Medicine and Health Sciences Commons^™

Pharmacy Newsletter : July 2022, Pharmacy Department

Department of Pharmacy Archives

Content:

• TOX TOK! Liquid Nicotine Used in E-Cigarettes can Harm Children
• Monkey Pox FAQs
• Clinical Understanding of Different Formulations of Tenofovir: TDF Versus TAF
• Fluids And Electrolytes Maintenance Calculation In Pediatric Patients
• A NEW Warning : FDA recommends thyroid monitoring in babies and young children who receive injections of iodine-containing contrast media(ICM) for medical imaging.
• CHOLERA
• The 2 Million Dollar Injection
• Retinoic Acid Preparations & their Differ

Assessment Of Exam Anxiety Level Among Students From Selected Educational Institutions With A View To Prepare A Self-Help Guide, Dr. Sunil Moothedath, Chithritha P J, Crislin Leen Mathew

Manipal Journal of Nursing and Health Sciences

Introduction: The determination and aim of education are to make all-round development of the human child. On the contrary to it, the real fact is that education alone is not capable of fulfilling all the aims of man in the modern age. The curriculum, teaching methodology, pattern of education, methods of discipline, teachers and teaching behaviour and methods of doing valuation, etc. also play a major role. There exists competition between the children as well as pressure from parents as well as from peers. In the present world, children do have different levels of anxiety before exams which may vary …

How Climate Change May Threaten Progress In Neonatal Health In The African Region, Britt Nakstad, Veronique Filippi, Adelaide Lusambili, Nathalie Roos, Fiona Scorgie, Matthew F. Chersich, Stanley Luchters, Sari Kovats

Institute for Human Development, East Africa

Climate change is likely to have wide-ranging impacts on maternal and neonatal health in Africa. Populations in low-resource settings already experience adverse impacts from weather extremes, a high burden of disease from environmental exposures, and limited access to high-quality clinical care. Climate change is already increasing local temperatures. Neonates are at high risk of heat stress and dehydration due to their unique metabolism, physiology, growth, and developmental characteristics. Infants in low-income settings may have little protection against extreme heat due to housing design and limited access to affordable space cooling. Climate change may increase risks to neonatal health from weather …

Child Disability And Family-Centred Care In East Africa: Perspectives From A Workshop With Stakeholders And Health Practitioners, Pauline Samia, Susan Wamithi, Amina Kassam, Melissa Tirkha, Edward Kija, Ayalew Moges, Arnab Seal, Peter Rosenbaum, Robert Armstrong

Paediatrics and Child Health, East Africa

Background: Our understanding of child disability has undergone major changes over the last three decades transforming our approach to assessment and management. Globally there are significant gaps in the application of these 21st century models of care. There is recognition that economic, cultural, and social factors influence transitions in care and there is need to consider contextual factors.

Objectives: A two-day workshop brought together key stakeholders to discuss current models of care and their application in the East African context. This article summarises workshop proceedings and identifies a broadly supported set of recommendations that serve to set a …

Are Sexual And Reproductive Health And Rights Taught In Medical School? Results From A Global Survey, Margit Endler, Taghreed Al-Haidari, Chiara Benedetto, Sameena Chowdhury, Jan Christilaw, Faysal El Kak, Diana Galimberti, Miguel Gutierrez, Shaimaa Ibrahim, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Our aim was to investigate the inclusion of sexual and reproductive health and rights (SRHR) topics in medical curricula and the perceived need for, feasibility of, and bar-riers to teaching SRHR. We distributed a survey with questions on SRHR content, and factors regulating SRHR content, to medical universities worldwide using chain referral. Associations between high SRHR content and independent variables were analyzed using unconditional linear regression or χ2 test. Text data were analyzed by thematic analysis. We collected data from 219 respondents, 143 universities and 54 countries. Clinical SRHR topics such as safe pregnancy and childbirth (95.7%) and contraceptive methods …

Synthesis And Characterization Of Novel Reformulated Bioactive Paclitaxel Complexes And Considerations For Administration Via Inhalation Method For Targeted Lung Cancer Treatment, Teighlor Nicole Livingston

