Medicine and Health Sciences Commons^™

2020 April 21 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

2020-04-21_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., with COVID-19 results included as of 10 a.m.

Note on cumulative counts: This report is provisional and subject to change. As public health investigations of individual cases continue, there will be corrections to the status and details of referred cases that result in changes to this report.
Note on the deaths: Deaths must be reported by health care providers, medical examiners/coroners, and recorded by local health departments …

Holistic Home Modification: Developing A Client-Centered Approach To Home Assessments And Quality Of Life Measures, Maggie Little

OTD Capstone Projects

This project is an appraisal of home assessments and quality of life measures in order to find the best fit for pediatric populations and their caregivers.

2020-04-21_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Standards Of Care For Children In Emergency Departments: International Federation Of Emergency Medicine Agenda For The Care Of Children., Camilo E Gutierrez, Marianne Gausche-Hill, Rodrick K Lim

Paediatrics Publications

No abstract provided.

Behind The Numbers: Covid-19 In Selected Locations On 21 Apr 2020., Vivian Mcalister

Data and Test Instruments

No abstract provided.

Table 1. Behind The Numbers: Covid 19 In Selected Locations On 21 Apr 2020., Vivian Mcalister

Data and Test Instruments

No abstract provided.

2020-04-21 Daily Unm Global Health Covid-19 Briefing, Christophe G. Lambert, Shawn Stoicu, Lori D. Sloane, Anastasiya Nestsiarovich, Praveen Kumar, Nicolas Lauve, Hannah Groves, Rachel D. King, Alexandra Yingling, Jenny Situ, Allison Price, Lynnmarie Jarratt, Ariel Hurwitz, Shahad Hersi, Ryen Ormesher, Samuel Anyona, Perez Olewe, Elly Munde, Cristian Bologa, Kristine Tollestrup, Orrin Myers, Gregory Mertz, Ingrid Hendrix, Douglas J. Perkins

HSC Covid 19 Briefings

Executive Summary:

NM updates. YesNM assistance. Ventilator production. Georgia reopening. Wisconsin legal challenge. Pending immigration suspension. Religious restriction parity. Hong Kong restrictions. Global food shortages. Mexico rapid spread. Oil futures negative. Socio-economic implications. Clinical disease patterns. Healthcare worker testing. WHO courses. Vaccine volunteers to be infected. Intervention impacts. Social distancing tribal. NIH releases treatment guidelines. Guidelines on: thromboembolism Tx, IBD endoscopy, vascular surgery, nutritional management, cutaneous lymphomas, cardiac surgery triage, cellular therapy. LA has 40X known cases. At-home testing. ELISA diagnostic tool. CRISPR vs. PCR. Testing coordination. Hydroxychloroquine prophylaxis. VA hydroxychloroquine study. 52 new clinical trials. Coagulation disorders. Cardiac injury. …

An Osteoporosis Risk Assessment Workshop For Advanced Practice Nurses, Linda Gay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Osteoporosis is noted as one of the foremost causes of disability and morbidity worldwide (Rapp et al., 2016). An osteoporotic fracture can result in significant debility, resulting in significant financial burdens. Screening guidelines for osteoporosis are in place, but confounding variables often lead to missed screening and treatment opportunities. Xu, Lombardi, Jiao, and Banfi (2016) state that bone health is essential for maintaining quality of life and overall health and that one out of two Caucasian women will suffer an osteoporotic-related fracture in her lifetime. Current research supports identifying those at risk, screening, and potentially implementing pharmacological treatment regimens to …

Nurses Improving Nutrition Group Attendance Through Rn Invitations, Shelly Johnson, Susanna Mitchell

Articles, Abstracts, and Reports

Background: Gestational diabetes (GDM), a common pregnancy complication, increases the risk of dangerous birth outcomes, fetal anomalies, and sustained disease and comorbidity for mothers and infants throughout the lifespan. Insulin use is an independent predictor of anomalies. Our prenatal care did not include detailed nutrition assessments and modifications such as Mediterranean diet, a lifestyle associated with reduction in non-pregnant adult diabetes incidence, even reversal. Adding hands-on cooking to nutrition counseling has improved A1c outcomes. We hypothesized a comprehensive package of diet review, nutrition guidelines, and participation in an onsite cooking class initiated at the beginning of prenatal care (Green …

2020-04-21_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Data About Places. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.

