Medicine and Health Sciences Commons^™

A Systematic Review: Light Therapy For Individuals With Dementia And Implications For Practice, E. Goodman, Ots, A. Milione, Ots, C. Mikus, Ots, E. Jacobs, Ms, Ots, A. Torres, Ots, V. Vu, Ots, L. Kaiser, Otd, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review seeks to answer the question: is light therapy an effective intervention for sundowning symptoms experienced by individuals who have dementia?

Optimizing Clinical And Cost Outcomes For Patients On Enteral Nutrition Support For Treatment Of Exocrine Pancreatic Insufficiency: Proceedings From An Expert Advisory Board Meeting, Joseph I. Boullata, Janice L. Clarke, Archie Stone, Alexis Skoufalos, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Guidebook To Eastern Medicine, Jessica Wyn

Honors Projects

A practical guide to Eastern Medicine, aimed at a Western clinican. This guide covers diagnostics, herbalism, acupuncture and long-term practices. Each section aims to cover not only the practical portions of how these medical interventions are practiced, but also the relevant scientific data on their effectiveness and clinical applications.

Clinical Accuracy Of The Nidek Ark-1 Autorefractor, Nabin Paudel, Sameep Adhikari, Ajit Thakur, Bhairaja Shrestha, James Loughman

Articles

Autorefractors are commonly used by eye care practitioners worldwide as a starting point for clinical prescribing and by researchers as an instrument to study development of refractive errors and accommodation. This study demonstrates that the Nidek ARK-1 provides a reasonable and repeatable estimate of refractive error.

The Endocannabinoid System In Migraine: From Bench To Pharmacy And Back., Cristina Tassorelli, Rosaria Greco, Stephen D. Silberstein

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Migraine is a common, highly disabling disorder. Its treatment involves acute and preventive therapy. Many of available preventive medications are not well tolerated, which results in poor compliance and limited effectiveness. Cannabinoids have been proposed for the treatment of migraine but their efficacy and tolerability are controversial.

RECENT FINDINGS: Cannabinoids modulate functions and activity of signaling pathways that have a key role in pain control. Growing preclinical evidence and initial clinical findings suggest that modulation of the endocannabinoid system, via endogenous or exogenous cannabinoids may be relevant for migraine via multiple mechanisms.

SUMMARY: The endocannabinoid system qualifies …

Prior Authorizations And Continued Treatment In Addiction Medicine, Wendy Hunting

Doctoral Projects

Introduction: Patients that require medication assisted treatment for opioid addiction can have their treatment delayed through the prior authorization process. A prior authorization is required by many insurance companies and can cause lengthy delays before the drug is approved. The two drugs that were considered for this project were Suboxone® (buprenorphine/naloxone) and Sublocade® (buprenorphine). These drugs are used for the treatment of opiate addiction. The proposed solution to the problem was to use quality improvement methods to implement a tracking and tickler system to improve the approval time from the insurance company.

Objectives: The project goal was to decrease the …

Testing An Implementation Strategy Bundle On Adoption And Sustainability Of Evidence To Optimize Physical Function In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver: A Multi-Site Pragmatic Hybrid Type Iii Protocol, Sandra L. Spoelstra, Monica Schueller, Alla Sikorskii

Open Access Publishing Support Funded Articles

Background: In partnership with a state Medicaid home and community-based waiver program, this study tests implementation strategies for adoption and sustainability of an evidence-based intervention to support disabled and older adults who have difficulty with physical function and daily living tasks. A multi-level implementation strategy bundle will be directed at relationship, coalition, and team building; readiness to implement, leadership, and clinician attitude toward evidence assessments; intervention and facilitation training; interdisciplinary coordination; facilitation; and audit and feedback to support practice change.

