Medicine and Health Sciences Commons^™

Laboratory Markers Predictive Of Fulminant Clostridioides Difficile Infection Refractory To Fluid Resuscitation, Omar Ahmad, Timothy N. Crawford, Vaneet Arora, Mitu Karki Maskey

Family Medicine Faculty Publications

Background: Old age, leukocytosis, hypoalbuminemia, and elevated creatinine have been identified as risk factors for fulminant Clostridioides difficile infection (CDI). High ATLAS scores have also been linked to fatal disease. The affiliated studies, however, involved patients prescribed metronidazole - a regimen no longer standard of care. The variables were thus reassessed in patients prescribed optimal therapy.

Methods: Adults hospitalized with CDI at University of Kentucky Medical Center were retrospectively reviewed. Enrolled subjects were separated according to disease classification i.e. non-severe/severe versus fulminant CDI. Fulminant patients were further subdivided into hypotensive persons responsive to fluid resuscitation, and those with sequent shock, …

Modeling Seizures In The Human Phenotype Ontology According To Contemporary Ilae Concepts Makes Big Phenotypic Data Tractable., David Lewis-Smith, Peter D Galer, Ganna Balagura, Hugh Kearney, Shiva Ganesan, Mahgenn Cosico, Margaret O'Brien, Priya Vaidiswaran, Roland Krause, Colin A Ellis, Rhys H Thomas, Peter N Robinson, Ingo Helbig

Faculty Research 2021

OBJECTIVE: The clinical features of epilepsy determine how it is defined, which in turn guides management. Therefore, consideration of the fundamental clinical entities that comprise an epilepsy is essential in the study of causes, trajectories, and treatment responses. The Human Phenotype Ontology (HPO) is used widely in clinical and research genetics for concise communication and modeling of clinical features, allowing extracted data to be harmonized using logical inference. We sought to redesign the HPO seizure subontology to improve its consistency with current epileptological concepts, supporting the use of large clinical data sets in high-throughput clinical and research genomics.

METHODS: We …

Promise And Complexity Of Lupus Mouse Models, Erica Moore, Joshua A. Reynolds, Anne Davidson, Stefania Gallucci, Laurence Morel, Deepak A. Rao, Howard A. Young, Chaim Putterman

United States Public Health Resources

As a follow up to a 2010 meeting deliberating on the benefits of studying mouse models of systemic lupus erythematosus (SLE), the virtual conference “Mouse models of lupus 10 years later” convened on 10 December 2020 to address a challenging decade that saw few new therapies approved, despite leaps in knowledge

Abnormalities in both innate and adaptive immunity characterize SLE, a systemic autoimmune disease with potentially severe consequences in patients. Treatment has traditionally been limited to broad-acting, side-effect-heavy immunosuppressants, which are also incompletely effective. Thus, the need for specific therapies targeting the pathogenic mechanisms of SLE remains unmet. Affirming the …

Smoking Cessation Interventions In South Asian Region: A Systematic Scoping Review, Sajid Iqbal, Rubina Barolia, Pammla Petrucka, Laila Ladak, Rameesha Rehmani, Abdul Kabir

School of Nursing & Midwifery

Background: Cigarette smoking is one of the most preventable causes of morbidities and mortalities. Since 2005, the World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) provides an efficient strategic plan for tobacco control across the world. Many countries in the world have successfully reduced the prevalence of cigarette smoking. However, in developing countries, the prevalence of cigarette smoking is mounting which signifies a need of prompt attention. This scoping review aims to explore the extent and nature of Smoking Cessation (SmC) interventions and associated factors in South Asian Region (SAR) by systematically reviewing available recently published and unpublished literature. …

Sglt2i Use In Non-Diabetics, Sarah Nadeem, Masooma Rana, Kaleem Ahmed, Sanjay Kalra

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.