Contains the tables Statewide Available Bed Tracking for COVID-19, COVID-19 Metrics, Statewide Available PPE Tracking for COVID-19 (Statewide Available PPE and Bed Tracking), as well as the table Reports of Congregate Setting Respiratory Outbreaks in 2020 by County.

The Effect Of Grooming And Therapeutic Riding By Adolescents With Autism Spectrum Disorder On Equine Salivary Cortisol Concentrations, Morgan Shields

Undergraduate Honors Thesis Projects

The use of horses in therapeutic riding programs, especially for adolescents with autism spectrum disorder (ASD), has grown, yet the impact of grooming and riding on equine stress levels remains unknown. The aim of this study was to compare the effects of grooming and therapeutic riding on salivary cortisol concentrations of 10 horses in a therapeutic riding program. Samples were taken pre and post over two control and grooming days and over two series of nine therapeutic riding lessons for adolescents with ASD. On grooming days, each horse was groomed using a set protocol. On riding days, horses were ridden …

2020-04-21 A Message From Chancellor Roth, Paul B. Roth

HSC Messages from the Chancellor

No abstract provided.

Brain Volumes And Dual‑Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jason K. Longhurst, Morgan A. Wise, Daniel J. Krist, Caitlin A. Moreland, Jon A. Basterrechea, Merrill R. Landers

Integrated Health Sciences Faculty Research

Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. To examine associations between brain volumes, dual-task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual-task performance, and measures of gait and balance. Greater cognitive and combined dual-task efects (DTE) are associated with smaller brain volumes. In contrast, motor DTE is not associated with distinct pattern of brain volumes. As brain volumes decrease, …

Nevada’S Secret Killer: Opioid Deaths, Vanessa Marie Booth

Calvert Undergraduate Research Awards

Emerging Scholars Winner

Presented in this study is an analysis of the Nevada opioid crisis and how a viable solution can impact its severity. It does so in a public policy environment while synthesizing outside sources to support the presented claims. The scope of this study is to present a problem, cause, solution scenario on how to solve this policy problem. This study also takes into consideration Nevada’s current economic state amid the coronavirus (COVID-19). In addition, this analysis also addresses the history behind the opioid epidemic across the United States and how it is impacting Nevada in present times. …

Spiritual And Religious Interventions For Medically High-Risk Adults: A Systematic Review, Nathanael J. Strissel

Senior Honors Theses

This systematic review is an update and expansion to the population and methods of a previous systematic review concerning spiritual and religious interventions for the well-being of terminally ill adults. After expanding the criteria to incorporate a more diverse population and including non-randomized experimental studies that contained relatively few concerns of bias, the results of the review are inconclusive due to insufficient data. The lack of usable data in the field highlights the ethical and theoretical issues with the use of experimental trials in analyzing the efficacy of spiritual and religious interventions. The development of spirituality in healthcare will remain …

Process Monitoring Of Moisture Content And Mass Transfer Rate In A Fluidised Bed With A Low Cost Inline Mems Nir Sensor, Claudio R Avila, Joan Ferré, Rodrigo Rocha De Oliveira, Anna De Juan, Wayne E Sinclair, Faiz M Mahdi, Ali Hassanpour, Timothy N Hunter, Richard A Bourne, Frans L Muller

Faculty, Staff and Students Publications

PURPOSE: The current trend for continuous drug product manufacturing requires new, affordable process analytical techniques (PAT) to ensure control of processing. This work evaluates whether property models based on spectral data from recent Fabry-Pérot Interferometer based NIR sensors can generate a high-resolution moisture signal suitable for process control.

