Medicine and Health Sciences Commons^™

Delirium Assessment For Acute Ischemic Stroke Patients At Unmc, Haeyoung Baang, T. Scott Diesing, Daniel L. Murman

Graduate Medical Education Research Journal

No abstract provided.

Different Strokes For Different Folks: Trends In Elective Surgery For Diverticular Disease, Rishi Batra, Matt Fuglestad, Brad Hall, Jiangtao Luo, Jennifer Leinick, Sean Lagenfeld

Graduate Medical Education Research Journal

No abstract provided.

Renal Sympathetic Vasomotion Monitoring As A Novel Method For Intraprocedural Feedback For Renal Denervation, Peter Ricci Pellegrino Et Al, Alicia M. Schiller, Han-Jun Wang, Yiannis S. Chatzizisis, Irving H. Zucker

Graduate Medical Education Research Journal

No abstract provided.

Synthetic Resorbable Vs. Cellulose Bandage For Minor Hemorrhage In A Porcine Model, Ujwal R. Yanala, Sandra Noriega, Ruben Spretz, Jorge Ragusa, Luis Nunez, Gustavo Larsen, Mark Carlson

Graduate Medical Education Research Journal

No abstract provided.

A Comparative Analysis Of Survival And Funding Discrepancies In Cancers With High Mortality, Bradley R. Hall, Andrew Cannon, Pranita Atri, Christopher S. Wichman, Lynette M. Smith, Sushil Kumar, Surinder K. Batra, Hongmei Wang, Apart Kishor Ganti, Aaron R. Sasson, Chandrakanth Are

Graduate Medical Education Research Journal

No abstract provided.

The Effects Of Stiff Stent-Grafts On Segmental Aortic Stiffness And Left Ventricular Mass: A Pilot Swine Model Study, Paul Aylward, Alexey Kamenskiy, Jason Mactaggart

Graduate Medical Education Research Journal

No abstract provided.

A Performance Improvement Project In Antibiotic Administration For Open Fractures, Benjamin Ogden, Christopher Deans, Matthew Mormino, Michaela Mccarthy, Elizabeth Lyden, Justin Siebler

Graduate Medical Education Research Journal

No abstract provided.

Virtual Reality (Vr) To Improve The Experience Of The Mohs Patient: A Prospective Interventional Study, Shauna Higgins, Shera Feinstein, Makenzie Hawkins, Myles Cockburn, Ashley Wysong

Graduate Medical Education Research Journal

No abstract provided.

Sarcoidosis Of The Mandibular Condyle: A Rare Disease That Can Mimic Malignancy, Chad Sloan, Ben Lacrosse, Lei Yu, Alexander Braun, Scott Lauer, Timothy Donovan, John Baker, Jason Untrauer

Graduate Medical Education Research Journal

Sarcoidosis can involve any of the organs, however intraosseous involvement is rare and ranges from 5 to 15%, with lesions of the mandible being even rarer – currently with few known cases reported. Intraosseous lesions involving the mandible have been noted to be asymptomatic or associated with chronic jaw pain. Additionally, mandibular involvement can present as a lytic bone lesion mimicking osseous malignancy. Chronic polyarthritis is commonly associated with the progression of sarcoidosis and intraosseous involvement has been considered a late-stage sequelae. We report a case of biopsy-proven sarcoidosis within the mandibular condyle in an asymptomatic 56-year-old Caucasian female who …

A Case Of Parsonage-Turner Syndrome, Steven Embry, T. Jason Meredith

Graduate Medical Education Research Journal

Neuralgic Amyotrophy, also known as Parsonage-Turner Syndrome (PTS), is a clinically diagnosed and largely under-recognized inflammatory disorder which primarily affects the brachial plexus. Correct diagnosis is often delayed and the disease causes significant patient morbidity due to extreme pain, paresis, and often sensory abnormalities of the upper extremity. Although the pathophysiology is not completely understood, it is classically preceded by an identifiable inciting event and complete recovery may take months to years.

An Uncommon Adverse Effect Of A Common Drug-Dress Syndrome-Not Just Skin Deep!, Alamelu Udayappan

Graduate Medical Education Research Journal

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome is a rare, life-threatening hypersensitivity reaction that causes skin exfoliation, hematological abnormalities, lymphadenopathy, and extensive internal organ involvement. Characterized by a long latency period, this unusual side effect of aromatic anti-epileptic drugs, as well as many common drugs cause a mortality rate of up to 10% if left untreated. In the absence of a well-established therapy, primary and secondary prevention have a key role in the management of DRESS Syndrome. Herewith presenting a case of an adolescent girl with rashes and systemic symptoms, the cause of which, on obtaining a detailed …

The Financial Burden Of The Urology Match: Room For Improvement, Jinfeng Jiang, Joshua S. Engelsgjerd, Chad A. Lagrange, Christopher M. Deibert

Graduate Medical Education Research Journal

Abstract

Introduction/ Background – The Urology match remains highly competitive, but there is limited published data on the costs of the application process for contemporary applicants. This study aims to determine the financial burden of the Urological match and the effect it has on applicants.