Clinical Presentations Associated With Adverse Outcomes Among Patients Admitted With Dengue At A Tertiary Hospital In Dar Es Salaam., Nakiganda John Mkasa

Master of Medicine in Family Medicine

Introduction Dengue is one of the most important mosquito viral borne infections caused by four viral serotypes (DENV 1-4). In 2019 WHO named dengue as among the top ten global threats due to an increase in the number of cases worldwide. Tanzania is among the countries in Africa with multiple outbreaks; 2010, 2013-2014, and 2019. Dengue has variable clinical presentations ranging from nonspecific such as fever, joint pain, and fatigue to more serious such as hemorrhage and shock. Dengue can result in adverse outcomes such as ICU admissions and prolonged hospital stays. Clinical presentations associated with adverse outcomes have been …

The Contribution Of Dysphagia To Acute Stroke Morbidity And Mortality In Nigeria: A Prospective Study, O O. Olajide, Philip Adebayo, F T. Taiwo, M O. Owolabi, A Ogunniyi

Faculty of Health Sciences, East Africa

Background:

The assessment of time-trend morbidity and mortality in acute stroke is critical to clinical policy decisions and resource allocation.

Objectives:

To determine the prevalence of dysphagia in acute stroke and the impact of dysphagia on short term stroke outcome (30 days post-stroke).

Methods:

This was a prospective longitudinal study. Bedside screening for dysphagia modified Rankin score (MRS) and Barthel Index (BI) were performed on acute stroke patients on day 1, day 7, day 14 and day 30 after stroke to determine the frequency of dysphagia. Patients with dysphagia were then compared with age- and gender-matched controls (stroke patients without …

Testicular Torsion Induced By Epididymo-Orchitis: A Case Report, Ali Akbar Zehri, Allyzain Ismail, Philip Adebayo, Authar Ali

Faculty of Health Sciences, East Africa

Introduction and importance:

Acute scrotum is considered a urological emergency requiring early intervention depending on the cause. There are multiple causes of acute scrotum with testicular torsion being the most feared as delayed treatment leads to testicular loss. However, differentiating between epididymo-orchitis and torsion can be very difficult.

Case presentation: We present a case of an 18-year old male patient with 2 separate episodes of acute scrotum. He had epididymo-orchitis as the first presentation followed by testicular torsion 5 days later. To our knowledge this is the first case of testicular torsion secondary to epididymo-orchitis.

Clinical discussion: Differentiating between epididymo-orchitis …

Adjuvant Drugs For Peripheral Nerve Blocks: The Role Of Nmda Antagonists, Neostigmine, Epinephrine, And Sodium Bicarbonate, Amber N. Edinoff, Joseph S. Fitz-Gerald, Krisha Andrea A. Holland, Johnnie G. Reed, Sarah E. Murnane, Sarah G. Minter, Aaron J. Kaye, Elyse M. Cornett, Farnad Imani, Seyed Hossein Khademi, Adam M. Kaye, Richard D. Urman, Alan David Kaye

School of Pharmacy Faculty Articles

The potential for misuse, overdose, and chronic use has led researchers to look for other methods to decrease opioid consumption in patients with acute and chronic pain states. The use of peripheral nerve blocks for surgery has gained increasing popularity as it minimizes peripheral pain signals from the nociceptors of local tissue sustaining trauma and inflammation from surgery. The individualization of peripheral nerve blocks using adjuvant drugs has the potential to improve patient outcomes and reduce chronic pain. The major limitations of peripheral nerve blocks are their limited duration of action and dose-dependent adverse effects. Adjuvant drugs for peripheral nerve …

Adjuvant Drugs For Peripheral Nerve Blocks: The Role Of Alpha-2 Agonists, Dexamethasone, Midazolam, And Non-Steroidal Anti-Inflammatory Drugs, Amber N. Edinoff, Garrett M. Houk, Shilpa Patil, Harish Bangalore Siddaiah, Aaron J. Kaye, Priya Shelvan Iyengar, Elyse M. Cornett, Farnad Imani, Kamran Mahmoudi, Adam M. Kaye, Richard D. Urman, Alan David Kaye

