Medicine and Health Sciences Commons^™

Finding Needle In A Haystack; Neuroleptic Malignant Syndrome Disguising Meningitis In A 2-Years-Old Girl, Raman Kumar, Farah Shams Abbasi, Asma Noreen

Pakistan Journal of Neurological Sciences (PJNS)

Fever with CNS symptoms in children is almost, always considered to be a CNS infection and treated as Meningitis. Central causes of fever are not usually taken in to the account in such cases. We present a case of a 2- year old girl who developed fever and CNS symptoms after she was given anti-emetic medications for her initial presentation of acute gastroenteritis. She developed high grade fever and spasticity and was treated on lines of meningitis empirically without any evidence of infection. She did not improve and once she fulfilled clinical criteria of Neuroleptic malignant syndrome, her condition improved, …

Pediatric Neurology In Pakistan: Past, Present And Future, Iram Javed

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

A Rare Case Of X-Linked Bulbo-Spinal Muscular Atrophy With Sensory Neuropathy And Tremors, Waleed Shahzad, Muhammad Hassan, Mansoor Iqbal, Zakir Jan, Tehmina Inayat, Mazhar Badshah, Muhammad Irshad

Pakistan Journal of Neurological Sciences (PJNS)

Kennedy disease (KD) is also known as spino bulbar muscular atrophy caused by a tandem C-A-G tri-nucleotide repeat. It is an adult-onset X-linked recessive inherited neurodegenerative disease involving lower motor neuron damage with predominance of facial muscles. It is often accompanied with androgen sensitivity, sensory nerve damage and endocrinal involvement. It has similar confusing symptoms and is often mis-diagnosed with most of the neuromuscular diseases like POEMS syndrome, myasthenia gravis, mitochondrial myopathy and amyotrophic lateral sclerosis. Hence clinical differentiation is important to prevent adverse outcomes and un-necessary treatment. Here we describe a rare case of a 46 year old Pakistani …

Folate As Adjunct Therapy To Ssri/Snri For Major Depressive Disorder: Systematic Review & Meta-Analysis, Rabail Altaf, Irasema Gonzalez, Kimberly Rubino, Eric C. Nemec

Physician Associate Studies Faculty Publications

Objective: Evaluate depression scores, response, and remission rates in patients with major depression receiving adjunct therapy with folate (L-Methylfolate or folic acid) compared to selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor (SSRI or SNRI) monotherapy.

Methods: Academic Search Premier, CINAHL Complete, Cochrane Database of Systematic Reviews, Medline with Full Text, PsychInfo, PubMed, ClinicalTrials.org, and Google Scholar were searched utilizing specific key words. Identified studies were independently screened for inclusion by two reviewers, were assessed for risk of bias using the Revised Cochrane risk-of-bias tool (RoB2), then meta-analyzed using a random effects model with Review Manager (5.4) software.

Results: The …

Exploring Barriers And Enablers Of Service Provision For Survivors Of Human Trafficking In The Bay Area: An Action Research Study, Pooja Sripad

Reproductive Health

Despite increasing recognition of public health and rights issues associated with human trafficking globally and in the United States following the Trafficking Victims Protection Act of 2000, there has been limited research on how to systematically strengthen service access for survivors of sex and labor trafficking. The experience of service providers may provide insight into how trafficking survivor responses and service networks function in California’s Bay Area. This study explores provider perspectives on existing service networks and collaboration dynamics, including the barriers to and enablers of long-term service provision and survivor follow-up. A participatory research design included qualitative interviews with …

Reversing The Effects Of Androgen-Deprivation Therapy In Men With Metastatic Castration-Resistant Prostate Cancer, Catherine H Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, Rakhee Gawande, Clifford R Weiss, Samuel R Denmeade, Corinne Joshu

Department of Medical Oncology Faculty Papers

OBJECTIVE: To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.

PATIENTS AND METHODS: Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.

RESULTS: …

Going Off The Deep End - The Life And Controversies Of Henry Heimlich, Md, Bradford L. Walters, Matthew Drogowski

Articles

No abstract provided.

