Medicine and Health Sciences Commons^™

Alumni Journal - Volume 90, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | Guest Editorial: Tiffany C. Priester '04
4 | From the President
7 | From the Dean

News
8 | This and That
10 | APC Preview
12 | School of Medicine News
14 | Students
15 | Wedding Announcements
16 | Alumni News

Missions
18 | Missions Feature - inspiring stories from the mission field

Features
45 | Alumni Spotlight - Lloyd Rudy Broomes '66
46 | Canadian Rockies Alumni Trip
50 | Department Report: Otolaryngology
53 | The Storm of Our Shores [Book review]

In Memoriam
53 | Featured Obituary - Stanley G. Sturges '55
54 …

The Effects Of Dry Needling In The Management Of Sub-Acromial Impingement Syndrome: A Case Report, Kaitlyn Radice, Lindsey Bramlette, Kristin Fenstermaker

Miami, Fall 2019

The purpose of this study was to evaluate the effectivness of dry needling to an active trigger point in the anterior deltoid musculature in conjunction with physical therapy. This case study presents a 77-year-old male with traumatic pull into flexion injury. In addition to being given RTC and postural musculature strengthening exercises, PROM, joint mobilization, and soft tissue mobilization, dry needling was performed at week 2 and week 4 of treatment.

From this case study, we can conclude that TrP-DN to an active TrPin the anterior deltoid can yield statistically significant improvements in ROM, strength, pain, and functional abilities when …

Physical Therapy Management Of Stress Urinary Incontinence In The Pediatric Population: A Case Study, Debra Dy, Maureen Egizii

Miami, Fall 2019

The purpose of this study was to determine if external pelvic floor examination and treatment can be an effective, non-invasive intervention for urinary incontinence in the pediatric population. The case study examines the effectiveness of exercise therapy for an 11-year-old female with pelvic floor dysfunction. This case demonstrates that pelvic floor strengthening exercises can help to resolve incontinence symptoms without the implementation of internal examination or treatment. Although commonly used to address incontinence in adults, pelvic floor physical therapy may also be an effective, non-invasive intervention option for children who are experiencing urinary incontinence.

Treatment Of Phantom Limb Pain And Knee Flexion Contracture Due To Transtibial Amputation: A Case Study, Kristin Smead, Donna Leigel

Miami, Fall 2019

This case study evaluated the effectiveness of a combination of visual mirror therapy for phantom limb pain desensitization in conjunction with a physical therapy regimen of therapeutic exercise, short-wave diathermy, and gait training in a 66-year-old male with left lower extremity amputation.

Through a combination of mirror therapy, short-wave diathermy over the hamstring musculature, and therapeutic exercise, the patient displayed an overall improvement in left lower limb knee flexion contracture and a reduction in perceived phantom limb pain.The patient can now tolerate full weight bearing through this extremity from an improved fit of the prosthesis socket. Throughout the course of …

An Investigation Into The Relationships Between Bullying, Discrimination, Burnout And Patient Safety In Nurses And Midwives: Is Burnout A Mediator?, Judith Johnson, Lorraine Cameron, Lucy Mitchinson, Mayur Parmar, Gail Opio-Te, Gemma Louch, Angela Grange

HPD Articles

BACKGROUND: Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this. AIMS: The aims of this study were to investigate the relationships between workplace bullying, perceived discrimination, levels of burnout and patient safety perceptions in nurses and midwives and to assess whether bullying and discrimination were more frequently experienced by Black, Asian and minority ethnic than White nurses and midwives. METHODS: In total, 528 nurses and midwives were recruited from four hospitals in the United Kingdom to complete a cross-sectional survey between February and March 2017. The survey …

Implementation Of Ventilator Bundle For Prevention Of Ventilator-Associated Pneumonia In Pediatric Intensive Care Unit, Abd-Elaleem Elgendy, Ahmed Y. Alsawah, Mahmoud M. Al-Shahat, Mohamed F. Alsoda, Mohammad A. M. Abboud, Sherif M. K. Reda

Journal of Medicine in Scientific Research

Background Ventilator-associated pneumonia (VAP) is associated with increased morbidity and mortality in pediatric intensive care unit (PICU) patients. Objective The aim was to examine the effect of adherence to VAP prevention bundle on the incidence of VAP in PICU. Patients and methods A prospective comparative study was conducted in Al-Hussein University Hospital on all patients admitted and ventilated in PICU in a year from September 2017 until September 2018. They were divided into two groups: the first group included patients admitted to PICU after implementation of the study, comprising 43 patients as cases, and the second group included patients admitted …

