Transplant Critical Care: Is There A Need For Sub-Specialized Units? — A Perspective, Sujit Vijay Sakpal, Suresh Kumar Agarwal, Hector Saucedo-Crespo, Christopher Auvenshine, Robert N. Santella, Steven Donahue, Jeffery Steers

Department of Surgery

The critical care involved in solid-organ transplantation (SOT) is complex. Pre-, intra- and post-transplant care can significantly impact both – patients’ ability to undergo SOT and their peri-operative morbidity and mortality. Much of the care necessary for medical optimization of end-stage organ failure (ESOF) patients to qualify and then successfully undergo SOT, and the management of peri-operative and/or long-term complications thereafter occurs in an intensive care unit (ICU) setting. The current literature specific to critical care in abdominal SOT patients was reviewed. This paper provides a contemporary perspective on the potential multifactorial advantages of sub-specialized transplant critical care units in …

Medical School Watercooler Newsletter - July 15, 2018, Lindsey Lyle

Watercooler Newsletter

This is the July 15, 2018 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Hope for Honduras: Students Embark on Medical Mission Trip
• Mark Your Calendar: 45th Annual Summer Medical Student Research Day
• USA Department of Neurology Welcomes Dr. William Kilgo
• Dr. Vaughan Lee Appointed Professor of Medical Education

Adapted Aquatics For Children With Severe Motor Impairments, Phillip Conatser, Eric James, Ulku Karabulut

International Journal of Aquatic Research and Education

Available research clearly shows that more children who have disabilities, including those with severe disabilities, are participating in swimming programs as well as wanting to be taught in a regular aquatic class without being segregated. Aquatic instructors need to prepare lessons that include children both with and without disabilities. This means that aquatics instructors need to understand and be willing to implement unique teaching and managerial techniques that foster the safe and successful learning environment for all children. While the task of teaching children who have severe disabilities may seem difficult at first, with a little knowledge and experience, instructors …

Streamlined Surgical Draping Reduces Subcutaneous Implantable Cardioverter-Defibrillator Implant Procedure Preparation Time., Marcy Mcqueen, Lori A Woodford, Eric Holick, Kevin Wolfer, Anish K Amin

Heart and Vascular Articles

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a proven alternative to transvenous implantable cardioverter-defibrillator systems. One critique of S-ICD use, however, has been the time required for implantation. Here, we discuss the use of an alternative surgical draping technique to reduce preparation time for device implantation.

Identification Of Coliphages In The Aviary At Brookgreen Gardens And The Factors That Might Influence Coliphage Population Dynamics In This Cypress Swamp Environment, Olivia Shirley, Lisa Pieterse, Paul E. Richardson

Journal of the South Carolina Academy of Science

It has been understood that the presence of coliphages (bacteriophages specific for E. coli) in water is an indirect measurement of fecal contamination. Bacteriophages have been suggested to hold an important role in regulating the bacterial population. This pilot study analyzes the relationship between the presence of coliphages in the water in the aviary at Brookgreen Gardens and how environmental factors such as temperature, pH, and turbidity affect the presence of these viruses over the time period of three months (June 2017 through August 2017). Coliphages found in volary water sources were speculated to be deposited directly by birds that …

Systemic Lidocaine As An Analgesic Technique In The Perioperative Setting, Joe J. Lennon

Nursing Capstones

No abstract provided.

Niemann-Pick C1, Its Connection To Obesity, And Its Impact On Human Evolution, Joseph Joshua Castillo

Biomedical Sciences ETDs

Niemann-Pick type-C disease is a rare autosomal recessive neurodegenerative disease that classically presents in the first decade, leading to ataxia, vertical-gaze palsy, loss of communication skills, epileptic seizures, and eventually death. The stark reality about NPC disease underlines the important role the NPC1 protein plays in whole-body lipid homeostasis. It is no surprise, then, that the NPC1 gene has been associated with other diseases as well, such as obesity, diabetes, and Ebola virus infection. In this manuscript, a connection will be made that intertwines genetics, biochemical and molecular mechanisms, physiology, and evolutionary pressures, and will explain how a gene, discovered …