Prevalence And Subgroup Comparisons Of Obesity And Severe Obesity Among Mississippi Public School Students, Lei Zhang, Xiaoshan Z. Gordy, Jerome Kolbo, Jacquelynn Johnson

Faculty Publications

This study examined the prevalence of obesity and severe obesity among Mississippi K-12 public school students and the obesity rate differences within subgroups categorized by sex, race, and grade level. Anthropometric data from a weighted, representative sample of Mississippi public school students were collected through the biennial Child and Youth Prevalence of Obesity Survey (CAYPOS). Overall prevalence rates and those of the subgroups were calculated and compared. The 2017 data indicated that overall 23.7% of Mississippi public schools students met the criterion of class I obesity, 9.1% met the criterion of class II obesity, and 3.2% met the criterion of …

Validation Of A Single Channel Eeg For The Athlete: A Machine Learning Protocol To Accurately Detect Sleep Stages, Kayla Thompson, Kamil Celoch, Frankie Pizzo, Ana I. Fins, Jaime Tartar

Journal for Sports Neuroscience

There is a large and growing movement towards the use of wearable technologies for sleep assessment. This trend is largely due to the desire for comfortable, burden free, and inexpensive technology. In tandem, given the competitive nature of professional athletes enduring high training load, sleep is often jeopardized which can result in adverse outcomes. Wearable devices hold the promise of increasing the ease of monitoring sleep in athletes which can inform health and recovery status, as well as aid performance optimization. However, wearable devices typically lack sufficient validity to assess sleep – and especially sleep stages. To address this concern, …

Hemorrhagic Stroke Outcomes Of Kapsr Patients With Co-Morbid Diabetes And Alzheimer’S Disease, Amanda L. Trout, Christopher J. Mclouth, Patrick Kitzman, Michael R. Dobbs, Lisa Bellamy, Kelley Elkins, Justin F. Fraser

School of Medicine Publications

Background: Vascular risk factors, such as diabetes mellitus (DM), are associated with poorer outcomes following many neurodegenerative diseases, including hemorrhagic stroke and Alzheimer’s disease (AD). Combined AD and DM co-morbidities are associated with an increased risk of hemorrhagic stroke and increased Medicare costs. Therefore, we hypothesized that patients with DM in combination with AD, termed DM/AD, would have increased hemorrhagic stroke severity.

Methods: Kentucky Appalachian Stroke Registry (KApSR) is a database of demographic and clinical data from patients that live in Appalachia, a distinct region with increased health disparities and stroke severity. Inpatients with a primary indication of hemorrhagic stroke …

A Phase 1-2 Study Of Rovalpituzumab Tesirine In Combination With Nivolumab Plus Or Minus Ipilimumab In Patients With Previously Treated Extensive-Stage Sclc, Jyoti Malhotra, Daniel Morgensztern, Et Al.

2020-Current year OA Pubs

INTRODUCTION: This open-label, phase 1-2 study evaluated the safety and efficacy of rovalpituzumab tesirine (Rova-T), an antibody-drug conjugate targeting DLL3, plus immune checkpoint inhibitors nivolumab plus or minus ipilimumab in previously treated extensive-stage SCLC (ES SCLC).

METHODS: Patients with histologically or cytologically confirmed, previously treated (two or more lines of therapy) ES SCLC were enrolled into two cohorts. Cohort 1 received 0.3 mg/kg Rova-T (once every 6 wk for two cycles) plus 360 mg nivolumab (two 3-wk cycles beginning on week 4). Cohort 2 received the same dosage of Rova-T as cohort 1 plus 1 mg/kg nivolumab (four 3-wk cycles) …

American Society Of Transplantation And Cellular Therapy, Center Of International Blood And Marrow Transplant Research, And European Society For Blood And Marrow Transplantation Clinical Practice Recommendations For Transplantation And Cellular Therapies In Mantle Cell Lymphoma, Pashna N Munshi, Brad Kahl, Amanda F Cashen, Et Al.