PCOM Biomedical Studies Student Scholarship

Paclitaxel is a natural plant product derived from bark of the Pacific Yew Tree. The secondary metabolite has been extensively studied and developed as an anticancer agent for the treatment of ovarian, breast, and lung cancer. A significant issue with the drug is its low water solubility⏤ requiring the utilization of drug vehicles for effective drug administration. Two novel paclitaxel-containing drugs, Cu5Fe5PAC and (CUPAC)5GLU12DALB, are synthesized and tested against the National Cancer Institute’s sixty cell line panel for anticancer activity. The drugs are also analyzed using MALDI-TOF-MS, FT-IR, and 1H-NMR. One major concern with paclitaxel is the toxicity associated with …

Associating Infection By Chlamydia Pneumoniae And The Presence Of Amyloid-Β Plaques In The Brains Of Alzheimer’S Disease/Dementia Patients, Paul J. G. Carango

PCOM Biomedical Studies Student Scholarship

Sporadic late-onset AD (LOAD) is the most common form of dementia (Woods et al, 2020). In recent years, significant attention has been given to the role of infection in the pathogenesis of late-onset AD/dementia. The Cpn pathogen has been an organism of particular focus following the seminal study Balin et. al 1998 which found that Cpn DNA was present in 90% of brains from patients diagnosed with LOAD. Subsequent immunohistochemical studies demonstrated that Cpn antigens were present in the frontal and temporal cortices of LOAD brains and that Aβ amyloid plaques found in those regions of the brain co-localize with …

Effects Of Combined Gentamicin And Furosemide Treatment On Cochlear Macrophages, Liana Sargsyan, Austin R Swisher, Alisa P Hetrick, Hongzhe Li

Faculty, Staff and Student Publications

Combining aminoglycosides and loop diuretics often serves as an effective ototoxic approach to deafen experimental animals. The treatment results in rapid hair cell loss with extended macrophage presence in the cochlea, creating a sterile inflammatory environment. Although the early recruitment of macrophages is typically neuroprotective, the delay in the resolution of macrophage activity can be a complication if the damaged cochlea is used as a model to study subsequent therapeutic strategies. Here, we applied a high dose combination of systemic gentamicin and furosemide in

Establishing A New Graduate Nurse Peer Mentoring Program, Teresa Biediger Bowers

Doctor of Nursing Practice Scholarly Projects

Problem Statement: New Graduate Nurses (NGN) report increased stress, likely due to decreased confidence and social support (Frogeli et al., 2019). The most current NGNs are disadvantaged as much of their undergraduate clinical experience has been affected by the COVID-19 pandemic (Smith et al., 2021). At the end of their residency, information gathered from former NGNs suggested they feel they need "more support" during the residency. Purpose: The purpose of this quality improvement project was to determine if the addition of a peer mentor to the already existing nurse residency program would improve nurse confidence, job satisfaction, and intent to …

A Nursing-Driven Delirium Protocol, Alexandria Gray Bridges

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Delirium is a common, often preventable, condition in hospitalized patients and is associated with increased complications, worse outcomes, increased risk of death, and increased health care costs. Purpose: The purpose of this project was to determine if, utilizing a nursing-driven, non-pharmacological intervention, based on the NICE Guidelines, can decrease the incidence of delirium. Methods: Using the Iowa Model of Evidenced Based Practice to Promote Quality Care (Iowa Model), an EBP project was implemented. Patients were identified as being at risk of delirium using The Confusion Assessment Method (CAM) and these patients received the non-pharmacologic intervention as part of …

Assessing The Readiness Of Chf Patients To Use The Medisafe App To Increase Medication Adherence, Janet Lynn Kubas

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart failure (HF) is a complex cardiovascular disease that affects 6.2 million Americans and is associated with high morbidity and mortality, with almost 400,000 deaths annually. Medication adherence in HF can lower the risk of death and rehospitalization. As many as 46% of heart failure patients have medication nonadherence. The 2021 Update to the 2017 American College of Cardiology Expert Consensus Decision Pathway for Optimization of Heart Failure Guidelines recommends smartphones or other mobile health (mHealth) applications (apps) for medication adherence tracking. Purpose: This evidence-based practice project aimed to assess the readiness of HF patients admitted to an …

