Medicine and Health Sciences Commons^™

Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection.

Using Clinical Decision Support Within The Electronic Health Record To Reduce Incorrect Prescribing For Acute Sinusitis, Regina Ginzburg, Justin J. Conway, Eve Waltermaurer, Wendy Song, Samantha P. Jellinek-Cohen

Journal of Patient-Centered Research and Reviews

Purpose: Acute sinusitis has viral etiology in more than 90% of cases, but antibiotics are prescribed for more than 80% of adults in the United States. While applications of computer-assisted guidelines have been found effective in reducing inaccurate prescribing for acute respiratory infections, there is a paucity of research focused specifically on the utilization of electronic best practice alerts (BPA) in improving treatment for acute sinusitis.

Methods: This observational cohort study examined prescribing behavior for sinusitis at a single Federally Qualified Health Center 1 year prior and during the first year of implementation of a BPA in the electronic health …

An Analysis On Non-Specialist Outpatient Referrals At Beji And Depok Jaya Health Centers In 2018, Tasya Caesarena Pertiwi, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

The Health Social Security Agency (BPJS kesehatan) is one of the government’s efforts to provide quality healthcare for the people. To guarantee its quality and maintain efficiency, a tiered referral system is used. However, there were many problems in its implementation. One of the ways to investigate is to evaluate the non-specialist outpatient referrals (RRNS). Therefore, in March-July 2018, this research was performed in order to analyze whether the system was implemented at Beji and Depok Jaya Health Center. The method used was the qualitative research method, with primary data from in-depth interviews and secondary data from documents. It was …

Medical School Watercooler Newsletter - July 29, 2018, Lindsey Lyle

Watercooler Newsletter

This is the July 29, 2018 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• USA Welcomes Dr. Eva Alnajjar to Obstetrics and Gynecology
• Boxing Out Hunger Program Adds Fresh Produce
• Michelle Dudley Named Executive Director of Practice Management for USA Health
• 45th Research Day Features Keynote Speaker, Medical Student Presentations
• Pediatrics Grand Rounds Set for Aug. 17
• USA College of Medicine Welcomes Dr. Roger Berkow to Pediatrics

Pth1r-Casr Cross Talk: New Treatment Options For Breast Cancer Osteolytic Bone Metastases., Yanmei Yang, Bin Wang

Department of Medicine Faculty Papers

Metastatic breast cancer (BrCa) is currently incurable despite great improvements in treatment of primary BrCa. The incidence of skeletal metastases in advanced BrCa occurs up to 70%. Recent findings have established that the distribution of BrCa metastases to the skeleton is not a random process but due to the favorable microenvironment for tumor invasion and growth. The complex interplay among BrCa cells, stromal/osteoblastic cells, and osteoclasts in the osseous microenvironment creates a bone-tumor vicious cycle (a feed-forward loop) that results in excessive bone destruction and progressive tumor growth. Both the type 1 PTH receptor (PTH1R) and extracellular calcium-sensing receptor (CaSR) …

Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

Only 50% of pediatric patients presenting with significant pain receive any form of analgesia while in the emergency department (ED). The American College of Emergency Physicians endorses the use of triage protocols to improve the speed and consistency of analgesia in the ED. However, given the unique needs of the pediatric population insufficient evidence exists, if any, to support the use of triage protocols for their treatment in the ED. After a review of the literature it is concluded that triage pain protocols are a safe and effective method for providing pediatric analgesia in the ED. However, the variability in …

Association Between Bone-Specific Physical Activity Scores And Pqct-Derived Measures Of Bone Strength And Geometry In Healthy Young And Middle-Aged Premenopausal Women., Sojung Kim, Breanne S Baker, Pragya Sharma-Ghimire, Debra A Bemben, Michael G Bemben

College of Science & Mathematics Departmental Research

The aim of this study was to determine if bone-specific physical activity questionnaire (BPAQ) scores were positively related to bone health in healthy young and middle-aged premenopausal women. The total BPAQ was a stronger predictor of bone strength and bone mineral density of hip in young women as compared to middle-aged premenopausal women.

