Medicine and Health Sciences Commons^™

Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery., Alan H. Daniels, Robert A. Hart, Alan S. Hilibrand, David E. Fish, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, P. Justin Tortolani, D. Alex Stroh, Ahmad Nassr, Bradford L. Currier, Arjun S. Sebastian, Paul M. Arnold, Michael G. Fehlings, Thomas E. Mroz, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study of prospectively collected data.

OBJECTIVE: To examine the incidence of iatrogenic spinal cord injury following elective cervical spine surgery.

METHODS: A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was conducted. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of iatrogenic spinal cord injury.

RESULTS: In total, 3 cases of iatrogenic spinal cord injury following cervical spine surgery were identified. Institutional incidence rates ranged …

Epidemiology And Outcomes Of Vertebral Artery Injury In 16 582 Cervical Spine Surgery Patients: An Aospine North America Multicenter Study., Wellington K. Hsu, Abhishek Kannan, Harry T. Mai, Michael G. Fehlings, Zachary A. Smith, Vincent C. Traynelis, Ziya L. Gokaslan, Alan S. Hilibrand, Ahmad Nassr, Paul M. Arnold, Thomas E. Mroz, Mohamad Bydon, Eric M. Massicotte, Wilson Z. Ray, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Robert E Isaacs, Jeffrey C. Wang, Elizabeth L. Lord, Zorica Buser, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI).

OBJECTIVE: To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery.

METHODS: Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36).

RESULTS: VAIs were identified in a total of 14 of 16 582 …

Chilblain Lupus Erythematosus In An Adult Male., Stephanie Bayruns Md, Tyler Stutzman Mph

Department of Medicine

No abstract provided.

Enterobius Vermicularis In Tubo-Ovarian Abscess: A Rare And Interesting Incidental Finding - A Case Report, Faryal Saleem, Faizan Malik, Saira Fatima

Department of Pathology and Laboratory Medicine

Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015. Histopathology of the resected tissue revealed necrosis and in one area Enterobius vermicularis …

Integrating Osteopathic Students Into Clinical Clerkships At An Allopathic Regional Medical Campus., Brian L. Bennett Med, Margaret A. Hadinger Edd, Ms, Robert D. Barraco Md, Mph, Joseph M. Kaczmarczyk Do, Mph, Danielle Pedrotty Med, Angela Davis

Department of Education

No abstract provided.

The Grass Is Always Greener: Surviving Mergers And Acquisitions, No Matter Your Side Of The Fence., Margaret A. Hadinger Edd, Ms, Robert D. Barraco Md, Mph

Department of Education

No abstract provided.

Critical Analysis Of Breastfeeding Education Provided In The Hospital, Abigail Sweet

Senior Honors Projects

The World Health Organization (W.H.O) recommends exclusive breastfeeding for the first six months of an infant’s life. A large majority of new mothers are making the decision to breastfeed their newborn child. According to the Centers for Disease Control and Prevention, as of 2016, high breastfeeding initiation rates show that most mothers in the U.S. want to breastfeed and are trying to do so. However, there are several indicators that suggest that mothers may not be getting the support they need and the early postpartum period is a critical time for establishing support for breastfeeding. Depending on the type of …

An Examination Of Step Frequency And The Running Readiness Scal As Predictors Of Running-Related Injury In Collegiate Cross-Country Athletes, Jenna D'Errico

Undergraduate Distinction Papers

The objective of this study was to determine the relationship between step frequency, the Running Readiness Scale, and Running-Related Injury rate among the Otterbein cross-country team during the Fall 2016 season. Step frequencies were calculated for each athlete at a preferred and pre-determined pace. As a part of the running Readiness Scale assessment, each athlete completed a series of screening tasks to assess body alignment, weight distribution, and muscular endurance. Each participant logged their running and injury history throughout the season using the Otterbein Run Tracker app. The researchers hypothesized that higher step frequencies and Running Readiness Scale pass rates …

