Medicine and Health Sciences Commons^™

Public Knowledge And Attitudes Towards Bystander Cardiopulmonary Resuscitation (Cpr) In Ghana, West Africa., M. Anto-Ocrah, N. Maxwell, J. Cushman, E. Acheampong, R. Kodam, C. Homan, T. Li

Journal Articles

BACKGROUND AND OBJECTIVES:Early bystander cardiopulmonary resuscitation (CPR) is one of the most important predictors of out-of-hospital cardiac arrests (OHCA) survival. There is a dearth of literature on CPR engagement in countries such as Ghana, where cardiovascular events are increasingly prevalent. In this study, we sought to evaluate Ghanaians' knowledge of and attitudes towards bystander CPR, in the context of the country's nascent emergency medicine network. METHODS:Capitalizing on the growing ubiquity and use of social media across the country, we used a novel social media sampling strategy for this study. We created, pre-tested, and distributed an online survey, using the two …

Ultrasound Identification Of Retrobulbar Hematomas By Emergency Physicians In A Cadaveric Model, E. Carlin, A. Palmieri, T. Bajaj, M. Nelson

Journal Articles

Copyright: © 2020 Carlin et al. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ Introduction: Retrobulbar hemorrhage (RBH) is a rare complication of facial trauma that can lead to dangerous orbital compartment pressures and must be rapidly recognized to prevent permanent vision loss. Point-of-care ultrasound (POCUS) offers a rapid modality for evaluating a wide variety of ocular pathologies, and prior case reports demonstrate the ability of clinicians to recognize RBH using ultrasound. This study aimed to assess the ability of clinicians at various stages of …

A Framework For Advancing Our Understanding Of Cancer-Associated Fibroblasts, E. Sahai, I. Astsaturov, E. Cukierman, D. G. Denardo, M. Egeblad, R. M. Evans, D. Fearon, R. G. Maki, D. C. Ramirez, Z. Werb, +10 Additional Authors

Journal Articles

No abstract provided.

Covid-19 And Thrombotic Or Thromboembolic Disease: Implications For Prevention, Antithrombotic Therapy, And Follow-Up: Jacc State-Of-The-Art Review, B. Bikdeli, M. V. Madhavan, D. Jimenez, T. Chuich, I. Dreyfus, E. Driggin, C. D. Nigoghossian, W. Ageno, A. C. Spyropoulos, G. Y. Lip, +10 Additional Authors

Journal Articles

© 2020 American College of Cardiology Foundation Coronavirus disease-2019 (COVID-19), a viral respiratory illness caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), may predispose patients to thrombotic disease, both in the venous and arterial circulations, because of excessive inflammation, platelet activation, endothelial dysfunction, and stasis. In addition, many patients receiving antithrombotic therapy for thrombotic disease may develop COVID-19, which can have implications for choice, dosing, and laboratory monitoring of antithrombotic therapy. Moreover, during a time with much focus on COVID-19, it is critical to consider how to optimize the available technology to care for patients without COVID-19 who have thrombotic …

Development And Validation Of Clinical Scoring Tool To Predict Outcomes Of Treatment With Vedolizumab In Patients With Ulcerative Colitis., P. S. Dulai, S. Singh, N. V. Casteele, J. Meserve, A. Winters, S. Chablaney, S. Aniwan, P. Shashi, A. Swaminath, C. Cao, +10 Additional Authors

Journal Articles

BACKGROUND & AIMS:We created and validated a clinical decision support tool (CDST) to predict outcomes of vedolizumab therapy for ulcerative colitis (UC). METHODS:We performed logistic regression analyses of data from the GEMINI 1 trial, from 620 patients with UC who received vedolizumab induction and maintenance therapy (derivation cohort), to identify factors associated with corticosteroid-free remission (full Mayo score of 2 or less, no subscore above 1). We used these factors to develop a model to predict outcomes of treatment, which we called the vedolizumab CDST. We evaluated the correlation between exposure and efficacy. We validated the CDST in using data …

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

#Realcollege During The Pandemic: New Evidence On Basic Needs Insecurity And Student Well-Being, Sara Goldrick-Rab, Vanessa Coca, Gregory Kienzl, Carrie R. Welton, Sonja Dahl, Sarah Magnelia, Sarah Magnelia

Rebuilding the Launchpad: Serving Students During Covid Resource Library

In March 2020, the coronavirus pandemic struck American higher education. Colleges closed campuses, students lost jobs, and emergency resources failed to meet the demands caused by the crisis. This report examines the pandemic’s impact on students, from their basic needs security to their well-being, as indicated by employment status, academic engagement, and mental health.

