Medicine and Health Sciences Commons^™

Decompression And Interlaminar Stabilization For Lumbar Spinal Stenosis: A Cohort Study And Two-Dimensional Operative Video, Olivia E. Gilbert, Sarah E. Lawhon, Twila L. Gaston, Jared M. Robichaux, Gabriel Claudiu Tender

School of Medicine Faculty Publications

Background and Objectives: Lumbar spinal stenosis is one of the most common causes of disability in the elderly and often necessitates surgical intervention in patients over the age of 65. Our study aimed to evaluate the clinical efficacy of interlaminar stabilization following decompressive laminectomy in patients with lumbar stenosis without instability. Materials and Methods: Twenty patients with lumbar stenosis underwent decompressive laminectomy and interlaminar stabilization at our academic institution. Clinical outcomes were measured using the visual analog scale (VAS) and Oswestry disability index (ODI) at the 2-month, 6-month, and 1-year postoperative visits, and these outcomes were compared to the preoperative …

Perceptions Of Weight Status And Energy Balance Behaviors Among Patients With Non-Alcoholic Fatty Liver Disease, Natalia I Heredia, Ruchi Gaba, Yan Liu, Shilpa Jain, Manasi Rungta, Manav Rungta, Hashem B El-Serag, Fasiha Kanwal, Aaron P Thrift, Maya Balakrishnan

Faculty, Staff and Students Publications

Weight loss through behavioral modification is central to treating non-alcoholic fatty liver disease (NAFLD). To achieve this, patients need to accurately self-perceive their health behaviors. We aimed to identify predictors of concordance between self-perception and objective measures of body weight, physical activity (PA) and dietary behaviors. We used data from the Harris County NAFLD Cohort, an ongoing prospective study in a regional safety-net healthcare system. Patients completed self-administered baseline questionnaires on demographics, diet, PA, and self-perceptions. We assessed concordance between actual and self-perceived body weight and energy-balance behaviors. Multivariable logistic regression identified predictors of concordance. Patients (n = 458; average …

Demographic And Regional Trends Of Mortality In Patients With Aortic Dissection In The United States, 1999 To 2019, Salik Nazir, Robert W Ariss, Abdul Mannan Khan Minhas, Rochell Issa, Erin D Michos, Yochai Birnbaum, George V Moukarbel, P Kasi Ramanathan, Hani Jneid

Faculty, Staff and Students Publications

Background Aortic dissection (AoD) is associated with high morbidity and mortality. However, the burden of AoD mortality is not well characterized, and contemporary data and mortality trends in different demographic and geographic subgroups have not been described. Methods and Results Trends in AoD mortality were assessed using a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Crude and age-adjusted mortality rates (AAMR) per 1 million people with associated annual percent changes were determined. Joinpoint regression was used to assess trends in the overall sample and different demographic (sex, race and ethnicity, …

Covid-19 Newsletter (Vol. 113), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Safety And Efficacy Of Colchicine In Covid-19 Patients: A Systematic Review And Meta-Analysis Of Randomized Control Trials, Farah Yasmin, Hala Najeeb, Abdul Moeed, Wardah Hassan, Mahima Khatri, Muhammad Sohaib Asghar, Ahmed Kunwer Naveed, Waqas Ullah, Salim Surani

Department of Medicine Faculty Papers

Background: Colchicine has been used an effective anti-inflammatory drug to treat gout diseases. Owing to its pharmacodynamic of inhibiting interleukins, it has been repurposed to target the cytokine storm post-SARS-CoV-2 invasion. The goal of this meta-analysis was to evaluate the safety profile of colchicine in COVID-19 patients using the gold-standard randomised-control trials.

Methods: Electronic databases (Pubmed, Google Scholar, and Cochrane) were systematically searched until June 2021 and RCTs were extracted. Outcomes of interest included all-cause mortality, COVID-19 severity, mechanical ventilation, C-reactive protein and D-dimer levels. Using a random-effects model, dichotomous outcomes were pooled using odds ratios (OR) through the generic …

Building First‑Year Medical Students’ Skills In Finding, Evaluating, And Visualizing Health Information Through A “Debunking Medical Myths” Curricular Module, Katherine Akers, Ella Hu, Narmeen Rehman, Ho Jun Yun, Jacob Hoofman, Rachel Monconduit, Jennifer Mendez

Internal Medicine Faculty Publications

To provide an online service learning opportunity for medical students during the COVID-19 pandemic, medical faculty and librarians developed and implemented a “Debunking Medical Myths” module in which students learned to search for emerging medical literature, evaluate evidence, and use that evidence to create an infographics debunking a COVID-19-related myth for a non-medical audience. The resultant infographics are visually appealing and designed to make complex health information easy to understand. The module was well-received by students, who demonstrated a nuanced understanding of the use of infographics to convey health information, and students’ work was evaluated highly by community members.