2020-Current year OA Pubs

Autologous (auto-) and allogeneic (allo-) hematopoietic cell transplantation (HCT) are accepted treatment modalities in contemporary treatment algorithms for mantle cell lymphoma (MCL). Chimeric antigen receptor (CAR) T cell therapy recently received approval for MCL; however, its exact place and sequence in relation to HCT remain unclear. The American Society of Transplantation and Cellular Therapy, Center of International Blood and Marrow Transplant Research, and the European Society for Blood and Marrow Transplantation jointly convened an expert panel to formulate consensus recommendations for role, timing, and sequencing of auto-HCT, allo-HCT, and CAR T cell therapy for patients with newly diagnosed and relapsed/refractory …

Differential Effects Of The Novel Neurosteroid Hypnotic (3Β,5Β,17Β)-3-Hydroxyandrostane-17-Carbonitrile On Electroencephalogram Activity In Male And Female Rats, Srdjan M Joksimovic, Dayalan Sampath, Kathiresan Krishnan, Douglas F Covey, Vesna Jevtovic-Todorovic, Yogendra H Raol, Slobodan M Todorovic

2020-Current year OA Pubs

BACKGROUND: We recently showed that a neurosteroid analogue, (3β,5β,17β)-3-hydroxyandrostane-17-carbonitrile (3β-OH), induced hypnosis in rats. The aim of the present study was to evaluate the hypnotic and anaesthetic potential of 3β-OH further using electroencephalography.

METHODS: We used behavioural assessment and cortical electroencephalogram (EEG) spectral power analysis to examine hypnotic and anaesthetic effects of 3β-OH (30 and 60 mg kg

RESULTS: We found dose-dependent sex differences in 3β-OH-induced hypnosis and EEG changes. Both male and female rats responded similarly to i.p. 3β-OH 30 mg kg

CONCLUSIONS: Based on its behavioural effects and EEG signature, 3β-OH is a potent hypnotic in rats, with …

Precision And Trueness Of Implant Placement With And Without Static Surgical Guides: An In Vitro Study, Arndt Guentsch, Laxmi Sukhtankar, Hongseok An, Paul Luepke

School of Dentistry Faculty Research and Publications

Statement of problem

Malpositioning of implants is one of the main factors leading to hard- and soft-tissue deficiencies. Whether static computer-guided implant placement increases accuracy and prevents malpositioning is unclear.

Purpose

The purpose of this in vitro study was to determine accuracy defined by trueness and precision (according to International Organization for Standardization 5725) of computer-assisted implant surgery (fully guided and partially guided) in comparison with freehand single implant placement.

Material and methods

Implants (n=20) were placed fully guided (sleeve-bone distance of 2, 4, or 6 mm), partially guided (guide used for pilot drill), or free hand in identical replicas …

Mixed Methods Study Of Nurse Assessment Of Patient Preferences For Engagement During Hospitalization, Teresa Jerofke-Owen, Alexandria Zielinski, Roger L. Brown

College of Nursing Faculty Research and Publications

Background

Global healthcare initiatives emphasize the importance of engaging patients in their healthcare to improve patients’ experience and outcomes. Assessing patient preferences for engagement is critical, as there are many ways patients can engage in their care and preferences vary across individuals.

Objective

The primary purpose of this study was to evaluate the effect of implementation of the Patient Preferences for Engagement Tool 13-Item Short Form (PPET13) during hospitalization on patient and nurse experience of engagement. Readmissions and emergency department (ED) usage within 30 days postdischarge were also examined.

Methods

The mixed methods study was conducted within two medical units …

Medical Device-Related Pressure Injuries Associated With Electroencephalogram Leads In A Tertiary Care Children’S Hospital: A Retrospective Chart Review, Christine A. Schindler, Rebekah Barrette, Aaron Sandock, Evelyn M. Kuhn

College of Nursing Faculty Research and Publications

BACKGROUND: Medical device-related pressure injuries (MDRPIs) present a substantial safety risk for children who are hospitalized. PURPOSE: This study aimed to describe patient and clinical characteristics of children who develop MDRPIs related to electroencephalogram (EEG) leads, determine risk factors associated with their development, and determine if there are common risk factors that can lead to actionable strategies to reduce MDRPIs related to EEG leads. METHODS: A retrospective review was completed of the electronic health records of all 3136 children who had EEG lead placements between January 1, 2014, and April 16, 2018, at a large tertiary care children’s hospital. Data …