July 2018, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Importance Of Welfare And Ethics Competence Regarding Animals Kept For Scientific Purposes To Veterinary Students In Australia And New Zealand, Teresa Collins, Amelia Cornish, Jennifer Hood, Chris Degeling, Andrew D. Fisher, Rafael Freire, Susan J. Hazel, Jane Johnson, Jennifer K.F. Lloyd, Clive J.C. Phillips, Vicky Tzioumis, Paul D. Mcgreevy

Professional Science Research Ethics Collection

Veterinarians are in a strong position of social influence on animal-related issues. Hence, veterinary schools have an opportunity to raise animal health and welfare standards by improving veterinary students’ animal welfare and ethics (AWE) education, including that related to animals used for scientific purposes. A survey of 818 students in the early, mid, and senior stages of their courses at all eight veterinary schools across Australia and New Zealand was undertaken on their first day of practice (or Day One Competences) to explore how veterinary students viewed the importance of their competence in the management of welfare and ethical decision-making …

Salts Of Therapeutic Agents: Chemical, Physicochemical, And Biological Considerations, Deepak Gupta, Deepak Bhatia, Vivek S. Dave, Vijaykumar B. Sutariya, Sheeba Varghese Gupta

Pharmacy Faculty/Staff Publications

The physicochemical and biological properties of active pharmaceutical ingredients (APIs) are greatly affected by their salt forms. The choice of a particular salt formulation is based on numerous factors such as API chemistry, intended dosage form, pharmacokinetics, and pharmacodynamics. The appropriate salt can improve the overall therapeutic and pharmaceutical effects of an API. However, the incorrect salt form can have the opposite effect, and can be quite detrimental for overall drug development. This review summarizes several criteria for choosing the appropriate salt forms, along with the effects of salt forms on the pharmaceutical properties of APIs. In addition to a …

Analyzing The Medical Definition Of Death In Criminal Homicide Prosecution, Mariah Wood

Nursing ETDs

I investigated the use of the medical definition of human death in the criminal justice system and the impact of this definition on the prosecution of criminal homicide. The units of design for this research were two violent crimes cases investigated by the Homicide Unit of the Albuquerque Police Department. Data was collected from officer interviews, case files, Office of the Medical Investigator reports, media and social media.

I identified the themes of pursuit of justice, frustration, and family from the collected data. Key findings include that the medical definition of human death causes confusion and delay in the criminal …

Bowel Preparation Quality Scales For Colonoscopy., David Kastenberg, Gerald Bertiger, Stuart Brogadir

Division of Gastroenterology and Hepatology Faculty Papers

Colorectal cancer (CRC) is the third most common cancer and second leading cause of cancer-related death in the United States. Colonoscopy is widely preferred for CRC screening and is the most commonly used method in the United States. Adequate bowel preparation is essential for successful colonoscopy CRC screening. However, up to one-quarter of colonoscopies are associated with inadequate bowel preparation, which may result in reduced polyp and adenoma detection rates, unsuccessful screens, and an increased likelihood of repeat procedure. In addition, standardized criteria and assessment scales for bowel preparation quality are lacking. While several bowel preparation quality scales are referred …

Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed

Department of Paediatrics and Child Health

Background: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.
Methods: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate …

Immature Auditory Evoked Potentials In Children With Moderate-Severe Developmental Language Disorder., Elaine Yuen Ling Kwok, Marc F Joanisse, Lisa Archibald, Janis Oram Cardy

Health and Rehabilitation Sciences Publications

Purpose: Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities.

