Medicine and Health Sciences Commons^™

Mandatory Review Of A Prescription Drug Monitoring Program And Impact On Opioid And Benzodiazepine Dispensing, Erin L. Winstanley, Yifan Zhang, Rebecca Mashni, Sydney Schnee, Jonathan Penm, Jill Boone, Cameron Mcnamee, Neil J. Mackinnon

Clinical and Translational Science Institute

Background—The purpose of this study is to determine whether Ohio House Bill 341, which mandated the use of Ohio’s Prescription Drug Monitoring Program (PDMP), was an effective regulatory strategy to reduce opioid and benzodiazepine dispensing. Method—Secondary analysis of Ohio’s PDMP data on prescription opioids and benzodiazepines dispensed from November 2014 to March 2017. An interrupted time series analysis was conducted to determine if there was a significant change in the quantity of opioids and benzodiazepines dispensed. Results—After HB341 became effective in April 2015, there was a statistically significant decrease in the monthly quantity (number of pills) opioids and benzodiazepines dispensed …

Atypical Presentation Of Obstructed Hemivagina And Ipsilateral Renal Anomaly, Christopher Grant, Christopher E. Bayne, N. Kern, Craig A. Peters

Urology Faculty Publications

Herlyn-Werner-Wunderlich Syndrome, otherwise known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), is a rare Müllerian anomalyconsisting of uterine didelphys, hemivaginal septum, and ipsilateral renal agenesis. Patients often present at the onset of menarche with abdominal pain and a pelvic mass from an obstructed hemivagina. We report a child who presented with a febrile urinary tract infection and upon further workup was found to have OHVIRA.

Promoting The Health Of Individuals With Intellectual And/Or Developmental Disabilities Through Community Gardening, Stephanie Brown

Department of Advanced Practice Nursing

No abstract provided.

Test Performance And Test-Retest Reliability Of The Vestibular/Ocular Motor Screening And King-Devick Test In Adolescent Athletes During A Competitive Sport Season, Phillip R. Worts, Philip Schatz, Scott O. Burkhart

Faculty Publications - Doctor of Psychology (PsyD) Program

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Bacterial Vaginosis, Shreya Patel

Nursing Student Class Projects (Formerly MSN)

Bacterial vaginosis (BV) is a dysbiosis, or a microbial imbalance in the normal vaginal flora. Anaerobic pathogenic bacteria, particularly Gardnerella vaginalis, outgrow the normal, protective lactobacilli leading to symptoms of abnormal vaginal discharge and malodor. BV affects 21 million women in the United States alone. It is the most common vaginal disorder in women ages 15 to 44 years. Serious complications from BV include preterm labor, pelvic inflammatory disease and increased risk of acquiring sexually transmitted infections (STIs), including HIV. The advanced practice nurse (APN) should have significant understanding of this disorder since it is so prevalent and recurring among …

Multiple Myeloma, Anne Doup

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Comprehending Angioedema: Ace-Inhibitor Reaction, Joseph Runyan

Nursing Student Class Projects (Formerly MSN)

The following will discuss the implications of ACE-Inhibitor induced angioedema in relation to advanced nursing practice. The poster will first introduce a brief overview of what angioedema is and how it affects the patient. Along with an overview of ACE-Inhibitor usage and related effect interaction with bradykinin. The poster proceeds with discussion on signs and symptoms and underlying pathophysiology. Then finishes with significance of pathophysiology, treatment, implications of nursing care and concludes with the authors opinion of rapid recognition and treatment.

Osteoarthritis, Melissa Kloeppel

Nursing Student Class Projects (Formerly MSN)

Osteoarthritis (OA) is a slow-progressing inflammatory joint disorder that significantly reduces the quality of life for millions of Americans worldwide. This type of arthritis commonly impacts the weight-bearing joints and pain is often the first symptom experienced. OA is projected to increase both in prevalence and incidence. There are specific risk factors associated with this disease and knowing these risk factors, especially those that are modifiable, are essential in decreasing the likelihood of developing OA. Since there is no real cure for OA, considering the risk factors, knowing the signs and symptoms, becoming aware of the pathophysiology, and understanding what …

Thyroid Storm, Allison Caudill

Nursing Student Class Projects (Formerly MSN)

Thyroid Storm is an extreme form of hyperthyroidism that can lead to death. This poster explores the pathophysiology behind the topic and it’s importance.

