Medicine and Health Sciences Commons^™

Oncology Navigation: Improving The Patient Experience, Rhonda Hjelm

Books, Presentations, Posters, Etc.

No abstract provided.

Renal Considerations In The Oncology Patient, Sridhar K. Reddy

Books, Presentations, Posters, Etc.

No abstract provided.

Khat Use And Psychotic Symptoms In A Rural Khat Growing Population In Kenya: A Household Survey, Linnet Ongeri, Fredrick Kirui, Erastus Muniu, Veronica Manduku, Leah Kirumbi, Lukoye Atwoli, Safari Agure, Peter Wanzala, Lydia Kaduka, Mercy Karimi, Richard Mutisya, Elizabeth Echoka, Joseph Mutai, David Mathu, Charles Mbakaya

Internal Medicine, East Africa

Background:Khat is an amphetamine like psychostimulant chewed by over 10 million people globally. Khat use is thought to increase the risk of psychosis among its chewers. The evidence around this however remains inconclusive stemming from the scanty number of studies in this area and small study sample sizes. We undertook a large household survey to determine the association between psychotic symptoms and khat chewing in a rural khat growing and chewing population in Kenya.

Methods:For this cross-sectional household survey, we randomly selected 831 participants aged 10 years and above residing in the Eastern region of Kenya. We used …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

The Hemoglobin A1c Of African-Americans/Blacks With Diabetes Mellitus Type Two Using Low-Fat Diabetes Plate Diet, Ednah K. Makori

Doctor of Nursing Practice Projects

Diabetes Mellitus type two (DMT2) is a chronic disease that leads to high blood sugar in the body and if not corrected over a period of time, it leads to development of complications. Some of those complications include blindness, kidney failure, and retinopathy, among others. DMT2 continues to affect many people in the USA, especially African-Americans/Black who have the highest prevalence as compared to other races. Proper diet management especially the Low-Fat diabetes diet helps to decrease Hemoglobin A1c, which could result in reduction of risk of developing complications and morbidity related to DMT2. This project was done to educate …

Targeting Sec61Α By Ipomoeassin F Leads To Highly Cytotoxic Effect, Zhijian Hu

Graduate Theses and Dissertations

Ipomoeassin F is a flagship congener of a resin glycoside family that inhibits growth of many tumor cell lines with only single-digital nanomolar IC50 values. However, biological and pharmacological mechanisms of ipomoeassin F have been undefined. To facilitate exploration of the biological and pharmacological properties, we performed sophisticate SAR (Structure–activity relationship) studies of ipomoeassin F to understand its pharmacophore and structure properties so that we can design favorable probes for further biological investigation. By applying appropriate deviates that possess fluorescent groups and similar bio-activity, the target protein was found to be localized in endoplasmic reticulum (ER). Through biotin affinity pull …

New Oral Anticoagulants Versus Warfarin For Cerebral Venous Thrombosis: A Multi-Center, Observational Study, Mohammad Wasay, Maria Khan, Haris Majid Rajput, Salman Farooq, Mohammed Ibrahim Memon, Suhail Abdulla Alrukn, Abdul Malik, Foad Abd-Allah, Raja Farhat Shoaib, Rizwana Shahid, Sadia Nishat, Safia Awan

Section of Neurology

No abstract provided.

A New Health Care Model For Pakistan, Mohammad Wasay, Ashar Malik

Section of Neurology

No abstract provided.

Per- And Polyfluoroalkyl Substances And Bone Mineral Density In Mid-Childhood, Shravanthi M. Seshasayee, Rachel Cluett, Lisa B. Rokoff, Sheryl L. Rifas-Shiman, Diane R. Gold, Brent Coull, Catherine M. Gordon, Clifford J. Rosen, Emily Oken, Sharon K. Sagiv, Abby F. Fleisch

MaineHealth Maine Medical Center

Background:

• Identifying factors that impair bone accrual during childhood is a critical step toward osteoporosis prevention.

• One potential risk factor not well characterized in childhood is the role of chemicals in the environment.

• Perfluoroalkyl substances (PFASs) are synthetic additives used to make clothing, furniture, and cookware stain repellant and are detectable in almost all US adults.

• PFASs act as PPAR-γ agonists,2 androgen receptor antagonists, and directly intercalate into bone, raising the possibility that they may lead to low bone accrual.

