Medicine and Health Sciences Commons^™

Comparing The Outcomes Of Ceftaroline Plus Vancomycin Or Daptomycin Combination Therapy Versus Monotherapy In Adults With Complicated And Prolonged Methicillin-Resistant Staphylococcus Aureus Bacteremia Initially Treated With Supplemental Ceftaroline, Omar Ahmad, Timothy N. Crawford, Thein Myint

Internal Medicine Faculty Publications

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia confers considerable morbidity and mortality. Although vancomycin or daptomycin monotherapy is usually curative, prolonged bacteremia necessitating supplemental ceftaroline has occurred. The practice has led to the question of whether to continue with ceftaroline following bacteremia resolution.

METHODS: Adult patients hospitalized with MRSA bacteremia at the University of Kentucky Medical Center between January 2015 and December 2017 were retrospectively reviewed. Study subjects required supplemental ceftaroline due to 4 or more days of bacteremia despite vancomycin or daptomycin. They additionally had accompanying native valve infective endocarditis, osteomyelitis, or brain abscess. Patients were divided into two cohorts. …

Amylin As A Potential Link Between Type 2 Diabetes And Alzheimer Disease, Florin Despa, Larry B. Goldstein, Geert Jan Biessels

Pharmacology and Nutritional Sciences Faculty Publications

No abstract provided.

Frequency Of Depression And Anxiety Among Patients With Chronic Spontaneous Urticaria Visiting A Tertiary Care Hospital In Karachi, Pakistan, Muhammad Rizwan Rafique, Sadia Masood, Sana Tanzil, Saadia Tabassum, Shaheen Naveed

Section of Internal Medicine

Objective: To determine the frequency of anxiety and depression among chronic spontaneous urticarial patients presenting at a tertiary care hospital.
Methods: The prospective, cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from February to August 2015, and comprised patients diagnosed with chronic spontaneous urticaria at the dermatology clinic. All the participants were assessed for anxiety and depression using Aga Khan University-Anxiety Depression Scale. Data was collected in face-to-face interview using a structured questionnaire. The association of the condition with different characteristics were calculated after stratification for age, gender, occupation and monthly income. SPSS 19 was used for …

Changes In Tendon Thickness Only Occurs In Patients With Achilles Tendinopathy, Sarah Garner, Kelsey Harnar, Jesus Soltero Plaza, Kevin Coriano, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

A previous George Fox Study examined the effect of a heavy load eccentric exercise program for patients with achilles tendinopathy (AT) to test the hypothesis of improved outcomes and decreased tendon thickness.

Social Adversity, Sleep Characteristics, And Elevated Blood Pressure Among Young Adult Black Females, Jewel Scott Phd, Rn, Fnp-C, Susan Silva, Leigh Ann Simmons

Faculty Publications

Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women. Methods: This is a cross-sectional analysis of existing data from 581 black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics were measures of duration, latency, continuity, and snoring. Logistic regression was used to evaluate the influence of social exposures and sleep characteristics on BP. Results: Among the women (mean age=29.1 years), 32.4% had …

Telemedicine In Pediatric Speech Therapy: Characteristics Of Child, Mother, And Speech-Language Pathologist Vocal Interaction., Abigail L Betts

College of Arts & Sciences Senior Theses

Telemedicine is a potential solution to provide distant or underserved clients with access to their clinician. The purpose of this thesis is to examine how the use of telemedicine affects the vocal characteristics of children who received cochlear implants (CI), their mother, and a speech-language pathologist (SLP) as they engage in a speech-language therapy intervention. The children (n = 5), her caregiver, and the SLP engaged in one 30 minute in person session and one 30 minute telemedicine session in a counterbalanced order. The frequency of vocalizations, vocal turns, and between-speaker pause (BSP) duration in both sessions were examined. The …

Our Wicked Problem, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

The Coronavirus is more than a health problem. It is a “wicked” problem disrupting work, education, travel, politics, financial indicators, and more. This label came about in 1973 to help describe a special class of situations that are volatile, uncertain and ambiguous, often difficult to recognize, and difficult or impossible to solve because of incomplete, contradictory, and changing requirements. There is no clear problem definition due to interdependencies so the problem cannot be fully understood until after the solution comes about.