The Use Of Gonadotropin-Releasing Hormone Antagonist In Women Undergoing Intrauterine Insemination, Bassem Sobhy, M Yousef Elsemary

Journal of Medicine in Scientific Research

Background Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. Aim The aim was to evaluate whether the addition of gonadotropin-releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Materials and methods A prospective study was performed at El-Galaa Maternity Teaching Hospital where 124 women with primary or secondary infertility were subjected to controlled ovarian stimulation with human menopausal gonadotropin (74–150 IU/day) only (control group, n=62) or to human menopausal gonadotropin (75–150 IU/day) plus Cetrorelix (0.25 mg/day, starting when the leading follicle was ≥16 mm; …

Determinants Of Infarction Patterns In Posterior Cerebral Circulation, Ahmed H. T Badr Ahmed, Mohamed M. Fouad, Ramez R. Moustafa, Taha K. Alloush

Journal of Medicine in Scientific Research

Background Ischemic stroke is defined as focal or global neurological dysfunction lasting longer than 24 h or leading to death that is caused by vascular insult, either stricture or occlusion of a specific vascular territory. Aim of the study This study aimed to determine the relationship between different risk factors and different infarction patterns in posterior circulation such single small lacunar lesion, single large lesion, and multiple scattered lesions. Patients and methods This study included 60 patients recruited from the stroke unit of Ain Shams University and El Sahel Teaching Hospitals during the period from April to October 2018 with …

Omental Flap Harvested Through Transdiaphragmatic Approach At The Same Sternotomy Incision For Poststernotomy Mediastinitis: A New Approach, Waleed El-Awady

Journal of Medicine in Scientific Research

Background The surgical treatment of poststernotomy mediastinitis is still a challenge and associated with high mortality. Conservative treatment and various surgical procedures are sometimes inadequate and need more aggressive treatment. Omental flap improves control of infection and prognosis, but harvesting is an additional procedure with its associated morbidity and trauma. Patients and methods A total of 14 patients had omental flap, which was harvested through a diaphragmatic opening at the lower part of the same sternotomy incision, without additional laparotomy incision or extension of sternotomy incision into the upper abdomen or even laparoscopically. The mean age of the patients was …

Oral Development And Breastfeeding: An Assessment Of The Lactation Care Provider Approach, Robin Gatlin

Dental Hygiene ETDs

Breastfeeding influences the infant’s oral development in many ways. Lactation care providers work closely with the mother-infant pair and may be the first to provide information on oral health. The purpose of this study is to assess lactation care provider’s perception, attitude and behavior on the relationship between breastfeeding and oral development; including oral malocclusion, breathing patterns, tethered oral tissues and dental caries. A survey sent to lactation care providers who are members of The United States Lactation Consultant Association. A total of 12 members participated in the survey. Of that, 11 were International Board Certified Lactation Consultants (IBCLCs) and …

Growth Differentiation Factor 11 Locally Controls Anterior-Posterior Patterning Of The Axial Skeleton., Joonho Suh, Je-Hyun Eom, Na-Kyung Kim, Kyung Mi Woo, Jeong-Hwa Baek, Hyun-Mo Ryoo, Se-Jin Lee, Yun-Sil Lee

Faculty Research 2019

Growth and differentiation factor 11 (GDF11) is a transforming growth factor β family member that has been identified as the central player of anterior-posterior (A-P) axial skeletal patterning. Mice homozygous for Gdf11 deletion exhibit severe anterior homeotic transformations of the vertebrae and craniofacial defects. During early embryogenesis, Gdf11 is expressed predominantly in the primitive streak and tail bud regions, where new mesodermal cells arise. On the basis of this expression pattern of Gdf11 and the phenotype of Gdf11 mutant mice, it has been suggested that GDF11 acts to specify positional identity along the A-P axis either by local changes in …

Comparative Analysis Of Metabolome Of Rice Seeds At Three Developmental Stages Using A Recombinant Inbred Line Population., Kang Li, Dehong Wang, Liang Gong, Yuanyuan Lyu, Hao Guo, Wei Chen, Cheng Jin, Xianqing Liu, Chuanying Fang, Jie Luo

Faculty Research 2019

Plants are considered an important food and nutrition source for humans. Despite advances in plant seed metabolomics, knowledge about the genetic and molecular bases of rice seed metabolomes at different developmental stages is still limited. Here, using Zhenshan 97 (ZS97) and Minghui 63 (MH63), we performed a widely targeted metabolic profiling in seeds during grain filling, mature seeds and germinating seeds. The diversity between MH63 and ZS97 was characterized in terms of the content of metabolites and the metabolic shifting across developmental stages. Taking advantage of the ultra-high-density genetic map of a population of 210 recombinant inbred lines (RILs) derived …