Methods/ Materials – All applicants to the University of Nebraska Medical Center (UNMC) Urology Residency in the 2019 Urology match were invited to complete an anonymous, IRB approved online survey containing 16 questions on interview travel and costs, financial aid, and debt burden.

Results – Thirty-nine out of 183 (21%) applicants responded to the survey. …

An Overview Of Neurology Residency Training In Epilepsy At The University Of Nebraska Medical Center, Daniel Crespo Artunduaga, Mohamed Taha, Arun Swaminathan

Graduate Medical Education Research Journal

Neurology residency offers a comprehensive training program over 4 years in management of various neurological disorders. Epilepsy represents a common condition managed by neurologists and forms a core curriculum in the training of neurology residents. We conducted an anonymous survey among the trainees at our neurology program to identify knowledge and treatment gaps and help us modify our training regimens to provide high impact and good quality training to our trainees. We conducted a 35-question survey to determine various aspects of our neurology residents’ training to identify and overcome shortfalls. Our program requirements are rigorous and match up with those …

Long Term Outcomes Of Surgical And Clinical Symptoms Following Minimally Invasive Heller Myotomy: A Retrospective Clinical Database Review, Laura E. Flores, Priscila Rodrigues Armijo, Bhavani Pokala, Sarah Samreen, Dmitry Oleynikov

Graduate Medical Education Research Journal

I

Introduction

Minimally invasive Heller myotomy rates have increased, but little evidence is available regarding long term clinical and surgical outcomes. Our aim was to evaluate long term symptom improvement and medication resolution for patients undergoing minimally invasive Heller myotomy.

Methods

A single-institution database was retrospectively reviewed for patients undergoing laparoscopic Heller myotomy (LHM) or robotic Heller myotomy (RHM) during 2007-2018. Patients with primary HM followed by a Dor fundoplication were included. Demographics and surgical data were analyzed. Esophageal symptoms, testing, and medication use were collected preoperatively (pre-op), at 6-month (6-mo), 12-month (12-mo), and long-term (LT; 12-mo+) follow-up. Analysis was …

Necrotizing Enterocolitis Following Gastroschisis Repair: An Update, Rachel K. Schlueter, Shahab F. Abdessalam, Stephen C. Raynor, Robert A. Cusick

Graduate Medical Education Research Journal

Purpose:

Necrotizing enterocolitis (NEC) is a known complication of gastroschisis with an incidence above the expected rate in the neonatal population. While many physicians today are aware of this association, the last publication to explore this association in detail and identify possible risk factors of NEC in gastroschisis patients was published over twenty years ago. From our large database of patients with gastroschisis managed by a single group of pediatric surgeons, we reviewed our experience and the recent literature to update what is known about gastroschisis and NEC.

Methods:

From 2001 to 2017, a gastroschisis registry was maintained. Data from …

Comprehensive Chronic Pain Treatment: Does Smoking Affect Outcomes?, Jamison Hofer, David Cates, Valerie K. Shostrom, Brendan Thelen, Kimberley Haynes-Henson

Graduate Medical Education Research Journal

Abstract

Objective: To determine whether smoking status effects pain and functional outcomes in a chronic pain program.

Methods: A retrospective cohort study of 178 patients treated at the Nebraska Medicine comprehensive Pain Management Program over a five year period was completed. Outcomes measures were the Visual Analog Scale Past Month Average Pain score (VAS-PMA), Multidimensional Pain Inventory pain and interference scales (MPI-P and MPI-I), and the Pain and Impairment Relationship Scale (PAIRS). Patients were categorized by smoking status into non-smoker or current smoker groups. Wilcoxon tests were used to compare the pre scores, post scores, and post-minus-pre scores between smoking …

Perceptions Of Safety And Support Among High School Football Players Utilizing A Helmet Impact Detection System, Chris Snyder, Kailey Snyder, Alyssa Irby, Danae Dinkel, Adam B. Rosen

