Medicine and Health Sciences Commons^™

Interleukin‐1 Blockade Inhibits The Acute Inflammatory Response In Patients With St‐Segment–Elevation Myocardial Infarction, Antonio Abbate, Cory R. Trankle, Leo F. Buckley, Michael J. Lipinski, Darryn Appleton, Dinesh Kadariya, Justin M. Canada, Salvatore Carbone, Charlotte S. Roberts, Nayef Abouzaki, Ryan Melchior, Sanah Christopher, Jeremy Turlington, George Mueller, James Garnett, Christopher Thomas, Roshanak Markley, George F. Wohlford, Laura Puckett, Horacio Medina De Chazal, Juan G. Chiabrando, Edoardo Bressi, Marco Giuseppe Del Buono, Aaron Schatz, Chau Vo, Dave L. Dixon, Giuseppe G. Biondi-Zoccai, Michael C. Kontos, Benjamin W. Van Tassell

Internal Medicine Publications

Background

ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]).

Methods and Results

We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the …

Can Graft Vs. Leukemia Effect Be Uncoupled From Graft Vs. Host Disease? An Examination Of Proportions, Elizabeth Krieger, Amir Ahmed Toor

Massey Comprehensive Cancer Center Publications

Can Graft vs. Leukemia Effect Be Uncoupled From Graft vs. Host Disease? An Examination of Proportions

Ocular Findings In The 16p11.2 Microdeletion Syndrome: A Case Report And Literature Review, Cybil S. Stingl, Colleen Jackson-Cook, Natario L. Couser

Ophthalmology Publications

The recurrent 16p11.2 microdeletion is characterized by developmental delays and a wide spectrum of congenital anomalies. It has been well reported that individuals with this ∼593-kb interstitial deletion have an increased susceptibility toward the autism spectrum disorder (ASD). Abnormalities of the eye and ocular adnexa are also commonly associated findings seen in individuals with the 16p11.2 microdeletion syndrome, although these ophthalmic manifestations have not been well characterized. We conducted an extensive literature review to highlight the eye features in patients with the 16p11.2 microdeletion syndrome and describe a 5-year-old boy with the syndrome. The boy initially presented with intellectual disability, …

Oculodentodigital Dysplasia: A Case Report And Major Review Of The Eye And Ocular Adnexa Features Of 295 Reported Cases, Virang Kumar, Natario L. Couser, Arti Pandya

Ophthalmology Publications

Oculodentodigital dysplasia (ODDD) is a rare genetic disorder associated with a characteristic craniofacial profile with variable dental, limb, eye, and ocular adnexa abnormalities. We performed an extensive literature review to highlight key eye features in patients with ODDD and report a new case of a female patient with a heterozygous missense GJA1 mutation (c.65G>A, p.G22E) and clinical features consistent with the condition. Our patient presented with multiple congenital anomalies including syndactyly, microphthalmia, microcornea, retrognathia, and a small nose with hypoplastic alae and prominent columella; in addition, an omphalocele defect was present, which has not been reported in previous cases. …

Post Procedural Care Of Patients Receiving Percutaneous Transhepatic Biliary Drainage Catheter Placement, Erin Pacelli, Jennifer Almeda, Christina Graham, Malcolm Sydnor, Kunal Patel

VCU Health Nursing

A recent review of patients undergoing transhepatic biliary drainage catheter placement showed a 30-day readmission rate of 28%. New post-procedural processes were created to standardize the care of this patient population to decrease readmission rates and improve patient satisfaction.

Improving Access To Care In Virginia: Reaching Nurse Practitioner Training Capacity Through Preceptor Incentives, Debra Barksdale, Christine Kennedy, Shelly Smith

Translational Research Fellows Policy Briefs

Workforce data reinforces the notion that educating nurse practitioners in Virginia is critical in helping to improve access to care in the Commonwealth, particularly in underserved communities. Six of Virginia’s thirty-nine state funded colleges and universities offer nurse practitioner programs. All of these universities report their capacity to train nurse practitioners is not limited by qualified applicants but rather by a shortage of clinical preceptors. This paper provides a summary of public policy initiatives that support preceptors as an example for Virginia to consider.