School of Pharmacy Faculty Articles

Adjuvant drugs for peripheral nerve blocks are a promising solution to acute postoperative pain and the transition to chronic pain treatment. Peripheral nerve blocks (PNB) are used in the brachial plexus, lumbar plexus, femoral nerve, sciatic nerve, and many other anatomic locations for site-specific pain relief. However, the duration of action of a PNB is limited without an adjuvant drug. The use of non-opioid adjuvant drugs for single-shot peripheral nerve blocks (sPNB), such as alpha-2 agonists, dexamethasone, midazolam, and non-steroidal anti-inflammatory drugs, can extend the duration of local anesthetics and reduce the dose-dependent adverse effects of local anesthetics. Tramadol is …

Impact Of Flattening Filter-Free Field On Online Adaptive Radiotherapy Using Virtual Couch Shift (Vcs) Technique, Q Liu, J Liang, D Yan

Conference Presentation Abstracts

No abstract provided.

Review Article: Diagnosis, Management And Patient Perspectives Of The Spectrum Of Constipation Disorders., Amol Sharma, Satish S C Rao, Kimberly Kearns, Kimberly D Orleck, Scott A Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: Chronic constipation is a common, heterogeneous disorder with multiple symptoms and pathophysiological mechanisms. Patients are often referred to a gastroenterology provider after laxatives fail. However, there is limited knowledge of the spectrum and management of constipation disorders.

AIM: To discuss the latest understanding of the spectrum of constipation disorders, tools for identifying a pathophysiologic-based diagnosis in the specialist setting, treatment options and the patient's perspective of constipation.

METHODS: Literature searches were conducted using PubMed for constipation diagnostic criteria, diagnostic tools and approved treatments. The authors provided insight from their own practices.

RESULTS: Clinical assessment, stool diaries and Rome IV …

Serological Survey Of Leptospira Infection In Arabian Horses In Poland, Bernard Wasiński, Katarzyna Paschalis-Trela, Jan Trela, Michał Czopowicz, Jerzy Kita, Monika Żychska, Anna Cywińska, Iwona Markowska-Daniel, Craig N. Carter, Lucjan Witkowski

Veterinary Diagnostic Laboratory Faculty Publications

Leptospirosis is one of the most common zoonotic infections worldwide, including in most livestock, some companion animals, horses, wildlife, and humans. Epidemiological estimation of its prevalence in all species is difficult due to the variety of clinical presentations and challenges regarding laboratory diagnosis. The purpose of this study was to measure the seroprevalence of leptospiral infection in Arabian horses kept in the largest breeding farms in Poland, representing over 15% of the Polish Arabian horse population. Leptospira antibodies were detected by MAT (cut-off 1:100) in 33.2% of serum samples (204 of 615 animals) (CI 95%: 29.6–37.0%), most frequently reacting with …

Post-Operative Seizure Control In Patients With Glioblastoma, Ummey Hani, Muhammad Ammar Haider, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

While the median survival in patients with glioblastoma has not improved significantly over the past decade, aggressive attempts have been made on palliation and improving quality of life in these patients. A confluence of two debilitating pathologies which massively distorts the normal day-to-day functioning of the patients who experience it, seizures in glioblastoma patients portends a poor prognosis. There exists a paucity of reported seizure outcomes after glioblastoma treatment in neurosurgical literature. Herein we present a review examining post-operative seizure control in patients with glioblastoma.

The Necessity Of Human Factors Training In Emergency Medicine Residency: A Road Less Travelled, Abdul Ahad Chhotani, Shahan Waheed

Department of Emergency Medicine

No abstract provided.

Streptococcal Pharyngitis: Delving Deeper Than The Throat, Sadaf Sheikh, Umair Javed, Muhammad Akbar Baig

Department of Emergency Medicine

Acute rhabdomyolysis and elevated transaminases during streptococcal pharyngitis are rare presentations. The proposed pathophysiological mechanisms include direct bacterial invasion and toxin generation. Physicians should be aware of the association between these infections and the above-mentioned complications to facilitate optimal treatment of these patients. We present the case of a 18-years-old gentleman with β-haemolytic streptococcal pharyngitis complicated by rhabdomyolysis and elevated liver function tests. Such high levels of creatine phosphokinase of 111856 IU/L and elevated liver function tests with aspartate aminotransferase (AST) of 1862 U/L and alanine aminotransferase (ALT) of 1003 U/L in streptococcal pharyngitis is rare to find in the …