The Jax Synteny Browser For Mouse-Human Comparative Genomics., Georgi Kolishovski, Anna Lamoureux, Paul Hale, Joel E Richardson, Jill M. Recla, Omoluyi Adesanya, Allen K. Simons, Govindarajan Kunde-Ramamoorthy, Carol J Bult

Faculty Research 2019

Visualizing regions of conserved synteny between two genomes is supported by numerous software applications. However, none of the current applications allow researchers to select genome features to display or highlight in blocks of synteny based on the annotated biological properties of the features (e.g., type, function, and/or phenotype association). To address this usability gap, we developed an interactive web-based conserved synteny browser, The Jackson Laboratory (JAX) Synteny Browser. The browser allows researchers to highlight or selectively display genome features in the reference and/or the comparison genome according to the biological attributes of the features. Although the current implementation for the …

Assessment Of Bones Deficient In Fibrillin-1 Microfibrils Reveals Pronounced Sex Differences., Lukas Altinbas, Nicole Bormann, Daniel Lehmann, Sarah Jeuthe, Dag Wulsten, Uwe Kornak, Peter N Robinson, Britt Wildemann, Georgios Kararigas

Faculty Research 2019

Defects in the extracellular matrix protein fibrillin-1 that perturb transforming growth factor beta (TGFβ) bioavailability lead to Marfan syndrome (MFS). MFS is an autosomal-dominant disorder, which is associated with connective tissue and skeletal defects, among others. To date, it is unclear how biological sex impacts the structural and functional properties of bone in MFS. The aim of this study was to investigate the effects of sex on bone microarchitecture and mechanical properties in mice with deficient fibrillin-1, a model of human MFS. Bones of 11-week-old male and female Fbn1^mgR/mgR mice were investigated. Three-dimensional micro-computed tomography of femora and vertebrae …

Cardiovascular Risk In Patients With Rheumatoid Arthritis: The Role Of Cholesterylester Transfer Protein, Ali M. Mursi, Emad M. Elshebiny, Lobna Y. Ebrahim, Sahar H. Quashwa, Sherry K. Abdelrahman, Taghreed F. Mohammed Mostafa

Journal of Medicine in Scientific Research

Aim To detect serum level of cholesterylester transfer protein (CETP) (the enzyme involved in reverse cholesterol transport) in patients with rheumatoid arthritis (RA) and to evaluate its relation to various clinical parameters of the disease, lipid profile, and carotid intima-media thickness (CIMT) as a marker of atherosclerosis and cardiovascular disease risk. Patients and methods This study involved a total of 80 participants, comprising 50 patients with RA and 30 age-matched and sex-matched healthy controls. Detailed medical history and thorough clinical examination (general and musculoskeletal) as well as laboratory investigations including lipid profile were performed for all patients with RA. Serum …

The Functional Outcome Of Direct Lateral Approach For Fixation Of Proximal Humeral Fractures: A Case Series From A Tertiary Care Hospital, Mujahid Jamil, Irfan Anwer, Muhammed Tabish Saleem, Ahmed Abdul Habib Khan, Mohammad Zohaib Nawaz Khan

Section of Orthopaedic Surgery

Displaced proximal humeral fractures warrant surgical fixation for early rehabilitation and better functional outcome. These fractures are traditionally fixed by delto pectoral surgical approach. Direct lateral approach has recently gained interest as it involves less soft tissue dissection and is particularly helpful in certain fracture patterns. However, there have been concerns of axillary nerve damage with this approach. We report a case series of proximal humerus fractures fixed by direct lateral approach from our institution. All displaced Type 2 and 3 fractures were included in our study. Pathological and comminuted Type 4 fractures and fractures with ipsilateral clavicle or elbow …

Responding To Crisis: Farmer Mental Health Programs In The Extension North Central Region, Shoshanah Inwood, Florence Becot, Andrea Bjornestad, Carrie Henning-Smith, Andrew Alberth

Counseling and Human Development Faculty Publications

A number of current events are exacerbating farm stress. Extension and farm organizations have mobilizedresponses to an emerging mental health crisis among farmers. To evaluate these responses, we conducted anonline scan of resources to present a baseline typology of current mental health programs and response effortsin the 12-state Extension North Central Region. We classified responses by type of program, target audience,and delivery format. We identified the need to train mental health counselors and state suicide hotlineresponders on farm issues and farm culture.