Our Invisible Enemy, Larry M. Starr, Darshi Mody

School of Continuing and Professional Studies Coronavirus Papers

The novel coronavirus is invisible to the eye because it is microscopic measuring 80-160 nanometers in size; a nanometer is one billionth of a meter.

While we cannot see it in the air or on a surface, millions of us have seen the virus in full color when we discuss it on the local and national TV news, in articles and stories online, and in print media. This is because the virus is routinely pictured and used to attract us to the information being presented. The paradox is that millions of people can now recognize this invisible enemy.

Repeatedly presenting …

Disruptive Effects Of The Coronavirus – Errors Of Commission And Of Omission?, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

It is increasingly evident that the coronavirus disease, COVID-19, is more than a health problem; it is and will continue to adversely affect work and workplaces, education, families and social engagements, political and environmental dimensions, and financial indicators. Apart from its health ramifications, the crisis is revealing serious challenges in the global supply chain. Those difficulties are, at least in part, consequences of unwise, short-sighted business decisions made over the course of decades to outsource and downsize.

Pandemic Lockdown Must Fail: Save Lives Without Crippling The Economy, Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

In the following working paper, I want to make a plea for what I am calling a “reverse quarantine”—quarantining people who are over 65 (who number 52 million), before they get sick. We need to complement this policy with federally funded and locally organized efforts to support seniors in place, drawing on the wellsprings of American pragmatism, the capacity to respond in emergencies, American volunteerism, and neighbor-to-neighbor assistance. We can’t turn quarantine into imprisonment. We must work as hard as we can to create a psychological sense of community at a moment when, paradoxically, social distancing is driving us apart. …

Total Knee Arthroplasty Gap Balancer, Christina Grigorian, Andrew Beckley, Alexandra Rockett

Biomedical Engineering

California Polytechnic State University’s Biomedical Engineering Department worked in conjunction with local San Luis Obispo orthopedic surgeon Dr. Dimitri Delagrammaticas. The goal of the project was to create a surgical tool that assists a surgeon in measuring knee gap distance and balancing collateral ligament tension during a total knee arthroplasty (TKA) surgery. The final product of this project was completed in five months and initially began with understanding our sponsor’s expectations for the device. A portion of time was devoted to conducting research to understand the process of a knee replacement surgery, the requirements of the device, and the limitations …

Continuity Of Care And Outpatient Management For Patients With And At High Risk For Cardiovascular Disease During The Covid-19 Pandemic: A Scientific Statement From The American Society For Preventive Cardiology, Amit Khera, Seth J. Baum, Ty J. Gluckman, Martha Gulati, Seth S. Martin, Erin D. Michos, Ann Marie Navar, Pam R. Taub, Peter P. Toth, Salim S. Virani

Office of the Provost

The coronavirus disease 2019 (COVID-19) pandemic has consumed our healthcare system, with immediate resource focus on the management of high numbers of critically ill patients. Those that fare poorly with COVID-19 infection more commonly have cardiovascular disease (CVD), hypertension and diabetes. There are also several other conditions that raise concern for the welfare of patients with and at high risk for CVD during this pandemic. Traditional ambulatory care is disrupted and many patients are delaying or deferring necessary care, including preventive care. New impediments to medication access and adherence have arisen. Social distancing measures can increase social isolation and alter …

Mount Fuji Sign Following Nasal Polypectomy: Conservative Management Of Pneumocephalus, Matthew Szymaszek, Gentian Toshkezi

Department of Emergency Medicine Faculty Papers

Pneumocephalus is seen in conjunction with a variety of conditions, particularly traumatic injury, neurosurgical, and ears, nose, and throat (ENT) procedures. We describe the successful, non-operative management with supplemental oxygen of symptomatic pneumocephalus following polypectomy without further complication. This case adds to other case reports of pneumocephalus but differs in the non-invasive, conservative management with supplemental oxygen obviating the need for more invasive neurosurgical intervention such as decompressive craniectomy, burr holes, or drain placement.