Improving Self-Efficacy In Heart Failure Care, Tracy Bennett Mcleod

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart Failure contributes significantly to the morbidity and mortality of the adult population and is one of the leading causes of 30-day readmissions. The cost of heart failure is a substantial healthcare burden. Purpose: The purpose of this project was to determine if implementing the “Rise Above Heart Failure” educational program would improve heart failure knowledge, weight monitoring, and reduced re-admission rates in heart failure patients. Methods: A pre-test and post-test survey named The Dutch Heart Failure Knowledge Scale was utilized. Van der Wal, Jaarsma, Moser, and Van Veldhuisen (2005) developed this questionnaire to evaluate patients' knowledge. The …

The Use Of A Clinical Pathway To Increase Child Abuse Screenings Of Young Children With Fractures, Stephanie Li Schaller

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nationally, infants and young children who present to emergency departments with fractures are not being screened adequately for possible physical abuse with a skeletal survey (Paine & Wood, 2018; Shelmerdine et al., 2014; Wood et al., 2019). Without universal screenings, implicit bias along racial and socioeconomic lines becomes a factor in deciding which children with fractures get screened, resulting in either under-or over-utilization of skeletal survey screenings (Kim et al., 2017; Paine & Wood, 2018). When child abuse is not diagnosed correctly, further abusive injuries or death can occur (Ravischandiran et al., 2010). Purpose: This evidence-based practice project …

Pediatric Patients In Diabetic Ketoacidosis: A Pathway To Improvement, Rebecca Russell Vincent

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Pediatric patients in diabetic ketoacidosis (DKA) frequently present to non-pediatric specific care centers initially for medical management where providers may or may not be familiar with standards and treatment guidelines particular to this specialty population. Purpose: The purpose of this project was to establish a pediatric DKA clinical pathway (CPW). Pediatric patients require precise treatments tailored to age and weight specifications. A pediatric DKA CPW identifies treatment order sets, goals, and outcomes customized to the patient’s metabolic demand. Commonalities within a predictable course of treatment for patients with a shared clinical diagnosis result in accelerated care, improved patient …

Patient Activation In Individualized Coaching For Congestive Heart Failure Patients, Jessica Marie Thomas

Doctor of Nursing Practice Scholarly Projects

Adult patients diagnosed with congestive heart failure suffer from high hospitalization rates, recurrent readmissions, decreased quality of life, increased healthcare expenditures, and increased mortality. This project aimed to determine if individualized coaching plans based on patients’ activation scores impacted emergency room visits and hospital readmissions. A pretest-posttest design was used. The 13-item Patient Activation Measure® (PAM®) tool was administered before and after completing 30-day individualized coaching. Seventy-five participants were recruited from referrals to the outpatient Continuum Case Management (CCM) program. Inclusion criteria included English-speaking adult patients diagnosed with congestive heart failure 18 years of age. The intervention consisted of individualized …

The Impact Of Nurse-Patient Engagement With Health Information Technology On Patient Portal Usage, Quyen Thuy Vo

Doctor of Nursing Practice Scholarly Projects

The patient portal, a Health Information Technology (HIT) tool, was created to promote patient engagement with available health information to improve health outcomes. Low patient portal use of available educational interventions with a HIT tool is an identified problem at a rural hospital in North Carolina. Low usage could be related to nurses’ unfamiliarity with HIT tools. This DNP project provided nursing staff with a flipped classroom learning module on utilizing available HIT tools within the hospital setting, increasing nurses’ engagement with the patient portal. A sample of Registered Nurses (RNs) from two units who were previously taught to utilize …

Bridging The Gap: Improving Hypertension In African American Women And Preventing Cardiovascular Disease, Latoshia Danielle Williams

Doctor of Nursing Practice Scholarly Projects

Problem Statement: There is a disproportionate number of African American women (AAW) diagnosed with hypertension (HTN) with modifiable health and behavior risk factors that contribute to cardiovascular disease (CVD). Purpose: The purpose of this DNP project was aimed at evaluating if a 12-week educational program using Life Simple 7 guidelines from the American Heart Association (AHA) within a primary care facility for adults diagnosed with hypertension and who are overweight would reduce blood pressure, body mass index, and increase knowledge regarding hypertension. Methods: A pretest and posttest intervention design was utilized to determine the outcomes of this study. The setting …