Can Cmws Sustain Quality Services And High Coverage As Private Providers In Chitral? A Three-Year Prospective Qualitative Study, Rafat Jan, Arusa Lakhani, Salma Rattani, Laila Lalji, Kiran Mubeen, Mehtab Q. Jaffer

Journal of Asian Midwives (JAM)

Background: The maternal and neonatal mortality ratesof Chitral district of Pakistan are among the highest in the country. One of the factors that found to havepositive impact on maternal and newborn health indicators is the availability ofquality skill birth attendance because the majority of the poor women cannot access facility-based maternity care. Therefore, in 2006, the Government of Pakistan (GOP) has initiated a program to train and deploy Community Midwives (CMWs) to support safe pregnancies and births. The Aga Khan Health Service’ Pakistan, initiated the Chitral Child Survival Program (CCSP) in partnership with the National Maternal Neonatal and Child Health …

Hiv-Related Discriminatlon And Cervical Cancer Screening In Zambia, Crystal J. Cazier

Dissertations and Theses (Open Access)

Background: The Republic of Zambia has the third-highest incidence of cervical cancer in the world, where approximately 700,000 women over age 15 are living with HIV. Women living with HIV (WLHIV) are at increased risk for cervical cancer. While literature suggests that discrimination is a barrier to HIV care, no studies have explored if discrimination experienced in HIV clinics is related to cervical cancer screening using nationally representative datasets. Objective: The primary objective of this study was to examine whether perceived discrimination by healthcare workers due to HIV status is related to having been screened for cervical cancer among WLHIV. …

La Priorización De Comportamientos Para Mejorar Programas De Cambio Social Y De Comportamiento Durante Una Emergencia De Salud Pública: Un Llamado A La Acción, Breakthrough Research

Poverty, Gender, and Youth

A medida que los especialistas en desarrollo internacional continúan trabajando en los desafíos de la salud pública y nuevas enfermedades emergentes, es de suma importancia la priorización de comportamientos. Este breve informe tiene como objetivo argumentar por qué es importante la priorización de comportamientos para fortalecer los programas de cambio social y de comportamiento (CSC). El documento finaliza con un llamado a la acción a que diferentes actores interesados aboguen por y participen en procesos que prioricen comportamientos como parte del diseño, planificación y adaptación de programas de cambio social y de comportamiento.

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As the international development community continues …

Effect Of Education About Pediatric Immunization Schedule And Vaccine Administration On Family Medicine Clinic Providers And Clinical Staff Knowledge And Confidence, John Matthew Derfelt

Doctor of Nursing Practice Scholarly Project

Significance: In this original research, the purpose of this project is to compare and promote increased pediatric immunization knowledge among healthcare providers and clinic staff of a family medicine clinic. In turn, there is greater compliance with the Centers for Disease Control and Prevention’s (CDC) recommended immunization schedule and adherence to vaccinations against the 17 vaccine-preventable diseases.

Methods: This exploratory pilot case study surveyed 34 individuals by using an educational tool with information regarding the current CDC-recommended pediatric vaccination schedule. Prior to reviewing the educational material, the participant tested their baseline knowledge about vaccination scheduling and immunization administration. …

Chapter 14: Hospice And End-Of-Life Care, Sally Pelon, Brandon Youker, M. Paola Leon

Books and Contributions to Books

This chapter explores end-of-life issues and concerns as well as the hospice movement’s role in assisting terminally ill individuals. Specific social work assessment and interventions tools are offered considered as well as controversial issues in end-of-life care.

Driving Sustainment: Quality Management Packages, Lynn Weddle

Articles, Abstracts, and Reports

Tired of revisiting the same problems? Quality Management Packages are an approach to sustain change around complex quality outcomes such as hospital acquired infections so that the problems remain solved.

Ulnar Collateral Ligament Reconstruction With Traditional Docking Compared To Novel Surgical Techniques, Kayley D. Guy, Brendon P. Mcdermott, Kaitlin Gallagher, Tyrone Washington

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Ulnar Collateral Ligament Reconstruction (UCLR) is a surgical procedure on one of the main ligaments that provides normal stability for the elbow joint against excessive valgus stress. Damage to this ligament is common in athletes performing overhead throwing activities, primarily baseball players, due to excessive valgus stress during the throwing motion. The most common form of treatment for this type of injury is reconstructive surgery of the ligament, especially if athletes wish to return to sport participation. This type of surgery is extremely invasive and requires extensive post-operative rehabilitation in order to facilitate return to play. To date, many …

Clinical Interventions Documented By Appe Students: Results From A Pilot Study, Elizabeth Laughlin, Bsps, Danielle Mayer, Pharmd, Bcacp, Sarah Lynch, Pharmd, Bcacp

College of Pharmacy Posters

Primary Objective: Evaluate the types of drug therapy problems identified by student pharmacists and the results of these interventions.

