Medicine and Health Sciences Commons^™

Allele-Specific Rna Interference Prevents Neuropathy In Charcot-Marie-Tooth Disease Type 2d Mouse Models., Kathryn H Morelli, Laurie B Griffin, Nettie K Pyne, Lindsay M Wallace, Allison M Fowler, Stephanie N Oprescu, Ryuichi Takase, Na Wei, Rebecca Meyer-Schuman, Dattatreya Mellacheruvu, Jacob O Kitzman, Samuel G Kocen, Timothy J Hines, Emily L Spaulding, James R Lupski, Alexey Nesvizhskii, Pedro Mancias, Ian J Butler, Xiang-Lei Yang, Ya-Ming Hou, Anthony Antonellis, Scott Q Harper, Robert W Burgess

Department of Biochemistry and Molecular Biology Faculty Papers

Gene therapy approaches are being deployed to treat recessive genetic disorders by restoring the expression of mutated genes. However, the feasibility of these approaches for dominantly inherited diseases - where treatment may require reduction in the expression of a toxic mutant protein resulting from a gain-of-function allele - is unclear. Here we show the efficacy of allele-specific RNAi as a potential therapy for Charcot-Marie-Tooth disease type 2D (CMT2D), caused by dominant mutations in glycyl-tRNA synthetase (GARS). A de novo mutation in GARS was identified in a patient with a severe peripheral neuropathy, and a mouse model precisely recreating the mutation …

An Electronic Medical Records-Based Approach To Identify Idiosyncratic Drug-Induced Liver Injury In Children., Tracy L. Sandritter, Jennifer Goldman, Clayton J Habiger, James F. Daniel, Jennifer Lowry, Ryan T. Fischer

Manuscripts, Articles, Book Chapters and Other Papers

Drug-induced liver injury (DILI) is the leading cause of liver failure in the United States and the most common cause of drug recall. As opposed to the recognized direct toxicity of super-therapeutic acetaminophen or chemotherapeutic agents in children, limited data exists for pediatric populations on the incidence of idiosyncratic DILI (iDILI) that may develop independently of drug dose or duration of administration. To improve the detection of adverse drug reactions at our hospital, we utilized electronic medical records-based automated trigger tools to alert providers of potential iDILI. Clinical criteria concerning for iDILI were defined as serum ALT > 5x or serum …

Expanding Services Of A Pharmacist-Led Rural Mobile Health Clinic To School-Aged Children And Working Class Parents, Megan Stephan, Karen Kier, Michael Rush

Pharmacy Faculty Scholarship

No abstract provided.

Increasing Adult Annual Wellness Visits, Martha Caceres

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase adult annual wellness visits in a high-volume family practice clinic. The significance of an adult annual wellness exam is health maintenance, disease prevention, early disease detection, and management of chronic diseases. Approximately 133 million Americans are diagnosed with at least 1 chronic disease, including cancer, diabetes, and heart disease, and 1 in 4 adults are diagnosed with multiple chronic diseases (Raghupathi & Raghupathi, 2018). In 2011, the Affordable Care Act mandated insurance companies to remove deductibles for preventative health services, relieving the financial burden of out-of-pocket expenses (Borsky et al., …

Medication Management In A Primary Care Practice, Melissa Fowler

Doctor of Nursing Practice

Improving medication management has become the 3rd National Patient Safety Goal. Medication errors cost $42 billion annually. A 5-month quality improvement project was conducted in a primary care clinic located in a south Texas metropolitan city to address medication reconciliation problems. The project improved medication management by implementing 7 tools to decrease preventable medication errors: One Source Medication List, staff knowledge pre- and post-tests, visual signs and staff badges, staff templates, Beers Criteria pocket guide, patient brochure, and a quality improvement tracking form. There were two objectives: 1. Staff would improve medication reconciliation documentation by 50%. 2. For patients 65 …

Cellular Corrosion Of Cocrmo Total Knee Implants: Understanding Underlying Mechanisms Through Retrieval Analysis And Simulated Inflammatory Conditions, Griffin Heise

Theses and Dissertations (ETD)

Introduction. Total joint arthroplasty is considered one of the most beneficial aspects of modern orthopedic surgery. Due to the increase in population, obesity rates, and medical advances, total joint replacements have become more commonplace in the United States. Recently, a unique type of damage has been investigated in cobalt-chrome (CoCr) implants that remains poorly understood and highly controversial. Originally, it was believed that this damage type was caused by inflammatory cells directly attacking the metal surface, leading to damage of the oxide layer. However, damage caused by electrocautery tools has shown identical characteristics, leading some to believe this is the …