Meloxicam Versus Celecoxib For Postoperative Analgesia After Total Knee Arthroplasty: Safety, Efficacy And Cost, Amer Haffar, Yale A Fillingham, Leigham Breckenridge, D'Andrew Gursay, Jess H Lonner

Rothman Institute Papers

INTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as part of multimodal analgesia in total knee arthroplasty (TKA). Selective cyclooxygenase (COX)-2 inhibitors (e.g., celecoxib) are believed to have fewer gastrointestinal (GI) adverse effects than nonselective NSAIDS. Meloxicam is less selective for COX-2 than celecoxib is and partially inhibits COX-1 at higher doses. Nonetheless, some surgeons prefer using nonselective NSAIDs because of their lower expense.

METHODS: Four thousand nine hundred ninety-four patients who underwent TKA between January 2015 and February 2020 and took either celecoxib (n = 3,174), meloxicam 15 mg/d (n = 1,819), or meloxicam 7.5 mg/d (n = 451) …

Csf-1 Maintains Pathogenic But Not Homeostatic Myeloid Cells In The Central Nervous System During Autoimmune Neuroinflammation, Daniel Hwang, Maryam S Seyedsadr, Larissa Ishikawa, Alexandra Boehm, Ziver Sahin, Giacomo Casella, Soohwa Jang, Michael V Gonzalez, James P Garifallou, Hakon Hakonarson, Weifeng Zhang, Dan Xiao, A M Rostami, Guang-Xian Zhang, Bogoljub Ciric

Department of Neurology Faculty Papers

SignificanceMultiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are autoimmune diseases characterized by accumulation of myeloid cells in the central nervous system (CNS). Both harmful and beneficial myeloid cells are present in EAE/MS, and a goal of MS therapy is to preferentially remove harmful myeloid cells. The receptor for CSF-1 (CSF-1R) is found on myeloid cells and is important for their survival. CSF-1R can bind two ligands, CSF-1 and IL-34, but it is not known whether their functions in EAE/MS differ. We found that blocking CSF-1 depleted only harmful myeloid cells in the CNS and suppressed EAE, …

Adapting Human-Based Transcutaneous Spinal Cord Stimulation To Develop A Clinically Relevant Animal Model, Dillon C. Malloy, Maria Knikou, Marie-Pascale Côté

Publications and Research

Transcutaneous spinal cord stimulation (tSCS) as a neuromodulatory strategy has received great attention as a method to promote functional recovery after spinal cord injury (SCI). However, due to the noninvasive nature of tSCS, investigations have primarily focused on human applications. This leaves a critical need for the development of a suitable animal model to further our understanding of this therapeutic intervention in terms of functional and neuroanatomical plasticity and to optimize stimulation protocols. The objective of this study is to establish a new animal model of thoracolumbar tSCS that (1) can accurately recapitulate studies in healthy humans and (2) can …

Implementation Of An Automated Grading Tool For Phonetic Transcription Training, Marisha Speights Atkins, Dallin J. Bailey, Cheryl D. Seals

Faculty Publications

Clinical phonetic transcription is regarded as a highly specialised skill requiring hours of practice for mastery. Although this skill is a critical part of students’ clinical preparation to become speech-language pathologists, students often report feeling unprepared to apply the skill in clinical practice. Previous studies suggest that increased opportunities for practice and timely feedback on transcriptions are needed in order to develop skill confidence. However, providing more opportunities for practice can be impeded by the limited resources to manage the grading of additional assignments. The purpose of this study is to show the implementation of a web-based learning management system …

