Medicine and Health Sciences Commons^™

Voltage-Gated Potassium Channels Are Critical For Infrared Inhibition Of Action Potentials: An Experimental Study, Junqi Zhuo, Matthew T. Mcpheeters, Michael W. Jenkins, Hillel J. Chiel

Faculty Scholarship

Thermal block of unmyelinated axons may serve as a modality for control, suggesting a means for providing therapies for pain. Computational modeling predicted that potassium channels are necessary for mediating thermal block of propagating compound action potentials (CAPs) with infrared (IR) light. Our study tests that hypothesis. Results suggest that potassium channel blockers disrupt the ability of IR to block propagating CAPs in Aplysia californica nerves, whereas sodium channel blockers appear to have no significant effect. These observations validate the modeling results and suggest potential applications of thermal block to many other unmyelinated axons.

Binge-Watching Behaviours: The Impact On Medical Students In Pakistan, Zouina Sarfraz, Muzna Sarfraz, Azza Sarfraz

Department of Paediatrics and Child Health

No abstract provided.

An Interprofessional Collaborative Approach To The Development Of A Content Valid Interview Questionnaire For Persons With Hearing Loss And Their Communication Partners, Nancy A. Delich, Stephen D. Roberts

JADARA

An assessment instrument needs to be valid in order for data to be accurately interpreted and applied. Currently, few rigorous content evaluations have been conducted on hearing-related questionnaires. This study describes a multiphase approach for obtaining content validity evidence in the development of a questionnaire that explores quality of life for persons with hearing loss and their communication partners. A panel of 15 interprofessional experts evaluated 41 questionnaire items for content relevance and content clarity. Findings revealed an overall scale of .99 for content relevance and .85 for content clarity, indicating high content validity for the revised 40-item questionnaire.

Noninvasive Detection Of Graft Injury After Heart Transplant Using Donor-Derived Cell-Free Dna: A Prospective Multicenter Study, Kiran K Khush, Jignesh Patel, Sean Pinney, Andrew Kao, Rami Alharethi, Eugene Depasquale, Gregory Ewald, Peter Berman, Manreet Kanwar, David Hiller, James P Yee, Robert N Woodward, Shelley Hall, Jon Kobashigawa

2020-Current year OA Pubs

Standardized donor-derived cell-free DNA (dd-cfDNA) testing has been introduced into clinical use to monitor kidney transplant recipients for rejection. This report describes the performance of this dd-cfDNA assay to detect allograft rejection in samples from heart transplant (HT) recipients undergoing surveillance monitoring across the United States. Venous blood was longitudinally sampled from 740 HT recipients from 26 centers and in a single-center cohort of 33 patients at high risk for antibody-mediated rejection (AMR). Plasma dd-cfDNA was quantified by using targeted amplification and sequencing of a single nucleotide polymorphism panel. The dd-cfDNA levels were correlated to paired events of biopsy-based diagnosis …

Std Education Among African American Women: An Educational Improvement Initiative, Marqueta V. Abraham

Electronic Theses and Dissertations

Research reveals there is a knowledge gap facing African American women regarding sexual health education, specifically sexually transmitted diseases. The Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) was used to assess participants’ knowledge and attitudes regarding sexually transmitted diseases. The STD-KQ self-assessment was administered to African American women and utilized to develop a 45-minute education seminar to bridge the knowledge gap. After an education seminar was held, a posttest was administered to test the women’s knowledge and to determine their level of awareness. Using a paired-samples t test, the researcher found an overall increase in awareness of the types of sexually …

Short-Interval Intracortical Inhibition Is Decreased In Restless Legs Syndrome Across A Range Of Severity, Samir Câmara Magalhães, Joselisa Péres Queiroz De Paiva, Alain Kaelin-Lang, Annette Sterr, Alan Luiz Eckeli, Anderson M. Winkler, Gilmar Fernandes Do Prado, Edson Amaro Jr