METHODS: Spectral data and offline moisture content were recorded for 14 fluid bed dryer batches of pharmaceutical granules. A PLS moisture model was constructed resulting in a high resolution moisture signal, used to demonstrate (i) endpoint determination and (ii) evaluation of mass transfer performance.

RESULTS: The sensors appear robust with respect to …

Patient With Questions About Cancer Risk, Deborah O. Himes, Jennie Vagher

Faculty Publications

Primary care nurse practitioners routinely care for patients with personal or family histories of cancer. Approximately 5% to 10% of all cancers are related to hereditary cancer syndromes (HCSs), which cause an increased risk for developing more cancers and cancers at earlier ages than the general population. Nurse practitioners in primary care must become comfortable with identifying patients at risk for HCSs. Ordering genetic tests can be a challenge because the number of genetic tests available is growing at a rapid pace. This case highlights a woman who survived breast cancer at age 25 and basal cell carcinoma at age …

Association Of Intensive Lifestyle Intervention, Fitness, And Body Mass Index With Risk Of Heart Failure In Overweight Or Obese Adults With Type 2 Diabetes Mellitus: An Analysis From The Look Ahead Trial, Ambarish Pandey, Kershaw V Patel, Judy L Bahnson, Sarah A Gaussoin, Corby K Martin, Ashok Balasubramanyam, Karen C Johnson, Darren K Mcguire, Alain G Bertoni, Dalane Kitzman, Jarett D Berry, Look Ahead Research Group

Faculty, Staff and Students Publications

BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with a higher risk for heart failure (HF). The impact of a lifestyle intervention and changes in cardiorespiratory fitness (CRF) and body mass index on risk for HF is not well established.

METHODS: Participants from the Look AHEAD trial (Action for Health in Diabetes) without prevalent HF were included. Time-to-event analyses were used to compare the risk of incident HF between the intensive lifestyle intervention and diabetes support and education groups. The associations of baseline measures of CRF estimated from a maximal treadmill test, body mass index, and longitudinal changes in these …

Iatrogenic Pulmonary Artery Dissection In Patient With Ostium Secundum Interatrial Septum Defect, Daniela Di Lisi, Giovanni D. Aquaro, Francesca Macaione, Salvatore Novo, Giuseppina Novo

Journal of the Saudi Heart Association

Pulmonary artery dissection is a rare and lethal condition. Few cases are reported in the literature, and most are derived from autopsies. In most cases, pulmonary artery dissection is a complication of chronic pulmonary hypertension leading to pulmonary artery aneurysm but there are other causes. We describe a case of iatrogenic pulmonary artery dissection in an elderly patient with ostium secundum defect. In particular, we describe the role of cardiac magnetic resonance in making this diagnosis and guiding future therapeutic decisions.

Thrombus In Transit Through A Patent Foramen Ovale, An Unusual Cause Of Cardiac Embolism, Carlos Minguito-Carazo, Tomas Benito-Gonzalez, Julio C. Echarte-Morales, Miguel Rodríguez-Santamarta, Mario Castano-Ruiz, Felipe Fernandez-Vazquez

Journal of the Saudi Heart Association

A 78-year-old woman with a history of transient ischemic attack was admitted for sudden aphasia. In order to assess the potential cardioembolic source an echocardiogram was performed, which revealed a large mass consistent with a thrombus in transit through a patent foramen ovale. Because of the high risk of systemic embolism, emergent surgical thrombectomy was performed with the intention to discharge the patient safely without any new embolic events. This case report highlights the importance of echocardiography in the evaluation of cardioembolic stroke and the requirement of an emergent approach in case of impending paradoxical embolism.