Prophylactic Administration Of Steroids And The Effect On Post-Extubation Stridor: A Scoping Review, Chelsey Benson Bsn, Rn, Karlene Ferraro Bsn, Rn, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Purpose/Background Stridor occurs due to laryngeal edema which arises when a patient has been intubated for an extended period of time. There are several factors that affect the degree of swelling. Post-extubation stridor signals that a patient requires reintubation because the airway is no longer patent. Corticosteroids, such as dexamethasone, can be used prior to extubation to minimize complications and overall length of stay if a patient is at high risk for stridor. This scoping review will evaluate the literature and the association between the use of prophylactic steroids on mechanically ventilated adult patients and the occurrence of post-extubation stridor. …

Implementing A New Emergency Department: A Qualitative Study Of Health Professionals' Change Responses And Perceptions, Nina Thórný Stefánsdóttir, Per Nilsen, Mette Bendtz Lindstroem, Ove Andersen, Byron J Powell, Tine Tjørnhøj-Thomsen, Jeanette Wassar Kirk

2020-Current year OA Pubs

BACKGROUND: The aim of the study is two-fold. It explores how managers and key employees at the Emergency Department (ED) and specialist departments in a university hospital in the Capital Region of Denmark respond to the planned change to a new ED, and how they perceive the change involved in the implementation of the new ED. The study investigates what happens when health professionals are confronted with implementation of policy that changes their organization and everyday work lives. Few studies provide in-depth investigations of health professionals' reactions to the implementation of new EDs, and particularly how they influence the implementation …

Healthcare Simulation: A Key To The Future Of Medical Education - A Review, Omair Ayaz, Faisal Wasim Ismail

Medical College Documents

Aim: Simulation originates from its application in the military and aviation. It is implemented at various levels of healthcare education and certification today. However, its use remains unevenly distributed across the globe due to misconception regarding its cost and complexity and to lack of evidence for its consistency and validity. Implementation may also be hindered by an array of factors unique to the locale and its norms. Resource-poor settings may benefit from diverting external funds for short-term simulation projects towards collaboration with local experts and local material sourcing to reduce the overall cost and achieve long-term benefits. The recent shift …

Maximising Access To Timely Trauma Care Across Population Of Karachi And Its Districts: A Geospatial Approach To Develop A Trauma Care Network, Muhammad Nabeel Ashraf, Mohammad Salman Khalil, Ahwaz Akhtar, Lubna Samad, Asad Latif

Department of Anaesthesia

Objectives: To develop and propose a cost-effective trauma care network for Karachi, Pakistan, by calculating maximum timely trauma care (TTC) coverage achieved with the addition of potential designated private and public level 1 and level 2 trauma centres (TCs).
Setting: A lower middle-income country metropolis, Karachi is Pakistan's largest city with a population of 16 million and a total of 56 hospitals as per government registry data.
Participants: 41 potential TCs selected using a two-level, contextually-relevant TC designation criteria adapted from various international guidelines.
Primary and secondary outcome measures: Maximum TTC coverage achievable with the addition of potential TCs. Proposed …

Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study, Karan Varshney, Talia Glodjo, Jenna R Adalbert

College of Population Health Faculty Papers

Objectives: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

Results: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β1 = 0.375, p = 0.001), followed by overcrowded households (standardized β2 = 0.346, p = 0.014), and total COVID-19 cases (standardized β3 = 0.311, p < 0.001). Our findings highlight that residing in overcrowded households may be an important risk factor for COVID-19 mortality. Public health entities should consider this population when allocating resources for prevention and control of COVID-19 mortality and future disease outbreaks.

Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study., Karan Varshney, Talia Glodjo, Jenna Adalbert

College of Population Health Faculty Papers

OBJECTIVES: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

RESULTS: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β

Targeting The Nrf2/Ho-1 Antioxidant Pathway In Flt3-Itd-Positive Aml Enhances Therapy Efficacy, Sankaranarayan Kannan, Mary E Irwin, Shelley M Herbrich, Tiewei Cheng, Lanisha L Patterson, Marisa J L Aitken, Kapil Bhalla, M James You, Marina Konopleva, Patrick A Zweidler-Mckay, Joya Chandra

