Medicine and Health Sciences Commons^™

Piloting A Social Screener In The Pediatric Clinic, Preethi Rajan, Madelyn Kapushy, Samantha A. Goodrich Phd, Kimberly C. Brown Md

USF-LVHN SELECT

No abstract provided.

Interactions In The Ed: Training For Proper Care Of Patients With A Disability, Katrina L. Wachter

USF-LVHN SELECT

No abstract provided.

Chronic Pain Protocol Adherence And Utilization In Primary Care, Abigail O'Reggio

USF-LVHN SELECT

No abstract provided.

Patient Satisfaction With The Annual Wellness Visit, Maria Espiridion, Raghavendra Mulinti, Md, Suzanne E. Kemper, Mph, Lynne J. Goebel, Md

Marshall Journal of Medicine

OBJECTIVES - To determine patient satisfaction with the Annual Wellness Visit (AWV)

DESIGN – Survey

SETTING- Charleston Area Medical Center and Marshall Health

PARTICIPANTS – 66 volunteers, average age 74 years

MEASUREMENTS – Patient satisfaction was assessed with a 13 item survey.

RESULTS - Of 1,537 eligible patients, 211 (14%) of these agreed to schedule their AWV. From 66 patients surveyed, 87% of patients said the visit “met expectations,” “would recommend to friends,” and “would do it again.” Only 5 (8%) were disappointed that new problems were not addressed and 2 (3%) were dissatisfied that physical exams and blood …

Incidence Of Hypomagnesemia On Proton Pump Inhibitors At The Huntington Veterans Affairs Medical Center – Ihop, Ebrahim Sabbagh, Do, Chelsey R. Houchins, James Allman, Ii, Pharmd, Samson Teka, Md

Marshall Journal of Medicine

Abstract

Title: Incidence of hypomagnesemia on proton pump inhibitors at the Huntington Veterans Affairs Medical Center – IHOP

Purpose:

Proton pump inhibitors (PPIs), both prescription and over-the-counter, are widely used for the treatment of acid-related disease states such as dyspepsia, gastroesophageal reflex disease, esophagitis, and peptic ulcers. These medications are generally considered safe in most patient populations; however, there are several adverse effects that may occur with long-term use. Hypomagnesemia is a newer complication arising in the literature following multiple case reports over the past several years, although the true incidence of hypomagnesemia associated with PPI use remains unclear at …

The Impact Of Tobacco Smoking On One Year Patient Outcomes At A Family Medicine Residency Clinic, Scott A. Fields, Phd, Satyakant Chitturi, Md, Anoop Kumar, Md, Jennifer Rose, Do, Andy Tanner, Do

Marshall Journal of Medicine

Abstract

Objectives: In Appalachia, tobacco smoking rates are significantly higher than the United States average, and many of the comorbidities that exist with tobacco are prominent. The researchers investigated the impact of tobacco smoking on patients for one year of health outcomes at our resident primary care clinic.

Methods: The present study examined outpatient clinic charts and hospital records for a calendar year to determine patient self-reported tobacco rates. Patient medical comorbidities were tracked as well as rates of hospital utilization during the calendar year, and those figures were compared for a group of 90 patients who currently smoke and …

Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy, Ashwini V. Mallad, Mbbs, Waseem Ahmed, Md, Madhulika Urella, Md, Dr. Mehiar El-Hamdani, Md, Facc, Fscai

Marshall Journal of Medicine

Isolated left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital condition occurring due to arrest of myocardial compaction in the first trimester, resulting in a thin layer of compacted epicardium and thick hypertrabeculated myocardium containing deep recesses. This article presents a 44-year-old female with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pleuritic chest pain. Examination revealed elevated jugular venous distention, lower extremity edema, and bibasilar crackles on lung auscultation, while the electrocardiogram (EKG) exhibited left bundle branch block. Two-dimensional echocardiography (2D-Echo) showed a dilated left ventricle (LV) with ejection fraction (EF) of 25% and severe diffuse hypokinesia. Cardiac magnetic resonance …

A Comparison Of Imaging Modalities For The Diagnosis Of Osteomyelitis, Brandon J. Smith, Md, Grant S. Buchanan, Md, Franklin D. Shuler, Md, Phd

Marshall Journal of Medicine

Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from Pubmed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors …

Potential Adverse Effects Of Long Term Use Of Proton Pump Inhibitors., Shreyans M. Doshi, Md, Kazumi A. Khamar, Ms, Inder Sehgal, Dvm, Phd, Nihar Shah, Md Facp

Marshall Journal of Medicine

Proton-Pump Inhibitors (PPIs) have changed the therapy of numerous upper gastrointestinal tract disorders; but their use is not without risk of adverse effects. Recent studies suggest more serious adverse events with chronic use of PPIs. Because of these risks, clinicians should reassess individual patient’s needs for chronic PPI therapy.