Massive Megarectum Secondary To Constipation In Institutionalized Patient, Dawit Ayalew, Yahya Alwatari, Lin M. Riccio

Surgery Publications

Chronic constipation is a common cause of morbidity in the elderly and institutionalized population. It can be associated with significant morbidity and socioeconomical burden. Chronic resistance constipation can rarely be associated with megarectum. Herein, we present the case of a patient with physical and mental disability that presented with refractory constipation associated with extreme stool burden and a massive megarectum. We discuss chronic constipation in the elderly population, its etiologies and diagnostic work-up including surgical options. The management of chronic constipation with megarectum should be on a case-by-case basis.

Increased C-Reactive Protein Is Associated With The Severity Of Thoracic Radiotherapy-Induced Cardiomyopathy, Justin M. Canada, Georgia K. Thomas, Cory R. Trankle, Salvatore Carbone, Hayley Billingsley, Benjamin W. Van Tassell, Ronald K. Evans, Ryan Garten, Elisabeth Weiss, Antonio Abbate

Internal Medicine Publications

Background: Irradiation of the heart during cancer radiotherapy is associated with a dose-dependent risk of heart failure. Animal studies have demonstrated that irradiation leads to an inflammatory response within the heart as well as a reduction in cardiac reserve. In the current study we aimed to evaluate whether inflammatory biomarkers correlated with changes in cardiac function and reserve after radiotherapy for breast or lung cancer.

Methods and results: We studied 25 subjects with a history of breast or lung cancer without a prior diagnosis of cardiovascular disease or heart failure, 1.8 years [0.4–3.6] post-radiotherapy involving at least 5 …

Vitamin C Intravenous Treatment In The Setting Of Atrial Fibrillation Ablation: Results From The Randomized, Double-Blinded, Placebo-Controlled Citris-Af Pilot Study, Cory R. Trankle, Laura Puckett, Theresa Swift-Scanlan, Christine Dewilde, Anna Priday, Robin Sculthorpe, Kenneth A. Ellenbogen, Alpha Fowler, Jayanthi N. Koneru

Internal Medicine Publications

Background
Catheter ablation is an effective treatment for atrial fibrillation (AF), but high levels of post-procedure inflammation predict adverse clinical events. Ascorbic acid (AA) has shown promise in reducing inflammation but is untested in this population. We sought to test the feasibility, safety, and preliminary effects on inflammatory biomarkers in the CITRIS-AF (Vitamin C Intravenous Treatment In the Setting of Atrial Fibrillation Ablation) pilot study.

Methods and Results
Patients scheduled to undergo AF ablation (N=20) were randomized 1:1 to double-blinded treatment with AA (200 mg/kg divided over 24 hours) or placebo. C-reactive protein and interleukin-6 levels were obtained before the …

Interleukin‐1 Blockade Inhibits The Acute Inflammatory Response In Patients With St‐Segment–Elevation Myocardial Infarction, Antonio Abbate, Cory R. Trankle, Leo F. Buckley, Michael J. Lipinski, Darryn Appleton, Dinesh Kadariya, Justin M. Canada, Salvatore Carbone, Charlotte S. Roberts, Nayef Abouzaki, Ryan Melchior, Sanah Christopher, Jeremy Turlington, George Mueller, James Garnett, Christopher Thomas, Roshanak Markley, George F. Wohlford, Laura Puckett, Horacio Medina De Chazal, Juan G. Chiabrando, Edoardo Bressi, Marco Giuseppe Del Buono, Aaron Schatz, Chau Vo, Dave L. Dixon, Giuseppe G. Biondi-Zoccai, Michael C. Kontos, Benjamin W. Van Tassell

Internal Medicine Publications

Background

ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]).

Methods and Results

We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the …

Can Graft Vs. Leukemia Effect Be Uncoupled From Graft Vs. Host Disease? An Examination Of Proportions, Elizabeth Krieger, Amir Ahmed Toor

Massey Comprehensive Cancer Center Publications

Can Graft vs. Leukemia Effect Be Uncoupled From Graft vs. Host Disease? An Examination of Proportions

Ocular Findings In The 16p11.2 Microdeletion Syndrome: A Case Report And Literature Review, Cybil S. Stingl, Colleen Jackson-Cook, Natario L. Couser

Ophthalmology Publications

The recurrent 16p11.2 microdeletion is characterized by developmental delays and a wide spectrum of congenital anomalies. It has been well reported that individuals with this ∼593-kb interstitial deletion have an increased susceptibility toward the autism spectrum disorder (ASD). Abnormalities of the eye and ocular adnexa are also commonly associated findings seen in individuals with the 16p11.2 microdeletion syndrome, although these ophthalmic manifestations have not been well characterized. We conducted an extensive literature review to highlight the eye features in patients with the 16p11.2 microdeletion syndrome and describe a 5-year-old boy with the syndrome. The boy initially presented with intellectual disability, …