Understanding Barriers To Clinical Management Of Rape (Cmr) Services Among Survivors Of Rape In Crisis Settings In Borno State, Osasuyi Dirisu

Reproductive Health

Sexual and gender-based violence (SGBV) is a global public health concern disproportionately affecting women, with negative consequences for their health, well-being, human rights, and equality. SGBV includes any act perpetrated against an individual that is against that person’s will and is predicated upon gender norms and unequal power relationships. SGBV occurs in crisis settings where vulnerability is increased, and social and legal sanctions are reduced. Internally Displaced Persons are vulnerable to SGBV during times of conflict as well as in post-conflict settings due to resultant losses of socioeconomic opportunities in addition to housing, security, lack of institutional protection, and familial …

The Impact Of Post Pcnl Tube Type On Blood Loss And Postoperative Pain, Salman Jamil, Hammad Ather

Section of Urology

Objective: To evaluate the impact of nephrostomy tube type on postoperative pain and blood loss following percutaneous nephrolithotomy (PCNL).
Methods: This is a prospective non-randomized study performed at Aga Khan University Hospital from July 2017 to June 2018. In this study we prospectively studied adult patients (16 to 65 years) who underwent unilateral PCNL. Patients who had nephrostomy with balloon (12Fr Foley's catheter) were compared with patients who had nephrostomy without balloon (12Fr Nelaton™ catheter). STONE Nephrolithometry score was used to assess the stone complexity. Mean pain score at six and 24 hours and mean hemoglobin drop at 24 hours …

Chronic Disease Management: How It And Analytics Create Healthcare Value Through The Temporal Displacement Of Care, Steve M. Thompson, Johnathan Whitaker, Rajiv Kohli, Craig Jones

Finance Faculty Publications

The treatment of chronic diseases consumes 86% of U.S. healthcare costs. While healthcare organizations have traditionally focused on treating the complications of chronic diseases, advances in information technology (IT) and analytics can help clinicians and patients manage and slow the progression of chronic diseases to result in higher quality of life for patients and lower healthcare costs.

We build on prior research to introduce the notion of temporal displacement of care (TDC), in which IT and analytics create healthcare value by displacing the time at which providers and patients make interventions to improve healthcare outcomes and reduce costs. We propose …

Roli I Infermierit Në Trajtimin E Pacientëve Nga Abcesi I Trurit, Mollëza Kamberi

Theses and Dissertations

Abcesi i trurit (BA) përcaktohet si një infeksion fokal brenda parenkimës së trurit, e cila fillon si një zonë e lokalizuar e cerebritit, e cila më pas shndërrohet në një koleksion qelbi brenda një kapsulë të vaskuluar mirë. BA duhet të jetë e diferencuar nga infeksionet duke përfshirë abscesin epidural dhe subdural. BA është një sfidë për neurokirurgun sepse kërkon aftësi të mira klinike, farmakologjike dhe kirurgjike për të siguruar rezultate të mira klinike dhe prognozë për pacientët me BA. E konsideruar si një infeksion i rrallë i trurit, BA mund të ishte një entitet shkatërrues që e la me …

Roli I Infermierit Në Trajtimin E Pacientëve Me Djegie, Mirjeta Jakupi

Theses and Dissertations

Hyrje: Djegia është një dëmtim i lëkurës ose i indit tjetër i shkaktuar kryesisht nga trauma akute ose termike. Ndodh kur disa ose të gjitha qelizat në lëkurë ose inde të tjera shkatërrohen nga lëngjet e nxehta, mjetet e nxehta (djegiet e kontaktit), zjarri, rrezatimi, energjia elektrike, fërkimi ose kimikalet. Qëllimi i studimit eshte të përshkruaj rolin e infermierëve në kujdesin e pacientëve me djegie si dhe se çfarë praktikojnë aktualisht infemierët në menaxhimin e djegieve në mënyrë që të hartohen udhëzime mbi menaxhimin e djegieve.