Effects Of A Balance And Strength Training Program On Functional Proprioceptive And Motor Control Abilities In Young Adults With Neurodevelopmental Disorders, Victoria Timmons

Undergraduate Distinction Papers

he objective of this study was to determine if young adults, ages 18-22, with neurodevelopmental disorders, including Autism Spectrum Disorder, Intellectual Disabilities, Communication Disorders, Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, and Motor Disorders, would benefit by adding a propioceptive intervention program to an already existing strength training program. Benefits hypothesized from this intervention were int he areas of agility and balance, two of the three components of propioceptive abilities. Increased agility and balance has been proved to increase functionality and safety as it can decrease fall risks. Subjects were all apart of a transitional program from high school into the adult …

C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review Of 59 Cases., Sara E. Thompson, Zachary A. Smith, Wellington K. Hsu, Ahmad Nassr, Thomas E. Mroz, David E. Fish, Jeffrey C. Wang, Michael G. Fehlings, Chadi A. Tannoury, Tony Tannoury, P. Justin Tortolani, Vincent C. Traynelis, Ziya Gokaslan, Alan S. Hilibrand, Robert E. Isaacs, Praveen V. Mummaneni, Dean Chou, Sheeraz A. Qureshi, Samuel K. Cho, Evan O. Baird, Rick C. Sasso, Paul M. Arnold, Zorica Buser, Mohamad Bydon, Michelle J Clarke, Anthony F. De Giacomo, Adeeb Derakhshan, Bruce Jobse, Elizabeth L. Lord, Daniel Lubelski, Eric M. Massicotte, Michael P. Steinmetz, Gabriel A. Smith, Jonathan Pace, Mark Corriveau, Sungho Lee, Peter I. Cha, Dhananjay Chatterjee, Erica L. Gee, Erik N. Mayer, Owen J. Mcbride, Allison K. Roe, Marisa Y. Yanez, D. Alex Stroh, Khoi D. Than, K. Daniel Riew

Rothman Institute Papers

STUDY DESIGN: A multicenter, retrospective review of C5 palsy after cervical spine surgery.

OBJECTIVE: Postoperative C5 palsy is a known complication of cervical decompressive spinal surgery. The goal of this study was to review the incidence, patient characteristics, and outcome of C5 palsy in patients undergoing cervical spine surgery.

METHODS: We conducted a multicenter, retrospective review of 13 946 patients across 21 centers who received cervical spine surgery (levels C2 to C7) between January 1, 2005, and December 31, 2011, inclusive. P values were calculated using 2-sample t test for continuous variables and χ(2) tests or Fisher exact tests for …

State Emergency Department Opioid Guidelines: Current Status., Robert I Broida, Tanner Gronowski, Andrew F Kalnow, Andrew G Little, Christopher M Lloyd

Trauma and Acute Care Articles

INTRODUCTION: The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM).

METHODS: We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP.

RESULTS: We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions …

Ventilator-Associated Pneumonia: New Definitions., M Chance Spalding, Michael W Cripps, Christian T Minshall

Trauma and Acute Care Articles

The National Healthcare Safety Network's new classification characterizes all adverse ventilator-associated events (VAE) into a tiered system designed to shift the focus away from ventilator-associated pneumonia as the only important cause or morbidity in ventilated patients. This new surveillance definition of VAE eliminates subjectivity by using clearly defined criteria and facilitates the automated collection of data. This allows for easier comparison and analysis of factors affecting rates of VAE. Numerous studies have been published that demonstrate its clinical application. This article presents the VAE criteria, contrasts the difference from the previous ventilator-associated pneumonia definition, and discusses its implementation over the …

Creation Of A Novel Human Wound Model To Test Novel Wound Healing Approaches, Nathan Northern