PURPOSE: The purpose of this study was to determine whether the BPAQ scores were predictive indices of volumetric BMD (vBMD), bone strength, and bone geometry in young and middle-aged premenopausal women.

METHODS: Healthy young (n = 60) and middle-aged premenopausal women (n = 54) between the ages …

Designed Cultural Adaptation And Delivery Quality In Rural Substance Use Prevention: An Effectiveness Trial For The Keepin’ It Real Curriculum, Michael L. Hecht, Youngju Shin, Jonathan Pettigrew, Michelle Miller-Day, Janice L. Krieger

Communication Faculty Articles and Research

This study examined how cultural adaptation and delivery quality of the school-based intervention keepin’ it REAL (kiR) influenced adolescent substance use. The goal of the study was to compare the effectiveness of the multi-cultural, urban (non-adapted) kiR intervention, a re-grounded (adapted) rural version of the kiR intervention and control condition in a new, rural setting. A total of 39 middle schools in rural communities of two states in the USA were randomly assigned to one of three conditions (i.e., control, non-adapted urban kiR, and adapted rural kiR). Data included adolescent self-reported lifetime substance use and observers’ ratings of delivery quality …

Α-Synuclein Concentration Increases Over Time In Plasma Supernatant Of Single Donor Platelets, Catherine M. Stefaniuk, Clifford V. Harding, Robert W. Maitta

Faculty Scholarship

OBJECTIVES: In platelets, α-synuclein is important in calcium-dependent granule release. Notably, cells release α-synuclein in setting of cell damage or death. Therefore, we investigated α-synuclein levels in plasma of single donor platelet (SDP) units during storage. METHODS: Aliquots were obtained from same SDP units for 7 days from day of donation. Additionally, randomly sampled SDP units at same storage time points were also assayed by enzyme-linked immunosorbent assay. RESULTS: α-Synuclein in SDP plasma increased continuously over time at each assayed time point. Significant increases were measured on day 3 (11.7 ± 9.6 ng/mL, P = 0.025), day 5 (15.3 ± …

Histone Deacetylase 8 Protects Human Proximal Tubular Epithelial Cells From Hypoxia-Mimetic Cobalt- And Hypoxia/Reoxygenation-Induced Mitochondrial Fission And Cytotoxicity, Soon-Duck Ha, Ori Solomon, Masoud Akbari, Alp Sener, Sung Ouk Kim

Anatomy and Cell Biology Publications

Cell death by hypoxia followed by reoxygenation (H/R) is responsible for tissue injury in multiple pathological conditions. Recent studies found that epigenetic reprogramming mediated by histone deacetylases (HDACs) is implicated in H/R-induced cell death. However, among 18 different isoforms comprising 4 classes (I-IV), the role of each HDAC in cell death is largely unknown. This study examined the role of HDAC8, which is the most distinct isoform of class I, in the hypoxia mimetic cobalt- and H/R-induced cytotoxicity of human proximal tubular HK-2 cells. Using the HDAC8-specific activator TM-2-51 (TM) and inhibitor PCI34051, we found that HDAC8 played a protective …

Fibroblasts As A Practical Alternative To Mesenchymal Stem Cells., Thomas E Ichim, Pete O'Heeron, Santosh Kesari

Articles, Abstracts, and Reports

Mesenchymal stem cell (MSC) therapy offers great potential for treatment of disease through the multifunctional and responsive ability of these cells. In numerous contexts, MSC have been shown to reduce inflammation, modulate immune responses, and provide trophic factor support for regeneration. While the most commonly used MSC source, the bone marrow provides relatively little starting material for cellular expansion, and requires invasive extraction means, fibroblasts are easily harvested in large numbers from various biological wastes. Additionally, in vitro expansion of fibroblasts is significantly easier given the robustness of these cells in tissue culture and shorter doubling time compared to typical …