Method: AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP-age) from 21 children with DLD. The relation …

Co-Expression Of Cd39 And Cd103 Identifies Tumor-Reactive Cd8 T Cells In Human Solid Tumors., Thomas Duhen, Rebekka Duhen, Ryan Montler, Jake Moses, Tarsem Moudgil, Noel F De Miranda, Cheri P Goodall, Tiffany C Blair, Bernard A Fox, Jason E Mcdermott, Shu-Ching Chang, Gary Grunkemeier, Rom Leidner, Richard Bryan Bell, Andrew D Weinberg

Articles, Abstracts, and Reports

Identifying tumor antigen-specific T cells from cancer patients has important implications for immunotherapy diagnostics and therapeutics. Here, we show that CD103+CD39+ tumor-infiltrating CD8 T cells (CD8 TIL) are enriched for tumor-reactive cells both in primary and metastatic tumors. This CD8 TIL subset is found across six different malignancies and displays an exhausted tissue-resident memory phenotype. CD103+CD39+ CD8 TILs have a distinct T-cell receptor (TCR) repertoire, with T-cell clones expanded in the tumor but present at low frequencies in the periphery. CD103+CD39+ CD8 TILs also efficiently kill autologous tumor cells in a MHC-class I-dependent manner. Finally, higher frequencies of CD103+CD39+ CD8 …

Recurrent Tumor-Specific Regulation Of Alternative Polyadenylation Of Cancer-Related Genes., Zhuyi Xue, René L Warren, Ewan A Gibb, Daniel Macmillan, Johnathan Wong, Readman Chiu, S Austin Hammond, Chen Yang, Ka Ming Nip, Catherine A Ennis, Abigail Hahn, Sheila Reynolds, Inanc Birol

Articles, Abstracts, and Reports

BACKGROUND: Alternative polyadenylation (APA) results in messenger RNA molecules with different 3' untranslated regions (3' UTRs), affecting the molecules' stability, localization, and translation. APA is pervasive and implicated in cancer. Earlier reports on APA focused on 3' UTR length modifications and commonly characterized APA events as 3' UTR shortening or lengthening. However, such characterization oversimplifies the processing of 3' ends of transcripts and fails to adequately describe the various scenarios we observe.

RESULTS: We built a cloud-based targeted de novo transcript assembly and analysis pipeline that incorporates our previously developed cleavage site prediction tool, KLEAT. We applied this pipeline to …

Religiosity/Spirituality And Cancer Risk Assessment For Hereditary Breast And Ovarian Cancer: Latina And Non-Latina Women In New Mexico, Belinda Vicuna Tellez

Psychology ETDs

Introduction: Although cancer risk assessment for high-risk individuals and families can offer life-saving information and options for cancer risk management, Latinas have historically underutilized cancer prevention services. Much needed is a better understanding of what encourages and discourages engagement in cancer risk assessment services among Latino populations. Religiosity/spirituality is potentially relevant to such engagement given religion has often been a central coping resource for Latina cancer survivors.

Aim: This study explored the potential impact of religiosity/spirituality and psychological processes on how Latinas and non-Latinas approach decisions regarding preventative health behaviors.

Methods: As a small subset of a larger research project, …

Hemostatic Nanoparticles Increase Survival, Mitigate Neuropathology And Alleviate Anxiety In A Rodent Blast Trauma Model, W. Brad Hubbard, Margaret Lashof-Sullivan, Shaylen Greenberg, Carly Norris, Joseph Eck, Erin Lavik, Pamela Vandevord

Spinal Cord and Brain Injury Research Center Faculty Publications

Explosions account for 79% of combat related injuries and often lead to polytrauma, a majority of which include blast-induced traumatic brain injuries (bTBI). These injuries lead to internal bleeding in multiple organs and, in the case of bTBI, long term neurological deficits. Currently, there are no treatments for internal bleeding beyond fluid resuscitation and surgery. There is also a dearth of treatments for TBI. We have developed a novel approach using hemostatic nanoparticles that encapsulate an anti-inflammatory, dexamethasone, to stop the bleeding and reduce inflammation after injury. We hypothesize that this will improve not only survival but long term functional …

An Investigation Of The Order Of Applying An Emollient With A Topical Steroid In The Treatment Of Atopic Dermatitis, Andrea Conner, Ashlee Tietje