Vitamin K2 (Menaquinone) Supplementation And Its Benefits In Cardiovascular Disease, Osteoporosis, And Cancer, Grant S. Buchanan, Md, Thomas Melvin, Brandon Merritt, Charles Bishop, Md, Franklin D. Shuler, Md, Phd

Marshall Journal of Medicine

Vitamin K is known to play an essential role in the coagulation cascade; however, a growing body of research has found that a subtype of this vitamin, vitamin K₂ (menaquinone) may have a beneficial effect in osteoporosis, cardiovascular disease, and cancer. This purpose of this article is to provide a comprehensive review of recent literature regarding menaquinone and its role in human health. This review discusses the physiology of menaquinone, its clinical benefits in cardiovascular disease, osteoporosis, and cancer, and how it may interact with certain medications. The authors conclude that menaquinone supplementation has been shown to improve carboxylation …

Endovascular Therapy Of Tasc-D Lesion In Critical Limb Ischemia, Ahmed Amro, Md, Alaa Gabi, Md, Dr. Mehiar El-Hamdani, Md, Facc, Fscai

Marshall Journal of Medicine

CLI (Rutherford class IV-VI) is a terminal stage of peripheral artery disease (PAD); it is defined by the presence of resting pain and/or tissue loss for at least two weeks that may require urgent revascularization to promote healing and prevent limb loss.For patients with infrarenal aortoiliac occlusive disease, the revascularization options are surgery like aortofemoral bypass and axillofemoral bypass or percutaneous intervention. Aortoiliac and aortofemoral bypass procedures are associated with 74% to 95% 5-year patency rates, respectively, which are comparable but not superior to percutaneous therapies.These operations may imply a significant morbidity and mortality on CLI patients who usually have …

The Role Of Arterial Blood Gas In Distinction Of Intravascular Hemolysis In A Patient With Lupus Nephritis., Ahlim Al Sanani, Md

Marshall Journal of Medicine

Dapsone is a Leprostatic agent routinely used for Malaria, Leprosy and as a prophylaxis for Pneumocystis jiroveci pneumonia (PCP), as well as Toxoplasma gondii in immunocompromised patients. Methemoglobinemia is an adverse effect of dapsone which can be life-threatening. Detailed is a case of dapsone-induced methemoglobinemia in a young woman with lupus nephritis treated with chronic immunosuppressant medications.

The Use Of Hyperbaric Oxygen Therapy In Idiopathic Sensorineural Hearing Loss: A Case Study, Chad B. Crigger, Md, Stephen L. Wilson, Md

Marshall Journal of Medicine

Idiopathic sudden sensorineural hearing loss (ISSHL) is an otologic emergency that can provoke anxiety in the patient and can be clinically challenging for the practitioner. The natural history of the condition can be as varied as its possible etiologies. Adding to the clinical challenge is the current debate of treatment modalities available. In what follows, we provide a case detailing our treatment course, including the novel use of hyperbaric oxygen therapy (HBOT) as an emerging therapy for sensorineural hearing loss. Additionally, we provide a brief review of the current state of treatment options available in the armament for ISSHL. As …

Linezolid Induced Delirium In The Absence Of Serotonin Syndrome: A Psychiatric Consultation/Liaison Case Report, Hani Nazha, Md, Nathan T. Harrington, Md

Marshall Journal of Medicine

Delirium is one of the most common mental illnesses that can affect elderly patients and patients with advanced medical problems. Because these patients are frequently on multiple medications and/or are more sensitive to medications secondary to their age, interactions with current medications, or existing medical problems; medication toxicity is frequently the etiology behind their delirium. This is a case report of a patient admitted for cellulitis that developed delirium from Linezolid however did not develop any other signs or symptoms of Serotonin Syndrome; a known side effect of Linezolid. This distinctive case highlights the importance of a careful analysis of …

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Marshall Journal of Medicine

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial …

Public Health West Virginia 3.0, Danny Scalise, Mba Ii, David Didden, Md

Marshall Journal of Medicine

Public health across West Virginia and the nation faces a time of tremendous change. Health is influenced by individual lifestyle, social networks, living and working conditions, and general environmental conditions. As a result, the West Virginia Bureau for Public Health created the West Virginia Public Health Impact Task Force (PHITF) to develop an innovative, custom fit public health system in West Virginia. With goals of improving health, improving quality, and reducing costs, the PHITF recommended a health in all policies approach which combines innovative patient-centered public health services in every community, and asks that local public health partner with stakeholders …

Transformational Teamwork: The Virtues And Values Of Collaboration, Darshana Shah, Phd. Editor-In-Chief

Marshall Journal of Medicine

No abstract provided.