Functional Impact Of A Germline Ret Mutation In Alveolar Rhabdomyosarcoma., Noah E Berlow, Kenneth A Crawford, Carol J Bult, Christopher Noakes, Ido Sloma, Erin R Rudzinski, Charles Keller

Faculty Research 2021

Specific mutations in the RET proto-oncogene are associated with multiple endocrine neoplasia type 2A, a hereditary syndrome characterized by tumorigenesis in multiple glandular elements. In rare instances, MEN2A-associated germline RET mutations have also occurred with non-MEN2A associated cancers. One such germline mutant RET mutation occurred concomitantly in a young adult diagnosed with alveolar rhabdomyosarcoma, a pediatric and young adult soft-tissue cancer with a generally poor prognosis. Although tumor tissue samples were initially unable to provide a viable cell culture for study, tumor tissues were sequenced for molecular characteristics. Through a hierarchical clustering approach, the index case sample was matched to …

Food Insecurity On Llu Campus And The Awareness Of Resources Available, Laura Aldama, Holly Lai-Eschen, Hannah Nua

Loma Linda University Research Reports

Background: The prevalence of food insecurity (FI) on college campuses in the United States was 41% in 2018. However, most studies focus on undergraduate students on public college campuses. Food insecurity has been shown to lead to poor sleep, higher BMI, worse academic outcomes, poor mental health, less physical activity, and the consumption of less fruits and vegetables than their food secure peers.

Objective: The purpose of this graduate student research study was to determine the prevalence of food insecurity among students at LLU (a private and predominately graduate university) and their awareness of local food resources.

Methods …

Longitudinal Analysis Of Myocardial Function Using Strain In Patients Receiving Cardiotoxic Chemotherapy, Anmol Goyal, Amulya Buddhavarapu, Kayla Simpson, Nataliya Kibiryeva, Wendy Hein, Joy M. Fulbright, Sanket Shah

Posters

Background:

Chemotherapy-related cardiotoxicity (CTRC) is associated with significant morbidity and mortality in long-term cancer survivors. Left ventricular [LV] Global longitudinal strain (GLS) is a sensitive parameter that can be used for earlier detection of contractile function changes in these patients. Recent literature suggested certain genotypes may influence CTRC. Our goal was to assess longitudinal myocardial function and identify any correlation between certain genetic variations and LV function regarding CTRC in our pediatric population.

Methods:

50 subjects ≥10 years of age who have survived >2 years after completion of cancer treatment were enrolled out of which 29 subjects agreed for genetic …

Transient Tricuspid Valvulitis: Another Brief Casualty Of Covid-19 In Children, Amulya Buddhavarapu, Girish S. Shirali, Stephen Kaine, Doaa Aly

Posters

Clinical Presentation:

We discuss 3 patients, 8-10 years old, with significant tricuspid valve dysfunction during initial days of admission for multi-system inflammatory syndrome in children (MIS-C) associated with coronavirus 2019 (COVID-19) infection.

All 3 patients had COVID antibodies and presented in uncompensated shock needing aggressive fluid resuscitation and vasoactive support. Elevated acute inflammatory markers, acute kidney injury (2/3 patients), troponin leak and repolarization abnormality on ECG were present on admission and resolved by discharge. All were treated with intravenous immunoglobulin (IVIG) infusion, high-dose steroids and prophylactic low molecular weight heparin. They were discharged home on aspirin and steroid taper.