School of Medicine Publications

Background

Decreased short-interval intracortical inhibition (SICI) to transcranial magnetic stimulation (TMS) of the primary motor cortexwas described in subjects with restless legs syndrome/Willis-Ekbom disease (RLS/WED). It remained to be determined whether the magnitude of SICI decrease would be similar across levels of RLS/WED severity. Moreover, it was unknown whether, in addition to decreases in SICI, changes in cortical thickness or area could be detected in subjects with RLS/WED compared to controls. The objective of this study was to compare SICI, cortical thickness, and cortical area in subjects with idiopathic mild to moderate RLS/WED, severe to very severe RLS/WED, and …

Coughing Up Casts: An Adult Case Of Plastic Bronchitis, Michael Lapelusa, Ayesha Hamid, Dayan Ojeda-Damas, Rehan Ansari, Supraja Thunuguntla, Daniella Concha, Carlos Ramos, Laura Garcia, James Hanley

School of Medicine Publications

Plastic bronchitis is characterized by the formation of bronchial casts that form in airways with the potential to cause obstruction. It is most commonly seen in pediatric patients with cyanotic heart disease. It is rare in adults, especially those without chronic lung or rheumatologic disease.

Examining Opportunities To Increase Flu Vaccine Uptake On College Campuses Through Pharmacy Partnerships, Kristi Hargrave

Electronic Theses and Dissertations

The purpose of this project was to examine a university health clinic’s influenza vaccination program in a suburban city in a western U.S. state, and to explore the effects of partnering with a local pharmacy to overcome billing issues. A program evaluation was conducted to identify the potential barrier of cost for students. The health clinic was not set up to bill private health insurance for students; therefore, if students wanted to get a flu shot, they had to pay out of pocket for it. A pilot program was created in conjunction with the program director, partnering with the local …

Outcomes Of An Interdisciplinary Work Rehabilitation Program, Mitchell R. Voss

College of Nursing Faculty Research and Publications

BACKGROUND: Work rehabilitation programs were developed to help workers with an injury return to work (RTW). While studies have examined intervention characteristics, prognostic factors, and disability level, there is little or no research examining interdisciplinary interventions, lifting capacity/strength and the level of a patient’s RTW status (e.g., not working, new job, or ongoing restrictions) at the time of discharge. OBJECTIVE: To evaluate outcomes (RTW status and lifting capacity/strength changes) of an interdisciplinary work rehabilitation program and examine whether time off work prior to the program and type of injury were related to RTW status and strength changes. METHODS: A retrospective …

Medical Specialty Camps: A Holistic Approach To Assist In The Management Of Diabetes, Takeyra Monique Collins

Human Movement Studies & Special Education Theses & Dissertations

From toddlers to adolescents, poor medical regimen and adherence occurs as youth face adversities caused by type 1 diabetes mellitus (T1DM). This inquiry-based research sought to explore the process of promoting resilience to attain personal diabetes management through outcome-focused programming. This dissertation was structured in a three-paper format to highlight three sectors of a medical specialty camp to identify the significance of building resilience among youth with T1DM, incorporating family support, and providing service-learning opportunities for students. The purpose of this study was to examine the impacts associated with campers’ resilience from pre- to post-camp based on their participation in …

Current Barriers To Dental Care Of Virginia Children With Autism Spectrum Disorder (Asd), Sfair Alkhthami

Dental Hygiene Theses & Dissertations

Objective: The purpose of this study was to determine the barriers to accessing professional dental care for Virginia children with Autism Spectrum Disorder (ASD) as a mechanism for evaluating dental hygiene curricula. Methods: Data was collected via Qualtrics® from caregivers of one or more children with ASD who were part of Families of Autistic Children in Tidewater (FACT). The survey was distributed through FACT to all 200 members (N=200) via an email link, and a response rate of 28.5% (N=57) was obtained. Linear regression and logistic regression models were used to analyze data at the p=.05 level of significance. Results: …

Keratoconus In A Patient With Alport Syndrome: A Case Report, Majid Moshirfar, David F. Skanchy, Aaron T. Gomez, Yasmyne C. Ronquillo, Benjamin Buckner, Phillip C. Hoopes

School of Medicine Publications

BACKGROUND Known ocular manifestations of Alport syndrome include features such as anterior lenticonus and fleck retinopathy. Reports of keratoconus in such patients are limited. We report tomographic findings consistent with keratoconus in a patient with Alport syndrome.