Faculty, Staff and Student Publications

Acute myeloid leukemia (AML) is a molecularly heterogenous hematological malignancy, with one of the most common mutations being internal tandem duplication (ITD) of the juxtamembrane domain of the fms-like tyrosine kinase receptor-3 (FLT3). Despite the development of FLT3-directed tyrosine kinase inhibitors (TKI), relapse and resistance are problematic, requiring improved strategies. In both patient samples and cell lines, FLT3-ITD raises levels of reactive oxygen species (ROS) and elicits an antioxidant response which is linked to chemoresistance broadly in AML. NF-E2-related factor 2 (NRF2) is a transcription factor regulating the antioxidant response including heme oxygenase -1 (HO-1), a heat shock protein implicated …

Genetic Evaluation For Hereditary Cancer Syndromes Among African Americans: A Critical Review, Ambreen Khan, Charles R Rogers, Carson D Kennedy, Ana Maria Lopez, Joanne Jeter

Department of Medical Oncology Faculty Papers

While hereditary cancer syndromes have been described and studied for centuries, the completion of the human genome project fueled accelerated progress in precision medicine due to the introduction of genetic testing in the 1990s, creating avenues for tailored treatments and medical management options. However, genetic testing has not benefited everyone equitably, with nearly all of the published work based on individuals of non-Hispanic White/European ancestry. There remains a gap in knowledge regarding the prevalence, penetrance, and manifestations of common hereditary cancer syndromes in the African-American population due to significant disparities in access and uptake of genetic testing. This review summarizes …

Antibody Dependent Enhancement Of Infectious Bronchitis Virus In Poultry, Zachary Hamilton, Barry Simpson, Donald L. Reynolds

UCARE: Research Products

Avian infectious bronchitis (IB) is a coronavirus infection of chickens that causes respiratory disease and reproductive problems in chickens. Currently, there are vaccines that are effective against IB. However, new variants and strains of avian infectious bronchitis virus (IBV) routinely emerge. A vaccine that is not the same strain as the virus is not completely effective in protecting against other variants because the vaccine will not allow the host antibodies to completely neutralize the strain. This is a problem because it makes IB difficult to control and diagnose.

Antibody-dependent enhancement (ADE) is a phenomenon whereby non-neutralizing antibodies, or low levels …

Left Ventricular Hypertrophy And Biomarkers Of Cardiac Damage And Stress In Aortic Stenosis, Elliot J Stein, Nishath Quader, Alan Zajarias, Anna Vatterott, Et Al

2020-Current year OA Pubs

Background Left ventricular hypertrophy (LVH) is associated with increased mortality risk and rehospitalization after transcatheter aortic valve replacement among those with severe aortic stenosis. Whether cardiac troponin (cTnT) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) risk stratify patients with aortic stenosis and without LVH is unknown. Methods and Results In a multicenter prospective registry of 923 patients with severe aortic stenosis undergoing transcatheter aortic valve replacement, we included 674 with core-laboratory-measured LV mass index, cTnT, and NT-proBNP. LVH was defined by sex-specific guideline cut-offs and elevated biomarker levels were based on age and sex cut-offs. Adjusted Cox proportional hazards models evaluated …

5-9-22 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Self-Portraits For Social Change: Audience Response To A Photovoice Exhibition By Women With Disability, Diane Macdonald, Angela Dew, Karen Fisher Assoc Prof, Katherine Boydell

The Qualitative Report

Negative attitudes about and behaviours towards women with disability are harmful and exclusionary, contributing to poorer health, income, educational, and employment outcomes. Our study focused on what audiences learnt, felt, and did (what changed) after viewing self-portraits and stories by women with disability. We questioned whether a public exhibition of their artworks, created through photovoice methodology, could be an effective platform to provoke social change and increase inclusion for people with disability. We collected audience response to our exhibition to address a research gap and to provide an example for other photovoice researchers. We employed interpretive thematic analysis through a …

Qualitative Data Analysis For Health Research: A Step-By-Step Example Of Phenomenological Interpretation, Sue Monaro, Janice Gullick, Sandra West

The Qualitative Report

Phenomenological studies have been critiqued when analytic activities and intersection with the underpinning philosophy lack clarity. This methodological discussion paper describes data analysis in hermeneutic interpretive phenomenology. Data management strategies (transcript preparation, coding, philosophy application, tabling/concept maps, and Microsoft Word) and data analysis processes (reduction, display, and conclusion drawing/verification) are illustrated. Deconstruction, reconstruction, and reorganisation of themes/subthemes using hierarchical heading styles to populate the navigation pane and philosophical tenets acted as analytic hooks. This paper has outlined data analysis in hermeneutic interpretive phenomenology, including the use of MS Word and its functionality, which was supported by other data display strategies …

