Medicine and Health Sciences Commons^™

Shared Language Builds A Foundation For Health Equity, Deborah Stamps, Ebony Caldwell, Ajda Ince

Advances in Clinical Medical Research and Healthcare Delivery

Achieving Health Equity requires developing a shared language that allows people to understand diversity in various contexts. For instance, shared language allows us to discuss diversity issues concerning gender identity, just as much as it allows us to discuss diversity issues concerning citizenship, race, or sexual attraction. This article sets out five key terms that form the foundation of a shared language: Diversity, Equity, Inclusion, Cultural Humility, and Cultural Responsiveness. The five key terms provide a solid foundation for efforts to further expand our shared language around diversity, such as a glossary defining terms like gender identity, race.

Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic is the first of its kind to hit the world in the modern information age. People working in healthcare across the globe have harnessed technological advances and modern digital tools in innovative new ways. This has brought specific, more recent trends in healthcare delivery to the forefront. In this review, we present a collection of articles that highlight some of the emerging trends in healthcare driven by the COVID-19 pandemic and that have the potential to transform healthcare in the coming decades. We provide a brief commentary on the opportunities and challenges for each trend.

Psychedelic Psychiatry, Neil Harjai

Advances in Clinical Medical Research and Healthcare Delivery

We are amidst a 'Renaissance' in the field of psychedelic psychiatry. For several decades, following a period of promising research, governmental barriers and regulations halted any research into the utility of these substances in psychiatry. Over the past few decades, however, we are seeing a revival of these studies due to an abundance of positive findings as well as the need for improved psychiatric treatments. Studies have established substances such as psilocybin and LSD to be effective in treating depressive disorders, sometimes even more so than current 'gold standards'. MDMA is being recognized as a powerful tool, in conjunction with …

Emergency Medicine Journal Club, Dave M. Gibbs, Dylan Norton, Kyle Barbour

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations and bottom line interpretation.

Hidradenocarcinoma Treated With Mohs Micrographic Surgery, Carly E. Wallace, Gian Vinelli

Advances in Clinical Medical Research and Healthcare Delivery

Hidradenocarcinomas are very uncommon malignant tumors of sweat gland origin that exhibit a high potential for local recurrence, metastasis, and poor outcome. These neoplasms typically resemble benign appearing dermal nodules that lack distinguishable features. We present the case of hidradenocarcinoma in a 39-year-old male with a 5-year history of a slow growing nodule along his right eyebrow. Excisional biopsy of the lesion was taken with pathology showing nuclear pleomorphism, increased mitoses, and foci of necrosis. Immunohistochemical analysis revealed reactivity for Ki-67/MIB1 and strong diffuse staining for p63, CK5/6, and CK7. Mohs micrographic surgery was performed and clear margins were obtained …

A Rare Presentation Of Pericardial Tumor Presenting As Chronic Cough, Swarup Sharma Rijal, William H. Risher, Aakankshya Kharel, Upendra Kaphle

Advances in Clinical Medical Research and Healthcare Delivery

Chronic cough can pose various diagnostic and therapeutic dilemmas to physicians. Airway narrowing secondary to endoluminal disease or extrinsic compression are known etiologies of chronic cough. We report an extremely rare case of chronic cough due to extrinsic airway compression by a large pericardial lipoma with subsequent resolution of symptoms after the resection of the mass. This case provides insight into the rare etiology of chronic cough that is addressable with surgical intervention.

Spontaneous Coronary Artery Dissection In A Young Male: A Case Report, Irene Tchuente M.D.

Advances in Clinical Medical Research and Healthcare Delivery

Abstract

Cardiovascular disease remains the number one cause of death worldwide. In recent years, there has been an increased focus on Coronary Artery Dissection due to the increasing number of young individuals without any cardiovascular risk factors presenting with chest pain. Many of these patients would also have elevated troponins and sometimes electrocardiogram changes suggestive of myocardial infarction. Many reported cases have been in women and only a handful of cases have been reported in men. Although some potential risk factors have been identified, more data is needed to support these hypotheses. Coronary Artery Dissection (CAD) mimics Acute Coronary Syndrome …

Management Of Right Sided Carcinoid Heart Failure, Ganesh Arun, Ismat Cheema, Lorrie Pennfield, Mohammed Raza, Erik Raborn, Ami Patel, Farhan Ali