Methods: Knowledge-to-Action model underpins this 2-arm, 3-year pragmatic mixed method randomized hybrid type III trial in 18 waiver program sites …

Protective Effects Of Novel Derivatives Of Vitamin D3 And Lumisterol Against Uvb-Induced Damage In Human Keratinocytes Involve Activation Of Nrf2 And P53 Defense Mechanisms, Anyamanee Chaiprasongsuk, Zorica Janjetovic, Tae-Kang Kim, Stuart G. Jarrett, John A. D'Orazio, Michael F. Holick, Edith K. Y. Tang, Robert C. Tuckey, Uraiwan Panich, Wei Li, Andrzej T. Slominski

Toxicology and Cancer Biology Faculty Publications

We tested whether novel CYP11A1-derived vitamin D₃- and lumisterol-hydroxyderivatives, including 1,25(OH)₂D₃, 20(OH)D₃, 1,20(OH)₂D₃, 20,23(OH)₂D₃, 1,20,23(OH)₃D₃, lumisterol, 20(OH)L₃, 22(OH)L₃, 20,22(OH)₂L₃, and 24(OH)L₃, can protect against UVB-induced damage in human epidermal keratinocytes. Cells were treated with above compounds for 24 h, then subjected to UVB irradiation at UVB doses of 25, 50, 75, or 200 mJ/cm², and then examined for oxidant formation, proliferation, DNA damage, and the expression of genes …

Performance Of The Promis In Patients Undergoing 3 Common Elbow Procedures, Edward O. Rojas, Natalie Glass, Jessell Owens, Chris A. Anthony, Matthew Bollier, Brian R. Wolf, Carolyn Hettrich

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Ulnar collateral ligament (UCL) reconstruction, distal biceps tendon repair, and elbow arthroscopic surgery are common elbow procedures performed in active patients.

Hypothesis: We hypothesized (1) good to excellent correlation between Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and traditional orthopaedic upper extremity patient-reported outcome (PRO) measures; (2) that PROMIS instruments would demonstrate ceiling effects; and (3) that the PROMIS physical function computer adaptive test (PF CAT) would demonstrate a low question burden compared with other PRO instruments.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: A total of 76 patients undergoing UCL repair/reconstruction, distal biceps tendon repair, …

Aseptic Loosening Of An Aptis Distal Radioulnar Joint Arthroplasty – Case Report, Karis Bennett, Srinath Kamineni

Orthopaedic Surgery and Sports Medicine Faculty Publications

Dysfunction of the distal radioulnar joint can cause significant pain and instability. The self-stabilizing APTIS distal radioulnar joint prosthesis is used as a solution for severe distal radioulnar joint pathologies. We present a case of a 60-year-old male, who received an APTIS distal radioulnar joint prosthesis which resulted in aseptic loosening within five years of the initial implantation. Infection, incorrect implantation, demographic differences and over-activity were all excluded as the source; therefore, mechanical aseptic loosening was concluded. Ultimately, two surgeries were required to resolve the patient's pain, which resulted in a one-bone forearm once the implant was extracted. The solution …

Initial Management Of Meningiomas: Analysis Of The National Cancer Database, Catherine R. Garcia, Stacey A. Slone, Monica Chau, Janna H. Neltner, Thomas A. Pittman, John L. Villano

Neurology Faculty Publications

BACKGROUND: Meningiomas are the most common central nervous system tumor. We describe current trends in treatment and survival using the largest cancer dataset in the United States.

METHODS: We analyzed the National Cancer Database from 2004 to 2014, for all patients with diagnosis of meningioma.

RESULTS: 201,765 cases were analyzed. Patients were most commonly White (81.9%) females (73.2%) with a median age of 64 years. Fifty percent of patients were diagnosed by imaging. Patients were reported as grade I (24.9%), grade II (5.0%), grade III (0.7%), or unknown WHO grade (69.4%). Patients diagnosed by imaging were older, received treatment in …

Unm Department Of Orthopaedic Surgery Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Evaluating The Epidemiology And Management Of Bovine Congestive Heart Failure, Adam Bassett