Social Determinants And Sexual Health In Adolescents, Makaylee Kempema, Camryn Janssen, Haley Evans, Bekah Horstman

Celebration of Research

After discovering a noticeable need for sexual health education and disease prevention for adolescents in the Promise Community Health Center community, we as a group set to work on researching how to address and combat this need. Ten articles pertaining to this issue highlighted four main factors in adolescent sexual health: practices and barriers to adolescents seeking information about sexual health, how they can most effectively learn about sexual health, parental influence on adolescent sexuality, and the healthcare provider’s effect on an adolescent’s sexual health visit. With these findings the project was able to identify interventions that Promise Community Health …

Importance Of Patient Bodyweight In Hospitals, Abby Petersen, Hannah Van Iperen, Brittany Berry, Karie Stamer

Celebration of Research

Ten research articles that included information about patient weights, weight errors, and importance on weight in relation to nutritional status, fluid assessment, and medication doses were reviewed to create a policy. The results of the articles conclude that within healthcare, the facilities are not doing enough in making sure each patient is being weighed during their hospital stay. Nurses and other patient care staff should be properly educated and trained on how to obtain body weights to reduce the instances of inaccuracy.

Addiction Generation: Stimulant Abuse In College Students, Jemma Kenobbie

Celebration of Research

Illicit use of prescription stimulants has come to the attention of clinicians, school administration, and the judicial system in recent years. Illicit stimulant use is defined as the use of prescription stimulants without a legitimate prescription or using stimulants inconsistent with the prescribed treatment plan, including diversion and inappropriate administration methods. These prescriptions have been known to cause serious side effects when taken incorrectly, yet their popularity as “study buddies” among college students has risen. The most current research has found that the percentage of undergraduate students abusing stimulants ranges from 8-43%, with an average of 17% of students abusing …

Cultural Sensitivity - The Impact Of A Three-Week Physical Therapy Internship In Mexico, Kailey Heemskerk, Paul Bartlett Ed.D

Celebration of Research

In this study, we examined if there was a change in cultural sensitivity as a result of a three-week, non-credit bearing internship in Puerto Vallarta, Mexico and, if so, what factors may have contributed to this change. We hypothesized there would be a significant difference in overall intercultural sensitivity growth and in each of the five constructs of intercultural sensitivity. The students completed a pre- and post-Intercultural Sensitivity Scale (ISS) survey and three open-ended questions at the completion of their internship. A paired T-test found overall mean scores to be significantly higher for the post-test as compared to the pre-test …

Bouffants Vs. Cloth Surgical Caps In The Prevention Of Infection, Audrey Leyen, Maura Mould, Brenna Rauwerdink

Celebration of Research

The purpose of this Evidence-Based Practice Project is to gather information from previous studies in order to find out what practice is most effective in preventing infections acquired in the Operating Room during surgery and provide the information that will allow Sioux Center Health to better their practices and provide a safe surgical environment for both patients and operating room staff.

Optimizing Vernix Caseosa In Neonates, Shaeli Herman

Celebration of Research

Vernix caseosa is a “white, creamy, naturally occurring biofilm covering the skin of the fetus during the last trimester of pregnancy” (Singh & Archana, 2008). While there are many variations of birth plans that one may choose regarding their pregnancy, the health and wellness benefits of leaving the vernix caseosa on the neonate immediately following birth can be substantial. This is especially important when considering the thermal needs of a neonate along with the risk that could occur if those thermal needs are not met. The vernix caseosa, which forms around the twenty first week of gestation, also serves as …

Climate Change And Infectious Diseases, Brennan Haggerty, Jake Lynott, Carsyn Hamstra, Taylor Mccarthy

Celebration of Research

The impact of climate change on human health is a relatively new topic within the field of research. Several research studies indicate rises in temperature, droughts, increase in vector-borne diseases, and heatwaves are becoming more prevalent. Despite the fluctuations in climate, little information is being conveyed to the public regarding the effects of such on human health. This review sought to identify and assess what is currently understood about climate change and the impacts of it on human health. A literature review was designed and conducted using EBSCOhost and Worldcat. Out of all the articles identified, ten articles met the …