Reducing Medication Risks In Older Adult Drinkers, Faika Zanjani, Nancy Schoenberg, Catherine Martin, Richard Clayton

Gerontology Publications

Objectives: Prevalent concomitant alcohol and medication use among older adults is placing this group at risk for adverse health events. Given limited existing interventions to address concomitant alcohol and medication risk (AMR), a brief educational intervention was demonstrated. The purpose of the current study was to examine change in AMR behaviors 3 months post-education among older adult drinkers.

Methods: A convenience sample of 58 older adult drinkers (mean age = 72) was recruited and followed (n = 40; 70% at follow-up), from four pharmacies in rural Virginia.

Results: Findings indicated decreased alcohol consumption in high-risk drinkers.

Conclusion: Future research …

The Benefits Of Physical Activity On Depression, Edward F. Ansello

Director's Editorials from Age in Action

Physical exercise can be an effective counter-measure against depression. Activity need not be strenuous and it may reduce the risk for depression, even among those with a family history or genetic disposition for depression. And depression in itself may not cause a reduction in physical activity. It could be that we will see health care providers increasingly prescribing doses of physical activity for our mental health.

Creating Covid-19 Work-Arounds For Vulnerable Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

In response to disruptions in care due to the COVID-19 pandemic, the Geriatrics Workforce Enhancement Program (GWEP) has decided to focus energies on vulnerable populations, specifically: low income older adults in the Richmond Health and Wellness Program (RHWP), which delivers healthcare coordination at rental assistance housing complexes in Richmond, who had been receiving regular in-person help from interprofessional teams of faculty and students; residents with dementia and staffs of long-term care facilities who’d been intended to participate on-site in a non-pharmacological dementia care intervention called TimeSlips, as well as family caregivers of individuals in the community with dementia; and older …

Finding Light In The Darkness: The Role Of Humor, Edward F. Ansello

Director's Editorials from Age in Action

The human story of confrontations with darkness can be lightened with the aid of humor and laughter.

Ageism In The Age Of Covid-19, Edward F. Ansello

Director's Editorials from Age in Action

Greater awareness of biases in health care and protective services are needed. Ageism is not going away but at least COVID-19 has unveiled some of its manifestations.

A Multifaceted Approach To Address Food Insecurity In Urban Dwelling Older Adults, Ana Diallo, Katherine Falls

Case Studies from Age in Action

Educational Objectives

1. Identify and discuss concepts of food insecurity as a social determinant of health in older adults.

2. Explain the health benefits of participation in a nutrition initiative, Healthy Meals Program, to address food insecurity among low-income older adults living in an urban food desert.

3. Describe the use of motivational interviewing and goal setting techniques for nutrition-related behavior in the management of chronic disease.

4. Summarize the lessons learned and implications for clinical practice.

Two Professionally Led Choir Programs: Empowering People With Dementia And Their Care Partners, Helen Kivnick, Debra Sheets

Case Studies from Age in Action

Educational Objectives

Identify the benefits of participation in a community-based choir for persons with dementia (PwD) and their care partners.

1. Describe the work of the choirs to show the potential of living well with dementia.

2. Identify the ways in which the choirs address stigma and social isolation.

3. Highlight lessons learned

The Agony Of Da Feet: Reexamining The Foundation To Fitness, Amanda M. Lutter, Christopher B. Stewart

Case Studies from Age in Action

Educational Objectives

1. Explain the role of podiatry in helping older adults maintain wellbeing.

2. Provide an overview of common foot and ankle conditions that older adults should be concerned about.

3. Discuss newer services and techniques provided by podiatrists.

4. Review several cases in which podiatry supported patients’ health through early interventions.

The Health Empowerment Program: A Primary Care – Area Agency On Aging Partnership, Daniel Bluestein, Brad Lazernick, Britt Gnilka

Case Studies from Age in Action

Educational Objectives

1. Appreciate the benefits of a primary care-area agency on aging collaboration.

2. Identify strategies for enhancing this cross-organizational partnership.

Centering Health Equity And Structural Racism In Health Sciences Curriculum, Lynn E. Pelco, Kevin A. Harris, Carolyn Watts, Lisa B. Webb

Publications from the Office of the Senior Vice President for Health Sciences

This paper overviews scientific evidence and some of the local Richmond, Virginia history related to structural racism and health disparities. The paper then describe recent demands for racial justice and curriculum transformation that have been made by Virginia Commonwealth University (VCU) health sciences students, faculty and community members as well as the action steps the university has taken to address these demands. The paper concludes by calling on VCU health sciences faculty members to take action in the following three ways: (a) by participating in professional conversations about the intersections of health equity, structural racism, and health sciences education, (b) …

Teledentistry: An Innovative Workforce Model For Dental Hygienists, Kayla T. Khau, Hannah H. Nguyen

Dental Hygiene Student Scholarship

Objective/Aims: This review of literature seeks to explore teledentistry as an alternative dental hygiene workforce model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally-connected oral healthcare team. It will also emphasize the innovative methods of teledentistry giving better health care delivery to diverse populations.