Journal of the South Carolina Academy of Science

In 2007, the prevalence of Atopic Dermatitis had increased two to three-fold within the last three decades and affected 15-20% of young children (Buys, 2007). Current treatment includes the use of both steroid and emollient creams. Current suggestions for the order of application are contradictory. This study aims to examine the role of the order of application of treatments for Atopic Dermatitis (AD). Hairless mice (SKH-1) were induced to a mild AD flare-up using 2,4-dinitrochlorobenzene (DNCB) and treated with either 1% hydrocortisone (Maximum Strength Cortizone 10 cream) alone, 1% hydrocortisone followed by Cetaphil (emollient), or Cetaphil followed by 1% hydrocortisone. …

Investigating The Lytic Staphylococcus Aureus Bacteriophage Reservoir Amongst A South Carolina University Population: Discovery, Characterization, And Identification Of A Potential Bacteriophage Treatment For Methicillin-Resistant Staphylococcus Aureus, Lisa Pieterse, Amy Powers, Derek Pride, Lisha Van Onselen, Giovanna E. Leone, Paul E. Richardson

Journal of the South Carolina Academy of Science

Bacteriophages are viruses that only infect bacterial cells and can be used to treat antibiotic resistant bacterial infections. This study focused on the isolation and characterization of bacteriophages lytic to Staphylococcus aureus at Coastal Carolina University (CCU) in Conway, South Carolina, as a means to isolate bacteriophages that can potentially be used to treat methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant S. aureus variant. From 2014 to 2018, collection of ear and nose samples from 225 randomly selected CCU volunteers was conducted. Filter sterilization, amplification, microbial tests, and PCR analyses were performed in order to identify and characterize bacteriophages. Coliphage populations …

Emergency Nurses’ Department Design Recommendations For Improved End-Of-Life Care, Renea L. Beckstrand, Elise M. Corbett, Janelle L. B. Macintosh, Karlen E. (Beth) Luthy, Ryan J. Rasmussen

Faculty Publications

Introduction: Although death is common in emergency departments, there is limited research regarding ED design as an obstacle to end-of-life care. This study identifies emergency nurses’ recommendations regarding ways designs have negative or positive impact on care for dying patients and their families.

Methods: A 25-item questionnaire was sent to a national random sample of 500 emergency nurses. Inclusion criteria were nurses who could read English, worked in emergency departments, and had cared for at least 1 patient at the end of life (EOL). Responses were individually reviewed and coded.

Results: Major obstacles included (1) issues related to limited space, …

Laterality In The Power Five And Group Of Five Conferences In Women's College Softball, Jon C. Nachtigal

Health, Exercise, and Sports Sciences ETDs

Females in sport are under-represented in data and analysis when compared to their male counterparts. This disparity also applies to women’s softball in comparison to men’s baseball. To help fill this gap, this study evaluated the extent and impact of laterality in women’s college softball’s Power Five and Group of Five conferences from 2015-2017.

This study focused on the extent of a left-sided lateral preference in women’s college softball, possible interactions between throwing hand and batting preference, to what extent the platoon effect exists in the sport, and the extent of positional bias in the sport. As one of the …

Dental Hygienists' Knowledge Of Medical Marijuana: A Survey, Lizbeth Hinojos

Dental Hygiene ETDs

Cannabis consumption is at an all-time high in the United States. Due to its fast growth in the medical industry and the lack of FDA approval, research is very limited. Dental hygienists’ will likely encounter a patient under the influence of this substance in the dental office. To provide the best quality of care, the dental hygienist must be aware of the oral implications, side effects and necessary modifications to treatment. Therefore, dental hygiene providers must be knowledgeable on medical marijuana to have discussions with patients when needed. Due to scarce research on the topic it makes it difficult to …

Doxorubicin-Induced Elevated Oxidative Stress And Neurochemical Alterations In Brain And Cognitive Decline: Protection By Mesna And Insights Into Mechanisms Of Chemotherapy-Induced Cognitive Impairment ("Chemobrain"), Jeriel T. R. Keeney, Xiaojia Ren, Govind Warrier, Teresa Noel, David K. Powell, Jennifer M. Brelsfoard, Rukhsana Sultana, Kathryn E. Saatman, Daret K. St. Clair, D. Allan Butterfield

