or preventing atrial fibrillation. Stem cell delivery to the atrium is entirely unstudied. This is a significant gap in medical research, as atrial disease contributes significantly to health care costs.

Purpose: The purpose of this pilot study is to establish a technique to deliver MSC to the atria through an open-chest model, to assess the safety of …

Eosinophils From Murine Lamina Propria Induce Differentiation Of Naïve T Cells Into Regulatory T Cells Via Tgf-Β1 And Retinoic Acid, Hong-Hu Chen, Ai-Hua Sun, David M. Ojcius, Wei-Lin Hu, Yu-Mei Ge, Xu'ai Lin, Lan-Juan Li, Jian-Ping Pan, Jie Yan

All Dugoni School of Dentistry Faculty Articles

Treg cells play a crucial role in immune tolerance, but mechanisms that induce Treg cells are poorly understood. We here have described eosinophils in lamina propria (LP) that displayed high aldehyde dehydrogenase (ALDH) activity, a rate-limiting step during all-trans retinoic acid (ATRA) synthesis, and expressed TGF-β1 mRNA and high levels of ATRA. Co-incubation assay confirmed that LP eosinophils induced the differentiation of naïve T cells into Treg cells. Differentiation promoted by LP eosinophils were inhibited by blocked either TGF-β1 or ATRA. Peripheral blood (PB) eosinophils did not produce ATRA and could not induce Treg differentiation. These data identifies LP eosinophils …

Synthesis Of Graphitic Nanostructures On Noble Metals, Amelie Adele Parmentier

Theses and Dissertations

In this research, two subjects are studied: the growth of graphene from various catalysts with RF-CVD and the growth of graphitic nanostructures from gold-decorated graphene with RF-CVD. In the first topic, various catalysts are made with magnesium oxide and metal nanoparticles: iron, silver and gold. Using a radio-frequency generator, these catalysts are heated and placed in contact with three gases (argon, hydrogen and methane). By controlling various parameters, graphene synthesis can happen. The results are analyzed with Scanning electron microscopy (SEM), Transmission electron microscopy (TEM), Thermo-gravimetrical analysis (TGA), and X-ray diffraction (XRD). In the second topic, commercial graphene is functionalized …

Operating Room First Start Efficiency Throughout A Large Urban Hospital System, Callie Cox Bauer, Kiley A. Bernhard, Danielle M. Greer, Scott Kamelle

Journal of Patient-Centered Research and Reviews

Background: Operating room delays decrease health care system efficiency and increase hospital costs. Data on delays in a multihospital system are sparse.

Purpose: In an effort to improve our operating room efficiency, we investigated operating room delays, the causes and the impending financial impact.

Methods: A retrospective analysis on first case-of-the-day surgeries at three hospitals during 2013 was conducted. Delays were defined as in-room time being after scheduled surgery start time. Length of delay and causes were recorded. Patient demographics, body mass index, hospital facility, total number of procedures, provider specialty and time of patient arrival were incorporated into a …

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium assessment …

Score Big For Decreasing Mortality: Icd Risk Score Model, Linda Francaviglia, Rachel Petersen, Maria Stone, M. Eyman Mortada

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care, a system of 14 acute care hospitals in eastern Wisconsin, has been a long-time participant in the American College of Cardiology’s National Cardiovascular Data Registries, submitting data to its ICD Registry™ since 2005. Our system’s implantable cardioverter-defibrillator (ICD) procedure volume averages 930 cases annually. During 2012 we experienced an increase in in-hospital mortality/morbidity for ICD cases.

Purpose: A single-center study examining in-hospital mortality/morbidity post-ICD implant before and after changes in practice and patient selection.

Methods: ICD implants and generator changes discharged from January 1, 2009, to December 31, 2012, were included in developing a risk model …

Geographic Distribution Of Infant Death During Birth Hospitalization And Maternal Group B Streptococcus Colonization: Eastern Wisconsin, Jessica J.F. Kram, Dennis J. Baumgardner, Kiley A. Bernhard, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Background: Neonatal death rate in the United States is 4/1,000 live births; infant death rate is 6/1,000. Group B Streptococcus (GBS) may be transmitted from a colonized mother (rates vary from 15% to 35%) to the newborn during a vaginal delivery, and may contribute to neonatal death.

Purpose: To explore the geographic distribution and associated risk factors for maternal GBS colonization and infant death prior to discharge in eastern Wisconsin births.

Methods: Retrospective study of institutional data from PeriData.net, a comprehensive birth registry, utilizing data from 2007 through 2013 at all Aurora medical centers. Categorical variables were analyzed with chi-square …

Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson

Journal of Patient-Centered Research and Reviews

Background: A prognostication predictive model incorporated into the electronic health record (EHR) may be useful in assisting the health care team in accurately predicting mortality and may be used in appropriately allocating palliative care services.