Graduate Medical Education Research Journal

Background: Concussions are common in high school football athletes and can have short and long-term health impacts. New football helmets furnished with accelerometers to detect rate and location of impact have recently emerged. The use of these helmets offers the ability to rapidly and objectively assess concussions on the sideline. However, minimal research has explored athlete’s perceptions of the use of these helmets. Purpose: The purpose of this study was to determine high school football players’ perceptions of safety and support following a season of use of a Helmet Impact Detection System. Methods: 118 high school football players from a …

A Retrospective Study At Two Level One Trauma Centers On The Association Of Internal Injuries With Femoral Fractures, Ryan E. Miller, Catherine Olinger, Leonid Grossman, Dennis Chakkalakal, Karl Bergmann, Elizabeth Lyden, Justin Siebler

Graduate Medical Education Research Journal

Abstract: Injuries capable of fracturing the femur often involve concurrent internal organ damage. However, up to 25% of injuries are initially missed. Prior studies evaluating the association of femur fractures with internal injury included only automobile trauma, were skewed toward more severe injuries, and were broad database studies. To our knowledge, there are no studies of this kind that include bicycle, motorcycle, and motor vehicle-pedestrian trauma, excluding those deceased at the scene, and which included chart reviews. We hypothesized that in the trauma setting, the presence of a femur fracture would correlate with an increase in concomitant internal organ injuries. …

Orthopaedic In-Training Examination (Oite) Preparation And Study Habits Of Orthopaedic Residents: Revisited, Christopher F. Deans, Emmett J. Gannon, Joseph Morgan, Elizabeth Lyden, Matthew Mormino

Graduate Medical Education Research Journal

Introduction: The Orthopaedic In-Training Examination (OITE) is well-established as the cornerstone for educational evaluation of orthopaedic surgery residents. Great significance has been placed on the OITE, particularly as it has been found to correlate closely with successful completion of the American Board of Orthopaedic Surgery Part I Exam (ABOS I). Our study correlated different aspects of OITE study preparation, including resources and habits, with OITE performance.

Methods: An online survey was created to assess these different aspects and distributed to 163 programs across the United States for distribution to orthopedic residents in each program.

Results: Data analysis showed …

Dr. Ahmed Abdelmoity To Receive Endowed Chair, Children's Mercy Hospital

Our Story Continues

Former Children’s Mercy CEO Rand O’Donnell, PhD, and his wife, Melva, are establishing an endowed chair position that will be awarded to Ahmed Abdelmoity, MD, FAAP, Division Director of Child Neurology, Section Chief of Epilepsy and Neurophysiology. Dr. Abdelmoity will become our 31st endowed chair at Children’s Mercy.

Effects Of Stem Cell Therapy On 6-Minute Walk Test Distance And Left Ventricular Ejection Fraction In Patients With Nonischemic Cardiomyopathy, Kayleigh Hunt, Alexa Maziuk

Physician Assistant Capstones, 2016 to 2019

Objective

To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.

Design

Systematic literature review

Methods

A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.

Results

Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m …

Corticosteroid Vs Platelet Rich Plasma Injections In The Treatment Of Chronic Plantar Fasciitis, Elizabeth J. Meaney, Emma W. Adelman

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the effectiveness of platelet rich plasma (PRP) injections in the treatment of chronic plantar fasciitis compared to traditional corticosteroid injections. Design: Systematic literature review. Methods: A literature search was performed in Pubmed using the search terms “plantar fasciitis” and “platelet rich plasma”. Inclusion criteria included publication within 10 years, randomized control trial, human study, and containing the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scoring system. Results: Our literature search resulted in the review of three randomized- control trials. Mahindra et al. showed that PRP was superior to corticosteroid injections in the treatment of chronic plantar …

Crystalloids Or Colloids… What’S In Your Iv? Determining Fluid Type For Septic Shock Resuscitation, Eleanor L. Jordan, Amy K. Lansing

Physician Assistant Capstones, 2016 to 2019

Objective: To compare the efficacy of crystalloid versus colloid solutions, specifically normal saline versus albumin, in decreasing mortality among patients with septic shock requiring resuscitation fluids in the intensive care unit (ICU) setting. Design: Systematic literature review. Methods: Research was conducted in PubMed and UpToDate, utilizing the search terms sepsis, septic shock, fluid resuscitation, colloids and crystalloids. Specifically, in PubMed, the following limits and terms were used: randomized control trial, human subjects, English, and within the last 7 years. Results: The Annane et al study found no significant difference in colloid fluid resuscitation versus crystalloid fluid resuscitation in the decreasing …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

The Effect Of Yoga On Fatigue In Breast Cancer Patients Undergoing Radiotherapy, Magdalene Bredehoeft, Karli Ribsam