Methods: The review of literature analyzed the conclusions and discussions of primary and secondary scholarly articles from PubMed, Google Scholar, Embase, and CINAHL. Specific key terms included teledentistry, telehealth, teleconsultation, dental hygiene, dentistry, workforce model, health care delivery. Articles included in this review were published within the …

Ectopic Pregnancy In A Woman With T9 Ais A Paraplegia Secondary To High-Grade Spinal Cord Pilocytic Astrocytoma, Elisabeth K. Acker

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Ectopic pregnancy in a woman with T9 AIS A (motor complete, sensory complete) paraplegia secondary to a high-grade spinal cord pilocytic astrocytoma

Background

In the United States, 20,000 women of childbearing age have a spinal cord injury (SCI). While SCI induces transient amenorrhea immediately after injury, women generally have normal reproductive function after SCI, and their fertility is unimpaired. Medications that commonly manage complications of SCI should be avoided or discontinued during pregnancy. Complications inherent to SCI, including urologic issues, are often exacerbated during pregnancy.

Methods

This is a case report on a female Veteran who initially presented to the …

Erector Spinae Plane Block And Improved Perioperative Outcomes In Breast Brachytherapy, Jialiu D. Li, Yvonne Nguyen Md, Michael Buxhoeveden, Sabrina Dhillon

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Utility Of Non-Invasive Testing For Fibrosis Assessment In Patients With End Stage Renal Disease, Nikita Chadha Do, Taseen Syed Mbbs, Richard K. Sterling Md, Msc

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Background: Non-alcoholic fatty liver disease (NAFLD) risk factors including metabolic syndrome (MS) and its components obesity (BMI ≥ 30), diabetes mellitus (DM), hypertension (HTN), and dyslipidemia (DL), has an increased prevalence in end stage renal disease (ESRD). The goal of study was to assess utility of non-invasive testing (NIT) including transient elastography (TE) for liver stiffness (LS), controlled attenuated parameter (CAP) for steatosis, Fibrosis-4 (FIB-4), AST to platelet ratio (APRI) and NAFLD Fibrosis score (NFS), for assessment of NAFLD in patients with ESRD undergoing renal transplant (RT) evaluation.

Methods: Demographic, clinical and laboratory data were collected within 12 weeks of …

A Closer Look At The Psychiatric Effects Of Deep Brain Stimulation To Further Guide Treatment Of Refractory Epilepsy: A Focused Review, Latangela Smith

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction: Effective treatment of medically-refractory epilepsy remains a formidable challenge in many patients. The SANTE trial (2010) led to the FDA approval of deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) for the treatment of medically-refractory epilepsy. However, ANT DBS also raised significant mental health concerns. This review will take another look at the psychiatric effects of DBS to more definitively outline the mental health risks and identify additional targets to guide future treatment.

Methods: A search of the clinical literature published between January 1, 1990 and December 31, 2019 was completed. The most relevant papers …

Are You In Or Obs? A Qi Project To Improve Resident Accuracy Of Admission Status Of Hospitalized Patients, Brooke Farquhar

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Efficacy Of Combined Spinal Epidural With Adductor Canal Block For Total Knee Arthroplasty, Simrat Kaur, Nicholas Bastug, Michael Buxhoeveden, Sabrina Dhillon

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction: Combined Spinal Epidural (CSE) is often used as the primary anesthetic for Total Knee Arthroplasties (TKA) (4). Intrathecal morphine (ITM) is associated with pruritus, post-operative nausea and vomiting (PONV), and respiratory depression(3). Our institutional preference for TKA includes an opioid free CSE with Adductor Canal (AC) block. The objective of this study is to ascertain if CSE with AC block is beneficial as compared to CSE with ITM for TKA. We hypothesized improved side-effect profile and non-inferior pain control.

