Medicine and Health Sciences Commons^™

Re-Excision Rates Following Breast Conserving Therapy: A Single Institutions Experience Over Ten Years, Kathryne J. Blair, Mary Legenza

Marshall Journal of Medicine

As breast conserving therapy has become the standard of care for patients with early stage breast cancer an area of debate within the surgical literature has been the rate of positive surgical margins requiring re-excision. Nationally re-excision rates are highly variable and have been reported as high as 40%. Any cancer diagnosis and treatment is stressful for patients and having to return to the operating room for a second surgery can greatly affect both patient satisfaction and cosmetic outcomes. Within our institution we wanted to examined our population over ten years undergoing breast conserving therapy to determine our re-excision rates …

The Impact Of Neonatal Abstinence Syndrome: The View From A Rural Kentucky Hospital, Sydni Fazenbaker Crowell, Allison M. Crump-Rogers, William Crump, Leann Langston

Marshall Journal of Medicine

Abstract

Introduction

Cases of neonatal abstinence syndrome (NAS) increased 3-fold in the United States from 2000 to 2009, with some indication that the problem may be worse in rural areas. The purpose of our study was to report the incidence of NAS in a small rural community with a regional referral hospital and describe aspects of these infants’ NICU stay.

Methods

Using maternal prenatal positive urine drug screens (UDS) as our initial focus, deliveries at 35 weeks or beyond between March 2015 and May 2016 were included. NAS severity score, length of NICU stay, and hospital charges for each infant …

Anomalous Origin Of The Coronary Arteries-Review Article., Abdelrahman M. Aljadi, Shaheed Elhamdani, Majd Kanbour, Mehiar El-Hamdani

Marshall Journal of Medicine

Anomalous origin of the coronary arteries is rare in clinical practice. Different anomalies have different clinical or symptomatic manifestations depending on the patient’s age. However, the majority of coronary artery origin anomalies are silent and are only discovered incidentally during Left Heart Catheterization (LHC). Acute Myocardial Infarction (MI) or even sudden death may occur in patients with an anomalous origin of the Left Main (LM) coronary artery from the right coronary cusp with a subsequent course between the aorta and the pulmonary artery. Therefore, recognition of anomalous origin of the coronary arteries is essential for clinical practice to further classify …

Optimizing Heart Failure Outcomes Through Diet: A Review, Farley B. Neasman Iii

Marshall Journal of Medicine

Heart failure is a growing epidemic that will add significant monetary and human costs to an already overtaxed health-care system. Though promising new medications have recently been approved, this complex condition is largely preventable through aggressive risk factor modification, with diet being shown to have a greater effect than exercise. An underrated component of a healthy diet is the simple addition of nuts – the anti-inflammatory fatty acids, healthy proteins, and general availability have been shown to improve survival and reduce the primary risk factors contributing to heart failure, making the addition of nuts and legumes to the diet an …

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were determined …

Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka

Marshall Journal of Medicine

Purple Urine Bag Syndrome is a rare condition characterized by purple discoloration of the urinary drainage bag. It is typically seen in elderly patients with chronic indwelling urinary catheterization, and is associated with urinary tract infections with high bacterial load, female gender, severe disability, constipation, and alkaline urine. This phenomenon occurs when tryptophan metabolites in the urine are broken down by bacteria containing indoxyl sulphatase and phosphatase enzymes. This results in the production of indigo and indirubin, which combine to give a purple appearance. This article presents a 78-year-old male with chronic urinary retention requiring intermittent Foley catheterization for the …

Call For Vigilance – Red Flags In Systemic Lupus Erythematous, Badar Hasan, Talal Asif, Maryam Hasan, Amr Edrees

Marshall Journal of Medicine

Systemic Lupus Erythematous(SLE) is a multisystem autoimmune disease. It has been identified as the underlying cause for death for an average 1,034 deaths from 2000 and 2014. Our cases highlight two rare but life threatening complications of SLE; Catastrophic antiphospholipid syndrome (CAPS) and Diffuse alveolar hemorrhage (DAH) with mortality as high as 50-90%. Both cases presenting with respiratory symptoms, required meticulous monitoring in ICU and initially treated with broad spectrum antibiotics However, unlike pneumonia these patients required immunosuppressive and plasmapheresis leading to clinical improvement.