All …

Challenges In Echocardiographic Diagnosis Of Corrected Malposition Of Great Arteries: The Segmental Approach Coming Handy, Amulya Buddhavarapu, Anmol Goyal, Sanket Shah, Nitin Madan, Hayley S. Hancock, Maria Kiaffas

Posters

Clinical Presentation

Two cases of {S,D,L} anatomically corrected malposition of great arteries (ACMGA) are presented with differences in conal anatomy. Case 1: A fetal echocardiogram (echo) performed at 28 weeks gestation due to multiple anomalies revealed atrial situs solitus, D-loop ventricles, a large conoventricular septal defect (VSD) and an overriding, anterior and leftward aorta. The diagnosis of double outlet right ventricle (DORV) vs ACGMA was entertained. Postnatal echo revealed {S,D,L} segmental anatomy with ventriculoarterial concordance consistent with ACGMA and a muscular VSD. Case 2: A 3-week-old boy presented to clinic for a murmur evaluation with no associated cardiac symptoms. Transthoracic …

Delayed Intracranial Hemorrhage After Blunt Head Trauma While On Direct Oral Anticoagulant: Systematic Review And Meta-Analysis, Thaddeus J Puzio, Patrick B Murphy, Heather R Kregel, Ryan C Ellis, Travis Holder, Michael W Wandling, Charles E Wade, Lillian S Kao, Michelle K Mcnutt, John A Harvin

Library Staff Publications

Introduction: Delayed intracranial hemorrhage (ICH) after a negative initial head cat scan (CT) is a recognized complication after blunt trauma but the risk of this condition is unknown. Due to theoretical increased risk in patients on direct oral anticoagulants (DOACs) and inability to monitor degree of anticoagulation, there is a lack of consensus regarding need for additional observation or routine repeat head CT. We hypothesized that patients on DOACs would have a low risk of delayed ICH after blunt head trauma.

Methods: In June 2020, an electronic literature search of MEDLINE (Ovid), Embase (Elsevier), and Cochrane Library was performed by …

Systematic Review On Epidemiology, Interventions And Management Of Noncommunicable Diseases In Acute And Emergency Care Settings In Kenya, Christine Ngaruiya, Annrita Kawira, Florence Mali, Faith Kambua, Beatrice Mwangi, Mbatha Wambua, Denise Hersey, Laventa Obare, Rebecca Leff, Benjamin Wachira

Emergency Medicine, East Africa

Introduction: Mortality and morbidity from Non-Communicable Diseases (NCDs) in Africa are expected to worsen if the status quo is maintained. Emergency care settings act as a primary point of entry into the health system for a spectrum of NCD-related illnesses, however, there is a dearth of literature on this population. We conducted a systematic review assessing available evidence on epidemiology, interventions and management of NCDs in acute and emergency care settings in Kenya, the largest economy in East Africa and a medical hub for the continent.

Methods: All searches were run on July 15, 2015 and updated on December 11, …

2020 Nursing Annual Report, Children's Health System Of Texas

2020

No abstract provided.

Depression, Depression Literacy, And Sociodemographic Characteristics Of Korean Americans: A Preliminary Investigation, Kunsook Bernstein, Young-Me Lee, Philmon N. Gona, Shinhi Han, Soonsik Kim, Sun S. Kim

Publications and Research

Despite the rapid growth in the number of Korean Americans (KAs) and the alarmingly high prevalence of depression in this population, relatively little is known about the impact of depression literacy on KAs’ depression. This study investigated the prevalence of depressive symptoms among a community-based sample of KA adults; the associations among socio-demographic characteristics, depression literacy, and depressive symptoms; and predictors related to depressive symptoms. A sample of 600 KAs completed depression and depression literacy scales, as well as socio-demographic questionnaires. Data analyses were conducted to assess the association between depressive symptoms, depression literacy, and the covariates. Forty-five percent of …

Cilësia E Jetës Te Pacientët Me Diabet Tip 2, Arta Rama

Theses and Dissertations

Hyrja: Diabeti mellitus i tipit 2 (T2DM) është një problem global shëndetësor në zgjerim, i lidhur ngushtë me epideminë e mbipeshes. Individët me diabet mellitus tip 2 janë në rrezik të lartë për të dy ndërlikimet mikrovaskulare (përfshirë retinopatinë, nefropatinë dhe neuropatinë) dhe komplikimet makrovaskulare (të tilla si sëmundjet kardiovaskulare) për shkak të hiperglikemisë dhe përbërësve individualë të sindromës së rezistencës ndaj insulinës (metabolike).