Purpose: To systematically review and summarize current medical literature regarding the factors predictive of mortality in an inpatient population above 65 years of age.

Methods: Nondisease-specific prognostication indices that predict 1-year mortality in an inpatient population of adults over age 65 were included. We excluded studies that estimated intensive care unit, disease-specific or in-hospital mortality. A MEDLINE, CINAHL, Ovid and Cochrane literature search of English-language …

A Meta-Analysis Of Incidence And Risk Factors Of Trastuzumab-Induced Cardiotoxicity In Breast Cancer, Zeeshan Ali Jawa, Ruth M. Perez, Lydia Garlie, Maharaj Singh, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: A monoclonal antibody, trastuzumab targets the human epidermal growth factor receptor 2 (HER2) oncogene that is overexpressed in 25–30% of breast cancers. In combination with first-line therapy, trastuzumab resulted in significant improvement in survival outcomes for those with HER2-positive metastatic breast cancer. Due to its improvement in outcome and prolonged survival, trastuzumab has been established as standard of care in both adjuvant and metastatic settings. However, along with common adverse events, trastuzumab has been found to be associated with cardiotoxicity. An estimated 1–4% of patients treated with trastuzumab will develop heart failure and ~10% of patients will experience a …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Journal of Patient-Centered Research and Reviews

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics.

Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics.

Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Fair Weight Loss After Gastric Rebanding For Slippage, Ahmed Dalmar, Maharaj Singh, Sara K. Roloff, Thomas Y. Chua

Journal of Patient-Centered Research and Reviews

Background: Laparoscopic adjustable gastric banding (LAGB) is one of the most common bariatric surgery procedures performed in the United States. LAGB results in safe and satisfactory weight loss, but it is often complicated with slippage, a complication requiring rebanding (reoperation). There is a paucity of studies and no uniform consensus regarding weight loss after rebanding.

Purpose: This study assessed the effect of rebanding for slippage after LAGB on weight loss up to five years.

Methods: This is a historical cohort study of 865 patients who underwent LAGB from 2001 to 2011. Rebanding was performed in 103 (11.9%) patients. Primary outcome …

Contemporary Usage Of Intra-Arterial Catheter-Directed Thrombolytic (Cdt) Power Pulse Spray With Rheolytic Thrombectomy In Failed Cdt Alone For Acute Limb Ischemia, Hani Hashim, M. Fuad Jan, Maharaj Singh, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Background: Acute lower limb ischemia (ALI) caused by arterial embolism, thrombosis of native vessels, and/or grafts is a serious condition associated with substantial morbidity and mortality. Peripheral arterial thrombolysis utilizing catheter-directed thrombolytic (CDT) has become established as a useful option in the management of ALI. However, use and outcome of adjunctive power pulse spray with rheolytic thrombectomy (PPSRT) following unsuccessful CDT is underreported in the literature.

Purpose: To evaluate outcome of contemporary use of intra-arterial CDT PPSRT as an adjunct to unsuccessful standard CDT for ALI.

Methods: We reviewed 78 consecutive patients (mean age 69 ± 14.2 years, 48.8% female) …

Complete Genome Sequence Of Staphylococcus Aureus, Strain Ilri_Eymole1/1, Isolated From A Kenyan Dromedary Camel, Saima Zubair, Anne Fischer, Anne Liljander, Jochen Meens, Jan Hegerman, Hadrien Gourlé, Richard P. Bishop, Ina Roebbelen, Mario Younan, Mudassir Imran Mustafa, Mamoona Mushtaq, Erik Bongcam-Rudloff, Joerg Jores

All Peer-Reviewed Publications

We report the genome of a Staphylococcus aureus strain (ILRI_Eymole1/1) isolated from a nasal swab of a dromedary camel (Camelus dromedarius) in North Kenya. The complete genome sequence of this strain consists of a circular chromosome of 2,874,302 bp with a GC-content of 32.88 %. In silico annotation predicted 2755 protein-encoding genes and 76 non-coding genes. This isolate belongs to MLST sequence type 30 (ST30). Phylogenetic analysis based on a subset of 283 core genes revealed that it falls within the human clonal complex 30 (CC30) S. aureus isolate cluster but is genetically distinct. About 79 % of the protein …

Neurophysiological Activity Related To Speech Production: An Erp Investigation, Adithya Chandregowda