• While two population-based studies in adults have shown associations between PFASs and low areal bone …

Health And Quality Of Life Of Children Undergoing Elective Surgery, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Multiple studies have found that poorer health is associated with significantly lower quality of life when comparing children and adults with health conditions such as cancer, diabetes, asthma, and ADHD to their normal healthy counterparts. The relationship between health and quality of life, however, has yet to be examined in children who have undergone elective surgery. More than 5 million children in the U.S. undergo surgery each year. These children are often undergoing surgery for a number of health issues that may impede quality of life. Consequently, this study analyzes the effects of health on the quality of life of …

Measuring Neural Time Series Data In A Sensory Deprivation Tank, Jackson Gregory, Tian Lan, Uri Maoz, Amir Raz

Student Scholar Symposium Abstracts and Posters

We are interested in studying the neurological and physiological effects of the float pod, also known as REST therapy, or sensory deprivation tank. Float pods rely on the concept of depriving most senses (from sound and light to temperature and proprioception) in a pool filled with buoyant salt water at body temperature. While float pods are most commonly used in spa environments, we intend to look at the potential benefits of floating under the empirical lens. In this study, we aim to measure neural activity using electroencephalography (EEG). We intend to look at the different levels of relaxation and the …

Reporting Charcoal Rot In Chia And Developing A Susceptibility Assay, Reis M. Misaka, Hagop S. Atamian Dr., Julien Besnard Dr.

Student Scholar Symposium Abstracts and Posters

Chia (Salvia Hispanica) cross breeds were planted in the summer of 2018 with the intent of selective breeding for agricultural benefit. Preexisting pathogens in the soil caused 40-50% fatality of adult plants. This was surprising due to the precursory knowledge that chia has antibiotic and antifungal oils (Elshafie et. al. 2018); chia was only recently documented to be susceptible to Fusarium wilt (Fusarium oxysporum). The primary pathogen responsible was identified as Macrophomina phaseolina (aka charcoal rot); a widespread soilborne pathogen which has multiple commercial hosts (Su et. al. 2001).

M. phaesolina on wheat seed vector where used as …

Effect Of Tyrosine On The Productivity Of Pc12 Cells By Measuring Extracellular Atp Release, Sabrina Burkholder, Mary Rapmund, David Fogel, Jon Flees

Student Scholar Symposium Abstracts and Posters

Given the challenge to “reverse-engineer the brain”, our group tried to address the problems of a lack of long term focus and attention span. Tyrosine was determined to aid in mental focus and brain productivity as it is a precursor to the neurotransmitter Dopamine. Given that Tyrosine is naturally occurring in the body, it is preferable to add to the body, whereas a substance like Adderall has negative effects, including increased heart rate that, over time, can cause cardiovascular damage. Drawing connections between in increase ATP and an increased ability to focus and perform under stress, extracellular ATP secretion of …

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

Provider Suicide, Amy Quinn

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine the risks factors for, the identification of and repercussions of provider suicide. In this review, databases searched included Pubmed, Cochran Database of Systematic Reviews, PsycInfo, National Institute of Health, Medscape and Google Scholar from September 8, 2018 to January 13, 2019. A variety of key terms were used when searching include suicide, provider suicide, suicide, costs of suicide, physician burnout, physician assistant burnout, nurse burnout, doctor suicide, physician assistant suicide, and nurse practitioner suicide. Works chosen for review were published between 1979 and 2018, as the topic has …

Managing Anxiety With Pharmacogenomic Testing, Ashley Pommer

Physician Assistant Scholarly Project Papers

Anxiety affects approximately three to seven percent of the United States population, and nearly 50% of the diagnosed patients fail to respond to first-line treatment regimens (Boland, Duffy, & Meyer 2018). Traditional first-line treatments include medication therapy, cognitive behavioral therapy (CBT), or the combination of both. With such a high initial failure rate, recent studies indicate promising results in managing anxiety with pharmacogenomic testing. Pharmacogenomic testing is allowing providers to prescribe medication based on individual genetic makeup, focusing on how each patient metabolizes certain medications. The purpose of this literature review was to determine if first-line methods or pharmacogenomic testing …

Expedited Partner Therapy Using Oral Cefixime And Oral Azithromycin For Gonorrheal And Chlamydial Infections Among Adult Outpatients In The United States, Nicholas Coburn-Pierce

Physician Assistant Scholarly Project Papers

Sexually transmitted infections (STI) such as Neisseria Gonorrhoeae and Chlamydia Trachomatis pose a challenge to the healthcare system worldwide. Treating sexual partners is as crucial to controlling the spread of these infections as treating index patients. However, because of problems associated with stigma, reaching affected populations, and ensuring follow-up, unique solutions are require to ensure partners receive treatment. One solution is Expedited Partner Therapy (EPT). EPT refers to treating patients, and providing necessary medication for both patient and partner. Current recommendations are for oral doses one gram of azithromycin and 400 milligrams of cefixime. This literature review looked at thirteen …

Can Early Intervention With Group Therapy Or Individual Therapy Improve The Family Dynamic In Ptsd Patients?, Killian Norton