CASE SUMMARY A 52-year-old female was referred to our ophthalmology clinic with decreased vision and increased tearing. She was diagnosed with stage III Alport syndrome two years prior. Upon examination she was found to have average keratometries of 48 D bilaterally with tomographic evidence of keratoconus.

CONCLUSION Although a rare presentation, concurrent Alport syndrome and keratoconus should be considered when reviewing the ocular …

End Tidal Carbon Dioxide Monitoring (Capnography) In The Cardiac Intensive Care Unit, Madeline Elaine Huff, Kenneth T. Shelton

School of Medicine Publications

Background: Carbon dioxide levels can be monitored throughout the respiratory cycle via capnography. In this way, capnography allows healthcare professionals to follow several respiratory factors in real-time, including respiratory depression, apnea, and hypercapnia. Postoperative patients are subjected to significant harm while receiving sedating medications without appropriate monitoring and intervention. Earlier detection of alterations to ventilation status will better enable providers to more accurately dose medications during procedures, especially in high-risk patient populations.

Methods: Patient selection included post-operative patients in the intensive care unit that were receiving sedation/analgesia, high dose or high frequency opioids, epidural or intrathecal pain management, patients that …

Gender-Specific Differences In Clinical And Metabolic Variables Associated With Nafld In A Mexican Pediatric Population, Eréndira Villanueva-Ortega, María José Garcés-Hernández, Arturo Herrera-Rosas, Juan Carlos Lopez Alvarenga, Estibalitz Laresgoiti-Servitje, Galileo Escobedo, Gloria Queipo, Sergio Cuevas-Covarrubias, Guadalupe Nayely Garibay-Nieto

School of Medicine Publications

Introduction and objectives: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD.

Methods: We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender.

Results: The mean age was 10.64±2.54 years. The frequency of NAFLD in boys …

Chemical Disaster Preparedness For Hospitals And Emergency Departments, Gregory K. Wanner, Do, Sukhi Atti, Md, Edward Jasper, Md

Department of Emergency Medicine Faculty Papers

Preparing to evaluate and treat victims of a chemical exposure incident is one aspect of hospital disaster preparedness. Past chemical disasters, including terrorist attacks and industrial or transit accidents, have highlighted the need for hospital planning, preparation, and training. Emergency department and hospital staff members must be familiar with their facility-specific protocols and be trained for their individual roles during these incidents. This article provides a brief review of the requirements and guidelines related to chemical disaster response from a healthcare perspective. Resources for training and the evaluation of chemically contaminated patients are discussed. Decontamination procedures, including pre-hospital and hospital-based …

Writing In The Health Sciences: A Collection Of Exemplary Student Writing Spring 2019, Valparaiso University, Valparaiso University Writing Program

English Curricular Materials

"The narratives that appear beyond this foreword, plus one modest literature review, one integrative study, and one healthcare guideline analysis, were written last spring by students from the College of Nursing and Health Professions in sections of English 205. English 205 is a writing-intensive course offered by the English department, listed in the catalog as “Writing in the Health Professions.” As titles go, that’s pretty bland, for a course or for a collection of writing. Writing in the health professions is anything but bland, as you’ll find out if you read any of the work in this collection. Health professionals …

Cardiovascular Risk Scoring And Magnetic Resonance Imaging Detected Subclinical Cerebrovascular Disease, Sonia S Anand, Jack V Tu, Dipika Desai, Phillip Awadalla, Paula Robson, Sébastien Jacquemont, Trevor Dummer, Nhu Le, Louise Parker, Paul Poirier, Koon Teo, Scott A Lear, Salim Yusuf, Jean-Claude Tardif, Francois Marcotte, David Busseuil, Jean-Pierre Després, Sandra E Black, Anish Kirpalani, Grace Parraga, Michael D Noseworthy, Alexander Dick, Jonathan Leipsic, David Kelton, Jennifer Vena, Melissa Thomas, Karleen M Schulze, Eric Larose, Alan R Moody, Eric E Smith, Matthias G Friedrich

Medical Biophysics Publications

AIMS: Cardiovascular risk factors are used for risk stratification in primary prevention. We sought to determine if simple cardiac risk scores are associated with magnetic resonance imaging (MRI)-detected subclinical cerebrovascular disease including carotid wall volume (CWV), carotid intraplaque haemorrhage (IPH), and silent brain infarction (SBI).