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

A form of congestive heart failure is increasingly reported as a cause of death in feedlot cattle located at moderate altitude (≤ 1,524 m.). Significant knowledge gaps exist in the epidemiology and management of this form of bovine congestive heart failure (BCHF) regarding frequency and timing of BCHF cases and ways in which beef cattle producers and veterinarians can mitigate this condition. These knowledge gaps present major barriers to understanding the mechanism of BCHF and mitigating the consequences of BCHF. The purpose of this thesis is to summarize current knowledge about BCHF, define gaps in knowledge for which more research …

Commencement Program 2019, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2019 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | Criteria for Institutional Awards—Loma Linda University and Loma Linda University Health

15 | Loma Linda University Health and Loma Linda University Honorees

34 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 35
• School of Pharmacy, 66
• School of Dentistry, 79
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, …

Zinc Chloride Enhanced Chondrogenesis Is Vegf Dependent, Gilbert M. Sharp Iv

Seton Hall University Dissertations and Theses (ETDs)

Researchers have begun investigating whether insulin mimetics such as ZnCl2 could promote bone healing in both non-diabetic and diabetic fracture healing similarly to insulin. Our research focused on understanding the mechanism by which ZnCl2 affects chondrogenesis, an important component of bone fracture healing. The increases in proteoglycan deposition and cell proliferation seen in our data may be a result of ZnCl2 induction of the IGF-1 pathway. When the VEGF pathway was inhibited in ZnCl2- or insulin-treated cells significant decreases in proteoglycan deposition occurred on day 7 and 14 (P=0.007 for ZnCl2, P=0.028 for insulin) when compared to controls. This data …

Asian Midwifery In 2019, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Examining Clinical Indications For Cesarean Section In A University Hospital In Karachi, Pakistan, Zehra Kanji, Shannon D. Simonovich, Nida Najmi, Jessica Bishop-Royse

Journal of Asian Midwives (JAM)

Background and objectives: Current research reports that Pakistan exceeds the recommended percent of deliveries via cesarean sections, including both emergent and non-emergent. In order to better understand the high rate of cesarean sections in Pakistan we examined the medical and non-medical indications of these surgeries at a private university hospital in Karachi.

Methods: A retrospective analysis of patient medical record data was conducted from January 1st, 2018 to March 31st, 2018. The data collected was analyzed using SPSS 25.

Results: The total number of deliveries during the period was n= 1,211, out of which n=602 (49.70%) were CS. The top …

Electrocardiogram And Cardiac Testing Among Patients In The Emergency Department With Seizure Versus Syncope., Jennifer L. White, Judd E. Hollander, Jesse M. Pines, Peter M. Mullins, Anna Marie Chang

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Cardiogenic syncope can present as a seizure. The distinction between seizure disorder and cardiogenic syncope can only be made if one considers the diagnosis. Our main objective was to identify whether patients presenting with a chief complaint (reason for visit) as seizure or syncope received an electrocardiogram in the emergency department across all age groups.

METHODS: We conducted a secondary analysis of data collected in the 2010 to 2014 National Hospital Ambulatory Medical Care Survey comparing patients presenting with a chief complaint of syncope versus seizure to determine likelihood of getting an evaluation for possible life threatening cardiovascular disease. …

Amniotic Fluid Embolism In The Parturient Patient, Vanessa Pasquariello

Nurse Anesthesia MSNA Student Capstones

An amniotic fluid embolism (AFE) occurs when amniotic fluid enters maternal circulation, causing a physical obstruction or an anaphylactoid reaction, both of which are often detrimental to the parturient patient. This paper reviews a series of studies to examine the incidence, risk factors, presentation, and management of an AFE in the healthcare setting. Diagnosing an AFE remains difficult as a universal diagnostic criterion does not exist (aside from in reported research); thus, its identification is often made when another differential diagnosis fails to manifest. The presentation of the following biomarkers: squamous cell carcinoma antigen, CK13, and CK10/13 can aid in …

Robotic-Assisted Versus Video-Assisted And Open Thoracic Surgery: Outcomes, Advantages, And Costs, Ananth Thitte