The University Honors Program

In the US there is a growing prevalence of chronic wounds such as such as leg ulcers, diabetic foot ulcers, and pressure ulcers. These wounds persist for long periods of time and are expensive to manage. Improved human-based model systems that emulate the wound healing process in humans would accelerate the identification of novel healing strategies that are directly translatable to humans. The goal of this study was to develop a novel wound model able to imitate the human wound healing process. To do this, 8mm punch biopsies were taken from human abdominoplasty samples and 2mm wounds were created in …

Improved Outcomes Associated With An Early Mobilization Protocol Among Hip And Knee Replacement Patients, Emily Emma, Dnp, Rn-Bc, Onc

Doctor of Nursing Practice Projects

Background: According to the National Association of Orthopedic Nurses (NAON), research indicates that evidence-based practice for post-operative hip and knee replacement patients includes early mobilization several hours following surgery. Findings indicate that early mobilization on the day of surgery directly correlates to decreased pain, increased distance ambulated and decrease in length of stay (LOS) in the hospital. Objectives: The aim of this research was to validate findings in the literature indicating that improved patient outcomes (pain, distance ambulated and LOS) are associated with implementation of an Early Mobilization Protocol among post-operative total hip and knee replacement patients. Methods: The study …

A Retrospective Analysis Of Surgeon Estimated Time And Actual Operative Time To Develop An Efficient Operating Room Scheduling System, Pearly T. Brown, Dnp, Rn, Cnor

Doctor of Nursing Practice Projects

Problem: Surgical departments account for sizable budgets in hospitals. To ensure efficiency, optimal processes need to be maintained. The current practice for posting a surgical case is using surgeon estimated times (SETs), which only includes the reporting points of component 2 (C2) “incision” to “dressing.”

Objective: To analyze if there was a significant difference in minutes between actual operative times (AOT) and SET in patients undergoing outpatient general laparoscopic and inpatient orthopedic total joint surgery.

Methods: The facility is a level one trauma teaching center, with 371 beds, and a yearly surgical volume of 17,000 cases. This retrospective …

Effects Of A Comprehensive Bariatric Program Implementation On 30-Day Readmission And 30-Day Er/Infusion Clinic Visit Rates Due To Dehydration, Azra Kukic, Dnp, Rn, Cbn, Acm

Doctor of Nursing Practice Projects

Background: Program accreditation requires adherence to MBSAQIP standards to assist patient in making needed changes to his/her diet and lifestyle. However, literature provides conflicting information regarding the value of a comprehensive bariatric program accreditation and its effects on 30-day readmission and 30-day ER/infusion clinic visit due to dehydration development.

Objectives: To examine the effects of implementing a comprehensive bariatric surgical program on 30-day readmission rates, and 30-day emergency room (ER) and infusion clinic visit rates due to dehydration for bariatric surgical patients.

Methods: Our study was a retrospective separate sample pre-post intervention chart review. The data were collected before and …

Variables Associated With Overweight/Obesity Among African-American Women With Hypertension And/Or Diabetes, Monica A. Hamilton, Dnp, Rn, Acns-Bc

Doctor of Nursing Practice Projects

BACKGROUND

Obesity is the second leading cause of preventable death next to tobacco use. Although it is prevalent in all populations, it disproportionately affects AA women. Overweight/obesity increases AA women’s chances of developing chronic illnesses such as diabetes, hypertension, heart disease, and decreases their life expectancy. The purpose of this study was to explore variables associated with overweight/obese AA women with hypertension and/or diabetes.

METHODS

A secondary data analysis was conducted using a descriptive-correlational design to analyze cross-sectional data obtained from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). The sample consisted of AA women (n =1823). The dependent variable …

An Assessment Of Errors And Near-Misses From Pre-Licensure Student Nurses, Megan Wolfe, Dnp, Fnp-C, Ms Ed., Rd, Rn, Cne

Doctor of Nursing Practice Projects

Background: Approximately one-half of new nurses with less than one year of experience who were involved in adverse patient events identified that their formal education preparation was a causal factor in their error (Saintsing, Gibson & Pennington, 2011). An examination of quality and safety measures of a current hospital based associate degree nursing (ADN) educational program provided data regarding errors committed by prelicensure students. Tracking and analysis of frequency and type of student clinical errors provided for identification of similarities and an opportunity for system evaluation and improvements.