Validation Testing Of A Synthetic Spine And Upgraded Protocol For A Biomechanical Evaluation Of A Lumbar Spinal Orthosis, Daniel Hoyer

Theses and Dissertations (ETD)

Low back pain (LBP) is highly prevalent in all walks of life. Standard conservative treatment methods may work for some, but others go on to have spinal injections, opioids, or surgical procedures to alleviate pain. The Distractive and Mobility-Enabling Orthosis (DMO) was developed to meet the need for a conservative, drug-free treatment method. In this research, the low back support test protocol for evaluating DMO success was upgraded with a new synthetic lumbar spine model. The latest generation of the DMO project was then evaluated using the new system in a laboratory setting and on a pilot physical therapy patient.First, …

Implementation Of Liberate Protocol With Focus On Delirium In An Acute Care Community Hospital’S Medical And Cardiovascular Intensive Care Units, Jasmine M. Hossler, Emily A. Sedio, Karen L. Kier

Pharmacy Faculty Scholarship

No abstract provided.

Evaluation Of A Perioperative Multi-Modal Analgesia Approach In Regards To Enhanced Recovery After Surgery, Seth Wollenhaupt, Jeremy Ebert, Karen Kier

Pharmacy Faculty Scholarship

No abstract provided.

Implementation Of A Pharmacist-Driven Prescription Delivery And Home Visitation Service In A Rural Community, Clayton L. Miller, Katie Westgerdes, Michael Rush, Karen L. Kier, Megan Stephan

Pharmacy Faculty Scholarship

No abstract provided.

Analysis Of Ashp Pgy1 Residency Placement Rates With Student Pharmacist Characteristics, Bradley S. Troyer, Karen L. Kier, Heather P. Roecker

Pharmacy Student Scholarship

No abstract provided.

Integrating Pharmacist Involvement Into A Student-Led, Peer-Reviewed Journal, Crystal Zheng, Nicole A. Mcelroy, Karen L. Kier

Pharmacy Student Scholarship

No abstract provided.

College Students And Snap: The New Face Of Food Insecurity In The United States, Nicholas Freudenberg, Sara Goldrick-Rab, Janet Poppendieck

Publications and Research

Over the last decade, multiple studies of food insecurity among college students have found rates from 20% to more than 50%, considerably higher than the 12% rate for the entire US population.

Reasons for higher rates of food insecurity among college students include a growing population of low-income college students, high college costs and insufficient financial aid, more financial hardship among many low- and moderate-income families, a weak labor market for part-time workers, declining per capita college resources, and Supplemental Nutritional Assistance Program (SNAP) policies that specifically exclude many college students from participation.

This essay reviews the causes and consequences …

Implementing The Patient-Centered Care Paradigm In An Academic Research Environment, Fernando Orgas

Theses & Dissertations

Research Focus. The healthcare landscape is transitioning from a provider-centered care model toward greater emphasis on patient-centered care (PCC). The shift to PCC reflects efforts to increase the quality of healthcare and the care experience. The current state of research within healthcare remains focused on how to provide high-quality and sound research that will bring new equipment, procedures, and verify strategies that may benefit healthcare globally. However, changes in the healthcare atmosphere bring a new perspective to research. How is the paradigm shift to patient-centered care implemented in an academic research environment? Does this holistic mindset fully cross into …

Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek

Theses & Dissertations

It is a commonly held belief that access to health insurance affects the level of utilization of preventive care services, and thus plays a crucial role in the effective management of avoidable chronic illnesses, decreasing levels of premature mortality, and enabling individuals to live wholesome long lives. Based on this belief, among other goals, the Affordable Care Act (ACA) was designed to increase access to health insurance and related medical services for the population of the United States. This dissertation attempts to identify whether this belief is valid or not by testing whether the usage of preventive care changed between …

Preventive Healthcare Usage In The United States: Does Health Insurance Matter, Diane Rodriguez

Theses & Dissertations

The Centers for Disease Control in the United States has maintained that adults who avoid preventive care services are more likely to suffer from long term chronic diseases because they are not addressed or treated in a timely manner. Examining the effects of providing access to healthcare to uninsured adults and increasing preventive services can help in reducing chronic diseases and enable adults to live longer, healthier lives. The purpose of this study was to identify the relationship between the utilization of preventive health services and socioeconomic factors such as insurance status, race/ethnicity, household income, marital status, education, gender, age, …