Methods: We reviewed 20 patients that received a CSE and AC block for TKA in 2018 and compared them to …

More Than Meets The Ipex: Finding The Right Source In An Immunosuppressed Patient, Ban Wang, Brant Ward

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Patients with immune dysregulation polyendocrinopathy enteropathy X-linked (IPEX) syndrome usually present with autoimmunity, but are also prone to significant infections. In this case report, we introduce a 21-year-old gentleman with IPEX syndrome who presented to our ED with witnessed episodes of tonic-clonic seizures that likely represented aseptic meningitis secondary to Ehrlichia infection.

We determined that our patient’s clear exposure history to animals likely carrying zoonotic diseases fits the clinical picture of aseptic meningitis that was triggered by systemic tick-borne infection. We were able to make our conclusions based on our patient’s multiple negative viral and bacterial in both blood and …

Erector Spinae Plane (Esp) Blocks In Patients Receiving Subcutaneous Icd Placement: A Noninferiority Trial, Andrew Cutshall, Sabrina Dhillon, Michael Buxhoeveden, Juhee Sharma

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

How To Improve Resident Firearm Safety Education, Hannah Hollon, Elizabeth Wolf, Darina Dinov

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Abstract: How to Improve Resident Firearm Safety Education

Hannah Hollon, MD, Darina Dinov, DO, Elizabeth Wolf, MD, MPH

Background: Gun violence is the second leading cause of death in children, and one third of children in the United States live with a gun in the home.¹ Despite this public health challenge, there is a lack of firearm safety education in residency programs. One study from 1997 surveyed pediatric residencies across the country and found that 34% of programs reported having formal firearm safety education as part of their curricula. The programs cited lack of trained personnel, educational …

The Effect Of Stress Inoculation Training On Endotracheal Intubation, Alexandra P. Lambert

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Stressful situations pervade emergency medicine. Many studies demonstrate the deleterious impacts of stress on a physician’s immediate actions and lasting mental health. It is well-documented in the literature that preparedness can help mediate stress. Stress inoculation training (SIT) is utilized to prevent adverse stress response. This training teaches coping skills and defensive thinking to actively mitigate the negative physiological effects that occur during stressful events. SIT theory involves a conceptualization phase, skills training phase and application phase. The goal of this study is to evaluate the effect of SIT on endotracheal intubation performance of novice intubators.

Methods

The study …

Seminal Vesicle Adherent To Rectal Wall Following Neoadjuvant Chemoradiotherapy: A Potential False-Positive Diagnostic Pitfall, Samia Liaquat, Michael O. Idowu, Bryce Hatfield

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

The standard of care for stage T3 and stage T4 rectal adenocarcinomas involves neoadjuvant chemoradiotherapy followed by either low anterior resection or abdominopelvic resection. The presence of residual adenocarcinoma or positive surgical margins provides useful prognostic information and can influence ongoing adjuvant therapy. Although uncommon, mimics of treated adenocarcinoma may be present in the surgical specimen. A high index of suspicion is critical in avoiding potential false-positive pitfall, and the exclusion of mimics of treated adenocarcinoma is paramount to accurate diagnosis and treatment. Seminal vesicle epithelium has long been a challenge in differentiating prostatic adenocarcinoma from benign epithelium. However, the …

Increasing Accurate And Timely Completion Of Medication Reconciliation In Pediatrics, George Thieroff, Megan Coe, Maria Belen Pappa, Imen Becetti, Kemper Wesley Steffe, Kelley Byrum, Kristi Higgins, Ashlie Tseng

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Quiet Please: The Effects Of Sleep Quality And Quantity As A Result Of A Qi Project To Minimize Nighttime Sleep Interruptions, Chari Stump, Ashlie Tseng, Jennifer Brigle, Clifton Lee

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Quiet Please! The effects on sleep quality and quantity as a result of QI project to minimize nighttime interruptions

INTRODUCTION: Sleep is a significant component of health that is often overlooked in hospitalized patients. We introduced a QI project in 2016 to minimize nighttime interruptions in clinically stable patients by performing “passive vitals” which eliminated temperature and blood pressure readings at 4am and allowed patients to sleep longer overnight. Despite this intervention, the effects on sleep quality and quantity are unknown.

OBJECTIVE: The objective was to compare total sleep time, sleep interruptions, and sleep quality between patients eligible for passive …