Secondary Objective: Evaluate trends in trends of what type of interventions are identified and how they are defined.

Sighting Acute Myocardial Infarction Through Platelet Gene Expression., Giuliana Gobbi, Cecilia Carubbi, Guidantonio Malagoli Tagliazucchi, Elena Masselli, Prisco Mirandola, Filippo Pigazzani, Antonio Crocamo, Maria Francesca Notarangelo, Sergio Suma, Elvezia Paraboschi, Giuseppe Maglietta, Srikanth Nagalla, Giulia Pozzi, Daniela Galli, Mauro Vaccarezza, Paolo Fortina, Sankar Addya, Adam Ertel, Paul Bray, Stefano Duga, Carlo Berzuini, Marco Vitale, Diego Ardissino

Department of Cancer Biology Faculty Papers

Acute myocardial infarction is primarily due to coronary atherosclerotic plaque rupture and subsequent thrombus formation. Platelets play a key role in the genesis and progression of both atherosclerosis and thrombosis. Since platelets are anuclear cells that inherit their mRNA from megakaryocyte precursors and maintain it unchanged during their life span, gene expression profiling at the time of an acute myocardial infarction provides information concerning the platelet gene expression preceding the coronary event. In ST-segment elevation myocardial infarction (STEMI), a gene-by-gene analysis of the platelet gene expression identified five differentially expressed genes: FKBP5, S100P, SAMSN1, CLEC4E and S100A12. The logistic regression …

Implementing A Result Notification And Referral System In A Nurse-Led Wellness Center, Christine Bollom

Doctor of Nursing Practice

Cervical and breast cancer screenings reduce the risk of morbidity and mortality for American women. In 2017, about 70% of U.S. women over the age of 21 obtained a Papanicolaou (Pap) test, which screens for cervical cancer. African American women have a cervical cancer screening rate of 74.6% and Hispanic women have a rate of 68.6%. The cervical cancer screening rates decrease to 51% for women who are uninsured (Centers for Disease Control and Prevention, 2017). In the United States, 50% of women older than 40 are current on their screening mammogram. African American women have a screening mammogram rate …

Surviving Sepsis: A Treatment Process Improvement In High Volume Emergency Departments, Brittney Burns

Doctor of Nursing Practice

Sepsis is the 3rd leading cause of death in the United States, accounting for approximately 270,000 deaths annually (CDC, 2017). It is the number one cause of death in hospitals, the number one cause of hospital readmissions, and the costliest diagnosis in the hospital setting (Fingar & Washington, 2015; Torio & Andrews, 2015). This quality improvement project aimed to increase the percentage of antibiotics administered within 1 hour for sepsis patients. Mortality rates significantly decrease when this goal is met (Howell & Davis, 2017). There is an 8% increase in mortality risks with every hour that passes with elevated lactic …

Using The Adam Questionnaire In Primary Care To Identify Hypoandrogenism In Males Aged 40 Years Or Older, Jeremy Burns

Doctor of Nursing Practice

Testosterone replacement therapy (TRT) has been shown to improve the symptoms of metabolic syndrome by reducing Hemoglobin A1C, belly fat, cholesterol, and blood pressure (Cunningham, 2015). The ultimate goal for testosterone-deficient patients is to have an improved quality of life by starting TRT. This quality improvement project was conducted at a small primary care clinic in South Texas. The project was started by screening 84 male patients ≥ 40 years of age using the Androgen Deficiency in Aging Males (ADAM) questionnaire. The ADAM questionnaire was considered positive for anyone who answered “yes” to 3 or more questions or “yes” to …

Implementation Of Ace Inhibitor Regimen In Patients With Type 2 Diabetes Mellitus, Rita Chukwurah

Doctor of Nursing Practice

The incidence of type 2 diabetes has increased dramatically and is associated with many problems, including chronic kidney disease. The purpose of this quality improvement project was to implement two evidence-based guidelines that may detect chronic kidney disease and slow its progression in patients with type 2 diabetes by implementing angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy according to evidence-based guidelines from the American Diabetes Association. Patients with type diabetes were screened for microalbuminuria and eGFR of < 60 mL/min/1.73 m². Based on lab results, the provider recommended either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to patients with as …