Advances in Clinical Medical Research and Healthcare Delivery

Carcinoid heart disease is a rare complication of an already rare disease. This issue is theorized to be secondary to released proinflammatory molecules that deposit on the surfaces of heart valves. These molecules are released from the carcinoid tumor itself and manifest symptoms based on liver, lung and brain function. The detection of 5-HIAA, a breakdown source of serotonin, is useful for diagnosis. These deposits occur most commonly on the endocardium of valvular cusps and cardiac chambers. This case presents a 48 year old woman with echo findings of right heart failure in the setting of a carcinoid tumor. It …

A Case Report Of Pulmonary Actinomycosis: A Diagnostic Quagmire, Sarah Akbani, Aderinsola O. Ademiluyi, Jonathan Dean, Vinita Mathur

Advances in Clinical Medical Research and Healthcare Delivery

The implications of misdiagnosis can be drastic, especially when the correct diagnosis is treatable. Pulmonary actinomycosis is one of the complications of infection with actinomyces, an anaerobic gram-positive organism that is usually found as a part of the normal flora in the human body infection. It is a very rare disease and is frequently mistaken with other diagnoses owing to its nonspecific presentation. In this report, we present a 67-year-old male with a mass like lesion on a CT scan of his chest that was done due to progressively worsening productive cough, weight loss and fatigue. These symptoms could have …

Hemoglobin As A Predictor For Covid-19 Disease Severity, Nicholas Sarcia, Dan Thai, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: The dilemma of who is at highest risk for COVID-19 severe disease and death persists. Hemoglobin levels may be an indicator of COVID-19 disease severity. There is inconsistent data on Emergency Department (ED) hemoglobin levels and severity of disease. Our objective was to examine if COVID-19 patients presenting with abnormal hemoglobin levels have an increased risk of severe disease and in-hospital mortality.

Methods: We conducted a retrospective cohort study at Berkshire Medical Center in Pittsfield, MA to investigate the relationship of COVID-19 disease severity with hemoglobin level. Inclusion criteria consisted of ED patients over 18 years with …

Disease Severity In Covid-19 Breakthrough Cases, Dan Thai, Nicholas Sarcia, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background

Vaccine breakthrough is a phenomenon wherein vaccinated individuals become infected with disease despite adequate protection. During this study period, the Centers for Disease Control (CDC) reported 66.6% of US people have been fully vaccinated. Any measures to improve trust would increase vaccination rates. This study aims to understand vaccine breakthrough cases in COVID-19 by comparing their severity to unvaccinated cases. Our objective is to compare disease severity based on the worst initial vital signs (temperature, respiratory rate, oxygen saturation), length of stay (LOS), and age between vaccinated and unvaccinated COVID-19 cases.

Methods

We conducted a retrospective cohort study at …

A Nurse Is To A Patient What A Mother Is To A Child, Farhan S. Imran

Advances in Clinical Medical Research and Healthcare Delivery

A physician's tribute the profession of nursing.

Acute Pump Thrombosis Within One Hour Of A Heartmate 3 Implantation: Case Report, Zubair Shah, Noel Torres Acosta, Amandeep Goyal, Tarun Dalia, Sara Henkel, Travis Abicht

The VAD Journal

A 39-year-old male with a history of non-ischemic cardiomyopathy underwent a HeartMate 3 (Abbott Laboratories) implantation. Within an hour of implantation, low flow alarms were noted before exiting the operating room. The alarm was secondary to acute pump thrombosis. This is the first reported case of thrombosis immediately post-implant.

2022-05-31 Michiganoverview_Covidoutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/outbreak-reporting.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

COVID-19 outbreaks are generally defined as two or more cases with a link by place and time indicating a shared exposure outside of a household. Local health departments report the number of new and ongoing outbreaks they are investigating by the setting of the outbreak. New outbreaks are those outbreaks that were first identified during the current reporting week. Ongoing outbreaks are …

2022-05-31_Michiganoverview_Covidschooloutbreak, Michigan Department Of Health & Human Services

Michigan COVID-19 Outbreak Reports

The School Outbreak Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/school-outbreak.

This report is created by the Michigan Department of Health & Human Services from data self-reported by local health departments. Data is updated every week.