Case Report: An Undiagnosed Bladder Diverticulum Resulting In Foley Catheter Perforation During Cesarean Section, A. Allison Roy, Nadim Bou Zgheib, Joseph Assaley

Marshall Journal of Medicine

A bladder diverticulum is diagnosed when herniated bladder mucosa forms an outpouching from the bladder. Bladder diverticula are uncommon and are significantly more common in males. The following case presents a patient with an undiagnosed bladder diverticulum which was incidentally perforated during foley catheter placement for a repeat cesarean section. The diagnosis can be difficult in those who are asymptomatic and lack risk factors, such as the following patient.

Betel Nut Use And Hyperglycemia, Edward Nabrinsky, Badar Hasan, Talal Asif, Rebecca R. Pauly

Marshall Journal of Medicine

Betel nut chewing previously has not been common in North America, yet it is the fourth major source of addiction and abuse worldwide. Approximately 700 million individuals, or 10 % of the global population, chew beetle nut on regular basis. It is important for patient safety and improved quality to recognize its use in uncontrolled diabetes. Our case is of a 49 year-old Burmese female with PMH of DM2, HTN, and benign paroxysmal positional vertigo (BPPV) who presented with a complaint of dizziness. Patient denied alcohol or tobacco use, but reported a 20-year history of betel nut chewing (4-5 times/day). …

Physician, Heal Thy Community, Clay B. Marsh Md

Marshall Journal of Medicine

What if the opioid epidemic and the chronic health problems we encounter in West Virginia and beyond are a symptom of a deeper problem? How can we create healthcare to address the root issues here, and then spread these solutions globally?

Open Access Publishing: Pros, Cons, And Current Threats, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Variant Prevertebral Muscle: Unique Cadaveric Findings., Jocelyn R Gonzales, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The levator scapulae muscle typically runs from the transverse process of the atlas to the superior angle of the scapula. In this paper, we describe a rare finding identified during a dissection of a male cadaver, wherein a continuation of the right levator scapulae ran past its normal attachment to the C1 transverse process, fusing with the inferior attachment of the rectus capitis lateralis muscle. No variants were found on the opposite side, and the innervation of the levator scapulae muscle variant was typical of that of a normal levator scapulae. We also describe other related variants of the cranial …

Impact Of Sexual Violence Prevention Programming At Rowan University, Emily Kofman

Theses and Dissertations

The primary purpose of this study was to explore the impact of sexual violence prevention programming on the main Rowan University campus. This study focused primarily on the Take Back the Night event on April 4, 2017. The study evaluated the impact of the event on those who attended as well as looking at Social Norm Theory. A total population of 167 Rowan students were surveyed at the event with the instrument Take Back the Night Survey. Results of the data revealed that students positively benefitted from attending the event and were able to increase their knowledge of the subject. …

Compounded Apixaban Suspensions For Enteral Feeding Tubes, Maria Caraballo, Seda Donmez, Kobi T. Nathan, Fang Zhao

Doctoral External Publications

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days.

Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on …

Diabetic Gastroparesis: A Risk Factor For Perioperative Aspiration, Chelsea Stevens

Nursing Student Class Projects (Formerly MSN)

Diabetic gastroparesis is one of several long-term complications of diabetes mellitus. It is characterized by delayed gastric emptying secondary to autonomic neuropathy. As the incidence of diabetes mellitus continues to rise, it becomes even more important for anesthetists to address the risk of aspiration posed by diabetic gastroparesis. Currently, aspiration of gastric contents accounts for nearly half of all major airway complications in the operating room, often due to incomplete assessment of risk factors. Understanding the pathophysiology is the first step in recognizing diabetic gastroparesis as a significant risk factor for aspiration. Every effort should be made to mitigate perioperative …

Neuroleptic Malignant Syndrome, Melissa Moomaw

Nursing Student Class Projects (Formerly MSN)

This digital poster explains the pathophysiology behind the rare but fatal condition known as Neuroleptic Malignant Syndrome (NMS). Due to the uncommon nature of NMS, this poster is geared towards education. Information regarding the underlying pathophysiology, causes, signs and symptoms, risk factors, and treatments are presented to the reader. The goal is to spread knowledge about NMS in hopes of recognizing and treating this disorder before patients are harmed.