Acute Pulmonary Embolism As An Initial Presentation Of Klinefelter Syndrome: A Case Report, Ghizlane El Ouazzani, Chaimae Toutai, Ikbal Alla, Nabila Ismaili, Noha El Ouafi

Journal of the Saudi Heart Association

Venous thromboembolism (VTE) includes deep vein thrombosis and its complications and pulmonary embolism. Cancer, surgery, prolonged immobilization, fractures, paralysis, use of oral contraceptives, and hereditary coagulopathies are classic risk factors for VTE. An increased incidence of VTE has been reported in patients with Klinefelter syndrome (KS), with a reported prevalence of 0.1e0.2% in the general population and up to 3.1% in infertile men. Despite the high rate of thromboembolic disease in patients with KS, the etiology of this phenomenon is not well understood, and most of our current knowledge is limited to small sample studies. We present the case of …

Left Ventricular Aneurysmectomy In A Young Female Of Unknown Etiology With Pseudoaneurysm: A Case Report, Tariq Ashraf, Rashid Aziz, Amin M. Khuwaja, Syed M. Afaque, Musa Karim

Journal of the Saudi Heart Association

A left ventricular pseudoaneurysm is formed when there is free wall rupture of the myocardial wall with discontinuity and roof covered by pericardium mural thrombus or fibrous tissue without any myocardium. A left ventricular pseudoaneurysm is a rare and life-threatening event. We report a young 22-year-old female with unknown etiology of a pseudoaneurysm, who was previously managed as a psychiatric case and for musculoskeletal pain. On subsequent investigation and confirmation with cardiac magnetic resonance imaging, aneurysmectomy was done. This is a rare case in a young 22-year-old woman with a ventricular pseudoaneurysm of unknown etiology. Considering the high risk for …

Perioperative Management Of Wilms’ Tumor With Intracardiac Extension: Report Of Two Cases With Review Of Literature, Hayan Altwaeel, Mohamed S. Kabbani, Ahmad Al Shammari, Mohammed Al- Namshan, Abdullah A. Alghamdi

Journal of the Saudi Heart Association

Wilms’ tumor (WT) is one of the solid tumor that affects children. It involves the kidney and may extend to the lungs and liver. WT conquers the adjacent blood vessels such as renal veins and inferior vena cava (IVC); its extension to IVC and right-sided heart chambers is unusual. Furthermore, when the tumor extends to heart chambers, its surgical management becomes challenging and demands multidisciplinary medical and surgical specialties including pediatric cardiac surgery. In this report, we discuss the surgical management and perioperative treatment of two unusual cases of WT with IVC and intracardiac extension.

Mitral Valve Replacement In Dilated Cardiomyopathy: A Valid Option?, Mohamed H. Mashali, Nashwa Badawi, Mohammed O. Galal

Journal of the Saudi Heart Association

Background: Dilated cardiomyopathy (DCM) is characterized by left ventricular dilation and dysfunction. The association with significant mitral regurgitation worsens the prognosis. Case report: A 2-year-old girl presented withDCMand severe mitral regurgitation. She had a history of viral myocarditis at the age of 4 months, necessitating recurrent hospital admissions for management of intractable heart failure, pneumonia, and failure to thrive. The decision was taken to proceed for mitral valve surgery, which ended with mitral valve replacement. Over 3 years of follow-up after surgery, there was significant improvement in her weight gain and she improved clinically. There were still recurrent admissions, but …

Cardiac Amyloidosis—An Underdiagnosed Cause Of Heart Failure In The Elderly, Tahir Nazir, Mahmud Nuffati

Journal of the Saudi Heart Association

Amyloidosis is a rare, generally multisystem disease that can also involve the heart. Infiltration of the myocardium with amyloid proteins is an important and underappreciated cause of heart failure with preserved ejection fraction in the elderly. We present the case of an 84-year-old man with chest tightness, dyspnoea, and ascites. He had a history of dyslipidaemia and ischaemic heart disease. Initial investigations showed severe diastolic dysfunction and elevated pulmonary artery systolic pressure on echocardiogram along with elevated serum natriuretic peptides. Further evaluation by a magnetic resonance imaging scan of the heart and endomyocardial biopsy confirmed the diagnosis of senile systemic …