Metodologjia: Metodologjia e punimit është deskriptive dhe retrospektive. Ky hulumtim është kryer …

Ameloplasty Is Counterproductive In Reducing Microleakage Around Resin Modified Glass Ionomer And Resin Based Fissure Sealants, Tabinda Nawaz Khan, Farhan Raza Khan, Syed Yawar Ali Abidi

Section of Dental-Oral Maxillofacial Surgery

Objective: To compare the microleakage around resin modified glass ionomer cement (RMGIC) based sealants and flowable resin based sealants placed with or without ameloplasty in extracted human teeth.
Methods: This in-vitro experimental study was conducted at the Operative Dentistry Department, Dow University of Health Sciences, Karachi, Pakistan from June 2017 to December 2018. Sixty extracted human molars and premolars were assigned to four groups (n=15) each, according to the type of fissure sealant (flowable resin based sealant or resin modified glass ionomer based sealant) used and either placed with or without ameloplasty. Specimens were thermocycled and then immersed in 1% …

Bio-Active Cements-Mineral Trioxide Aggregate Based Calcium Silicate Materials: A Narrative Review, Kamil Zafar, Shizrah Jamal, Robia Ghafoor

Section of Dental-Oral Maxillofacial Surgery

Recent advances in the field of endodontics have greatly improved the outcome and success rate of dental materials. For last three decades, there has been great interest in the development of bioactive dental material with the ability to interact and induce surrounding dental tissues to promote regeneration of pulpal and periradicular tissues. As these bioactive materials are mainly based on calcium silicates, they are also referred to as Calcium Silicate materials. The first material introduced was Mineral Tri-oxide Aggregate, which, due to its favourable biological properties, gained importance initially. However, later, due to its drawbacks, liked is colouration, long setting …

Exploring Changes In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Fafan And West Arsi Zones, Ethiopia, Getaneh Mehari, Asabneh Molla, Ayantu Mamo, Dennis Matanda

Reproductive Health

Globally, more than 200 million women and girls have undergone FGM/C. More than half of these girls and women live in three high-prevalence countries: Egypt, Ethiopia, and Indonesia. Given the increase in population growth, recent estimates show that the number of girls and women subject to FGM/C will continue to rise in the coming years unless sufficient efforts are undertaken to encourage abandonment of the practice. A descriptive analysis of changes in FGM/C prevalence over time in Ethiopia shows that the percentage of women aged 15–49 years who report undergoing FGM/C has been declining. Despite the decline, the FGM/C prevalence …

Improving Data Reporting To Nhmis From The Private Sector In Nigeria: Lessons From A Dhis2 Pilot With Community Pharmacists And Patent And Proprietary Medicine Vendors, Population Council

Reproductive Health

The IntegratE Project is a four-year initiative (2017–21) implemented by the Population Council and partners that seeks to increase access to contraceptive methods by involving the private sector (community pharmacists [CPs] and patent and proprietary medicine vendors [PPMVs]) in family planning (FP) service delivery in Lagos and Kaduna States, Nigeria. The project aims to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services, comply with FP regulations, and report service statistics to the Health Information Management System (HMIS). To achieve this, the project is implementing: a pilot three-tiered accreditation …

Serum Amyloid A Is Not Incorporated Into Hdl During Hdl Biogenesis, Ailing Ji, Xuebing Wang, Victoria P. Noffsinger, Drew Jennings, Maria C. De Beer, Frederick C. De Beer, Lisa R. Tannock, Nancy R. Webb

Saha Cardiovascular Research Center Faculty Publications

Liver-derived serum amyloid A (SAA) is present in plasma where it is mainly associated with HDL and from which it is cleared more rapidly than are the other major HDL-associated apolipoproteins. Although evidence suggests that lipid-free and HDL-associated forms of SAA have different activities, the pathways by which SAA associates and disassociates with HDL are poorly understood. In this study, we investigated SAA lipidation by hepatocytes and how this lipidation relates to the formation of nascent HDL particles. We also examined hepatocyte-mediated clearance of lipid-free and HDL-associated SAA. We prepared hepatocytes from mice injected with lipopolysaccharide or an SAA-expressing adenoviral …