Nurse Anesthesia MSNA Student Capstones

Thoracic surgery via video assisted thoracoscopic surgery (VATS) began in the early 1990s, as a minimally invasive alternative to open thoracotomy for performing lobectomies, wedge resections, and segmentectomies. It initially showed improved morbidity and mortality, decreased pain, and decreased length of stay when compared to traditional open thoracotomy (Zhang & Gao, 2015). To its detriment, VATS has a steep learning curve and manipulation of instruments has been described as non-intuitive. The video camera used provides a two-dimensional image, with limited depth perception compared to the naked eye in an open procedure. Due to these shortcomings, and in spite of its …

Vaping And Anesthesia, Wen Wang

Nurse Anesthesia MSNA Student Capstones

Electronic cigarettes (ECs) are a fast-growing class of Electronic Nicotine Delivery Systems (ENDS) which were first put on the market 15 years ago. These devices have been advertised as safer alternatives to conventional cigarettes and a tool for smoking cessation by their manufacturers regardless of inadequate safety data (Kalkhoran, 2016). Since ECs have only been on the market for one and half decades, data on short-term health effects from inhaling EC aerosols are inadequate, and data regarding long-term health effects are very limited. Despite insufficient safety data, the use of ECs has increased exponentially since they were put on the …

An Evaluation Of The Medicinal Plants Of Andros Island, Bahamas, Vivian Pedrozo

Theses and Dissertations

The earliest civilizations have been using plants as their foundation for healing and medicinal traditions for thousands of years. The use of plant medicinals, more commonly known as “bush medicine” on Andros Island, has been rapidly decreasing due an increased presence of western medicine and increased population pressures from urbanization that are threatening local biodiversity hotspots. Ethnobotany is not only important from a conservation standpoint but is also used to preserve traditional knowledge of herbal medicinals and applications, the people of Andros continue to rely on bush medicine, mainly in the form of teas to help manage health related problems. …

Acute Myocardial Infarction Triggered By Influenza: Role Of Vaccine In Its Prevention, Nischit Baral, Suman Sharma, Subash Ghimire, Sanjay Poudel, Savyata Hamal, Nisha Baral, Niranjan Nayak

Manipal Journal of Medical Sciences

Influenza is a major cause of hospitalization in all age groups. Cardiovascular complications due to influenza are important causes of morbidity and mortality in the US, especially in the elderly population (aged more than 65 years). Acute Myocardial Infarction (AMI) is the most serious among the cardiovascular causes of mortality following the attack of influenza, mainly in patients with various co-morbidities like pre-existing coronary artery disease (CAD), diabetes mellitus (DM), hypertension (HTN) and heart failure (HF). We have reviewed the association between influenza virus infection and AMI and extrapolated the beneficial effects of influenza vaccine in preventing AMI and its …

Prevalence Of Multidrug Resistant Tuberculosis: A Comparative Policy Analysis, Ansuman Swain

Manipal Journal of Medical Sciences

Tuberculosis (TB) remains a significant health issue in the Southeast Asian region with Multidrug resistant TB, increasingly becoming a public health problem in India and Bangladesh. Recognizing the threat, the countries developed the National Strategic Plan for Tuberculosis control (NSP 2012-17) and the National Strategic Plan for TB control (NSP 2011-15) respectively. This analyses the national policies of both the nations using the Health Policy Triangle framework by Kent and Bues. The framework consists of the Content, the Policy process, the Contextual factors and the involved Actors and stakeholders. It is followed by a comparison of the two national policies …

Sino-Orbital Fungal Granuloma: A Diagnostic Dilemma, Henry Seow, Rohit Singh, Dipak Ranjan Nayak, Manali Hazarika