Oculodentodigital Dysplasia: A Case Report And Major Review Of The Eye And Ocular Adnexa Features Of 295 Reported Cases, Virang Kumar, Natario L. Couser, Arti Pandya

Ophthalmology Publications

Oculodentodigital dysplasia (ODDD) is a rare genetic disorder associated with a characteristic craniofacial profile with variable dental, limb, eye, and ocular adnexa abnormalities. We performed an extensive literature review to highlight key eye features in patients with ODDD and report a new case of a female patient with a heterozygous missense GJA1 mutation (c.65G>A, p.G22E) and clinical features consistent with the condition. Our patient presented with multiple congenital anomalies including syndactyly, microphthalmia, microcornea, retrognathia, and a small nose with hypoplastic alae and prominent columella; in addition, an omphalocele defect was present, which has not been reported in previous cases. …

Post Procedural Care Of Patients Receiving Percutaneous Transhepatic Biliary Drainage Catheter Placement, Erin Pacelli, Jennifer Almeda, Christina Graham, Malcolm Sydnor, Kunal Patel

VCU Health Nursing

A recent review of patients undergoing transhepatic biliary drainage catheter placement showed a 30-day readmission rate of 28%. New post-procedural processes were created to standardize the care of this patient population to decrease readmission rates and improve patient satisfaction.

Improving Access To Care In Virginia: Reaching Nurse Practitioner Training Capacity Through Preceptor Incentives, Debra Barksdale, Christine Kennedy, Shelly Smith

Translational Research Fellows Policy Briefs

Workforce data reinforces the notion that educating nurse practitioners in Virginia is critical in helping to improve access to care in the Commonwealth, particularly in underserved communities. Six of Virginia’s thirty-nine state funded colleges and universities offer nurse practitioner programs. All of these universities report their capacity to train nurse practitioners is not limited by qualified applicants but rather by a shortage of clinical preceptors. This paper provides a summary of public policy initiatives that support preceptors as an example for Virginia to consider.

Reducing Medication Risks In Older Adult Drinkers, Faika Zanjani, Nancy Schoenberg, Catherine Martin, Richard Clayton

Gerontology Publications

Objectives: Prevalent concomitant alcohol and medication use among older adults is placing this group at risk for adverse health events. Given limited existing interventions to address concomitant alcohol and medication risk (AMR), a brief educational intervention was demonstrated. The purpose of the current study was to examine change in AMR behaviors 3 months post-education among older adult drinkers.

Methods: A convenience sample of 58 older adult drinkers (mean age = 72) was recruited and followed (n = 40; 70% at follow-up), from four pharmacies in rural Virginia.

Results: Findings indicated decreased alcohol consumption in high-risk drinkers.

Conclusion: Future research …

The Benefits Of Physical Activity On Depression, Edward F. Ansello

Director's Editorials from Age in Action

Physical exercise can be an effective counter-measure against depression. Activity need not be strenuous and it may reduce the risk for depression, even among those with a family history or genetic disposition for depression. And depression in itself may not cause a reduction in physical activity. It could be that we will see health care providers increasingly prescribing doses of physical activity for our mental health.

Creating Covid-19 Work-Arounds For Vulnerable Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

In response to disruptions in care due to the COVID-19 pandemic, the Geriatrics Workforce Enhancement Program (GWEP) has decided to focus energies on vulnerable populations, specifically: low income older adults in the Richmond Health and Wellness Program (RHWP), which delivers healthcare coordination at rental assistance housing complexes in Richmond, who had been receiving regular in-person help from interprofessional teams of faculty and students; residents with dementia and staffs of long-term care facilities who’d been intended to participate on-site in a non-pharmacological dementia care intervention called TimeSlips, as well as family caregivers of individuals in the community with dementia; and older …

Finding Light In The Darkness: The Role Of Humor, Edward F. Ansello

Director's Editorials from Age in Action

The human story of confrontations with darkness can be lightened with the aid of humor and laughter.

Ageism In The Age Of Covid-19, Edward F. Ansello

Director's Editorials from Age in Action

Greater awareness of biases in health care and protective services are needed. Ageism is not going away but at least COVID-19 has unveiled some of its manifestations.

A Multifaceted Approach To Address Food Insecurity In Urban Dwelling Older Adults, Ana Diallo, Katherine Falls

Case Studies from Age in Action

Educational Objectives

1. Identify and discuss concepts of food insecurity as a social determinant of health in older adults.

2. Explain the health benefits of participation in a nutrition initiative, Healthy Meals Program, to address food insecurity among low-income older adults living in an urban food desert.