USF Tampa Graduate Theses and Dissertations

The event related potential (ERP) technique is enjoying widespread application in neurophysiological research due to its fine temporal resolution. Of relevance to this study are ERPs related to voluntary movements. The precision with which movement related processes could be recorded using the ERP technique was demonstrated by Gilden, Vaughan and Costa (1966) and Kutas and Donchin (1974, 1977, and 1980) who found that the readiness potential (RP) immediately preceding hand movement was larger over the hemisphere contralateral to the responding hand. Given that left hemisphere controls right hand movements and vice versa, their findings confirmed that the lateralized readiness potential …

Research Brief: "Military Service Absences And Family Members’ Mental Health: A Timeline Followback Assessment", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief examines mental health correlating with a parent's absence during a military deployment. The findings show that adolescents were affected by a military parent being absent from significant events, and that they would benefit from programs that offer pre and post-deployment briefings. In the future, research should investigate how contact during military deployment affects the service member and their family.

Strengthening Exercises And Modalities To Prevent Growth Of Hypertrophic Scarring And Improve Wrist Strength And Mobility: A Case Report, Maggie Masiak

Case Report Posters

There is no gold standard for evaluation, treatment, and prevention of keloids. Keloids are elevated fibrous scars that extend beyond the original borders of the wound, they do not regress and they tend to reoccur even after surgical excision. Individuals younger than 30, with elevated hormone levels and darker skin tend to be at higher risks for keloids. The most susceptible areas are on areas of high tension like the sternum, shoulders, upper arms, earlobes, and cheeks. Scars are generally evaluated by depth of elevated tissue, color, softness, shape, and orientation. The etiology of keloids is uncertain but it is …

Using The Selective Functional Movement Assessment And Regional Interdependence Theory To Guide Treatment Of An Athlete With Back Pain: A Case Report, Gabriella Goshtigian

Case Report Posters

Incidence of low back pain (LBP) is as high as 36% among adolescents and even more prevalent in those who play sports. The majority of these cases lack an underlying diagnosis and are classified as non-specific LBP. Previous injury and longer durations of pain consistently emerge as prognostic factors in musculoskeletal pain. This affects movement patterns which then continue to contribute to dysfunction. The Regional Interdependence Theory (RI) views all regions of the body as being musculoskeletally linked, with impairments in remote regions to site of pain often being a cause. The Joint-by-Joint Theory compliments RI by arguing that joints …

Vestibular Rehabilitation And Cervical Postural Re-Education In A Young Athlete Who Presented With Post-Concussion Syndrome: A Case Report, Cristen Schmidt

Case Report Posters

A concussion is a pathophysiological process resulting in neurological impairments in response to a forceful impact directly on or transmitted to the head, neck, or face. ~300,000 concussions occur in high school athletes in the US, making sports 2nd to MVA as leading cause of concussions. Post-Concussion Syndrome (PCS) occurs when side effects are persistent past the 10 day period. 10% of people will develop PCS following a concussion. In previous research, cervico-vestibular rehabilitation and direct attention to the patient’s intolerance to activity is vital in order to return an athlete back to sport. The purpose of this case report …

Functional Training To Reduce Fall Risk In A Patient Following Cancer Treatment: A Case Report, Kristin O'Kelly

Case Report Posters

The National Cancer Institute reports that 39.6% of men and women will be diagnosed with some form of cancer during their lifetime. Studies have demonstrated that over half of cancer survivors age 55 and over have fallen in the past year, possibly as a result of treatment and subsequent muscle weakness, difficulty with balance, and impaired walking. Multiple studies have looked at the long term effects of cancer treatment and survivorship, but few studies look at interventions to combat decline in function. The purpose of this case report was to report the interventions utilized in the treatment of an individual …

Enhancing The Physiological Well-Being Of Individuals With Neuromuscular Movement Disorders, Through Community Based Fitness Programming, Stephanie Mims Dpt, Craig Souders Dpt, Giselle Monosa-Hefele Mspt, Eric Witzel Ep, Karla Plasco Dpt

Department of Medicine

No abstract provided.

Lipoproteins And Health Outcomes: Cognitive And Physical Function In Older Adults, Marianne Chanti-Ketterl

USF Tampa Graduate Theses and Dissertations

Cardiovascular health is a major determinant of quality of life and mortality, especially in older adulthood. With the world’s oldest population increasing at expedited rates, challenges from cardiovascular conditions and its implications are spawning. Although it is well known that dyslipidemia may lead to cardiac events, less is known about the effects on cognitive and physical function in older adults. Epidemiological studies show that optimizing current preventive strategies even at older ages may reduce the incidence of cardiovascular comorbidity (e.g. hypertension, stroke) and increase quality of life. Determining the association between lipoproteins and cognitive and functional performance in older adults …