Feeding/Swallowing Disorders: Maintaining Quality Of Life In Persons With Intellectual Disability, Luis Riquelme, Rebecca Benjamin, Hannah Tahhan, Gracelynn Sandoval, Naga Alomari, Alexandra Soyfer

NYMC Faculty Publications

Persons with intellectual disability (ID) have received little attention in systematic studies of healthcare and quality of life. Less attention has been provided to specific disorders, such as those impacting the swallowing mechanism. In comparison to the general population, persons with ID experience noticeably greater healthcare inequalities and despite greater life expectancy, it is still lower than the general population. This paper serves as an introduction to healthcare colleagues regarding the risks involved in choking and swallowing disorders in persons with ID, how to evaluate these potential risks and possible treatments. Associated etiologies are presented. A discussion on feeding disorders …

Subarachnoid Hemorrhage Caused By A Ruptured Aneurysm, Stephanie L. Carroll Mrs.

Nursing Student Class Projects (Formerly MSN)

Poster project on Subarachnoid Hemorrhage caused by a Ruptured Aneurysm.

Colstridium Difficile Colitis, Katie Bloomfield

Nursing Student Class Projects (Formerly MSN)

Colstridium Difficile Colitis incidence is continuing to increase and more difficult to treat due to increased resistance to antibiotics. This poster provides information on the pathophysiology, symptoms, risk factors, and nursing implications to decrease the spread.

Deep Vein Thrombosis (Dvt), Sara E. Sipes

Nursing Student Class Projects (Formerly MSN)

Deep vein thrombosis (DVT) is a common medical problem that affects 200,000-400,000 people in the United States each year (Anthony, 2013, p. 95). Nurses must be aware of the potential for DVT risk from pediatric to geriatric populations. The risk of DVT is associated with venous stasis, endothelial injury, and hypercoagulability (McNamara, 2014). These risks occur in both healthy people and those with disease states. The development of a DVT may lead to a life-threatening pulmonary embolism (PE). Understanding the pathophysiology of DVT formation can help nurses assess risk and assist in prevention. Early diagnosis of a DVT is important …

Zika Virus, Nurto A. Abdulla

Nursing Student Class Projects (Formerly MSN)

Zika virus infection, a mosquito-borne flavivirus that causes febrile illness associated with rash, has been rapidly emerging in the Western Hemisphere over the past few months. The virus was rarely identified until outbreaks occurred on Yap Island in the Federated States of Micronesia in 2007, Fresh Polynesia in 2013, and Easter Island in 2014 (Chen & Hamer, 2016). The virus was initially detected in Brazil in 2015, in the northeast, and was subsequently identified in other states and several South American countries, including Colombia, Ecuador, Suriname, Venezuela, French Guyana, and Paraguay. Local transmission has been documented in Central America in …

Pneumothorax Resulting From Costal Osteochondroma, Erin L. Jeffrey

Nursing Student Class Projects (Formerly MSN)

Osteochondromas are the most common neoplasm of the bone. Two percent of these tumors grow in the chest wall, and can cause severe complications such as pneumothorax. Costal exostoses can cause traumatic pneumothorax through puncture, laceration, or friction from chest wall movement during breathing (Kameda et al., 2016; Imai et al., 2014). The consequent change in intrapleural pressure and possible lung collapse is an urgent medical situation (ENA, 2014) that the advanced practice nurse should diagnose and treat quickly. This poster serves to summarize the pathophysiology of penumothorax caused by osteochondroma.

Type 1 Congenital Pulmonary Airway Malformation: The Most Common Lung Lesion In Newborns., Delilah Penn

Nursing Student Class Projects (Formerly MSN)

A poster project on Type 1 Congenital Pulmonary Airway Malformation: The most common lung lesion in newborns.