3. Describe the use of motivational interviewing and goal setting techniques for nutrition-related behavior in the management of chronic disease.

4. Summarize the lessons learned and implications for clinical practice.

Two Professionally Led Choir Programs: Empowering People With Dementia And Their Care Partners, Helen Kivnick, Debra Sheets

Case Studies from Age in Action

Educational Objectives

Identify the benefits of participation in a community-based choir for persons with dementia (PwD) and their care partners.

1. Describe the work of the choirs to show the potential of living well with dementia.

2. Identify the ways in which the choirs address stigma and social isolation.

3. Highlight lessons learned

The Agony Of Da Feet: Reexamining The Foundation To Fitness, Amanda M. Lutter, Christopher B. Stewart

Case Studies from Age in Action

Educational Objectives

1. Explain the role of podiatry in helping older adults maintain wellbeing.

2. Provide an overview of common foot and ankle conditions that older adults should be concerned about.

3. Discuss newer services and techniques provided by podiatrists.

4. Review several cases in which podiatry supported patients’ health through early interventions.

The Health Empowerment Program: A Primary Care – Area Agency On Aging Partnership, Daniel Bluestein, Brad Lazernick, Britt Gnilka

Case Studies from Age in Action

Educational Objectives

1. Appreciate the benefits of a primary care-area agency on aging collaboration.

2. Identify strategies for enhancing this cross-organizational partnership.

Centering Health Equity And Structural Racism In Health Sciences Curriculum, Lynn E. Pelco, Kevin A. Harris, Carolyn Watts, Lisa B. Webb

Publications from the Office of the Senior Vice President for Health Sciences

This paper overviews scientific evidence and some of the local Richmond, Virginia history related to structural racism and health disparities. The paper then describe recent demands for racial justice and curriculum transformation that have been made by Virginia Commonwealth University (VCU) health sciences students, faculty and community members as well as the action steps the university has taken to address these demands. The paper concludes by calling on VCU health sciences faculty members to take action in the following three ways: (a) by participating in professional conversations about the intersections of health equity, structural racism, and health sciences education, (b) …

Teledentistry: An Innovative Workforce Model For Dental Hygienists, Kayla T. Khau, Hannah H. Nguyen

Dental Hygiene Student Scholarship

Objective/Aims: This review of literature seeks to explore teledentistry as an alternative dental hygiene workforce model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally-connected oral healthcare team. It will also emphasize the innovative methods of teledentistry giving better health care delivery to diverse populations.

Methods: The review of literature analyzed the conclusions and discussions of primary and secondary scholarly articles from PubMed, Google Scholar, Embase, and CINAHL. Specific key terms included teledentistry, telehealth, teleconsultation, dental hygiene, dentistry, workforce model, health care delivery. Articles included in this review were published within the …

Ectopic Pregnancy In A Woman With T9 Ais A Paraplegia Secondary To High-Grade Spinal Cord Pilocytic Astrocytoma, Elisabeth K. Acker

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Ectopic pregnancy in a woman with T9 AIS A (motor complete, sensory complete) paraplegia secondary to a high-grade spinal cord pilocytic astrocytoma

Background

In the United States, 20,000 women of childbearing age have a spinal cord injury (SCI). While SCI induces transient amenorrhea immediately after injury, women generally have normal reproductive function after SCI, and their fertility is unimpaired. Medications that commonly manage complications of SCI should be avoided or discontinued during pregnancy. Complications inherent to SCI, including urologic issues, are often exacerbated during pregnancy.

Methods

This is a case report on a female Veteran who initially presented to the …

Erector Spinae Plane Block And Improved Perioperative Outcomes In Breast Brachytherapy, Jialiu D. Li, Yvonne Nguyen Md, Michael Buxhoeveden, Sabrina Dhillon

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Utility Of Non-Invasive Testing For Fibrosis Assessment In Patients With End Stage Renal Disease, Nikita Chadha Do, Taseen Syed Mbbs, Richard K. Sterling Md, Msc

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Background: Non-alcoholic fatty liver disease (NAFLD) risk factors including metabolic syndrome (MS) and its components obesity (BMI ≥ 30), diabetes mellitus (DM), hypertension (HTN), and dyslipidemia (DL), has an increased prevalence in end stage renal disease (ESRD). The goal of study was to assess utility of non-invasive testing (NIT) including transient elastography (TE) for liver stiffness (LS), controlled attenuated parameter (CAP) for steatosis, Fibrosis-4 (FIB-4), AST to platelet ratio (APRI) and NAFLD Fibrosis score (NFS), for assessment of NAFLD in patients with ESRD undergoing renal transplant (RT) evaluation.

Methods: Demographic, clinical and laboratory data were collected within 12 weeks of …