A Multi-Center Phase Ii Study Of High Dose Interleukin-2 Sequenced With Vemurafenib In Patients With Braf-V600 Mutation Positive Metastatic Melanoma., Joseph I Clark, Jatinder Singh, Marc S Ernstoff, Christopher D Lao, Lawrence E Flaherty, Theodore F Logan, Brendan Curti, Sanjiv S Agarwala, Bret Taback, Lee Cranmer, Jose Lutzky, Theresa L Luna, Sandra Aung, David H Lawson

Articles, Abstracts, and Reports

BACKGROUND: Preclinical studies suggest that BRAF inhibitors enhance anti-tumor immunity and antigen presentation. Combination BRAF inhibition with immunotherapy is an appealing therapeutic approach. We sequenced vemurafenib with HD IL-2 in patients with BRAF-mutated metastatic melanoma to improve long term outcomes.

METHODS: Eligible patients were HD IL-2 eligible with metastatic BRAF V600 mutated melanoma. Cohort 1 was treatment naïve and received vemurafenib 960 mg BID for 6 weeks before HD IL-2. Cohort 2 received vemurafenib for 7-18 weeks before enrollment. Both cohorts received HD IL-2 at 600,000 IU/kg every 8 h days 1-5 and days 15-19. The primary objective was to …

Prognostic Factors For Elderly Patients Treated With Stereotactic Body Radiation Therapy For Pancreatic Adenocarcinoma, Philip A. Sutera, Mark E. Bernard, Hong Wang, Dwight E. Heron

Radiation Medicine Faculty Publications

Introduction: Pancreatic ductal adenocarcinoma (PDAC) commonly presents later in life with a median age at diagnosis of 70 years. Unfortunately, elderly patients are significantly underrepresented in clinical trials. Stereotactic body radiation therapy (SBRT) is a promising treatment modality in this population as it has demonstrated excellent local control with minimal toxicity. We aimed to determine prognostic factors associated with outcomes in elderly patients treated with SBRT.

Materials and Methods: Elderly patients older than 70 treated with SBRT for PDAC at our institution, from 2004 to 2014 were included. Our primary endpoints included overall survival (OS) and local-progression-free survival (LPFS). Secondary …

The Impact Of Serum Glucose, Anti-Diabetic Agents, And Statin Usage In Non-Small Cell Lung Cancer Patients Treated With Definitive Chemoradiation, Nick A. Iarrobino, Beant S. Gill, Mark E. Bernard, Rainer J. Klement, Maria Werner-Wasik, Colin E. Champ

Radiation Medicine Faculty Publications

Introduction: Epidemiologic data indicate diabetes confers an augmented risk of lung cancer development, yet the relationship between hyperglycemia, metabolic agents, and prognosis is unclear. We analyzed the impact of hyperglycemia, anti-diabetic agents, and statins on outcomes in non-small cell lung cancer (NSCLC) patients undergoing chemoradiation.

Method and Materials: In total, data from 170 patients with stage III NSCLC treated at the University of Pittsburgh Medical Center between 2001 and 2014 were obtained for analysis. Kaplan-Meier survival analysis was used to estimate time-to-event for overall survival (OS), disease-free survival, distant metastasis (DM), and loco-regional control (LRC). Blood glucose values (n …

Assessing Heat-Related Mortality Risks Among Rural Populations: A Systematic Review And Meta-Analysis Of Epidemiological Evidence, Emmanuel A. Odame, Ying Li, Shimin Zheng, Ambarish Vaidyanathan, Ken Silver

ETSU Faculty Works

Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four …

Graduate Commencement, Philadelphia (2018), Philadelphia College Of Osteopathic Medicine

Commencements

Philadelphia Campus Graduate Program Commencement program, Class of 2018. Degrees include Doctor of Psychology in Clinical Psychology, Doctor of Psychology in School Psychology, Educational Specialist in School Psychology, Master of Science in School Psychology, Master of Science in Counseling and Clinical Health Psychology, Master of Science in Mental Health Counseling, Master of Science in Organizational Development and Leadership, Master of Science in Public Health Management and Administration, Master of Science in Aging and Long Term Care Administration, Master of Science in Forensic Medicine, Master of Science in Biomedical Sciences, Master of Science in Health Sciences – Physician Assistant Studies, and …