Multiprong Control Of Glioblastoma Multiforme Invasiveness: Blockade Of Pro-Inflammatory Signaling, Anti-Angiogenesis, And Homeostasis Restoration, Nicolas G. Bazan, Madigan M. Reid, Valerie A.Cruz Flores, Juan E. Gallo, William Lewis, Ludmila Belayev

School of Medicine Faculty Publications

Glioblastoma multiforme (GBM) is the most invasive type of glial tumor with poor overall survival, despite advances in surgical resection, chemotherapy, and radiation. One of the main challenges in treating GBM is related to the tumor’s location, complex and heterogeneous biology, and high invasiveness. To meet the demand for oxygen and nutrients, growing tumors induce new blood vessels growth. Antibodies directed against vascular endothelial growth factor (VEGF), which promotes angiogenesis, have been developed to limit tumor growth. Bevacizumab (Avastin), an anti-VEGF monoclonal antibody, is the first approved angiogenesis inhibitor with therapeutic promise. However, it has limited efficacy, likely due to …

Inactivation Mode Of Sodium Channels Defines The Different Maximal Firing Rates Of Conventional Versus Atypical Midbrain Dopamine Neurons, Christopher J. Knowlton, Tabea Ines Ziouziou, Niklas Hammer, Jochen Roeper, Carmen C. Canavier

School of Medicine Faculty Publications

Two subpopulations of midbrain dopamine (DA) neurons are known to have different dynamic firing ranges in vitro that correspond to distinct projection targets: the originally identified conventional DA neurons project to the dorsal striatum and the lateral shell of the nucleus accumbens, whereas an atypical DA population with higher maximum firing frequencies projects to prefrontal regions and other limbic regions including the medial shell of nucleus accumbens. Using a computational model, we show that previously identified differences in biophysical properties do not fully account for the larger dynamic range of the atypical population and predict that the major difference is …

Implementation Of A Non-Emergent Medical Transportation Programme At An Integrated Health System, Patrick G Lyons, Brett A Ramsey, Michael Welker, Megan Guinn, Janice K Ernest, Ali Kosydor, Thomas M Maddox

2020-Current year OA Pubs

OBJECTIVES: To implement a unified non-emergency medical transportation (NEMT) service across a large integrated healthcare delivery network.

METHODS: We assessed needs among key organisational stakeholders, then reviewed proposals. We selected a single NEMT vendor best aligned with organisational priorities and implemented this solution system-wide.

RESULTS: Our vendor's hybrid approach combined rideshares with contracted vehicles able to serve patients with equipment and other needs. After 6195 rides in the first year, we observed shorter wait times and lower costs compared with our prior state.

DISCUSSION: Essential lessons included (1) understanding user and patient needs, (2) obtaining complete, accurate and comprehensive baseline …

Acute Care Pediatric Nurse Practitioners As Leaders: Perceptions, Self-Identity, And Role Congruity, Katie Mcdermott, Christine A. Schindler, Krisjon R. Olson, Tara L. Petersen

College of Nursing Faculty Research and Publications

Introduction

This study aimed to gain an understanding of practicing acute care pediatric nurse practitioners’ (AC-PNPs’) perceptions of themselves as leaders in both clinical and professional contexts.

Method

This qualitative study was conducted at a midwestern quaternary care children's hospital. Cultural domain analysis, semistructured interviews, and free listing techniques were employed to identify areas of consensus and variation among a convenience sample of AC-PNPs.

Results

Findings demonstrated the AC-PNPs have a limited self-view of leadership.

Discussion

Nurse practitioners need additional leadership capacity and capability building during graduate education, the transition to practice, and throughout their careers.