Physician Assistant Scholarly Project Papers

Post-Traumatic Stress Disorder (PTSD) is a mental health disorder that affects an individual directly, while also affecting their family members around them. While PTSD is not directly correlated to the development of Secondary Stress Disorder (STS), PTSD has been shown to lead to increased rates of divorce and mood disorders in children whose parents are diagnosed with PTSD. Children who have grown up with divorced parents, or parents with PTSD, have been shown to have an increased chances of developing mood disorders and risky lifestyle behaviors. The combination of having a parent with PTSD who are also divorced, would likely …

Is A Varicocelectomy Beneficial In The Era Of Assisted Reproductive Technologies?, Chukwuka Oscar Nnoli

Physician Assistant Scholarly Project Papers

Clinical varicoceles are the most frequent physical finding associated with infertile men and impaired semen parameters. There is evidence that suggests varicocele repair improves semen parameter and increases the chances of natural pregnancy. Today, varicocele repair is often combined with assisted reproductive techniques (ART) such as intrauterine insemination (IUI), in Vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). In this literature review, data examining whether varicocelectomy before ART leads to improved pregnancy outcomes is reviewed. Current data suggest that there is a significant clinical benefit when correcting a varicocele in oligospermic men before IVF/ICSI. Similarly, men with non-obstructive azoospermia also …

Comparing Rates Of Macrosomia And Neonatal Hypoglycemia Of Differing Treatment Modalities Of Gestational Diabetes Mellitus, Ashleigh Milbrath

Physician Assistant Scholarly Project Papers

Gestational diabetes mellitus (GDM) is a known potential complication that can occur during pregnancy. Unmanaged GDM can result in maternal hyperglycemia, which can cause increased neonatal complications, two of which are macrosomia and neonatal hypoglycemia. To prevent maternal hyperglycemia, treatment of GDM typically begins with dietary changes, home glucose monitoring, increased exercise patterns and other lifestyle modifications. However, if maternal hyperglycemia persists after two weeks of maternal lifestyle modifications, there are not current best practice guidelines established for the treatment of GDM. Historically, subcutaneous multiple daily dosed insulin (MDI) has been the gold standard for treatment after lifestyle modification. However, …

Glucagon-Like Peptide-1s Compared To Sulfonylureas In The Treatment Of Adults Diagnosed With Type Ii Diabetes Mellintus In Primary Care, Tracy Kirchner

Physician Assistant Scholarly Project Papers

Type II diabetes mellitus (T2DM) is a prevalent disease in our country. Bullard et al. (2018) report approximately 21 million adults have T2DM in the United States. “The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity” (Yang et al., 2018). Treatment of T2DM is individualized to each patient based on their co-morbidities, fiscal responsibility, and route of administration options. Sulfonylureas and Glucagon-like Peptide-1s (GLP-1) are two classes of antidiabetic drugs that are available for use as second line treatment options after metformin. This review …

Pharmacotherapy For Impulsivity-Hyperactivity Behaviors In Autism Spectrum Disorder, Jenna Katnis

Physician Assistant Scholarly Project Papers

The incidence of Autism Spectrum Disorder (ASD) in 8-year old children is 1 in 59. This increased from approximately 1 in 150 reported in 2000-2002 (Baio et al., 2014). Autism includes deficits in social emotional reciprocity, non-verbal communication for social interactions, developing and maintaining relationships and in some cases, hyperactivity response to sensory input. Hyperactivity is a shared behavior with ASD and Attention Deficit Hyperactivity Disorder (ADHD). Medications such as Methylphenidate (MPH) and α 2-a adrenergic receptor agonists are used to modify hyperactivity behavior in ADHD and thus have been used as management in ASD. A review of literature was …

Outcomes In Treatment Of Major Depressive Disorder: Pharmacogenomic Testing Vs. Treatment As Usual, Zachary Horoshak

Physician Assistant Scholarly Project Papers

The goal of this systematic literature review is to evaluate the efficacy and cost effectiveness of pharmacogenomic testing (PGx) versus treatment as usual (TAU) in the treatment of major depressive disorder (MDD). According to Huang & Lin (2015), MDD is characterized by multiple signs and symptoms consisting of mood, vegetative, cognitive, and even psychotic behaviors that may cause substantial impairment in the functioning and quality of life in an affected individual. This literature review consisted of articles found in PubMed, Cochrane, and PsychINFO which were extensively reviewed. Articles prior to 2008 were excluded due to the ever-changing landscape of PGx …

Comparison Of Rivaroxaban And Warfarin In The Prevention Of Recurrent Venous Thromboembolism, Philip Joel Heiden