Malignant Melanoma, Angie Whitt

Nursing Student Class Projects (Formerly MSN)

Malignant melanoma is a rapidly proliferating, highly metastatic, deadly skin cancer and many people are unaware of the importance of early detection. It is especially crucial for advanced practice nurses to assess the skin of all of their patients, regardless of the primary complaint from the patient. The poster, Malignant Melanoma, describes the significance of the disease process, signs and symptoms, the pathophysiology, treatment, and implications of nursing care for this highly invasive skin cancer. The purpose of this electronic poster is to inform fellow peers and the public about the deadly effects of melanoma, ways to prevent contracting melanoma, …

Melanoma, Christina Pfeifer

Nursing Student Class Projects (Formerly MSN)

The focus of this poster was to obtain information to enhance knowledge and understanding about melanoma. The areas of focus were the presentation of melanoma along with signs and symptoms, risk factors, the underlying pathophysiology, as well as, the significance of the pathology. Implications to nursing care were also reviewed and discussed. The poster shows graphics in relation to the mnemonic “ABCDE” in relation to signs and symptoms presented, as well as, a graphic displaying a genetic link of patients diagnosed with melanoma. The incidence of melanoma was found to be on the rise and therefore it is relevant and …

The Role Of Peanut Allergy In Anaphylaxis, Jessica Schmelzer

Nursing Student Class Projects (Formerly MSN)

The rise of food allergies directly correlates with the increase in anaphylactic reactions. Food allergies currently affect an estimated 15 million Americans or 4% of children and 1% of adults. Anaphylaxis is a life-threatening reaction that is most commonly caused by food allergies. The top 8 allergens in the United States are: peanut, tree nut, milk, egg, wheat, soy, fish, shellfish. Peanut allergies are on the rise in the United States and are commonly a cause of anaphylaxis. Anaphylaxis causes rapid-onset respiratory compromise, skin/mucosal involvement and hypotensive end-organ dysfunction. Symptoms of anaphylaxis are severe and often occur very quickly after …

Pathophysiology Of Celiac Disease, Alexandria Vigil

Nursing Student Class Projects (Formerly MSN)

Celiac disease (CD) affects approximately 3 million Americans and approximately 1% of people worldwide (Cui, Basen, Philipp, Yusin, & Krishnaswamy, 2017). Of the estimated 3 million American’s living with CD, approximately 97% of them are undiagnosed or suffering from symptoms and not receiving proper treatment (The University of Chicago Celiac Disease Center, n.d.). My father-in-law fell into this un-diagnosed category, having had CD and suffering from symptoms for over a year prior to diagnosis. Due to the genetic predisposition for developing this disease, I was interested in further researching this topic as my fiancé and daughter are at a 4%-17% …

Chronic Bronchitis, Conrad Boyer

Nursing Student Class Projects (Formerly MSN)

Chronic Bronchitis is an aspect of the broad disease known as Chronic Obstructive Pulmonary Disease (COPD). It is a widely prevalent disease in the world today and effects 15 million people and is the third leading cause of death. The signs and symptoms of Chronic Bronchitis is very specific, however diagnoses and treatment is different for each patient and can be quite challenging. The pathophysiology underlying Chronic Bronchitis is quite complex with metaplasia changes within the lung parenchyma, increase in mucous from goblet cell hyperplasia and chronic inflammation leading to permanent scarring. The bodies adaptive processes because of Chronic Bronchitis …

Cardiac Tamponade, Madison Stauffer

Nursing Student Class Projects (Formerly MSN)

Cardiac tamponade is a rare but life-threatening condition requiring emergent evacuation of the excess fluid around the heart. The leading cause of cardiac tamponade is iatrogenic complications. Pathophysiology, signs and symptoms, and nursing considerations are further discussed within this poster.

Aspiration Pneumonitis, Meghan Little

Nursing Student Class Projects (Formerly MSN)

Aspiration pneumonitis is currently considered one of the major complications of anesthesia, with aspiration occurring in as many as 1 in every 2-3,000 surgical procedures (Nason, 2015). This process can result in severe postoperative complications, including respiratory failure and death. The purpose of this poster is to explain the presentation and pathophysiology behind aspiration pneumonitis and to explain the advanced practice nurse’s role in the prevention and treatment of it.

Chronic Obstructive Pulmonary Disease: Emphysema, Sherri Cardellino

Nursing Student Class Projects (Formerly MSN)

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. The purpose of this poster is to investigate and transfer knowledge of the pathophysiological concept of emphysema along with the significance of pathophysiology, and implications of nursing. The research also includes the signs and symptoms and treatment options available. Sources used were published between 2013- 2018 in the United States. The poster provides valuable information for providers to be competent when caring for this patient population.