Impacts Of Neonatal Hospitalization On Families During The 2019 Coronavirus Pandemic, Ashlee J. Vance, Kathryn J. Malin, Bingxin Chen, Clayton J. Shuman, Tiffany A. Moore

College of Nursing Faculty Research and Publications

Objective Limited data are available regarding family and financial well-being among parents whose infants were hospitalized during the 2019 coronavirus (COVID-19) pandemic. The study objective was to evaluate the family and financial well-being of parents whose infants were hospitalized in the neonatal intensive care unit (NICU) during COVID-19.

Study Design Parents were recruited for this online, cross-sectional survey via support groups on social media. Data collection was completed between May 18, 2020 and July 31, 2020. The final sample consisted of 178 parents, who had an infant hospitalized in an NICU between February 1, 2020 and July 31, 2020. The …

P53 And Vegf Expression In Human Temporomandibular Joint Discs With Internal Derangement Correlate With Degeneration, Sergio Castorina, C. Lombardo, Paola Castrogiovanni, Giuseppe Musumeci, E. Barbato, Luis Eduardo Almeida, Rosalia Leonardi

School of Dentistry Faculty Research and Publications

No abstract provided.

Promoting Patient Engagement: A Scoping Review Of Actions That Align With The Interactive Care Model, Georgia Tobiano, Teresa Jerofke-Owen, Andrea P. Marshall

College of Nursing Faculty Research and Publications

Background

Conceptual clarity for the term patient engagement is growing. However, there is variability in patient engagement in healthcare, which could be due to the absence of models to guide practice or a myriad of organisational, nurse and patient factors. The recently developed ‘Interactive Care Model’ provides guidance on how to genuinely promote individualised patient engagement. An understanding of how to action this model in nursing is required.

Aims

The aim of this scoping review was to examine actions in the published scientific literature that align with the Interactive Care Model, in the context of nursing care of hospitalised patients. …

Alzheimer's Disease Alters Oligodendrocytic Glycolytic And Ketolytic Gene Expression, Erin R Saito, Justin B Miller, Oscar Harari, Carlos Cruchaga, Kathie A Mihindukulasuriya, John S K Kauwe, Benjamin T Bikman

2020-Current year OA Pubs

INTRODUCTION: Sporadic Alzheimer's disease (AD) is strongly correlated with impaired brain glucose metabolism, which may affect AD onset and progression. Ketolysis has been suggested as an alternative pathway to fuel the brain.

METHODS: RNA-seq profiles of post mortem AD brains were used to determine whether dysfunctional AD brain metabolism can be determined by impairments in glycolytic and ketolytic gene expression. Data were obtained from the Knight Alzheimer's Disease Research Center (62 cases; 13 controls), Mount Sinai Brain Bank (110 cases; 44 controls), and the Mayo Clinic Brain Bank (80 cases; 76 controls), and were normalized to cell type: astrocytes, microglia, …

A Predictive Model, And Predictors Of Under-Five Child Malaria Prevalence In Ghana: How Do Lasso, Ridge And Elastic Net Regression Approaches Compare?, Justice Moses K. Aheto, Henry Ofori Duah, Pascal Agbadi, Emmanuel Kweku Nakua

College of Nursing Faculty Research and Publications

Malaria is among the leading causes of mortality and morbidity among children in Ghana. Therefore, identifying the predictors of malaria prevalence in children under-five is among the priorities of the global health agenda. In Ghana, the paradigm shifts from using traditional statistics to machine learning techniques to identifying predictors of malaria prevalence are scarce. Thus, the present study used machine learning techniques to identify variables to build the best fitting predictive model of malaria prevalence in Ghana. We analysed the data on 2867 under-five children with malaria RDT results from the 2019 Ghana Malaria Indicator Survey. LASSO, Ridge, and Elastic …

The Incidence Of Adding-On Or Distal Junctional Kyphosis In Adolescent Idiopathic Scoliosis Treated By Anterior Spinal Fusion To L3 Was Significantly Higher Than By Posterior Spinal Fusion To L3, Seung-Jae Hyun, Lawrence G Lenke, Yongjung Kim, Keith H Bridwell, Meghan Cerpa, Kathy M Blanke

2020-Current year OA Pubs

OBJECTIVE: To compare and identify risk factors for distal adding-on (AO) or distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) treated by anterior- (ASF) and posterior spinal fusion (PSF) to L3.