Treatment Of Severe Mitral Regurgitation That Mimics A Para-Ring Mitral Regurgitation After Failed Annuloplasty Ring With Mitraclip: A Case Report, Hesham Abdo Naeim, Waleed Saeed, Abeer Mahmood, Lamiaa Khedr, Ramy Elrowiny, Reda Abuelatta

Journal of the Saudi Heart Association

Background: Progressive remodelling of the left ventricle with lateral and apical displacement of one or both papillary muscles can lead to recurrence of severe mitral regurgitation (MR) in the presence of the mitral valve (MV) ring. The MitraClip (Abbott, USA) is the only option in cases with annuloplasty rings too large for implantation of a Sapien prosthesis in high surgical-risk patients. We present a case where the MR jet was directed toward a para-ring hole, and the MitraClip system was used successfully to treat this severe MR. Case summary: An 80-year-old woman underwent coronary artery bypass surgery plus MV repair …

Impact Of Stent Of Ductus Arteriosus And Modified Blalock–Taussig Shunt On Pulmonary Arteries Growth And Second-Stage Surgery In Infants With Ductus-Dependent Pulmonary Circulation, Bana A. Nasser, Mesned Abdulrahman, Abdullah A.L Qwaee, Ali Alakfash, Tageldein Mohamad, Mohamed S. Kabbani

Journal of the Saudi Heart Association

Introduction: Ducts-dependent pulmonary circulation is spectrum of congenital heart diseases that need urgent intervention to augment pulmonary blood. Systemic to pulmonary shunt is the classical surgical management. Stenting of ductus arteriosus emerged in the last 2 decades as an alternative plausible intervention. Objectives: To evaluate and compare the short and midterm effects of PDA stenting in compared to surgically placed shunt for augmentation of pulmonary blood flow looking to pulmonary artery (PA) branches growth, oxygen saturation and suitability for second stage repair. Methods: We conducted this prospective study in Cardiac Surgical Intensive Care Unit . Cases were divided into “stent …

Preoperative Blood Urea Nitrogen-To-Left Ventricular Ejection Fraction Ratio Is An Independent Predictor Of Long-Term Major Adverse Cardiac Events In Patients Undergoing Coronary Artery Bypass Grafting Surgery, Turan Erdogan, Mustafa Çetin, Goksel Çinier, Savas Ozer, Ahmet S. Yõlmaz, Ozan Karakisi, Tuncay Kõrõs

Journal of the Saudi Heart Association

Background: Long-term mortality rate following coronary artery bypass grafting (CABG) procedure is still considered to be high despite advances in surgical techniques and perioperative management. Identifying high-risk patients by using cost-effective and clinically useful parameters is needed. Methods: Patients who were admitted to our cardiology clinic with the diagnosis of coronary artery disease and underwent CABG between January 2008 and August 2010 were included. Study patients were followed-up for 112.6 ± 17.8 months for major adverse cardiac events (MACE) which were defined as all-cause mortality and new-onset decompensated heart failure (HF). Results: Patients in MACE (þ) group were older ( …

Left And Right Ventricular Speckle Tracking Study Before And After Percutaneous Atrial Septal Defect Closure In Children, Hala M. Agha, Islam S. Mohammed, Hassan A. Hassan, Hassan S. Abu Seif, Ibrahim M. Abu Farag

Journal of the Saudi Heart Association

Objectives: To analyze the acute and short-term deformation changes of both right (RV) and left (LV) ventricular wall before and after transcatheter closure of atrial septal defect (ASD) secundum in children. Outcome measures: To determine the feasibility of tissue Doppler and myocardial deformation imaging for evaluating RV and LV functions in children undergoing transcatheter ASD closure. Patients and methods: A prospective study was performed for 32 children with hemodynamic significant ASD secundum before and 6 months after percutaneous ASD closure in the Pediatric Cardiology Division of Specialized Pediatric Hospital, Cairo University. Speckle tracking echocardiography (STE) of LV and RV global …