METHODS AND RESULTS: A total of 7594 adults with no history of cardiovascular disease (CVD) underwent risk factor assessment and a non-contrast enhanced MRI of the carotid arteries and brain using a standardized protocol in a population-based cohort recruited between 2014 and 2018. The non-lab-based INTERHEART risk score (IHRS) was calculated in all participants; the …

What's Happening: September 30, 2019, Maine Medical Center

What's Happening

No abstract provided.

Bile Reflux Gastritis Patient Profile In Dr. Saiful Anwar Malang Hospital, Fadhila Nurisa, Supriono Supriono

Jurnal Penyakit Dalam Indonesia

Introduction. Bile reflux gastritis is bile reflux to gaster with fullness sensation, uncomfort, nausea, and vomiting. Bile reflux gastritis usually happens after surgery, as partial gastrectomy, truncal vagotomy, pyloroplasty, cholecystectomy, or sphinchteroplasty. This study aimed to determine the description of endoscopic of patients with bile reflux gastritis and the location of abnormalities found in endoscopy patient at Saiful Anwar Hospital Malang. Methods. Data were taken from the medical record of endoscopy patient in Saiful Anwar Hospital Malang from 2012 January the 1st until 2016 December the 31st that fulfill bile reflux gastritis inclusion criteria. Abnormality location divided near and far …

Neutrophil Lymphocyte Ratio As A Predictor Of The First Onset Acute Neutropenia After R-Chop Chemotherapy In Diffuse Large B-Cell Lymphoma Patients, Griskalia Christine, Lugyanti Sukrisman, Noorwati Sutandyo, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Background. Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma in Indonesia. R-CHOP chemotherapy has a moderate risk for neutropenia / febrile neutropenia. Lymphocytes can describe host immunity, while neutrophils and monocytes can describe the inflammatory response. No study has assessed differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. This study aimed to determine the relationship between differential count of leukocytes before chemotherapy as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. Methods. A retrospective cohort study was conducted among 18–60 years …

The Additive Effect Of Rosmarinic Acid For The Reduction Of Glomerular Nf-Kb Expression In Diabetes Rat That Was Given Telmisartan, Mochamad Fachrureza, Nur Samsu, Achmad Rudijanto

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic nephropathy is one of the common complications of diabetes, which one of its causes is the increase of free radicals through the activation of NF-kβ and Angiotensin II. Rosmarinic acid has the activity as the anti-oxidant and anti-inflammatory, and the telmisartan is the partial PPAR-γ agonist that has the anti-fibrotic effect. This study aimed to identify the effect of rosmarinic acid and telmisartan in the reduction of subunit p65 NF-kB expression on the glomerular diabetes rat. Methods. An experimental study with a post-test only controlled group was conducted in a group of rats (Rattus norvegicus). Rats were randomly …

Factors Affecting Rapid Decline In Glomerular Filtration Rate In Hiv/Aids Patients Using Tenofovir Disoproxil Fumarate, Prima Yuriandro, Evy Yunihastuti, Maruhum Bonar H Marbun, Pringgodidgo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Tenofovir disoproxil fumarate (TDF) treatment in HIV/AIDS patient has particular effect to the kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1.72 m2 one year after using the drug). The incidence rate for rapid decline in GFR and factors affecting it are still contradictive and not assessed completely. This study was done to identify cumulative incidence and factors affecting TDF related nephrotoxicity. Methods. A retrospective cohort study was conducted in HIV/AIDS outpatient clinic Cipto Mangunkusumo Hospital Jakarta. We included patients who start taking TDF as their medication from January 2010 until January 2015 with consecutive …