Horse Y Chromosome Assembly Displays Unique Evolutionary Features And Putative Stallion Fertility Genes, Jan E. Janečka, Brian W. Davis, Sharmila Ghosh, Nandina Paria, Pranab J. Das, Ludovic Orlando, Mikkel Schubert, Martin K. Nielsen, Tom A. E. Stout, Wesley Brashear, Gang Li, Charles D. Johnson, Richard P. Metz, Al Muatasim Al Zadjali, Charles C. Love, Dickson D. Varner, Daniel W. Bellott, William J. Murphy, Bhanu P. Chowdhary, Terje Raudsepp

Veterinary Science Faculty Publications

Dynamic evolutionary processes and complex structure make the Y chromosome among the most diverse and least understood regions in mammalian genomes. Here, we present an annotated assembly of the male specific region of the horse Y chromosome (eMSY), representing the first comprehensive Y assembly in odd-toed ungulates. The eMSY comprises single-copy, equine specific multi-copy, PAR transposed, and novel ampliconic sequence classes. The eMSY gene density approaches that of autosomes with the highest number of retained X–Y gametologs recorded in eutherians, in addition to novel Y-born and transposed genes. Horse, donkey and mule testis RNAseq reveals several candidate genes for stallion …

Evaluating Comfort Measures For Commonly Performed Painful Procedures In Pediatric Patients., Sana Dastgheyb, Keith Fishlock, Constantine Daskalakis, Jami Kessel, Paul Rosen

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Introduction: Management of pediatric pain from medical procedures is of great importance for improving both patient care and experience. In this study, we investigated methods of managing acute pain in infants and children by studying the correlation between the number of attempts to complete painful procedures, given different comfort measures.

Methods: The study is a retrospective review of 74,276 procedures performed at two pediatric hospitals in an integrated academic children's health system between 2013 and 2016. We compared three comfort measures most frequently offered: positions of comfort (POC), distraction (DIST), and pharmacological (PHARM). These methods were compared in the setting …

An Atypical Case Of Silent Aortic Dissection In A Peritoneal Dialysis Patient: A Case Report And Review Of Literature, Waqas Javed Siddique, Ali Arif, Mohammad Harisullah Khan, Maryam Khan, Muhammad Owais Hanif, Muhammad Junaid Mehboob, Muhammad Aslam, Ayesha Aslam, Hasan Arif, Sandeep Aggarwal

Medical College Documents

Objective: Unusual clinical course
Background: Aortic dissection presents with acute chest or back pain and is associated with high mortality. We present a case of aortic dissection with an atypical presentation in a peritoneal dialysis patient, and the challenges met with peritoneal dialysis.
Case Report: A 53-year-old African American male presented with progressively worsening exertional dyspnea and orthopnea for 3 days without any history of chest pain. His chest x-ray showed mild pulmonary edema. He was admitted with a diagnosis of heart failure. Bedside echocardiogram revealed severe aortic regurgitation and concern for possible aortic dissection. Computed tomography …

Combatting The Opioid Crisis On College Campuses: A Harm Reduction Approach, Corey L. Lepoudre

Celebration of Learning

College aged people are at a high risk of opioid misuse due to several risks including: an increased opioid misuse in people between the ages of 18-25, those who experience daily elevated stress, and those who live in metropolitan areas or in the Midwest region of the United States. Due to these risks, a harm reduction initiative geared toward college populations is beneficial to prevent a further increase in opioid misuse and overdose. A harm reduction approach was used to develop an educational toolkit for Quad City Harm Reduction to conduct a one-hour workshop for college faculty and students. Harm …

The Path Of Stroke Care: Nurse Education Materials For Unitypoint Health Trinity Medical Center, Nicole Montgomery

Celebration of Learning

Stroke is the fifth leading cause of death in the United States. About 795,000 people in the United States have a stroke every year. National best practice measures regarding stroke care are promoted through the quality and education department at UnityPoint Health Trinity Medical Center. Trinity’s nurses are encouraged to update their skills at the annual Spring Fling informational fair. Through working with the quality and education department, informational materials regarding the care path of a stroke patient were created and delivered in order to educate nurses about these national best practice measures. This project utilized interpersonal communication models to …

New President And Ceo Of Children's Mercy Named, Children's Mercy Hospital

Our Story Continues

Paul Kempinski, MS, FACHE, has been named the new President and Chief Executive Officer of Children’s Mercy, effective Nov. 1, 2018.