Using Video And Mobile Applications To Manage Distress Following Acute Copd Exacerbation With Respiratory Failure: A Case Report, Linda Rose Shober

Case Report Posters

Chronic lower respiratory diseases, mainly chronic obstructive pulmonary disorder (COPD), represent a significant economic burden to the healthcare system and are among the top three leading causes of death in the United States. An acute exacerbation of chronic pulmonary disorder (AECOPD) is a worsening of the respiratory symptoms associated with COPD including dyspnea, increased sputum production, cough, and airway obstruction. Frequent AECOPD influences psychological status and may worsen comorbid anxiety, depression, and increase distress levels. As a result, motivation, mood, and participation in therapy may also be affected. Most exacerbations may be treated effectively on an outpatient basis. A fraction …

A Hip Strengthening Protocol For A Patient Following Achilles Repair: A Case Report, Matthew Morris

Case Report Posters

The Achilles tendon is the most frequently ruptured tendon in the body and rupture most commonly occurs in men ages 30-50. Operative repair has more complications, but lower re-rupture rate, than non-operative management. Early weight-bearing after surgery has been shown to be beneficial. Hip weakness has been associated with lower extremity conditions such as gait deviations, ankle sprains, and knee instability. Previous research has found that individuals with Achilles tendinopathy have hip muscle weakness compared to controls. There is a lack of literature assessing the effect of using a hip strengthening protocol following Achilles repair. The purpose of this case …

Regaining Independence In Ambulation For A Visually Impaired Patient With Rhabdomyolysis: A Case Report, Brandon Bourgoin

Case Report Posters

Rhabdomyolysis is a myopathic condition with an acute onset that causes a rapid degradation of muscle tissue. It causes a significantly elevated release of creatine kinase (CK), a muscle enzyme that is a cellular component in healthy muscle tissue, into the blood stream. Common causes include muscle trauma (injury/strenuous activity), drug/alcohol abuse, medications, toxins, infections, and extended periods of immobility. Hallmark signs/symptoms include muscle pain, swelling, weakness, and dark “tea colored” urine. The purpose of this case report is to describe PT management for a homebound legally blind elderly male with rhabdomyolysis looking to increase independence in the home and …

Treatment Approach For Traumatic Myositis Ossificans Using Ultrasound And Stretch Protocol: A Case Report, Paul Eo

Case Report Posters

Traumatic Myositis Ossificans (MO) can happen at any age, but the highest prevalence occurs in young active males after trauma (60-75% are traumatic). MO can occur from repetitive minor trauma, which is common in horseback riders who develop MO in the adductors and shooters who present with MO in their deltoid. Patients with MO commonly present in the clinic with signs and symptoms of pain, a palpable mass, and joint stiffness. Patients often report persistent muscle pain longer than that of a simple muscle strain or contusion. Currently, there is a paucity of evidence in the conservative treatment of traumatic …

Muscle Energy Techniques As Part Of A Comprehensive Plan Of Care For A Patient With Hip And Knee Osteoarthritis: A Case Report, Daniel White

Case Report Posters

Osteoarthritis (OA) is a chronic musculoskeletal condition which affects over 27 million Americans. The hip and knee joints are most affected by OA. Many risk factors are modifiable in the development of OA. While muscle energy techniques (MET) are commonly used to treat lumbopelvic dysfunction, limited evidence exists for its use as part of a comprehensive plan of care in patients with OA. The purpose of this case report was to describe the management of a patient with mild/moderate OA utilizing a comprehensive plan of care including MET.

Balance And Strength Interventions For An Individual Post Left Sided Mca Cva: A Case Report, Annie Mckenzie

Case Report Posters

Cerebrovascular accident (CVA), or stroke, is the fifth leading cause of death in the United States (US) with more than 140,000 deaths each year. It is the leading cause of long-term disability in the US, reducing functional mobility in more than half of all stroke survivors ages 65 or older. This condition costs the US approximately 34 billion dollars a year and it is estimated to increase to 108 billion per year by 2025. Strokes are caused by the interruption of the blood supply to the brain, which occurs when a blood vessel ruptures (hemorrhagic stroke) or is blocked by …

Treatment Of A Work-Related Superior Glenoid Labral Repair: A Case Report, Alexandra Touri