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is to determine the efficacy and safety of rivaroxaban (Xarelto) compared to warfarin (Coumadin), for the long term prophylaxis of recurrent venous thromboembolism (VTE). Rivaroxaban was chosen as the primary representative of factor Xa inhibitors because of its simplistic once a day dosing regimen. The PubMed database was extensively searched, using a variety of key terms, from September 10 to November 30, 2018. Works chosen include propensity-matched cohorts, retrospective studies, systematic reviews, and meta-analyses. All of which were published within the last 10 years; sources dated prior to 10 years were excluded. Studies …

Reducing The Health Care Burden Caused By Undocumented Immigrants, Juan Carlos Garcia

Physician Assistant Scholarly Project Papers

Uncompensated health care and Emergency Department (ED) overcrowding are a national crisis in the United States, and uninsured patients are a major contributor. Undocumented Immigrants (UIs) are a large component of the uninsured patient population. The purpose of this study is to evaluate for efficacy and taxpayer value two large-scale potential solutions: Federally Qualified Health Centers (FQHCs), and expanded Medicaid. A brief analysis of smaller-scale solutions is also included. This study utilized a variety of key terms in electronic search databases such as CINAHL Complete, PubMed, and Google Scholar, and only articles published between 2014 and 2018 by peer-reviewed journals …

The Impact Of Shift Work On Health And Wellbeing, Stephanie Gagelin

Physician Assistant Scholarly Project Papers

Many of today’s industries require workers to perform shift work (typically during 1600-0700). If workers are awake during this time period, circadian misalignment occurs. This scholarly project uses research studies and meta-analyses to provide information about increased health risks associated with circadian misalignment, focusing particularly on the categories of glucose metabolism, cardiovascular system, carcinogenesis, and mental health and acuity. Shift work has been found to increase BMI and waist circumference of employees, as well as increase blood glucose levels to “prediabetic” levels in previously euglycemic individuals. Shift work has been proven to increase high-sensitivity C-reactive protein (hs-CRP), an acute phase …

Exercise Compared To Ssris In The Treatment Of Major Depressive Disorder, Tiffany Fletschock

Physician Assistant Scholarly Project Papers

Major Depressive Disorder (MDD) is a common disease seen every day by primary care providers across the United States. According to the Centers for Disease Control and Prevention (CDC, 2018), eight percent of all adults over the age of 20 suffer from depression, and a study by the American Psychological Association found depressive disorders to cost roughly $71 billion annually. Today, psychotherapy is the recommended first-line therapy for treating MDD, but pharmacotherapy is more commonly used. Alternative forms of therapy are also being researched in order to avoid the use of medication while adequately treating the symptoms of MDD. For …

Embolus Prevention: Anticoagulant Therapy In Comparison To Watchman's Procedure In Patients With Atrial Fibrillation, Erik Fladmo

Physician Assistant Scholarly Project Papers

Atrial fibrillation is a common cardiac disease that occurs as individuals age. One of the risk factors of atrial fibrillation is blood clot formation or embolus in the left atrium. Current treatment methods to prevent clot formation include a variety of anticoagulants, and left atrial appendage closure devices, specifically the relatively new Watchman’s device, the only FDA approved left atrial appendage closure device. This literature review researched articles comparing the differences in both long-term anticoagulation therapy and Watchman’s device for blood clot prevention. Study results confirm the rising efficacy and cost effectiveness of Watchman’s device versus long term anticoagulant therapy …

The Impact Of Medical Marijuana On The Opioid Crisis, Carl David Estep

Physician Assistant Scholarly Project Papers

In light of the current opioid crisis, research is needed to identify alternative treatments for acute and chronic pain. With medical marijuana being made available by rapidly changing state laws, it is prudent to identify what role it may play in pain control. This comprehensive literature review was conducted to determine what is known as to the effectiveness of medical marijuana, cannabis, or cannabinoids for treating acute and chronic pain as compared to prescription opiates. An additional comparison was also made between the addictive properties and adverse effects of medical marijuana and prescription opiates. The final parameter evaluated was the …

Fertility Options For Women With Endometriosis: In Vitro Fertilization Versus Surgical Excision Or Ablation, Jenny L. Brown

Physician Assistant Scholarly Project Papers

Endometriosis negatively affects the fertility of many women of reproductive age worldwide. Some women with endometriosis are able to conceive without reproductive assistance, while others require medical intervention. In vitro fertilization and surgical management are available and widely used in the treatment of endometriosis associated infertility. In vitro fertilization has been found to be effective in women with stages I-IV endometriosis, with varying degrees of success at each stage. These varying results may be due to oocyte quality and availability as well as endometriosis location. Surgical excision and/or surgical ablation of endometriosis/endometriomas may also improve chance of successful pregnancy but …