Chronic Inflammatory Demyelinating Polyneuropathy, Katherine Holland

Nursing Student Class Projects (Formerly MSN)

This poster focuses on chronic inflammatory demyelinating polyneuropathy (CIDP) and the complex pathophysiological processes associated with the disorder. CIDP is an autoimmune disease impacting the peripheral nervous system by attacking the myelin sheath that surrounds nerves. Specifically, T lymphocytes use many mechanisms to promote cytotoxic attacks on the myelin sheath. Symptoms present over a period of several months and usually begin with motor weakness. Several treatments are available such as corticosteroids, IVIG, and immunomodulating drugs. However, as many subtypes of CIDP exist, more research is needed to provide patient-specific treatment regimens. An overview of the pathophysiology, signs and symptoms, treatments, …

Amyotrophic Lateral Sclerosis, Amber Stewart

Nursing Student Class Projects (Formerly MSN)

This poster takes an in depth look at Amyotrophic Lateral Sclerosis (ALS). It reviews the commons signs and symptoms of the disease, the different ways it can present, why clinicians should pay closer attention to ALS, and the pathophysiology behind the disease. While exploring the pathophysiology of ALS, the poster also explores spontaneous ALS versus familial ALS and some of the known genetic mutations that occur causing this disease. The poster concludes with a recommendation for implications for nursing practice and a summary of the contents.

Pathophysiology Of Irritable Bowel Syndrome, Sarah Buck Davis

Nursing Student Class Projects (Formerly MSN)

Irritable Bowel Syndrome (IBS) is one of the most common functional gastrointestinal disorders and is one of the most common reasons gastroenterology referrals are placed. IBS causes abdominal pain and is associated with altered bowel habits (Dlugosz, Zakikhany, Acevedo, D'Amato, & Lindberg, 2017, p. 1). While the pathophysiology of IBS is still being explored, it is multifactorial, and recent studies have shown that inflammation and immunological alterations play a role in the development of IBS (Dlugosz et al., 2017, p. 1). IBS causes abdominal pain and discomfort, negatively affects patients’ quality of life, and contributes to increased anxiety and depression. …

Risks For Depression Among Ostomates In South Korea, Seungmi Park, Insun Jang, Phoebe (Yeon) S. Kim

Nursing Faculty Publications

AIM:

This study explored the factors that are associated with the depressive status among older adult ostomates in South Korea.

METHODS:

The study was a secondary analysis of data from a cross-sectional study with 217 ostomates who were aged ≥55 years from September 2, 2013 to October 30, 2013. The general characteristics, daily routines, and depressive status were assessed in order to identify the factors that were contributing to a depressed mood among the older adult ostomates in South Korea. The general characteristics included their sex, age group, educational level, financial status, employment, outing hours, perceived social isolation, leisure activity, …

Vasoplegic Syndrome, Monica Arce

Nursing Student Class Projects (Formerly MSN)

Vasoplegic syndrome is a loss of vasomotor tone and a medical emergency. It is frequently seen in cardiac surgery cases, long OR cases, with use of cardiopulmonary bypass, and in certain septic patients. It has a high morbidity and mortality, and must be recognized early for a positive outcome. Vasoplegia is vaguely defined as a severe hypotension that is nonresponsive to usual treatment, such as fluids, inotropes, or vasopressors. It has a complicated pathophysiology and requires precise and closely monitored treatment. Advanced practice nurses need to be prepared to care for these complex and emergent patients.

Coronary Artery Disease, Christopher Clouse

Nursing Student Class Projects (Formerly MSN)

Coronary Artery Disease (CAD) is one of the leading causes of death in the United States, killing 370,000 people annually (Centers for Disease Control and Prevention, 2017). CAD is an atherosclerotic process, eventually leading to impaired coronary blood flow and oxygen delivery. Atherosclerotic plaques can then rupture, causing vessel blockage, and further complications such as myocardial infarction, heart failure, stroke, and multi-system organ dysfunction. This poster dives into the pathophysiology behind atherosclerosis and CAD and offers treatment suggestions and nursing implications.

Polymorphisms Within Ryr3 Gene Are Associated With Risk And Age At Onset Of Hypertension, Diabetes, And Alzheimer's Disease, Shaoqing Gong, Brenda Bin Su, Hugo Tovar, Chunxiang Mao, Valeria Gonzalez, Ying Liu, Yongke Lu, Ke-Sheng Wang, Chun Xu

Pharmacology, Physiology and Toxicology

Background: Hypertension affects 33% of Americans while type 2 diabetes and Alzheimer's disease (AD) affect 10% of Americans, respectively. Ryanodine receptor 3 gene (RYR3) codes for the RYR which functions to release stored endoplasmic reticulum calcium ions (Ca2+) to increase intracellular Ca2+ concentration. Increasing studies demonstrate that altered levels of intracellular Ca2+ affect cardiac contraction, insulin secretion, and neurodegeneration. In this study, we investigated associations of the RYR3 genetic variants with hypertension, AD, and diabetes.

Methods: Family data sets were used to explore association of RYR3 polymorphisms with risk and age at onset (AAO) of hypertension, diabetes, and AD.