The Effects Of A Family Planning Training On Community Pharmacists And Patent And Proprietary Medicine Vendors’ Knowledge In Nigeria: Preliminary Pre And Posttest Results, The Integrate Project, Population Council

Reproductive Health

The IntegratE Project is a four-year initiative (2017–21) implemented by the Population Council and partners that seeks to increase access to contraceptive methods by involving the private sector (community pharmacists [CPs] and patent and proprietary medicine vendors [PPMVs]) in family planning (FP) service delivery in Lagos and Kaduna States, Nigeria. The project aims to establish a regulatory system with the Pharmacists Council of Nigeria to ensure that CPs and PPMVs provide quality FP services, comply with regulations, and report service statistics to the Health Information Management System. To achieve this, the project is implementing: a pilot three-tiered accreditation system for …

A Comparison Of The National Football League Coaches Strength And Conditioning Practices 1997-1998 To 2018, Corey Fitzgerald

All NMU Master's Theses

This study describes the results of a survey of the strength and conditioning practices of the National Football League’s (NFL) strength and conditioning (S&C) coaches. The primary purpose was to identify the common and unique aspects of the NFL S&C practices during 2018. A secondary purpose was to compare those results to 1997-1998 (‘97-98) to determine differences across years. The survey response rate was 28.1% (9 of 32 NFL teams) agreeing to participate. The survey instrument was a 150 item assessment divided into 10 sections examining the entire training program. Results revealed that subjects test 6.8 ± 3.1 fitness variables …

Inhibition Deficits Are Modulated By Age And Cgg Repeat Length In Carriers Of The Fmr1 Premutation Allele Who Are Mothers Of Children With Fragile X Syndrome, Jessica Klusek, Jinkuk Hong, Audra Sterling, Elizabeth Berry-Kravis, Marsha R. Mailick

Faculty Publications

Individuals who carry a premutation (PM) allele on the FMR1 gene may experience executive limitations associated with their genetic status, including inhibition deficits. However, poor understanding of individualized risk factors has limited clinical management of this group, particularly in mothers who carry the PM allele who have children with fragile X syndrome (FXS). The present study examined CGG repeat length and age as factors that may account for variable expressivity of inhibition deficits. Participants were 134 carriers of the PM allele who were mothers of children with FXS. Inhibition skills were measured using both self-report and direct behavioral assessments. Increased …

Donning And Doffing Ppe: Reducing Self Contamination, Holly Barrett Bsn, Rn, Lauren Mcdermott Bsn, Rn, Sarah Quigley Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

The Influence Of Light In The Built Environment To Improve Mental Health Outcomes, Nathanael T. Kohl

Theses and Dissertations

Current mental health statistics for US active duty and Veteran members justify research into the causes and remedies for those plagued with negative mental health outcomes. Recent research has suggested that the built environment is connected to our mental health. This study investigated this connection with active duty and Veteran populations across the US. A literature review was completed on what factors of light in the built environment affects mental health outcomes. An analysis of active duty and Veteran mental health symptoms and the natural light rating in their residence was completed to understand the design changes that can be …

Energy And Protein Requirements For Children With Ckd Stages 2-5 And On Dialysis-Clinical Practice Recommendations From The Pediatric Renal Nutrition Taskforce., Vanessa Shaw, Nonnie Polderman, José Renken-Terhaerdt, Fabio Paglialonga, Michiel Oosterveld, Jetta Tuokkola, Caroline Anderson, An Desloovere, Laurence Greenbaum, Dieter Haffner, Christina Nelms, Leila Qizalbash, Johan Vande Walle, Bradley A. Warady, Rukshana Shroff, Lesley Rees

Manuscripts, Articles, Book Chapters and Other Papers

Dietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2-5 and those on dialysis (CKD2-5D). We address energy requirements in the context of poor growth, obesity, and different …

Immunogenicity In Clinical Practice And Drug Development: When Is It Significant?, Valentina Shakhnovich, Bernd Meibohm, Amy Rosenberg, Andrzej M. Kierzek, Rachel Hasenkamp, Ryan S. Funk, Craig J. Thalhauser, Piet H. Van Der Graaf, Yow Ming C. Wang, Lora Hamuro

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.