Incorporating Indications Into Medication Ordering — Time To Enter The Age Of Reason, Gordon Schiff, Enrique Seoane-Vazquez, Adam Wright

Pharmacy Faculty Articles and Research

"In our current era of transparent, patient-centered medicine, such sentiments would hardly be accepted. Unfortunately, patients are often still in the dark regarding the purposes of their medications. It is said that there are five “rights” required for safe medication ordering and use: the right patient, the right drug, the right dose, the right time, and the right route. But there’s a sixth element that must be correct — and we believe it’s time to add to each prescription an ingredient that’s currently conspicuously missing: the right indication. This pivotal element affects and complements the other five, and considering it …

Pulmonary Hypertension Associated With Congenital Heart Disease, Sara M. Rinehart

Nursing Student Class Projects (Formerly MSN)

This academic poster discusses pulmonary hypertension associated with congenital heart disease. This poster is based off research and uses information collected from other articles. Within this academic poster pathophysiology changes that occur within the heart and lungs is discussed, the nurses role with pulmonary hypertension, the significance of the pathophysiology, and important signs and symptoms associated with this disease.

Type 1 Hepatorenal Syndrome, Ernest Evans

Nursing Student Class Projects (Formerly MSN)

Type 1 hepatorenal syndrome is kidney failure that occurs in advanced cirrhosis (Fagundes & Ginès, 2012). It is characterized by a, “significant reduction in creatinine clearance within 1-2 weeks of presentation” (Bacon, 2015). Patients that develop this condition have a median survival rate of one month (Dameron, 2011). Vasodilation leads to decreased perfusion to the kidneys and thus kidney injury (Boyer et al., 2011). Liver transplantation is the best treatment for hepatorenal syndrome (Fagundes & Ginès, 2012). Common causes of cirrhosis are hepatitis C infection, alcohol consumption, and fatty liver disease (Warner, Cuthbert, Bhore, & Rockey, 2011). Regardless of the …

Eosinophilic Esophagitis In Children, Jessica Desalvo

Nursing Student Class Projects (Formerly MSN)

Poster project on Eosinophilic esophagitis (EoE) which is a chronic immune-mediated disease resulting in inflammation of the esophagus.

Samarium-153-Edtmp (Quadramet®) With Or Without Vaccine In Metastatic Castration-Resistant Prostate Cancer: A Randomized Phase 2 Trial, Christopher R. Heery, Ravi A. Madan, Mark N. Stein, Walter M. Stadler, Robert S. Dipaola, Myrna Rauckhorst, Seth M. Steinberg, Jennifer L. Marté, Clara C. Chen, Italia Grenga, Renee N. Donahue, Caroline Jochems, William L. Dahut, Jeffrey Schlom, James L. Gulley

Internal Medicine Faculty Publications

PSA-TRICOM is a therapeutic vaccine in late stage clinical testing in metastatic castration-resistant prostate cancer (mCRPC). Samarium-153-ethylene diamine tetramethylene phosphonate (Sm-153-EDTMP; Quadramet^®), a radiopharmaceutical, binds osteoblastic bone lesions and emits beta particles causing local tumor cell destruction. Preclinically, Sm-153-EDTMP alters tumor cell phenotype facilitating immune-mediated killing. This phase 2 multi-center trial randomized patients to Sm-153-EDTMP alone or with PSA-TRICOM vaccine. Eligibility required mCRPC, bone metastases, prior docetaxel and no visceral disease. The primary endpoint was the proportion of patients without radiographic disease progression at 4 months. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and immune responses. …

Aptamer-Hybrid Nanoparticle Bioconjugate Efficiently Delivers Mirna-29b To Non-Small-Cell Lung Cancer Cells And Inhibits Growth By Downregulating Essential Oncoproteins., Maryna Perepelyuk, Christina Maher, Ashakumary Lakshmikuttyamma, Sunday A. Shoyele

College of Pharmacy Faculty Papers

MicroRNAs (miRNAs) are potentially attractive candidates for cancer therapy. However, their therapeutic application is limited by lack of availability of an efficient delivery system to stably deliver these potent molecules intracellularly to cancer cells while avoiding healthy cells. We developed a novel aptamer-hybrid nanoparticle bioconjugate delivery system to selectively deliver miRNA-29b to MUC1-expressing cancer cells. Significant downregulation of oncoproteins DNMT3b and MCL1 was demonstrated by these MUC1 aptamer-functionalized hybrid nanoparticles in A549 cells. Furthermore, downregulation of these oncoproteins led to antiproliferative effect and induction of apoptosis in a superior version when compared with Lipofectamine 2000. This novel aptamer-hybrid nanoparticle bioconjugate …