A Low-Cost Virtual Coach For 2d Video-Based Compensation Assessment Of Upper Extremity Rehabilitation Exercises, Ana Rita Coias, Min Hun Lee, Alexandre Bernardino

Research Collection School Of Computing and Information Systems

Background: The increasing demands concerning stroke rehabilitation and in-home exercise promotion grew the need for affordable and accessible assistive systems to promote patients' compliance in therapy. These assistive systems require quantitative methods to assess patients' quality of movement and provide feedback on their performance. However, state-of-the-art quantitative assessment approaches require expensive motion-capture devices, which might be a barrier to the development of low-cost systems.Methods: In this work, we develop a low-cost virtual coach (VC) that requires only a laptop with a webcam to monitor three upper extremity rehabilitation exercises and provide real-time visual and audio feedback on compensatory motion patterns …

Comparison Of Unmet Health Care Needs In Children With Intellectual Disability, Autism Spectrum Disorder And Both Disorders Combined, K. Haller, Adrienne Stolfi, John Duby

Medical Education Faculty Publications

Background: The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study.

Methods: The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine …

Vital Signs, Summer 2022, Boonshoft School Of Medicine

Vital Signs

A seventeen page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Quality And Transparency, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

In a recent JDR Clinical & Translational Research report, the American Dental Association's clinical practice guidelines (CPGs) were determined to offer high-quality guidance for the dental profession. The study employed the AGREE II tool to validate the ADA's guidelines’ methodological rigor and transparency, ensuring their quality. This external review is promising for the profession, as it indicates that the ADA has developed reliable CPGs that support advocacy and implementation. However, the article raises questions about consumer-targeted quality scores for dentist providers, such as DentaQual by P&R Dental Strategies LLC. It suggests that for such scoring systems to be credible, they …

Advocacy Spotlight: Are You An Advocate?, Vincent Benivegna Dds

The Journal of the Michigan Dental Association

Advocacy is crucial for dentists in Michigan, as they face a unique opportunity to impact Medicaid dental benefits positively. Governor Gretchen Whitmer's budget proposal for 2023 includes a substantial $240 million investment to revamp dental Medicaid benefits, a historic move for the state. The Michigan Dental Association (MDA) has actively engaged with government offices and legislators to ensure this opportunity is not missed. However, despite the MDA's efforts to mobilize members through action alerts, response rates have disappointed. The article emphasizes the importance of consistent advocacy, as it has the power to influence dental practices and the well-being of patients …

10-Minute Ebd: Stimulant Medications, Rampant Caries, And Prevention, Madison Thomas Bs, Nancy Poznick Dds, Melanie E. Mayberry Dds, Ms-Hcm

The Journal of the Michigan Dental Association

The 10-Minute Evidence-Based Dentistry Column illustrates how to implement the evidence-based dentistry search process to quickly identify and apply the best literature to answer a clinical question. Through critical appraisal, the author of this article answers the clinical question of a connection between stimulant medications, rampant caries, and prevention, with a focus on the impact of ADHD medication on oral health. The term "meth mouth" often associated with dental decay is discussed in the context of xerostomia (dry mouth), a common side effect of stimulant medications. The article uses the PICO (Population, Intervention, Comparison, Outcome) system to formulate a research …

An Evaluation Of Patients With Abdominal Pain After Lateral Lumbar Interbody Fusion, Tristan B Fried, Khoa Tran, Mark J. Lambrechts, Nicholas D D'Antonio, Brian A Karamian, Justin Chu, Jose A Canseco, Alan S. Hilibrand, Christopher K Kepler, Alexander R Vaccaro, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

Context: Abdominal pain after surgery can occur for numerous reasons. Postoperative radiographs may be indicated to evaluate for ileus or other reasons for the pain. Whether outcomes are significantly different based on whether patients get radiographs following lateral lumbar interbody fusion (LLIF) are unclear.

Aims: To investigate the postoperative outcomes of patients experiencing abdominal pain after LLIF.

Settings and design: This retrospective cohort study included patients at a tertiary academic medical center and surrounding affiliated hospitals.