Objectives: To identify the number, types and categories of Student …

A Comparison Of Influenza & Tdap Vaccination Rates By Characteristics Of Child-Bearing-Aged Women, Francis Connor, Dnp, Msn, Mph, Fnp-Bc

Doctor of Nursing Practice Projects

Background

The Advisory Committee on Immunization Practices recommend childbearing-aged women receive an annual influenza vaccine, one dose of Tdap instead of TD after 18 years of age, and one dose of Tdap during the 3^rd trimester of each pregnancy. Despite these recommendations, influenza and Tdap vaccination rates remain lower than current goals.

Objectives

The purpose was to assess influenza and Tdap vaccination rates among women of childbearing age by pregnancy status, age group, and race/ethnicity.

Methods

The retrospective secondary data analysis included a nationally representative sample of women aged 18 to 44 years from the 2014 Behavioral Risk Factors …

Female Madness In Greek Tradition And Medicine, Caitlin T. Connelly

Student Publications

This paper considers the similarities and differences in Greek thought concerning female madness among both traditional views of madness and medical views. It identifies three broad types of female madness – Dionysian madness, most often associated with maenads and maenadism; desire-induced madness, associated with Aphrodite or Eros; and the medical views of madness of the Hippocratic Corpus, Plato, and other writers. Divinely-inspired madness was considered an assault on the individual from the outside, while the physicians considered madness to be an affliction from within. However, while desire-induced madness and medical madness were seen as the results of women avoiding men, …

A Word From The Writing Center (April 2017), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Writing Tip: Punctuation
• Organizing your Research using a citation manager
• Writing Café hours

Level Of Patient-Physician Agreement In Assessment Of Change Following Conservative Rehabilitation For Shoulder Pain, Stephanie D. Moore-Reed, W. Ben Kibler, Heather M. Bush, Timothy L. Uhl

Biostatistics Faculty Publications

Background Assessment of health-related status has been shown to vary between patients and physicians, although the degree of patient–physician discordance in the assessment of the change in status is unknown.

Methods Ninety-nine patients with shoulder dysfunction underwent a standardized physician examination and completed several self-reported questionnaires. All patients were prescribed the same physical therapy intervention. Six weeks later, the patients returned to the physician, when self-report questionnaires were re-assessed and the Global Rating of Change (GROC) was completed by the patient. The physician completed the GROC retrospectively. To determine agreement between patient and physician, intra-class correlation (ICC) coefficient and Pearson’s …

White Matter Hyperintensity Associations With Cerebral Blood Flow In Elderly Subjects Stratified By Cerebrovascular Risk, Ahmed A. Bahrani, David K. Powell, Guoqiang Yu, Eleanor S. Johnson, Gregory A. Jicha, Charles D. Smith

Biomedical Engineering Faculty Publications

Objective: This study aims to add clarity to the relationship between deep and periventricular brain white matter hyperintensities (WMHs), cerebral blood flow (CBF), and cerebrovascular risk in older persons. Methods: Deep white matter hyperintensity (dWMH) and periventricular white matter hyperintensity (pWMH) and regional gray matter (GM) and white matter (WM) blood flow from arterial spin labeling were quantified from magnetic resonance imaging scans of 26 cognitively normal elderly subjects stratified by cerebrovascular disease (CVD) risk. Fluidattenuated inversion recovery images were acquired using a high-resolution 3-dimensional (3-D) sequence that reduced partial volume effects seen with slicebased techniques. Results: dWMHs but not …

What's New In Critical Illness And Injury Science? We Must Lead By Hope…., Michael Shay O'Mara

Trauma and Acute Care Articles

No abstract provided.