K-12 School-Related Outbreak Reporting: In accordance with the Council of State and Territorial Epidemiologists' outbreak definition, a K-12 school-associated COVID-19 case (confirmed or probable) is defined as a student, teacher, or staff member physically present in the school setting or participated in a school sanctioned extracurricular activity within 14 days prior to illness onset (or a positive test result) OR …

2022-05-31_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/stats/data-about-places/long-term-care-data.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Faculty Perspectives On Interprofessional Collaborations Between Occupational Therapy And Industrial Design: A Qualitative Ethnographic Inquiry, Kimberly S. Mollo, Madalyn Peterson, Rebecca Brown

Department of Occupational Therapy Faculty Papers

Incorporating a user-centred approach to universal design solutions improves functionality and access for a more diverse group of individuals to engage with end products within everyday environments successfully. Interprofessional collaborations between industrial design and occupational therapy are one approach that integrates a user-centred universal design perspective throughout the design process, as occupational therapists have unique expertise in understanding how individuals participate in activities and engage with everyday products and environments. This qualitative ethnographic inquiry explored faculty perspectives (n=5) involved in interprofessional academic collaborations between design and occupational therapy at the university level in the Northeastern United States. Five themes emerged: …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

Predictors Of Therapy Response In Chronic Aphasia: Building A Foundation For Personalized Aphasia Therapy, Sigfus Kristinsson, Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Jean Neils-Strunjas, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Chronic aphasia, a devastating impairment of language, affects up to a third of stroke survivors. Speech and language therapy has consistently been shown to improve language function in prior clinical trials, but few clinicially applicable predictors of individual therapy response have been identified to date. Consequently, clinicians struggle substantially with prognostication in the clinical management of aphasia. A rising prevalence of aphasia, in particular in younger populations, has emphasized the increasing demand for a personalized approach to aphasia therapy, that is, therapy aimed at maximizing language recovery of each individual with reference to evidence-based clinical recommendations. In this narrative review, …

Implementing A Diabetic Foot Care Program In A Virtual Primary Care Clinic, Zahra Naderi Asiabar

Doctor of Nursing Practice (DNP) Projects

Abstract

Background

Healthcare professionals (HCPs) have a key responsibility in delivering preventative and early intervention diabetes foot management within primary care. Diabetic foot ulcers (DFUs) are a major complication of diabetes and can lead to amputations and other wound issues.

Comprehensive care and treatment of diabetes are most effective when patients can access a supportive connection with providers. Before the pandemic, there were many reasons to utilize a technology-based distance approach to health care. The coronavirus pandemic in 2019 prompted additional reasons for the transition to distant care.

Problem

The yearly screening of a virtual foot exam on patients with …

Ultrapotent And Broad Neutralization Of Sars-Cov-2 Variants By Modular, Tetravalent, Bi-Paratopic Antibodies, Shane Miersch, Nitin Sharma, Reza Saberianfar, Chao Chen, Francesca Caccuri, Alberto Zani, Arnaldo Caruso, James Brett Case, Michael S Diamond, Gaya K Amarasinghe, Giuseppe Novelli, Sachdev S Sidhu

2020-Current year OA Pubs

Neutralizing antibodies (nAbs) that target the SARS-CoV-2 spike protein have received emergency use approval for treatment of COVID-19. However, with the emergence of variants of concern, there is a need for new treatment options. We report a format that enables modular assembly of bi-paratopic tetravalent nAbs with antigen-binding sites from two distinct nAbs. The tetravalent nAb purifies in high yield and exhibits biophysical characteristics that are comparable to those of clinically used therapeutic antibodies. The tetravalent nAb binds to the spike protein trimer at least 100-fold more tightly than bivalent IgGs (apparent K

On The Roles Of Trait Anxiety And Toll Like Receptor 4 In Amphetamine Sensitization In Adolescent Male Rats, Corey A. Calhoun

Graduate Doctoral Dissertations

Mammalian adolescence can be a difficult transition from childhood to adulthood, where increases in impulsivity and novelty- and risk-seeking are combined with heightened affect and elevated sensitivity to stress. Indeed, during adolescence, first drug use patterns emerge and in the continental United States, increasing misuse of amphetamines has been observed in adolescent youth. Myriad neural mechanisms underlie this shift in adolescence, including the dynamic remodeling of the mesocorticolimbic (MCL) pathway. Repeated drug administration affects neuroimmune substrates within the MCL circuit including toll-like receptor 4 (TLR4)Advances in addiction neuroscience indicate that drugs of abuse activate neural TLR4 and implicate glial TLR4 …

Global Health Electives In The Covid-19 Era: Resuming Travel And Strengthening Global Health Academic Partnerships., Heather Haq, Amos Msekandiana, Mogomotsi Matshaba, Linoeo Thahane, Jennifer Watts, Reena Tam, Nicole St Clair, Charles Schubert, Amy Rule, Pia Pannaraj, Michael Pitt, David Oleson, Brittany Murray, Lee Morris, Joanne Mendoza, Megan Mchenry, Elizabeth Keating, Kathy Ferrer, Heather Crouse, Tania Condurache, Maneesh Batra, Adelaide Barnes, James Conway