Case Report Posters

A superior glenoid labrum tear is a common injury in the shoulder. The highest incidences of superior labrum tear from anterior to posterior (SLAP) lesions occur in individuals from 20-29 years old and 40-49 years old. Common signs and symptoms include: instability in the joint, shoulder dislocations, pain with overhead activities, decreased range of motion, and loss of strength. SLAP lesions are less commonly seen in the workplace. There is little detail/research about which joint mobilizations/therapeutic exercises are most beneficial for this population. The purpose of this case report is to explore the post-operative PT management of a Workers’ Compensation …

Tissue Plasminogen Activator Effects On Stroke And Physical Therapy Outcomes In Acute Care: A Case Report, Lindsey Leboeuf

Case Report Posters

An ischemic stroke occurs when blood flow to an area of the brain is restricted by a blood clot. Symptoms include: Numbness or weakness on one side of the body, facial droop, trouble speaking, and trouble walking. Patients can also display decreased balance, ataxia, flaccidity, spasticity, inattention or neglect, and visual changes. Patients who can identify these symptoms within 3 hours of their onset can be eligible to receive tissue plasminogen activator (tPA). tPA works by dissolving the blood clot to enhance blood flow in the brain which helps decreases the damage caused by the stroke. Patients who receive tPA …

Return To Golf In A 71-Year-Old Female After A Mako Robotic-Arm-Assisted Unicompartmental Knee Arthroplasty: A Case Report, Katelyn Austin

Case Report Posters

Knee osteoarthritis (OA) is the most common joint disorder in the elderly. Unicompartmental knee arthroplasties (UKA) have been increasing in prevalence at a rate of 30% each year. Robotic-arm-assisted UKAs increases the accuracy of implant positioning compared to traditional techniques which helps with a quicker recovery. Little literature on UKAs, but total knee arthroplasty (TKA) interventions should focus on knee range of motion (ROM), strengthening, gait training, icing, and a home exercise program (HEP). There are good outcomes for return to golf post TKA, but no information about UKAs. The purpose of this case report was to look at the …

Physical Therapy Management Of Low Back Pain In A Young Female With Ankylosing Spondylitis Associated With Hla-B27 Antigen: A Case Report, Jake Adkins

Case Report Posters

Ankylosing spondylitis (AS) is a form of arthritis characterized by chronic inflammation of the axial skeletal system that causes back pain and loss of mobility with strong potential for slow, eventual spinal fusion. It affects 0.2-0.5% of the United States population and has no known cure, yet greater than 60 genetic components are involved. HLA-B27 is a genetic component highly correlated with AS. Its presence creates inflammatory response at bony attachment sites of tendons, ligaments, and joint capsules.Presentation can vary widely and may include intermittent and/or significant back pain and stiffness across multiple body segments for long periods of time, …

The Use Of Tai Chi With Conventional Therapy Practices For An Individual Presenting With Hemiparesis Post-Stroke: A Case Report, Ashley Pollina

Case Report Posters

No abstract provided.

Blood Flow Restriction Therapy And A Comprehensive Home Exercise Program Following An Acl And Meniscal Repair: A Case Report, Kathryn Demoor

Case Report Posters

Every year in the United States, up to 60 per 100,000 people sustain an anterior cruciate ligament (ACL) tear. Medial meniscus tears have been reported in roughly 60% of the ACL tear population, while lateral meniscus tears have been reported in approximately 30%. Blood flow restriction therapy (BFRT) has shown improved strength and muscle hypertrophy with low load exercises by occluding blood flow at the proximal thigh. A minimally structured physical therapy (PT) program with a home exercise program (HEP) has been shown to be more effective at 3 months after ACL reconstruction (ACLR) compared to standard PT sessions alone. …

Acute Inpatient Rehabilitation Of A Patient Following A Pontine Stroke With Limited Recorded Medical History: A Case Report, Russell Curl

Case Report Posters

795,000 strokes occur annually in the United States, or one every 4 seconds. Impairments following a stroke may include deficits in strength, coordination, sensation, and language skills. Expected impairments of pontine strokes include hemiplegia, sensorimotor dysfunction, ataxic hemiparesis, and dysarthria. There is little current research on pontine strokes. The purpose of this case report is to outline the physical therapy plan of care and response to treatment for a patient following a pontine stroke in the acute inpatient rehabilitation unit of a hospital.

Strength And Movement Interventions For A Female Patient With Neck And Upper Back Pain: A Case Report, Ross Kulick

Case Report Posters

No abstract provided.