Physician Assistant Capstones, 2016 to 2019

Objective: Assess the effect of yoga on levels of fatigue among women with breast cancer currently undergoing radiotherapy. Design: Systematic literature review. Methods: Searches were done on PubMed, utilizing the terms “yoga,” “fatigue,” “breast cancer,” and “radiotherapy.” Limits that led to inclusion of studies included: published after 2008, studies researching breast cancer, and studies that were randomized controlled trials. Results: Randomized controlled trials studied were by Chandwani et al. (2010), Chandwani et al. (2014), and Vadiraga et al. (2009). Conclusion: Yoga can improve quality of life among women with breast cancer undergoing radiotherapy, specifically by decreasing levels of fatigue. We …

Improving Chronic Hepatitis B Virus Screening At A Safety-Net Primary Care Clinic, Uwaezu J. Umeh

Doctor of Nursing Practice (DNP) Projects

Hepatitis B Virus (HBV) is a type of virus that affects the liver. Chronic hepatitis B is usually asymptomatic and many HBV carriers remain unaware of their viral status, thereby may unknowingly transmit the disease. If left untreated or undetected, it could lead to cirrhosis, hepatocellular carcinoma or mortality. Although this virus is endemic in some parts of the world such as Asia and Africa, it is important to note that HBV has become a global problem. The Centers for Disease Control and Prevention (CDC) in conjunction with the United States Preventive Services Task Force (USPSTF) estimates that about 700,000 …

Effect Of Postpartum Protocols On Maternal Outcomes, Kelsey Grimm, Emily Harnish

Physician Assistant Capstones, 2016 to 2019

Objective: To determine whether postpartum hemorrhage (PPH) protocols lead to decreases in maternal morbidity and mortality.

Design: Systemic literature review.

Methods: The clinical question investigated is whether the implementation of PPH protocols has measurable impact on maternal morbidity and mortality. Searches were done through PubMed using the keywords: “maternal hemorrhage postpartum protocol.” Studies were eliminated if they were more than 10 years old, conducted outside the United States, published in a non-English language, used other animal subjects besides humans, used non-female subjects, if they did not answer the clinical question, or were review articles. Eventually, three cohort …

Chlorhexidine Gluconate Vs Povidone-Iodine In The Prevention Of Clean-Contaminated Surgical Site Infections, Erin Layne, Abigail Stone

Physician Assistant Capstones, 2016 to 2019

Abstract

Background:

A patient’s skin is the major source of pathogens that can cause post-operative complications such as surgical site infections (SSIs). Optimization of pre-operative skin antisepsis is obtained with chlorhexidine gluconate (CG) and povidone-iodine (PI). These two solutions are the most widely used antiseptics for pre-operative purposes.

Objective:

Among surgical patients greater than 18 years of age undergoing clean-contaminated surgery, which antiseptic, iodophors or chlorhexidine gluconate, is more effective at reducing postoperative surgical site infections?

Methods:

A search was done in PubMed utilizing the terms chlorhexidine, infection control, iodophors, and surgical site infection. The limits applied included randomized …

Effects Of Prehospital Vs. In Hospital Therapeutic Hypothermia On Neurological Status After Cardiac Arrest, Cassandra Johnson, Ingrid Brown

Physician Assistant Capstones, 2016 to 2019

Objective: To conduct an analysis of literature that examines whether the use of prehospital therapeutic hypothermia (TH) results in significant changes in neurologic outcomes that are in adults that experienced out of hospital cardiac arrest (OHCA). Methods: Systematic searches were conducted through PubMed at the James Madison University Library. The inclusion criteria included human adults who experienced out of hospital cardiac arrest and were treated by Emergency Medical Services (EMS) with and/or without prehospital TH by means of intravenous cold fluids and surface cooling. Results: Three studies involving 2180 cases were included. This review indicated that prehospital TH after …

Comparing Effectiveness Of Colonoscopy Versus Fecal Immunochemical Testing In Screening For Colorectal Cancer, Hannah Vanrooyen, Lindsay Burns

Physician Assistant Capstones, 2016 to 2019

Introduction: Colorectal cancer (CRC) is deadly neoplasm that takes many lives in the United States and is a leading cause of cancer worldwide. If CRC is detected early through screening, there is a higher chance of remission which makes screening an important tool in CRC prevention. Currently, colonoscopy is the gold standard, but due to the undesirable preparation needed for a colonoscopy, patient compliance is low. Giving patients a screening option that requires less preparation may help to increase the compliance for CRC screening. Fecal Immunological testing has been shown to have higher compliance rates among patients as compared to …