Effect Of Stigma And Advocacy On Our State Of Mental Health: A Scientific And Personal Approach, Hannah Giangaspro

Senior Theses

The prevalence of mental health disorders amongst college students, especially studentathletes and honors students, has reached dangerously high levels. Furthermore, the stigma associated with mental disorders has been proven to prevent the struggling population from seeking help for themselves through mental health services. This study examined the relationship between mental health and college students (i.e. undergraduates, student-athletes, and honors students), as well as the effects of mental health advocacy on the speaker and the listener. Study participants consisted primarily of NCAA Division I undergraduate studentathletes at the University of South Carolina, with a sample size of 116. Results indicated that …

Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A Nayeem, Ranjan Dias, S. Ather Enam

Department of Surgery Docs

No abstract provided.

Effectiveness Of Plain X-Ray In Detection Of Fish And Chicken Bone Foreign Body In Upper Aerodigestive Tract, Talha Ahmed Qureshi, Mohammad Sohail Awan, Muntazir Hussain, Muhammad Wasif

Department of Surgery Docs

Abstract

OBJECTIVE:

To assess the use of plain film radiology in the detection of fish and chicken bones in the upper aerodigestive tract.

METHODS:

This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised medical charts of patients who had undergone oesophagoscopy for removal of fish and chicken bone from 1990 to 2015.SPSS 19 was used for data analysis.

RESULTS:

Of the 24 patients, foreign body was detected on X-ray in 7(29.2%) and through fibre optic laryngoscopy in 13(54.2%).All the patients underwent surgical intervention for removal of the foreign body. Also, 19(79.2%) patients underwent direct …

Perception Of Hearing Loss In Orchestral Musicians, Eva Gebel, Sherri M. Jones, Julie A. Honaker

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Musicians are at risk for hearing loss due to noise exposure and presbycusis (1, 2). Compared to non‐musicians with hearing loss, musicians with hearing loss show improvements in speech understanding in a background of noise, but by self‐report do not perceive an advantage (3). This project aimed to explore this further by studying six orchestral musicians aged 42‐64 with a perceived hearing loss. Scores on a variety of assessments were compared to published normative data and a survey was also completed. No significant differences were found between the musicians and the normative data. Survey responses indicated that overall, the musician …

Carisbamate Blockade Of T-Type Voltage-Gated Calcium Channels, Do Young Kim, Fang-Xiong Zhang, Stan T. Nakanishi, Timothy Mettler, Ik-Hyun Cho, Younghee Ahn, Florian Hiess, Lina Chen, Patrick G. Sullivan, S. R. Wayne Chen, Gerald W. Zamponi, Jong M. Rho

Spinal Cord and Brain Injury Research Center Faculty Publications

Objectives

Carisbamate (CRS) is a novel monocarbamate compound that possesses antiseizure and neuroprotective properties. However, the mechanisms underlying these actions remain unclear. Here, we tested both direct and indirect effects of CRS on several cellular systems that regulate intracellular calcium concentration [Ca²⁺]_i.

Methods

We used a combination of cellular electrophysiologic techniques, as well as cell viability, Store Overload‐Induced Calcium Release (SOICR), and mitochondrial functional assays to determine whether CRS might affect [Ca²⁺]_i levels through actions on the endoplasmic reticulum (ER), mitochondria, and/or T‐type voltage‐gated Ca²⁺ channels.

Results

In CA3 pyramidal neurons, kainic …

A Case Study Evaluating The Effects Of Augmented Feedback On The Gait Patterns Of Two College-Age Students With Disabilities, Tara Teeples

Undergraduate Distinction Papers

Best of Both Worlds (BOBW) is a program at Otterbein University for Westerville City School District students who have identified disabilities. The BOBW program is a comprehensive transition program, providing instruction in work skills, community participation skills, independent living skills, and self-advocacy skills. Same-aged peers (Otterbein students) work with the BOBW students and assist them in the development of a healthy, active adult life, through a peer buddy workout program. Gait disorders are common in individuals with a neurological disorder. These gait disorders have then been linked to increased incidence for falls. Falls are one of the most common risks …