Qëllimi: Ky punim ka për qëllim ngritjen e cilësisë së jetës te personat që vuajnë nga diabeti mellitus tip 2, pra përmirësimin e jetesës, këshillimin që të mirren me sporte të ndryshme, përfshirë këtu ecjen …

Hipertensioni Arterial Dhe Njohuritë E Të Semurëve Në Lidhje Me Dietën Dhe Stilin E Jetesës, Kaltrina Rexhepi Rizani

Theses and Dissertations

Hipertensioni është një problem serioz me ndikim të rëndësishme për individët, familjet, komunitetin dhe shërbimet shëndetësore. Hipertensioni arterial përcaktohet rritja e presionit të gjakut përmbi vlerat që konsiderohen normale. Sipas kritereve të përcaktuara nga OBSH (Organizata botërore e shëndetit) vlerat normale të presionit arterial janë rreth 140 mmHg, ndërsa presioni diastolik duhet ti ketë vlerat rreth 90 mmHg. Dihet se presioni arterial nuk është konstant dhe në periudha të ndryshme gjatë ditës ndryshon nga vlerat më të larta gjatë sistolës në vlerat më të ulëta gjatë diastolës së zemrës. Qëllimi i këtij studimi është të kuptojmë se cilët janë faktorët …

Ndikimi I Mjedisit Në Sëmundjet Kronike Obstruktive Të Mushkërive Dhe Shëndeti, Fitore Salihi

Theses and Dissertations

Sëmundja kronike obstruktive e mushkërive (SKOM) është shkaku kryesor i sëmundshmërisë dhe vdekshmërisë në të gjithë botën. Zhvillimi dhe përkeqësimi i SKOM ndikohen nga faktorët e mjedisit. Pirja e duhanit e cigareve është një faktor kryesor i rrezikut për sëmundjen e SKOM, dhe pirja e duhanit në mjedis gjithashtu kontribuon në zhvillimin e tij. Ekspozimi në punë ndaj avullit, pluhurit, gazit dhe tymrave janë faktorë të tjerë të rëndësishëm të rrezikut për sëmundjen e sëmundjes SKOM. Ndotja e ajrit në natyrë rrit pranimet në spital të lidhura me SKOM dhe është një faktor i rëndësishëm për përkeqësimin e sëmundjes dhe …

Njohuritë Dhe Praktikat Për Kontraceptivët Tek Femrat, Nexhibe Rexhepi

Theses and Dissertations

Në rastin e hartimit të këtij hulumtimi shkencor jam përpjekur që nivelin teorik e sistematik të trajtimit të qështjeve të caktuara të ia përshtasë parimeve të caktuara pedagogjike. Gjithashtu jam përpjekur që temën ta trajtoj në detaje, qysh nga kohët e lashta prej kur ka filluar njohja e metodave kontraceptive, përdorimi i tyre dhe inovacionet e tyre si pasojë e nevojave njerëzore për mbrojtjen nga sëmundjet transmisive dhe rritjes së kontrollit në lindje.

Abortet e shpeshta, numri i madhë i Shtatëzanive të padëshiruara, Edukimi i ulët seksual në Shoqërinë tonë më kanë shtyer të hulumtoj më shumë rreth këtyre çështjeve …

Satisfaksioni I Infermierëve Me Kushtet E Punës Në Kujdesin Parësor Në Lipjan, Leonard Buja

Theses and Dissertations

Hyrje: Kënaqësia e punës së infermierëve është një aspekt shumë i rëndësishëm dhe një pikë shqetësimi për cdo organizatë shëndetsore. Infermierët kanë vendet më të shumta të punës në këto institucione, dhe zëvendësimi i personelit është i kushtueshëm dhe konsumon shumë kohë. Në punën spitalore shumë kolegë infermierë janë të ekspozuar ndaj niveleve të ndryshme të kënaqësisë në punë, por cfarë i bën infermierët të jenë të kënaqur ose jo me profesionin e tyre, të cilin mund ta kenë zgjedhur edhe vetë. Qëllimi i punimit: Qëllimi i këtij punimi ishte vlerёsimi i kënaqshmërisë në punë i infermierëve me kushtet e …