Febrile Neutropenia, Tonja Plew

Nursing Student Class Projects (Formerly MSN)

Febrile Neutropenia (FN) is a common, yet potentially life-threatening, complication in cancer patients receiving myelosuppressive chemotherapy. FN occurs when a patient has a temperature of greater than 100.4℉ with an absolute neutrophil count of less than 500cells/mm³, which places the patient at a high risk for infection. Fever may be the only sign of FN. FN is an oncologic emergency, requiring immediate, aggressive treatment with broad-spectrum antibiotics. FN is associated with high morbidity and mortality in cancer patients.

Pathophysiology And Pathogenesis Of Endometriosis, Kathryn Vaubel

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Rheumatoid Arthritis, Ana Vigil

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Power Outage Preparedness And Concern Among Vulnerable New York City Residents, Christine Dominianni, Munerah Ahmed, Sarah Johnson, Micheline Blum, Kazuhiko Ito, Kathryn Lane

Publications and Research

Power outages can impact health, and certain populations may be more at risk. Personal preparedness may reduce impacts, but information on power outage preparedness and risk perception among vulnerable populations is limited. We examined power outage preparedness and concern among New York City residents, including vulnerable populations defined as older adults (≥ 65 years), and respondents with household members who require assistance with daily activities or depend on electric medical devices. A random sample telephone survey was conducted during November–December 2016. Preparedness was defined as having a three-day supply of drinking water, non-perishable food, and a working flashlight. Among all …

Evolution Of Cortical Neurogenesis In Amniotes Controlled By Robo Signaling Levels., Adrián Cárdenas, Ana Villalba, Camino De Juan Romero, Esther Picó, Christina Kyrousi, Athanasia C Tzika, Marc Tessier-Lavigne, Le Ma, Micha Drukker, Silvia Cappello, Víctor Borrell

Department of Neuroscience Faculty Papers

Cerebral cortex size differs dramatically between reptiles, birds, and mammals, owing to developmental differences in neuron production. In mammals, signaling pathways regulating neurogenesis have been identified, but genetic differences behind their evolution across amniotes remain unknown. We show that direct neurogenesis from radial glia cells, with limited neuron production, dominates the avian, reptilian, and mammalian paleocortex, whereas in the evolutionarily recent mammalian neocortex, most neurogenesis is indirect via basal progenitors. Gain- and loss-of-function experiments in mouse, chick, and snake embryos and in human cerebral organoids demonstrate that high Slit/Robo and low Dll1 signaling, via Jag1 and Jag2, are necessary and …

Both Rural And Urban Snap Recipients Affected By Proposed Work Requirements, Jess Carson

Carsey Publications

With the expiration of the current Farm Bill on September 30, 2018, the House and Senate are working in conference committee to reconcile their versions of its replacement. A major difference between the two is the House’s inclusion of a more intensive work requirement.

Evaluation Of An Ultrasound-Guided Radial Artery Catheterization Training Program For Nurse Anesthetists, Brandee J. Kroening

Nursing Capstones

No abstract provided.

Bariatric Surgery Regain And Long-Term Weight Loss Among Women: Self-Efficacy, Social Support And Health Promotion Lifestyle Behaviors, Raelene Z. Brooks

Dissertations

Although bariatric surgery appears to produce success in a short period of time immediately after surgery, weight regain over time in this population cannot be ignored. Understanding the relationship between potential psychosocial predicting post-surgical variables influencing bariatric surgery may prevent long-term weight regain. The purpose of this research is to examine self-efficacy, social support, and lifestyle habits and their relationship to long term weight loss and regain in women post bariatric surgery. Weight regain is observed as early as 18 months to 2 years after bariatric surgery. Patients face challenges sustaining the dramatic lifestyle changes required to ensure positive long-term …