Hyperspectral Data Processing Improves Ppix Contrast During Fluorescence Guided Surgery Of Human Brain Tumors., Jaime J. Bravo, Jonathan D. Olson, Scott C. Davis, David W. Roberts, Keith D. Paulsen, Stephen C. Kanick

Dartmouth Scholarship

Fluorescence guided surgery (FGS) using aminolevulinic-acid (ALA) induced protoporphyrin IX (PpIX) provides intraoperative visual contrast between normal and malignant tissue during resection of high grade gliomas. However, maps of the PpIX biodistribution within the surgical field based on either visual perception or the raw fluorescence emissions can be masked by background signals or distorted by variations in tissue optical properties. This study evaluates the impact of algorithmic processing of hyperspectral imaging acquisitions on the sensitivity and contrast of PpIX maps. Measurements in tissue-simulating phantoms showed that (I) spectral fitting enhanced PpIX sensitivity compared with visible or integrated fluorescence, (II) confidence-filtering …

Ten Elements Of Organizational Transformation: Strategies For Moving Towards Integrated Employment, Jaimie Ciulla Timmons, John Butterworth, Jonathan Lucus, Thinkwork! At The Institute For Community Inclusion At Umass Boston

All Institute for Community Inclusion Publications

This session will share ten key organizational characteristics necessary to strengthen competitive integrated employment outcomes. Get a first-hand look at the RRTC’s Organizational Transformation Toolkit and explore our Provider Employment Leadership Network, a yearlong facilitated Community of Practice of provider leaders in employment. In conjunction with The Arc of the United States, this PowerPoint offers ten essential elements necessary for successful organizational transformation, along with strategies for implementing each element.

De Novo Triiodothyronine Formation From Thyrocytes Activated By Thyroid-Stimulating Hormone, Cintia E. Citterio, Balaji Veluswamy, Sarah J. Morgan, Valerie A. Galton, J. Paul Banga, Stephen Atkins, Yoshiaki Morishita, Susanne Neumann, Rauf Latif, Marvin C. Gershengorn, Terry J. Smith, Peter Arvan

Pharmacy Faculty Articles and Research

The thyroid gland secretes primarily tetraiodothyronine (T₄), and some triiodothyronine (T₃). Under normal physiological circumstances, only one-fifth of circulating T₃ is directly released by the thyroid, but in states of hyperactivation of thyroid-stimulating hormone receptors (TSHRs), patients develop a syndrome of relative T₃ toxicosis. Thyroidal T₄ production results from iodination of thyroglobulin (TG) at residues Tyr⁵ and Tyr¹³⁰, whereas thyroidal T₃ production may originate in several different ways. In this study, the data demonstrate that within the carboxyl-terminal portion of mouse TG, T₃ is formed …

Brain Processing Of Contagious Itch In Patients With Atopic Dermatitis, C. Schut, Hideki Mochizuki, Shoshana Grossman, Andrew C. Lin, Chris Conklin, Feroze B. Mohamed, Uwe Gieler, Jorg P. Kupfer, Gil Yosipovitch

Department of Radiology Faculty Papers

Several studies show that itch and scratching cannot only be induced by pruritogens like histamine or cowhage, but also by the presentation of certain (audio-) visual stimuli like pictures on crawling insects or videos showing other people scratching. This phenomenon is coined "Contagious itch" (CI). Due to the fact that CI is more profound in patients with the chronic itchy skin disease atopic dermatitis (AD), we believe that it is highly relevant to study brain processing of CI in this group. Knowledge on brain areas involved in CI in AD-patients can provide us with useful hints regarding non-invasive treatments that …

Emergence Of Fluoroquinolone Resistance Among Drug Resistant Tuberculosis Patients At A Tertiary Care Facility In Karachi, Pakistan, Syed Mohammad Asad Zaidi, Abdul Haseeb, Shifa Salman Habib, Amyn Malik, Saira Khowaja, Nausheen Saifullah, Nadeem Rizvi

Community Health Sciences

Background: Pakistan is classified as one of the high multi-drug resistant tuberculosis (MDR-TB) burden countries. A poorly regulated private sector, over-prescription of antibiotics and self-medication has led to augmented rates of drug-resistance in the country. Pakistan's first national anti-tuberculosis drug resistance survey identified high prevalence of fluoroquinolone resistance among MDR-TB patients. Further institutional evidence of fluoroquinolone drug-resistance can support re-evaluation of treatment regimens as well as invigorate efforts to control antibiotic resistance in the country.
Findings: In this study, data for drug-susceptibility testing (DST) was retrospectively analyzed for a total of 133 patients receiving MDR-TB treatment at the Chest Department …