Manipal Journal of Medical Sciences

Fungal granuloma of the sino-orbital region is uncommon. Although imaging modalities like CECT and MRI scans are usually helpful, a pre-operative diagnosis may still be difficult because of subtle overlapping clinical features and a rather indolent disease course. Due to the anatomical relations of the orbit, FNAC is generally difficult and has a high incidence of complications and false-negative results. We report a case of a middle-aged woman, who presented with a painless, progressive swelling below her right eyebrow with difficulty in looking upwards and to the right. Initial diagnoses of orbital dermoid cyst and frontal sinus mucocoele were made …

Comparative Health Policy Analysis: National Blood Policy Of India, 2007 And National Blood Policy Of Bhutan,2007, Parul Malik

Manipal Journal of Medical Sciences

In 2001, blood safety was identified by the World Health Organization (WHO) as one of its key priority areas. In the same year, member countries of the South-East Asia Region (SEAR) formulated a Global blood safety strategy at a regional consultation. India and Bhutan, two developing nations in the SEAR formulated their National Blood Policies in the coming years to promote blood safety by improving the availability and quality of blood. This article uses the health policy triangle given by Walt and Gibson and the question four of the ‘What’s the problem represented to be?’ approach given by Carol Bacchi …

Kala-Azar Elimination In India-Where Do We Stand, Nupur Roy

Manipal Journal of Medical Sciences

No abstract provided.

Special Considerations For Clinical Trials In Fibrodysplasia Ossificans Progressiva (Fop)., Edward C Hsiao, Maja Di Rocco, Amanda Cali, Michael Zasloff, Mona Al Mukaddam, Robert J Pignolo, Zvi Grunwald, Coen Netelenbos, Richard Keen, Genevieve Baujat, Matthew A Brown, Tae-Joon Cho, Carmen De Cunto, Patricia Delai, Nobuhiko Haga, Rolf Morhart, Christiaan Scott, Keqin Zhang, Robert J Diecidue, Clive S Friedman, Fredrick S Kaplan, Elisabeth M W Eekhoff

Department of Anesthesiology Faculty Papers

Clinical trials for orphan diseases are critical for developing effective therapies. One such condition, fibrodysplasia ossificans progressiva (FOP; MIM#135100), is characterized by progressive heterotopic ossification (HO) that leads to severe disability. Individuals with FOP are extremely sensitive to even minor traumatic events. There has been substantial recent interest in clinical trials for novel and urgently-needed treatments for FOP. The International Clinical Council on FOP (ICC) was established in 2016 to provide consolidated and coordinated advice on the best practices for clinical care and clinical research for individuals who suffer from FOP. The Clinical Trials Committee of the ICC developed a …

Urdu Translation And Validation Of The Urogenital Distress Inventory (Udi-6) In Women With Urinary Incontinence, Nuzhat Faruqui, Novera G. Chughtai, Jamil Ahmed

Section of Urology

Objective: To provide an Urdu translation of the six-item version of the Urogenital Distress Inventory (UDI-6) and its validation in patients with urinary incontinence (UI), as the UDI-6 is a recognised, useful disease-specific questionnaire for the evaluation of UI in women.
Patients and Methods: We used a multi-step linguistic translation of the UDI-6, which comprised backward and forward translations coordinated by clinical investigators, followed by a pre-test in 10 patients. The final version was completed by a larger sample of women (n = 200), of which 100 had UI for the last 3 months and 100 had no UI. …

Negative Appendectomy Rate And Associated Factors In Urban Referral Hospitals In Tanzania, Masawa Klint Nyamuryekung’E

Master of Medicine in General Surgery

Background: Acute appendicitis is a common surgical emergency. In atypical presentation, making a clinical diagnosis is difficult leading to delays with high perforation rate or misdiagnoses and high negative appendectomy rates. In the urban referral hospitals in Tanzania the baseline perforation rate, negative appendectomy rate, and factors that drive it are unknown. These could serve as measures of performance, and as evaluation parameters of future interventions aimed at improving acute appendicitis case management in Tanzania. Objectives: The aim of this study was to establish the negative appendectomy rate and associated factors among patients undergoing emergency appendectomy for suspected acute appendicitis …