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Making The Case For The Accelerated Withdrawal Of Aducanumab, Peter J. Whitehouse

Faculty Scholarship

U.S. Food and Drug Administration-s (FDA) approval of aducanumab (Aduhelm® in the US) as a treatment for mild cognitive impairment of the Alzheimer type and Alzheimer-s disease has raised such major concerns about efficacy, safety, FDA processes, and regulatory capture that Biogen-s license to market this biologic should be immediately withdrawn. Aducanumab has not demonstrated benefit to patients, failed to meet regulatory guidelines, and is likely to cause both individual and societal harm.

Design Of Self-Assembled Peptides For Wound Healing, Ka-Kyung Kim

Dissertations

According to the CDC, 15% of diabetic patients develop diabetic foot ulcers (DFU) and approximately 170,000 patients undergo non-traumatic amputation annually. DFU is a major complication of diabetes caused by non-healing full-thickness wounds through the dermis. The current treatments include blood sugar control, frequent debridement, offloading, moist wound care, infection treatment, and amputation. To achieve wound closure of DFU, appropriate wound care and antibiotic therapy are essential. Topical regimens include hydrocolloids, alginates, foam, silver-impregnated dressings, and hydrogels. Wound healing is a complex and dynamic interplay between the immune system, keratinocytes, and dermal cells (in case of cutaneous wound). Angiogenesis has …

Pilot Phase Results Of A Prospective, Randomized Controlled Trial Of Narrowband Ultraviolet B Phototherapy In Hospitalized Covid-19 Patients, Frank H. Lau, Catherine E. Powell, Giacomo Adonecchi, Denise M. Danos, Andrew R. Dinardo, Robert J. Chugden, Peter Wolf, Carmen F. Castilla

School of Medicine Faculty Publications

COVID-19 morbidity and mortality are driven by poor immune regulation. Narrowband ultraviolet B (NB-UVB) phototherapy is standard of care in a number of immune-dysregulated diseases. To assess the efficacy of NB-UVB phototherapy for improving COVID-19 outcomes in high-risk, hospitalized, we developed the Adaptive Photo-Protection Trial. This is a multi-center, prospective, double-blinded, randomized, placebo-controlled trial. The pilot phase results are reported here. Consecutive patients admitted with a positive COVID-19 PCR were screened for eligibility. Enrolled subjects were computer randomized 1:1 to NB-UVB or placebo phototherapy. Subjects were treated daily with escalating doses on 27% of their body surface area for up …

Exploring The Impact Of Stress On Healthcare Student Competency: A Cognitive Model For Self-Regulating Performance During High-Stakes Scenarios, Michael J. Teachey

Critical and Creative Thinking Capstones Collection

Stress and anxiety are part of healthcare and are experienced not only by patients but also by clinicians. This work explores an issue prevalent in healthcare education, outlining the detrimental effects of stress-induced anxiety on student performance during practical assessments. Included in this paper are the research and investigative details that elaborate on the process taken towards resolving the issue. Research conducted in the fields of education, law, and medicine is used to explore how these areas address stress with regard to performance. Through the various processes of research and engagement, this action research project uncovers the underlying issue of …

A Systematic Review Of The Efficacy And Safety Of Fecal Microbiota Transplantation In The Treatment Of Hepatic Encephalopathy And Clostridioides Difficile Infection In Patients With Cirrhosis, Kyaw Min Tun, Annie S. Hong, Kavita Batra, Yassin Naga, Gordon Ohning

Department of Internal Medicine Faculty Research

The microbiome of the human gut and liver coexists by influencing the health and disease state of each system. Fecal microbiota transplantation (FMT) has recently emerged as a potential treatment for conditions associated with cirrhosis, such as hepatic encephalopathy and recurrent/refractory Clostridioides difficile infection (rCDI). We have conducted a systematic review of the safety and efficacy of FMT in treating hepatic encephalopathy and rCDI. A literature search was performed using variations of the keywords “fecal microbiota transplant” and “cirrhosis” on PubMed/MEDLINE from inception to October 3, 2021. The resulting 116 articles were independently reviewed by two authors. Eight qualifying studies …

Covid-19 Newsletter (Vol. 121), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.