METHODS: AIS patients undergoing ASF versus PSF to L3 from 2000-2010 were analyzed. Distal AO and DJK were deemed poor radiographic results. New stable (SV) and neutral vertebra (NV) scores were defined for this study. The total stability (TS) score was the sum of the SV and NV scores.

RESULTS: Twenty of 42 (ASF group: 47.6%) and 8 of 72 patients (PSF group: 11.1%) showed poor radiographic outcome. …

Consensus Recommendations On The Treatment Of Opioid Use Disorder In The Emergency Department, Kathryn Hawk, Jason Hoppe, Eric Ketcham, Alexis Lapietra, Aimee Moulin, Lewis Nelson, Evan Schwarz, Sam Shahid, Donald Stader, Michael P Wilson, Gail D'Onofrio

2020-Current year OA Pubs

The treatment of opioid use disorder with buprenorphine and methadone reduces morbidity and mortality in patients with opioid use disorder. The initiation of buprenorphine in the emergency department (ED) has been associated with increased rates of outpatient treatment linkage and decreased drug use when compared to patients randomized to receive standard ED referral. As such, the ED has been increasingly recognized as a venue for the identification and initiation of treatment for opioid use disorder, but no formal American College of Emergency Physicians (ACEP) recommendations on the topic have previously been published. The ACEP convened a group of emergency physicians …

Antimicrobial Resistance: A Challenge Awaiting The Post-Covid-19 Era, Tekle Airgecho Lobie, Aklilu Abrham Roba, James Alexander Booth, Knut Ivan Kristiansen, Abraham Aseffa, Kirsten Skarstad, Magnar Bjørås

Research on Antimicrobial Resistance

Microbe exposure to pharmaceutical and non-pharmaceutical agents plays a role in the development of antibiotic resistance. The risks and consequences associated with extensive disinfectant use during the COVID-19 pandemic remain unclear. Some disinfectants, like sanitizers, contain genotoxic chemicals that damage microbial DNA, like phenol and hydrogen peroxide. This damage activates error-prone DNA repair enzymes, which can lead to mutations that induce antimicrobial resistance. Public health priority programs that have faced drug-resistance challenges associated with diseases, such as tuberculosis, HIV, and malaria, have given less attention to risks attributable to the COVID-19 pandemic. Pathogen-specific programs, like the directly observed treatment strategy …

Can An Emergency Department Adequately Address An Older Adult Who Has Complex Needs?, Rami Tarabay, Adam Perry, Riwa Al Aridi, Michael Malone

Journal of Geriatric Emergency Medicine

Older adults account for a considerable percentage of all emergency departments (ED) patient encounters. Those with very complex needs or multiple co-morbid conditions often have lengthy ED evaluations culminating in admission, many of which are considered potentially avoidable. Provider and process elements can evolve to create efficient and more comprehensive geriatric assessments in ED. This paper describes an older adult with acute on chronic symptoms admitted through the ED to the Acute Care for Elders (ACE) inpatient unit. We illustrate how elements of the ACE model, when applied in the ED, may avoid hospitalization. We review the Domain Management Model …

Ascaris Suum Informs Extrasynaptic Volume Transmission In Nematodes, Louise E Atkinson, Yang Liu, Fiona Mckay, Elke Vandewyer, Charles Viau, Allister Irvine, Bruce A Rosa, Zihui Li, Qingxiao Liang, Nikki J Marks, Aaron G Maule, Makedonka Mitreva, Isabel Beets, Lingjun Li, Angela Mousley

2020-Current year OA Pubs

Neural circuit synaptic connectivities (the connectome) provide the anatomical foundation for our understanding of nematode nervous system function. However, other nonsynaptic routes of communication are known in invertebrates including extrasynaptic volume transmission (EVT), which enables short- and/or long-range communication in the absence of synaptic connections. Although EVT has been highlighted as a facet of