Lyme Disease, Courtney Bode

Nursing Student Class Projects (Formerly MSN)

Lyme disease (LD) is a zoonotic infection transmitted by black-legged (deer) ticks. This disease is the most common vector-bourne illness in the United States (Maloney, 2016). The tick transmits Borrelia burgdorferi, which is the bacterial agent of LD. The Center of Disease Control (CDC) suspects the disease is highly underreported in the United States (Clayton, Dunn, Jones, Jones, & Schaffner, 2015). Even with the disease being underreported, LD is the fifth most commonly reported nationally notifiable disease (Delorey, et al., 2015). Signs and symptoms of Lyme disease can vary greatly in severity. This disease often causes multisystemic illness, starting locally …

Advances In Neuroscience Imply That Harmful Experiments In Dogs Are Unethical, Jarrod Bailey, Shiranee Pereira

Professional Science Research Ethics Collection

Functional MRI (fMRI) of fully awake and unrestrained dog 'volunteers' has been proven an effective tool to understand the neural circuitry and functioning of the canine brain. Although every dog owner would vouch that dogs are perceptive, cognitive, intuitive and capable of positive emotions/empathy, as indeed substantiated by ethological studies for some time, neurological investigations now corroborate this. These studies show that there exists a striking similarity between dogs and humans in the functioning of the caudate nucleus (associated with pleasure and emotion), and dogs experience positive emotions, empathic-like responses and demonstrate human bonding which, some scientists claim, may be …

Brain Biomarkers And Pre-Injury Cognition Are Associated With Long-Term Cognitive Outcome In Children With Traumatic Brain Injury, Amy A Wilkinson, Maureen Dennis, Nevena Simic, Margot J Taylor, Benjamin R Morgan, Helena Frndova, Karen Choong, Craig Campbell, Douglas Fraser, Vicki Anderson, Anne-Marie Guerguerian, Russell Schachar, Jamie Hutchison

Paediatrics Publications

BACKGROUND: Children with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI.

METHOD: Outcome was assessed in 23 patients via parent-rated questionnaires related to attention deficit hyperactivity disorder …

What's Happening: July 24, 2017, Maine Medical Center

What's Happening

No abstract provided.

Mobilization Studies In Mice Deficient In Sphingosine Kinase 2 Support A Crucial Role Of The Plasma Level Of Sphingosine-1-Phosphate In The Egress Of Hematopoietic Stem Progenitor Cells, Mateusz Adamiak, Lakshman Chelvarajan, Kevin R. Lynch, Webster L. Santos, Ahmed Abdel-Latif, Mariusz Z. Ratajczak

Gill Heart & Vascular Institute Faculty Publications

Sphingosine-1-phosphate (S1P) is a bioactive lipid involved in cell signaling and, if released from cells, also plays a crucial role in regulating the trafficking of lympho-hematopoietic cells, including primitive hematopoietic stem/progenitor cells (HSPCs). It has been demonstrated that S1P chemoattracts HSPCs, and its level in peripheral blood creates a gradient directing egress of these cells during mobilization. In this paper we analyzed hematopoiesis in mice deficient in sphingosine kinase 2 (Sphk2-KO mice) and studied the effect of this mutation on plasma S1P levels. We found that Sphk2-KO mice have normal hematopoiesis, and, in contrast to Sphk1-KO mice, the circulating S1P …

Week Of July 24, 2017, New York Medical College

InTouch

• The Catherine and Ladislav P. Hinterbuchner Endowed Chair in Rehabilitation Medicine Dedication Ceremony Is Set for August 10
• Touro Scholar Offers Online Archive Designed to Showcase Scholarship
• Touro College of Dental Medicine at New York Medical College Welcomes the Class of 2021

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern Assesses Individuals’ Perceptions of their Income Sufficiency

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Assesses Individuals Perceptions of the Income Sufficiency

Using Timelines To Visualize Service Use Pathways To Alcohol Treatment, Lynda Berends, Michael Savic

The Qualitative Report

Many people in alcohol and other drug treatment are clients of other services, however there is limited consideration of the combinations and sequences of services and systems that they use. We used data visualization to analyze and re-present findings from a large research project on clients’ service use and referral sources in the year preceding alcohol treatment entry. Data were from 16 “high-end” service users with alcohol problems and analysis involved constructing individual text and timeline summaries and a visual encoding system to show service type and referral source. Three distinct service use pathways were identified and a visual model …