Results: …

Pharyngeal Airway Space Changes In Thai Mandibular Setback Patients, Chavanya Asavalertpalakorn, Thitapa Lelapityamit, Natawan Piriyakulkit, Phonkit Sinpitaksakul, Kevin A. Tompkins, Kanit Dhanesuan

Chulalongkorn University Dental Journal

Background/Objective: The aims of this study were to determine the mean pharyngeal airway space (PAS) area before and after mandibular setback surgery with Bilateral Sagittal Split Ramus Osteotomy (BSSRO) in class III skeletal deformity patients and to identify the correlation between the amount of mandibular setback and PAS change. Materials and Methods: Thirty-two patients who had undergone mandibular setback surgery with BSSRO at the Department of Oral Surgery, Faculty of Dentistry, Chulalongkorn University (Bangkok, Thailand) from January 2010-December 2015 were included in this study. The PAS areas were measured from lateral cephalometric radiographs preoperatively (T0), immediately postoperatively (TPO), 6 months …

Update On Surgical Approach In Accelerating Orthodontic Tooth Movement: A Concise Review, Arthessarat Sirisa-Ard

Chulalongkorn University Dental Journal

The orthodontic treatment is a time-consuming procedure. Fixed orthodontic treatment usually takes 2-3 years, with several regular follow up appointments, depending on various factors such as severity of the malocclusion, treatment planning, and patient compliance. The prolong treatment could increase more complications such as caries and root resorptions. A patient burnout also could happen because of this long term exhausted procedure. Thus, to be able to shorten the orthodontic treatment duration will be highly desirable for both patients and orthodontists. Up to now, several treatment modalities have been reported to accelerate orthodontic tooth movement including biomechanical, biological, physical/mechanical, and surgical …

Efficacy Of Self-Ligating Vs Conventional Fixed Orthodontic Appliance System: An Update, Arthessarat Sirisa-Ard

Chulalongkorn University Dental Journal

The conventional fixed orthodontic appliances have been used to treat number of patients effectively for a long time. However, the popularity of using self-ligating brackets has increased considerably over the last few years. Many advantages of using self-ligating brackets have proposed. These include minimized applied force from the appliance with reduced friction, favorable physiologic tooth movement, less treatment time, longer treatment intervals with fewer appointments, chair time saving, less patient discomfort, improved oral hygiene, etc. However, self-ligating brackets cost higher than conventional appliances. They also have more bulky profile due to their complicated mechanical design and their clip or slide …

Current Perspectives On Ceramic Post And Core Systems, Top Chitkraisorn, Terawat Tosiriwatanapong

Chulalongkorn University Dental Journal

In spite of a large number of in-vitro and in-vivo reports, it is still unclear regarding the ideal restoration of endodontically treated teeth, which requires comprehensive knowledge of dental science, materials science and principles of mechanical engineering, including biomechanics. With the advantage of digital technology, CAD/CAM technology offers high precision restorations with less time consuming and an ability of processing high-strength ceramic such as zirconia, which provides both high esthetics and strength. The review focuses on current knowledge regarding the post and core system, classification of ceramics, CAD/CAM workflow for manufacturing the post and core system and pre-clinical testing of …

Quality Of Life In Patients Prescribed Vitamin B1-6-12 For Treatment Of Sensory Impairment Related-Mandibular Orthognathic Surgery, Kamolratanakul Paksinee, Ruxwongkana Taya, Kraisittisirikul Gun, Trising Worawee, Subbalekha Keskanya

Chulalongkorn University Dental Journal

Background/objective: One of the most common complication in orthognathic surgery is inferior alveolar nerve injury, resulting in sensory impairment that affects patientûs daily life. Many studies reported the potential of vitamin B on nerve regeneration. No clinical study showed the effect of vitamin B1-6-12 on the quality of life. Therefore, we aim to evaluate the effect of vitamin B on oral health related quality of life in post-orthognathic surgical nerve injury. Materials and methods: A prospective, randomized, double blinded trial study were performed in thirty two patients who had undergone mandibular orthognathic surgery with Bilateral Sagittal Split Osteotomy procedure were …

Cancer - The Formidable Opponent, Loma Linda University Health

Scope

Table of Contents:

Features
14 | Mark Reeves on a cancer diagnosis
16 | Genetic testing
17 | Immunotherapy
18 | Psychosocial support
21 | Myths of clinical trials
22 | Treating cancer in children
24 | Hope for stage IV patients
26 | Treating leukemia in the surrounding Hispanic population
28 | Turning off a cell's switching mechanism
29 | Prompting leukemia cells to die
30 | Cancer-fighting foods
32 | Finding answers and treatments with California's cancer database
34 | Mapping cancer screening
36 | History of our proton therapy
37 | Out next step in battling cancer …