Medicine and Health Sciences Commons^™

Evaluation Of Cardiometabolic Monitoring In Patients Taking Antipsychotic Agents Within A Community Health System., Kendra Yarian Pharmd, Jenna Gilbert Pharmd, Bcpp, Libby Stabler Pharmd, Bcacp, Quyen Nguyen Pharmd, Bcacp, Leia Gaddis Pharmd, Bcps, Dpla

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that the majority of patients on antipsychotic agents do not have all baseline monitoring completed, and that there are significant gaps especially in lipid panel and hemoglobin A1c. Other parameters (e.g., blood pressure, weight) were more likely to be gathered, likely as part of routine visit procedure.

Medication Use Evaluation Of Fecal Microbiota Spores (Live-Brpk) For The Prevention Of Recurrent Clostridioides Difficile Infection., Haley Michaud Pharmd, Trent Towne Pharmd, Bcps, Sarah Ferrell Pharmd, Bcpps, Bhavika Patel Pharmd, Noah Budi Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation found that infectious diseases providers were more likely to prescribe advanced treatments such as fidaxomicin or fecal microbiota compared to other specialties. Of the 93.1% of patients seen by Infectious Disease, 62.9% (n=17) of those patients were prescribed fecal microbiota spores (live-brpk) (VOWST). Of the 29 eligible patients, 41.4% (n=12) were identified as missed opportunities.

Optimization Of Beta-Lactam Dosing In Critically Ill Patients With Continuous Veno-Venous Hemofiltration Or Augmented Renal Clearance., Kristin Lytal Pharmd, Mspgx, Robert D. Beckett Pharmd, Bcps, Luke Keller Pharmd, Bcps, Bcccp, Michael Todt Pharmd, Bcccp

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that traditional dosing of beta-lactams found in practice is often (20 to 90%) suboptimal when compared to ideal evidence-based dosing, that optimizes efficacy while limiting adverse effects from drug toxicity.

Dofetilide Initiation In A Tertiary Medical Center: A Medication Use Evaluation., Zhixi Lui Pharmd, Kris Howard Pharm, Aacc, Megan Straub Pharmd, Bcps, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that adherence to a pharmacist-managed protocol significantly increased dofetilide continuation rates at discharge and six months. Future implementation includes refining the current dofetilide order set, expanding the pharmacist’s role in dose selection, and standardizing documentation and intervention notes to improve protocol adherence.

Drop-It Like It’S Hot: A Droperidol Medication Use And Efficacy Evaluation In A Community Health System., Caleb Hoppe Pharmd, Sarah Meeks Pharmd, Allison Clemens Pharmd, Robert D. Beckett Pharm D

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This study found that higher doses of droperidol for abdominal pain could provide more analgesic benefit without compromising patient safety. While droperidol appears effective at relieving nausea, other more cost-effective anti-emetics may be trialed first (without diphenhydramine). Droperidol appeared to provide light sedation, although most doses were low and used on patients without severe agitation (e.g. RASS ≥ 3).

Optimizing Serum Magnesium Monitoring And Replacement In A Community Hospital., Gabrielle O. Carreon Pharmd, Ms, Jesse Christman Pharmd, Bcop, Joshua Winebaugh Pharmd, Bcps, Robert D. Beckett Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

Findings highlight the need to revise our healthcare system’s standard hematology/oncology treatment plans to better align with appropriate magnesium monitoring, with up to 93% of magnesium lab draws potentially being unnecessary, and replacement, including better utilization of oral magnesium formulations instead of IV which can lower costs.

Discharge Antibiotic Use In Patients Hospitalized With Chronic Obstructive Pulmonary Disease (Copd) Exacerbations., Jennifer Mccarthy Pharmd, Ms, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Ross Witte Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation identified opportunities for improved prescribing in this population. The majority of patients receiving antibiotics had increased dyspnea only. Because of this, 90% of patients did not receive antibiotics appropriately; 94% received an excessive duration. The majority of patients had no prior to admission COPD maintenance therapy, potentially related to lack of baseline FEV1 data required for initiating therapy classification.

Optimizing Laboratory Appointment Adherence Among Patients Prescribed Psychoactive Medications, Tamara N. Blake

Doctor of Nursing Practice Final Project Abstract

PURPOSE

The purpose of this scholarly project was to implement a standardized nurse-driven phone call reminder protocol to improve adherence to scheduled laboratory appointments among patients prescribed psychoactive medications requiring bloodwork. This protocol is aimed to increase appointment adherence and reduce no-show rates within the clinic.

BACKGROUND

The project was implemented within a small outpatient community-based clinic in Round Rock, Texas which provides mental health services. The clinic experienced high no-show rates for scheduled laboratory appointments among patients prescribed psychoactive medications. Monitoring these patients is essential to ensure medication safety and prevent potential adverse effects.

METHODOLOGY

The six-week quality improvement …

The Lived Experience Of Nurses Caring For People Experiencing Homelessness: A Descriptive Phenomenological Study, Debra Guerrini

Theses & Dissertations

Background:

Marginalized patient populations, such as people experiencing homelessness, receive a lower quality of care linked to stereotyping and biases (Alspach, 2018). Populations receiving substandard healthcare are often subconsciously identified by attributes such as age, race, mental health, housing, and social status (Padilla-Moledo et al., 2016). These stigmatized attributes can be the underpinning of bias. The health status of people experiencing homelessness is generally poorer than housed populations, with evidence demonstrating the difficulties they encounter when attempting access to healthcare (Klop et al., 2018).

Purpose:

The purpose of this phenomenological study was to explore and gain a more in-depth understanding …

The Lived Experience Of Older Adults Using Telemedicine Services, Cathy Anne Cahill

Theses & Dissertations

The coronavirus 2 (SARS-CoV-2) and the subsequent pandemic transformed the healthcare delivery system in the U.S. Telemedicine became an essential mode of healthcare, and its usage increased significantly during the public health emergency. Telemedicine improved access to care, especially for vulnerable patient populations and those with chronic medical conditions. There were many other benefits, including convenience, cost savings, and reduced coronavirus transmission. It also reduced the strain on healthcare facilities and overburdened healthcare providers. A qualitative, Heideggerian phenomenological method of inquiry was conducted to understand the experience of the older adult population utilizing telemedicine services. These methods included a description …

Leaders’ Perspectives On Approaches And Challenges In Enacting Faculty Vitality In The Contemporary Landscape Of Academic Medicine: A Deductive Thematic Analysis, Jennifer L. Allie, Robert Tillman, Beatriz Tapia, Elza Mylona, Koko Aung, Janet F. Williams

School of Medicine Publications

Continual changes in organizational structures within medical schools have contributed to the expanded scope and the centralization of faculty affairs offices, which support faculty administration and supportive functions. Using qualitative interviews, we investigated the perspectives of academic medicine faculty affairs leaders regarding their offices’ priorities in sustaining faculty vitality in the face of current and anticipated challenges. A semi-structured interview protocol based on the researchers' practical knowledge, informed by the study's research inquiries, and pertinent academic literature guided the interviews. Deductive thematic analysis approach was used to identify the patterns and themes across the interviews. Our analysis revealed a central …

Mexican Clinical Practice Guidelines For Adult Overweight And Obesity Management, Emma A. Chávez-Manzanera, Juan M. Vera-Zertuche, Martha Kaufer-Horwitz, Verónica Vázquez-Velázquez, José R. Flores-Lázaro, Leonor Mireles-Zavala, Raúl Calzada-León, Juan C. Garnica-Cuellar, Verónica Sánchez-Muñoz, Juan Carlos Lopez Alvarenga

School of Medicine Publications

Purpose

To develop Mexico’s first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers.

Recent Findings

A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and …

Endovascular Thrombectomy For Childhood Stroke (Save Childs Pro): An International, Multicentre, Prospective Registry Study, Peter B. Sporn, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G. Chun, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ameer E. Hassan

School of Medicine Publications

Background

Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.

Methods

In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular …

Cryoablation Of Primary Breast Cancer Tumors Induces A Systemic Abscopal Effect Altering Time (Tumor Immune Microenvironment) In Distant Tumors, Flávia Sardela De Miranda, Dalia Martinez-Marin, Rachel L. Babcock, Maribel Castro, Geetha P. Boligala, Sonia Y. Khan, Kathryn L. Furr, Isabel Castro-Piedras, Nicholas Wagner, Dakota E. Robison

School of Medicine Publications

Introduction: Despite recent advances, triple-negative breast cancer (TNBC) patients remain at high risk for recurrence and metastasis, which creates the need for innovative therapeutic approaches to improve patient outcomes. Cryoablation is a promising, less invasive alternative to surgical resection, capable of inducing tumor necrosis via freeze/thaw cycles. Necrotic cell death results in increased inflammatory signals and release of preserved tumor antigens, which have the potential to boost the local and systemic anti-tumor immune response. Thus, compared to surgery, cryoablation enhances the activation of T cells leading to an improved abscopal effect, defined as the occurrence of a systemic response after …

Accelerating Heritability, Genetic Correlation, And Genome-Wide Association Imaging Genetic Analyses In Complex Pedigrees, Brian Donohue, Si Gao, Thomas E. Nichols, Bhim M. Adhikari, Yizhou Ma, Neda Jahanshad, Francis J. Mcmahon, Elizabeth M. Humphries, William Burroughs, John Blangero

School of Medicine Publications

National and international biobanking efforts led to the collection of large and inclusive imaging genetics datasets that enable examination of the contribution of genetic and environmental factors to human brains in illness and health. High-resolution neuroimaging (~104–6 voxels) and genetic (106–8 single nucleotide polymorphic [SNP] variants) data are available in statistically powerful (N = 103–5) epidemiological and disorder-focused samples. Performing imaging genetics analyses at full resolution afforded in these datasets is a formidable computational task even under the assumption of unrelatedness among the subjects. The computational complexity rises as ~N2–3 (where N is the sample size), when …

Lipid-Based Niclosamide Delivery: Comparative Efficacy, Bioavailability, And Potential As A Cancer Drug, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Niclosamide, an FDA-approved anti-parasitic drug, has demonstrated significant potential as a repurposed anti-cancer agent due to its ability to interfere with multiple oncogenic pathways. However, its clinical application has been hindered by poor solubility and bioavailability. Lipid-based nanocarrier systems such as liposomes, solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), and lipid nanoemulsions (LNE), along with lipid prodrugs, have successfully been employed by researchers to overcome these limitations and improve niclosamide’s pharmacokinetic profile. Lipids are the core organic compounds which serve as the foundation of these advanced drug delivery methods and in turn play a critical role in enhancing niclosamide’s …

Validation Of Human Telomere Length Multi-Ancestry Meta-Analysis Association Signals Identifies Pop5 And Kbtbd6 As Human Telomere Length Regulation Genes, Rebecca Keener, Surya B. Chhetri, Carla J. Connelly, Margaret A. Taub, Matthew P. Conomos, Joshua Weinstock, Bohan Ni, Benjamin Strober, Stella Aslibekyan, John Blangero

School of Medicine Publications

Genome-wide association studies (GWAS) have become well-powered to detect loci associated with telomere length. However, no prior work has validated genes nominated by GWAS to examine their role in telomere length regulation. We conducted a multi-ancestry meta-analysis of 211,369 individuals and identified five novel association signals. Enrichment analyses of chromatin state and cell-type heritability suggested that blood/immune cells are the most relevant cell type to examine telomere length association signals. We validated specific GWAS associations by overexpressing KBTBD6 or POP5 and demonstrated that both lengthened telomeres. CRISPR/Cas9 deletion of the predicted causal regions in K562 blood cells reduced expression of …

Developing A Bilingual Health Education Program To Identify And Address Healthcare Misinformation In A Border Community, Sara Mansour, Nathan Holland, Sergio Saucedo, Amadeus Ramirez, Mariela Lane, Joshua Salisbury, Komal Marwaha, Lorena Fernandez, Jesse Allen, Ricardo Belmares

School of Medicine Publications

El Paso Health Education and Awareness Team (EP-HEAT®) is a bilingual program focused on increasing health awareness and dispelling health-related misinformation in the U.S.-Mexico border region. EP-HEAT® consists of students, faculty, staff, and Promotoras. The primary objective of EP-HEAT® is to empower the community with healthcare resources in a culturally acceptable way. EP-HEAT® established the bilingual “In the Hot Seat with EP-HEAT®: Dispelling Myths in Healthcare” series commonly referred to as Myth Busters events. Community members were surveyed following the events. Our results showed the majority of EP-HEAT® event attendees identified as Hispanic and were older than 46 years …

Oh, My Quad: A Clinical Commentary And Evidence-Based Framework For The Rehabilitation Of Quadriceps Size And Strength After Anterior Cruciate Ligament Reconstruction, Braidy Solie, Mitchell Carlson, Christopher Doney, Michael Kiely, Robert Laprade

Physical Therapy Faculty Research and Publications

Quadriceps weakness after anterior cruciate ligament reconstruction (ACLR) is a well-known phenomenon, with more persistent quadriceps weakness observed after ACLR with a bone-patellar tendon-bone or quadriceps tendon autograft than with a hamstring tendon autograft. Longstanding quadriceps weakness after ACLR has been associated with suboptimal postoperative outcomes and the progression of radiographic knee osteoarthritis, making the recovery of quadriceps size and strength a key component of ACLR rehabilitation. However, few articles have been written for the specific purpose of optimizing quadriceps size and strength after ACLR. Therefore, the purpose of this review article is to integrate the existing quadriceps muscle basic …

Immediate Effect Of Local Vibration On Motor Unit Firing Behavior And Muscle Strength In Healthy Young Adult Males, Yuichi Nishikawa, Aleš Holobar, Kohei Watanabe, Toshihiko Komatsuzaki, Takanori Chihara, Jiro Sakamoto, Takashi Kawagoe, Hidetaka Nagayasu, Kyoko Mori, Kenji Kawano, Noriaki Maeda, Shinobu Tanaka, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

Purpose

The aim of this study was to examine the effect of vibration on motor unit (MU) firing behavior and physical performance of antagonist muscles in healthy young adult males.

Methods

Fourteen males (age = 24.3 ± 3.6 years) were included in this study. There were two conditions, one in which participants received 80 Hz vibration in the distal tendon of the hamstring for 30 s and the control condition (no vibration). High-density surface electromyography (HD-SEMG) signals and maximal voluntary contraction (MVC) of knee extensor muscles were evaluated before and after the respective conditions and recorded from the vastus lateralis …

A Proposed Instrument To Determine Mobility Eligibility Criteria And Levels For Mechanically Ventilated Patients In The Intensive Care Unit, Keira Gabrielle Miller

Doctoral Scholarly Projects & Capstones

Immobility is a problem among mechanically ventilated patients in the intensive care unit. Early mobility has been shown to benefit mechanically ventilated patient outcomes by minimizing hospital stays and costs, decreasing the risk of infection, and improving muscle strength to lead to a better quality of life. No inclusive checklists exist to evaluate patients progressing to varying levels of mobility based on specific criteria such as hemodynamics, neurological function, and disease acuity. This gap was identified after a current and comprehensive literature review on early mobilization among mechanically ventilated patients. The purpose of this project was to combine a comprehensive …

Effect Of Running Cadence On Tibial Acceleration: Implications For Runners Experiencing Stress Injuries, Victoria Hilfiker

Honors Theses

I. Purpose The purpose of this study was to determine the influence of cadence modification on tibial acceleration (TA) in the interest of exploring potential methods to reduce the incidence of stress-related running injuries. II. Methods Eleven injury-free distance runners were recruited to run at 6 different cadences with acoustic pacing. An inertial measurement unit (IMU) containing an onboard triaxial accelerometer was mounted on the right medial distal tibia to record acceleration at each of these paces. A repeated-measures ANOVA was conducted to determine differences in tibial acceleration over varying cadences. Effect sizes (╖2 and Cohen’s d) were examined to …

Access To Health Care And Glycemic Control: The National Health And Nutrition Examinations Survey (Nhanes) 2005-2018., Mohamed M. Ali

Electronic Theses and Dissertations

Background and Purpose: Diabetes mellitus is a chronic metabolic condition associated with numerous medical and financial sequences. In 2018, 34.1 million adults aged 18 years or older had diabetes in the U.S. Access to Care for diabetic Americans remains a public healthcare concern. This study aims to examine the relationship between access to healthcare and selected diabetes indicators. Methods: A quantitative, repeated cross-sectional study uses four of the National Health and Nutrition Examinations Survey's (NHANES) access measures (insurance, the number of times of annual healthcare visits, routine place for healthcare, and type of place) and four diabetes indicators (Hemoglobin A1C …

Assessing Prescribing Trends And Pharmacist Role In Optimization Of Iv Iron Sucrose, Katherine Fernandez, Erika Dittmar, Heidi Clarke, Stephanie Palma, Jonathan Kline

Nursing & Health Sciences Research Journal

Background: Iron deficiency can occur in the presence or absence of anemia and is defined as ferritin less than 15–30 μg/L or transferrin saturation less than 20% per the American Society of Hematology guidelines. Intravenous (IV) iron is used to treat iron deficiency when oral iron supplements are ineffective or not tolerated due to gastrointestinal issues or inability to take medications orally. Intravenous iron allows for more rapid replenishment of iron stores, especially in cases where absorption is compromised. There is no significant difference in efficacy between IV iron formulations, making cost-effectiveness a crucial consideration in product selection. Our health …

Evaluation Of The Etiology Of Recurrent Pregnancy Loss (Rpl): An Explanatory Mixed Methods Study Exploring Obstetrician Gynecologist Clinical Provider Behaviors And Factors Contributing To Incomplete Evaluations, Emelia Grant

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: More than 50% of patients with recurrent pregnancy loss (RPL) are left without explanations for their losses. However, current research suggests that up to 90% of these individuals could receive explanations through evidence-based laboratory testing. Professional guidelines vary in their recommendations for laboratory testing and RPL evaluation, which can contribute to delayed or fragmented care and untreated maternal disease. Inequities in access to genetic testing further complicate the diagnostic landscape of RPL since payor policies often determine which tests are covered, leaving many patients without access due to financial constraints.

Objective: This study aimed to evaluate current practices of …

Focused Ultrasound: A New Era In Tremor Control, Sajid Hameed

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Young Adults’ Perceptions Of Adverse Childhood Experiences As Context And Causes Of Mental Health Conditions: Observations From The United States, Kathryn Sabella, Ian A. Lane, Murron O'Neill, Natalie Tincknell

Faculty Publications (Peer-Reviewed)

Background

Objective

Participants and setting

Methods …

Identification Of Lncrnas Involved In The Host Response To Venezuelan Equine Encephalitis Virus Infection, Mahgol Behnia

Biomedical Sciences ETDs

Venezuelan equine encephalitis virus (VEEV) is an enveloped positive-sense RNA virus in the alphavirus genus of the Togaviridea family, that causes encephalitis in humans and equids. Currently no FDA-approved vaccine or treatment is available for human use, emphasizing the importance of studying host-VEEV interaction. lncRNAs are regulatory RNAs involved in modulation of antiviral pathways during viral infections. Here we report differential lncRNAs expression in primary mouse astrocytes and neurons during non-pathogenic (TC-83) but not pathogenic (TrD) VEEV infection. We further demonstrated that suppression of four lncRNAs increased TC-83 replication, with lncRNA small nucleolar RNA host gene 15 (Snhg15) increasing TC-83 …

Pharmacological Inhibition Of Lsd1/Kdm1a In Diffuse Midline Glioma Models And Impact On Kinase Signaling, Faith Angelina Hernandez, Faith Angelina Hernandez

Dissertations and Theses (Open Access)

Diffuse Midline Gliomas (DMG) occur in the midline structures of the brain such as the brainstem. DMG, a subset of pediatric high-grade gliomas (pHGGs), confers poor prognosis in children with survival rates below two years post-diagnosis. This is heavily due to limited treatment options as radiation and chemotherapy are only temporarily effective and surgery pose high risks. DMG are characterized by histone mutations typically occurring in histone 3.1 and 3.3 alleles, with about more than 80% of patients containing the H3K27 mutation. Recent publications, highlight epigenetic modulators as promising cancer-specific targets emphasizing their potential as a novel therapeutic strategy. Epigenetic …

Editorial Board

Nursing & Health Sciences Research Journal

No abstract provided.