Materials and methods: Patients >18 years of age who underwent elective LLIF at a single institution were retrospectively identified. Patients were stratified into two …

2022-2023 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in adolescent medicine, allergy/immunology, child abuse pediatrics, child neurology, clinical neuro-psychology, coagulation, congenital cardiac surgery, clinical child psychology, developmental-behavioral pediatrics, epilepsy, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric bioethics, pediatric cardiology, pediatric EM/child abuse, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric ophthalmology; pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology; pediatric pulmonology, pediatric radiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, pediatric residency …

Examining Disparities In The Early Adoption Of Covid-19 Personal Mitigation Across Family Structures, Casey Harris, Kevin Fitzpatrick, Michael Nino, Priya Thelapurath, Grant Drawve

Sociology and Criminology Faculty Publications and Presentations

The United States' response to the COVID-19 pandemic has relied heavily on personal mitigation behaviors versus centralized governmental prevention strategies, especially early in the virus's outbreak. This study examines how family structure shapes mitigation, focusing on the intersectional effects of gender, marital status, and the presence of children while accounting for differences in worry about infection from the virus. Using data from a national survey of 10,368 United States adults early in the pandemic (March 2020), survey-weighted logistic regression models show important differences in the likelihood of personal mitigation adoption across family structures. Unmarried women with children were most likely …

Orofacial Pigmentation In Hemodialysis Patients: A Case Control Study, Asmaa Ras, Eman Khalil, Radwa Hussein, Nevine Kheir El Din

Dentistry

ABSTRACT Introduction: Orofacial pigmented lesions are one of the most significant changes that present in patients with end-stage renal disease (ESRD), reflecting a wide range of clinical entities ranging from physiologic changes to signs of systemic disorders and even cancers. The research on oral pigmentations is limited, so it is important to pay close attention to this topic. The majority of original publications is either focused on a single lesion or are narrative reports with limited demographic information. As a result, the current study’s goal was to determine the incidence of orofacial pigmentation in ESRD patients on hemodialysis in a …

Molecular Mechanisms Underlying Mucosal Attachment And Colonization By Clostridioides Difficile, Ben Sidner

Department of Food Science and Technology: Dissertations, Theses, and Student Research

Clostridioides difficile is a Gram-positive, spore-forming, anaerobic bacterium which causes gastrointestinal disease and is a leading cause of nosocomial infections. Although infection typically occurs following antibiotic therapy, in recent years there has been an increase in infections which are not preceded by antibiotic use. Additionally, community-associated infections and rates of disease recurrence have increased. While it is understood that a healthy gastrointestinal microbiota provides protection against infection, the molecular mechanisms which underly C. difficile's ability to colonize and persist in the gut are mostly unknown. Building on work from others that suggests C. difficile associates with the outer mucus …

Surgical Perspectives Of Primary Liver Tumors In Children: A Series Of 76 Consecutive Cases, Pailin Arunsopha, Kanokrat Thaiwatcharamas, Sinobol Chusilp, Patchareeporn Tanming, Pongserath Sirichindakul, Nimmita Srisan, Katawaetee Decharun, Soottiporn Chittmittrapap, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Background: Primary liver tumors in children are rare. The objective of this study was to review cases of primary liver tumors in children who underwent tumor removal. Methods: Children (0 - 15 years old) who underwent surgery for primary liver tumors between 2006 and 2019 were studied. Their clinical data and pathological reports were reviewed. Demographic data, types of procedures, operative time, and post-operative complications were described. Data are expressed as mean  standard deviation. Results: There were 76 children (male/female = 39/37), who underwent resection for primary liver tumors. Their average age was 27.9  32.0 months. Asymptomatic abdominal …

Antioxidative Properties Of Common Ready-To-Eat Cooked Foods And Beverages In Thailand, Kamonchanok Chuenwisad, Nattida Chotechuang, Chanchai Boonla

Chulalongkorn Medical Journal

Background: Increased dietary antioxidant consumption is associated with decreased risk of oxidative stressmediated diseases. Cooking process affects the quantity and quality of antioxidants in foods. In this study, we investigated the antioxidative properties of ready-to-eat (RTE) cooked meals. Objective: To determine the total antioxidant capacity (TAC), total phenolic content (TPC), and total flavonoid content (TFC) in RTE cooked foods and beverages commonly sold in Thailand. Methods: Thirty cooked food items were purchased from local fresh markets and canteens in Bangkok. The foods were categorized into Central food, Northern food, Northeastern food, Southern food, fast food, and beverage. Levels of TAC …