Chemistry Faculty Publications

Chemotherapy-induced cognitive impairment (CICI) is now widely recognized as a real and too common complication of cancer chemotherapy experienced by an ever-growing number of cancer survivors. Previously, we reported that doxorubicin (Dox), a prototypical reactive oxygen species (ROS)-producing anti-cancer drug, results in oxidation of plasma proteins, including apolipoprotein A-I (ApoA-I) leading to tumor necrosis factor-alpha (TNF-α)-mediated oxidative stress in plasma and brain. We also reported that co-administration of the antioxidant drug, 2-mercaptoethane sulfonate sodium (MESNA), prevents Dox-induced protein oxidation and subsequent TNF-α elevation in plasma. In this study, we measured oxidative stress in both brain and plasma of Dox-treated mice …

Coupling Of Smoothened To Inhibitory G Proteins Reduces Voltage-Gated K, Lan Cheng, Moza Al-Owais, Manuel Covarrubias, Walter J. Koch, David R. Manning, Chris Peers, Natalia A Riobo-Del Galdo

Department of Biochemistry and Molecular Biology Faculty Papers

SMO (Smoothened), the central transducer of Hedgehog signaling, is coupled to heterotrimeric G_i proteins in many cell types, including cardiomyocytes. In this study, we report that activation of SMO with SHH (Sonic Hedgehog) or a small agonist, purmorphamine, rapidly causes a prolongation of the action potential duration that is sensitive to a SMO inhibitor. In contrast, neither of the SMO agonists prolonged the action potential in cardiomyocytes from transgenic G_iCT/TTA mice, in which G_i signaling is impaired, suggesting that the effect of SMO is mediated by G_i proteins. Investigation of the mechanism underlying the change …

Coronary Slow-Flow Phenomenon As An Underrecognized And Treatable Source Of Chest Pain: Case Series And Literature Review., Chikezie Alvarez, Henry Siu, Md

Department of Medicine Faculty Papers

Background. Coronary slow-flow phenomenon (CSFP) is characterized by delayed distal vessel opacification of contrast, in the absence of significant epicardial coronary stenosis. CSFP has been reported as a cause of chest pain and abnormal noninvasive ischemic tests and is often underrecognized. Material and Methods. Charts and angiographic records from our institution were reviewed to identify 15 consecutive patients who were diagnosed with CSFP from January 2016 to January 2017. Results. Of the 15 patients (4 females and 11 males) studied, the mean age was 59.1 years (range = 45-86 years); all had left ventricular ejection fraction >45% …

Telehealth And Diabetes Self- Management Education And Support For Improving Health Outcomes In Adults With Type 2 Diabetes: An Integrative Review, Monica Allen

Doctoral Dissertations and Scholarly Projects

With the increasing problem of access to health care, telehealth is an evidence-based service that uses a variety of technologies to provide quality healthcare. The use of telehealth services improves self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus after adults receive Diabetes Self-Management Education and Support (DSMES). Type 2 diabetes is the most common form of diabetes. If not self-managed, adults with type 2 diabetes are at increased risk of complications, which can be serious, costly and deadly. This integrative review provides an appraisal of the evidence published regarding the use of telehealth for the management …

Optimizing The Involvement Of Women With Opioid Use Disorder In The Care Of Their Infants Experiencing Neonatal Abstinence Syndrome, Rebecca Boedeker

Dissertations

The incidence of opioid use disorder (OUD) has grown to epidemic proportions. Infants exposed to opioids inutero are likely to experience withdrawal symptoms during the hours and days immediately following birth, known as Neonatal Abstinence Syndrome (NAS). Research indicates maximizing non-pharmacologic, supportive management decreases Neonatal Intensive Care Unit (NICU) admissions, the length of stay, and the severity of NAS. The purpose of this project is to evaluate the effects of an antepartum consult designed to prepare mothers with OUD to participate in this nonpharmacologic care. The Women and Infants Substance Help (WISH) Center delivers prenatal care for women with OUD. …

Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman

Dissertations

Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.

Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the same …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …