Medicine and Health Sciences Commons^™

The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers To Chronic Pain Management In Primary Care In Three Steps, Laura Ellen Ashcraft, Megan E Hamm, Serwaa S Omowale, Valerie Hruschak, Elizabeth Miller, Shaun M Eack, Jessica S Merlin

Faculty, Staff and Student Publications

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Prozone Masks Elevated Sars-Cov-2 Antibody Level Measurements, Micaela N Sandoval, Samuel P Mcclellan, Stephen J Pont, Jessica A Ross, Michael D Swartz, Mark A Silberman, Eric Boerwinkle

Faculty, Staff and Student Publications

We report a prozone effect in measurement of SARS-CoV-2 spike protein antibody levels from an antibody surveillance program. Briefly, the prozone effect occurs in immunoassays when excessively high antibody concentration disrupts the immune complex formation, resulting in a spuriously low reported result. Following participant inquiries, we observed anomalously low measurement of SARS-CoV-2 spike protein antibody levels using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay from participants in the Texas Coronavirus Antibody Research survey (Texas CARES), an ongoing prospective, longitudinal antibody surveillance program. In July, 2022, samples were collected from ten participants with anomalously low results for serial dilution studies, and a …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

Higher Baseline Serum Bilirubin Levels Are Associated With Increased Risk Of Early Neurological Deterioration In Women With Acute Ischemic Stroke, Meng Sun, Yingfeng Weng, Jiwei Cheng, Guoyi Li, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Early neurological deterioration (END) occurs in up to one-third of patients with acute ischemic stroke (AIS) and associated with poor outcome. The role of serum bilirubin in END remains controversial. This study aims to investigate the association of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) with END.

METHODS: This study was a cross-sectional retrospective study with 344 AIS patients enrolled. We retrospectively reviewed consecutive AIS patients with END through a medical record retrieval system and enrolled patients as control randomly from the AIS patients without END at the same period. The bilirubin levels were …

Patterns Of Failure For Recurrent Head And Neck Squamous Cell Carcinoma Treated With Salvage Surgery And Postoperative Imrt Reirradiation, Abdallah S R Mohamed, Geoffrey V Martin, Sweet Ping Ng, Vinita Takiar, Beth M Beadle, Mark Zafereo, Adam S Garden, Steven J Frank, C David Fuller, G Brandon Gunn, William H Morrison, David I Rosenthal, Jay Reddy, Amy Moreno, Anna Lee, Jack Phan

Faculty, Staff and Student Publications

PURPOSE/OBJECTIVES: The purpose of this study was to evaluate patterns of locoregional recurrence (LRR) after surgical salvage and adjuvant reirradiation with IMRT for recurrent head and neck squamous cell cancer (HNSCC).

MATERIALS/METHODS: Patterns of LRR for 61 patients treated consecutively between 2003 and 2014 who received post-operative IMRT reirradiation to ≥ 60 Gy for recurrent HNSCC were determined by 2 methods: 1) physician classification via visual comparison of post-radiotherapy imaging to reirradiation plans; and 2) using deformable image registration (DIR). Those without evaluable CT planning image data were excluded. All recurrences were verified by biopsy or radiological progression. Failures were …

Addressing Inappropriate Polypharmacy: Investigating Perceived Facilitators And Barriers To U.S. Pharmacists' Ability To Recommend Deprescribing, Susanne Steiner

Theses and Dissertations

While the concurrent use of multiple prescriptions (polypharmacy) is common for those with chronic conditions, professional ownership is lacking when it comes to tapering or discontinuing potentially inappropriate medications. Our growing elderly population is especially vulnerable to negative risks associated with polypharmacy. Pharmacists are highly educated and skilled healthcare professionals working as critical touchpoints with patients; yet they are not empowered to deprescribe potentially inappropriate medications directly. This qualitative research study examined the perceived barriers and facilitators pharmacists encounter when pursuing deprescribing recommendations and initiatives with prescribers, healthcare staff, patients, and caregivers. Findings from this study revealed three key implications …

Ivermectin, Colleen Aldous, Eleftherios Gkioulekas, Philip Oldfield

School of Mathematical & Statistical Sciences Faculty Publications

No abstract provided.

Association Between Serum Procalcitonin Level With Exacerbation Severity In Chronic Obstructive Pulmonary Disease Patients, Dalia Abdellateif Abdelghany, Shimaa R. Hendawy, Rania Mostafa, Heba Wagih Abdelwahab

Mansoura Medical Journal

Background: There is a significant impact on morbidity, mortality, and quality of life due to chronic obstructive pulmonary disease exacerbations. Individuals with acute exacerbation of chronic obstructive pulmonary disease had considerably higher mean serum procalcitonin levels (PCT) compared to individuals with stable chronic obstructive pulmonary disease, according to previous investigations. Objective: This study aimed to assess whether procalcitonin levels were associated with the severity of exacerbations in patients with chronic obstructive pulmonary disease. Methods: thirty-nine patients who were suffering from an acute exacerbation of chronic obstructive pulmonary disease were included. Included patients were classified as having either no respiratory failure, …

A Case Of Amyloidosis Presenting With Nephrotic Syndrome And Acute Renal Failure, Ahmed Ali, Ahmed Abdelhaleem, Farrah Ibrahim, Ali Hachem

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

Psyched For Surgery — Preoperative Evaluation Of A Patient With Extensive Psychiatric History, Ashely Archer, Fizza Mahmood, Tarak Vasavada

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

Id: Identifying Best Practices For Patients With Intellectual Disabilities, Jacqueline Beard, Nikki Ahuja, Yesenia Lopez, Meredith Lewis

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

Posterior Reversible Encephalopathy Syndrome Leading To Diagnosis Of Acute Post‐Infectious Glomerulonephritis In A Pediatric Patient: A Case Report, Samuel B. Hayworth, Desalyn L. Johnson, Erinn O. Schmit

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

The Mental Health Crisis In Schools, Madison Jeziorski, Clinton Martin, Zachary Gilliam, Janaki Nimmgadda

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

A Calamity With The Mammary, Shelby Kaup, Elijah Fox

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

It’S A Heartache: A Case Of Chlamydial Myocarditis, Abigail Zane, Aesha Patel, Kelsey Ivey

UAB Huntsville Research Day - All Presentations

2024 clinical vignette poster

Anatomical And Histological Features Of The Brain Of Adult Common Carp (Cyprinus Carpio), Sayed Shaban, Galal Youssef, Safwat Ebada, Mahmoud B. Shoeib

Mansoura Veterinary Medical Journal

Background: investigated the anatomical features and histological structures of the brain of adult common carp. In addition, these features were compared with those of other types of fish.

Methods: Adult fish (8- 18 M) were collected, their gross anatomical features were inspected; and small specimens from different brain parts were fixed, sectioned, stained, and histologically examined.

Results: In the common carp, the olfactory bulb was round, somewhat tiny, and connected to the telencephalon by a very long, thin olfactory tract. The hemispheres of the telencephalon were located rostrally. Only one median ventral telencephalic ventricle was visible. The torus longitudinalis and …

Health Policies Within The Poverty Agendas Of Lula And Rousseff, Welington Lazarini, Francis Sodré, Carlos Eduardo Siqueira

Gastón Institute Publications

The anti-poverty agenda has been at the heart of the World Bank’s discourse in recent decades. Social policies started to be identified as strategic for combating poverty and promoting development in poor countries. We analyzed the health policy recommendations made by the World Bank to Brazil in the Lula da Silva and Rousseff administrations from 2003 to 2014. Document analysis was used to explore the partnership contracts between the World Bank and Brazil, projects financed by the World Bank in Brazil, and the document “20 Years of Construction of the Health System in Brazil: An Analysis of the Unified Health …

20-Year Outcomes Of High Tibial Osteotomy: Determinants Of Survival And Functional Outcome, Harry Constantin, Lucy Salmon, Vivianne Russell, Keran Sundaraj, Justin Roe, Leo Pinczewski

Medical Papers and Journal Articles

Background: High tibial osteotomy (HTO) is a successful joint-preserving procedure for the treatment of medial compartment osteoarthritis. Long-term survivorship of HTO ranges from 40% to 85%. There are consistent factors that predict failure.

Purpose: To determine the 20-year survival of HTO and identify predictors of failure.

Study Design: Case series; Level of evidence, 4.

Methods: A total of 100 consecutive patients with medial bone-on-bone arthritis were prospectively studied to provide long-term patient-reported outcome measures after lateral closing-wedge HTO and determine the time to failure. Failure was defined as conversion to arthroplasty (total knee arthroplasty or unicompartmental knee arthroplasty) or revision …

A Case Report: Regenerative And Robotic Rehabilitation In A Patient With Chronic Hypoxic-Ischemic Encephalopathy, Chieh Chen, Sun-Hui Tseng

Rehabilitation Practice and Science

Hypoxic-ischemic encephalopathy (HIE) occurs when the brain is deprived of sufficient oxygen or blood flow, resulting in brain dysfunction. According to the relevant literature, no curative therapies are currently available for HIE-related lifelong disabilities. Regenerative rehabilitation employs regenerative technologies and cell therapy combined with conventional therapeutic exercises to restore normal function. This study used robotic-assisted gait training with the Lokomat and two infusions of human umbilical cord mesenchymal stem cells (hUC-MSCs) to treat an adolescent with chronic HIE. At the seven-month follow-up assessment, we determined that the patient’s motor function had improved based on the Gross Motor Function Measure-88 (GMFM-88) …

The Lived Experience Of The Covid-19 Pandemic Among Mandate-Resistant Adults In Washington State, Amber N. Peterson

Antioch University Dissertations & Theses

This study examined the lived experience of self-identified, mandate-resistant adults in Washington state. This study explored participants’ experience of the COVID-19 pandemic, from a retrospective framework by uncovering challenges, silver linings, decision-making, and self-reported mental health. Remote interviews were conducted with nine participants. Participants were between 23–31 years old, mostly male, and over half identified as Black. Through semi structured interviews, data was collected and analyzed using Interpretive Phenomenological Analysis (IPA). Participants described their experiences during the COVID-19 pandemic and highlighted significant changes in the way they lived their lives. Most notably, participants described ways in which they defied COVID-19 …

From East To West: Exploring The Mental Health Of Punjabi Immigrants Residing In British Columbia, Jasleen Kaur

Antioch University Dissertations & Theses

Mental health has been a topic that is slowly gaining more acknowledgement and awareness over time. However, despite the elevation in awareness, there are many cultures where mental health issues remain subject to stigma, which discourages an individual from seeking, or even acknowledging, mental health treatment and services. This study focuses upon varying perceptions of mental health by exploring in-depth the perception of mental health within the Punjabi community and how Punjabi culture affects such perceptions. Specifically, this research study examines how young adults who immigrated from Punjab, India to British Columbia (B.C.) perceive and respond to mental health concerns. …

The Alignmnh 2023 Conference: Progress In Raising Parents’ Voices In Stillbirth Advocacy., Grace Mwashigadi, Treasure Lwantale, Aleena Wojcieszek, Hannah Blencowe, Susannah Hopkins Leisher, Caroline Wanjiru Kiunga, David Wanjala, Claire Storey

Centre of Excellence in Women and Child Health

No abstract provided.

Pattern And Determinants Of Contraceptive Use Among The Muslim Women In Wajir And Lamu Counties In Kenya: A Cross-Sectional Study., Batula Abdi, Jerry Okal, Gamal Serour, Vincent Were, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies.

Methods; We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15–49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study …

Remote Multi-Person Heart Rate Monitoring With Smart Speakers: Overcoming Separation Constraint, Ngoc Doan Thu Tran, Dong Ma, Rajesh Krishna Balan

Research Collection School Of Computing and Information Systems

Heart rate is a key vital sign that can be used to understand an individual’s health condition. Recently, remote sensing techniques, especially acoustic-based sensing, have received increasing attention for their ability to non-invasively detect heart rate via commercial mobile devices such as smartphones and smart speakers. However, due to signal interference, existing methods have primarily focused on monitoring a single user and required a large separation between them when monitoring multiple people. These limitations hinder many common use cases such as couples sharing the same bed or two or more people located in close proximity. In this paper, we present …

The Impact Of Covid-19 Pandemic On Global Neurosurgery Collaborations., Alvan Emeka Ukachukwu, Nancy Abu Bonsrah, Andreas Seas, Zoey Petitt, Romaric Waguia Kouam, Samantha Ramos, Alyssa Edwards, Di Deng, Michael Haglund, Mahmood Qureshi

General Surgery, East Africa

No abstract provided.

Evaluation Of Common Complications Following Tetralogy Of Fallot Surgical Repair By Magnetic Resonance Imaging, Zainab Ahmad Ramadan, Mohamed Salah Ayyad

Mansoura Medical Journal

Background: The operative procedures for correction of tetralogy of Fallot (TOF) concentrates on the impact of pulmonary valve regurgitation (PR) on the function of right ventricle (RV) pointing to alleviating right ventricle outflow tract (RVOT) narrowing, and minimizing the PR degree at the same time, closing ventricular septal defect (VSD). Various complications could be encountered after TOF repair as; PR, dilated RV with/without impaired function, RVOT residual obstruction/ dilatation, residual VSD, tricuspid regurge (TR), aortic root dilatation with/without regurge and significant difference in differential pulmonary flow. Objective: Address the most common complications that could be encountered following TOF surgical repair, …

Study Of Serum Bilirubin In Relation To Stable Chronic Coronary Artery Disease Severity And Outcome After Percutaneous Intervention, Khaled E Mahfouz, Ahmed W Suliman, Mahmoud A Youssef, Adel M Osman

Mansoura Medical Journal

Background: Bilirubin is endogenous antioxidant and increased its physiological concentrations reduce severity of coronary artery disease with better prognosis after PCI. Objective: Assess serum bilirubin level in patients with stable chronic coronary artery disease and correlate it with the severity of this disease and outcome after PCI. Methods: Cross sectional prospective observational study included 203 Patient with stable chronic coronary artery disease divided into 2 groups according to bilirubin: group I ≤ 0.6mg/dl group II > 0.6 (up to 1.2) mg/dl 100 cases underwent elective coronary angiography and PCI with full clinical examination, laboratory tests: total serum bilirubin, creatinine, lipid profile, …

Serum Interleukin-22 In Non-Segmental Vitiligo, Fatma Faisal El Dakrory, Maha Elsayed Mahmoud Elsayed, Yousra Ibrahim El-Tantawy Sadeq, Shereen Ezzalregal Alashry

Mansoura Medical Journal

Background: A depigmenting skin condition called vitiligo affects 0.5–2 percent of people globally. It seems to be caused by an interaction between neurological, immunological, and genetic factors. Vitiligo is mediated by cell-mediated reactions, as Th1/Th17 and Tc1 cells. It is thought that the Th17 cell's most specialized cytokine isIL-22. Aim: To explore the blood levels of IL-22 in non-segmental vitiligo and to investigate whether it can be a biomarker in monitoring disease activity and it’s correlation with disease severity. Patient and methods: This study included thirty healthy individuals and sixty non-segmental vitiligo cases (30 with stable vitiligo and 30 with …

Increasing Incidence And Unusual Presentations Of Chickenpox Infection In The Post Covid-19 Era In Egypt, Sara Hamdy, Amany Awad

Mansoura Medical Journal

Background: The aim of the current study was to analyze the incidence and clinical presentations of patients with chicken pox in the post COVID-19 era. Additionally, the management protocols of these patients were highlighted.

Patients and methods: This prospective cohort included 70 patients of Chicken pox diagnosed and managed in a tertiary referral center over a 2-months duration. Patients’ symptoms, complications, treatment, as well as outcomes were documented and analyzed.

Results: a sharp increase in the incidence of chickenpox was observed in our institute compared to the same season in the previous years. Unusual presentations were also …