Arterial And Venous Thrombosis In Patients With Myeloproliferative Neoplasms, Lugyanti Sukrisman

Jurnal Penyakit Dalam Indonesia

Introduction. Myeloproliferative neoplasm (MPN) is a hematologic disorder that consists of polycythemia vera (PV), essential thrombocythemia (ET and primary myelofibrosis (PMF) and complication of thrombosis is frequently found in patients with MPN. This study was conducted to observe complication of thrombosis in patients with MPN. Methods. A descriptive study was conducted among patients with MPN at MMC Hospital. Clinical data was obtained from medical records of patients with MPN who sought treatment with investigator between 2010 and 2018 and the data was collected consecutively. Evaluation on JAK2 mutation was performed at either the Research and Development Laboratory of Dharmais Cancer …

Meningoensefalitis Manifestation In Wegener’S Granulomatosis With Anca Negative: Case Report, Triyanti Kurniasari Ananta Putri Sudibyo, Deshinta Putri Mulya, Eko Budiono, Sekar Satiti, Levina Prima Rosalia

Jurnal Penyakit Dalam Indonesia

Wegener’s granulomatosis is a vasculitis that affects small to medium blood vessels, generally occurring at the age of 64- 75 years with an incidence of 8-10 / 1,000,000 people. Meningoencephalitis manifestations are rarely found in Wegener’s granulomatosis with the incidence only in the range of 0-7%. Anti-neutrophil cytoplasmic antibody (ANCA) is often used in diagnosing Wegener’s granulomatosis, but negative ANCA can be found in 10-20% of cases. A 30-year-old man came with a decrease in consciousness. His anamnesis and physical examination showed signs that led to Wegener’s granulomatosis, despite negative ANCA examination results. After getting therapy according to the management …

Implementing A Novel Quality Improvement-Based Approach To Data Quality Monitoring And Enhancement In A Multipurpose Clinical Registry, Jesse Pratt, Daniel Jeffers, Eileen C. King, Michael D. Kappelman, Jennifer Collins, Peter Margolis, Howard Baron, Julie A. Bass, Mikelle D. Bassett, Genie L. Beasley, Keith J. Benkov, Jeffrey A. Bornstein, Jose M. Cabrera, Wallace Crandall, Liz D. Dancel, Monica P. Garin-Laflam, John E. Grunow, Barry Z. Hirssch, Edward Hoffenberg, Esther Israel, Traci W. Jester, Fevronia Kiparissi, Arathi Lakhole, Sameer P. Lapsia, Phillip Minar, Fernando A. Navarro, Haley Neef, Kt Park, Dinesh S. Pashankar, Ashish S. Patel, Victor M. Pineiro, Chrles M. Samson, Kelly C. Sandberg, Steven J. Steiner, Jennifer A. Strople, Boris Sudel, Jillian S. Sullivan, David L. Suskind, Vikas Uppal, Prateek D. Wali

Pediatrics Faculty Publications

Objective: To implement a quality improvement based system to measure and improve data quality in an observational clinical registry to support a Learning Healthcare System.

Data Source: ImproveCareNow Network registry, which as of September 2019 contained data from 314,250 visits of 43,305 pediatric Inflammatory Bowel Disease (IBD) patients at 109 participating care centers.

Study Design: The impact of data quality improvement support to care centers was evaluated using statistical process control methodology. Data quality measures were defined, performance feedback of those measures using statistical process control charts was implemented, and reports that identified data items not following data quality checks …

Tenofovir Dan Gangguan Fungsi Ginjal Pada Hiv, Ni Made Hustrini

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Polycythemia: A Clinical Approach, Rahmat Cahyanur, Ikhwan Rinaldi

Jurnal Penyakit Dalam Indonesia

Polycythemia or erythrocytosis is an increase in the number of red blood cells in circulation marked by the increase in hematocrit. Polycythemia is a case that still raises questions and dilemma for doctors. In this paper, it will be discussed about the diagnostic approach and management of polycythemia. The initial complaints of polycythemia are generally nonspecific, such as weakness and dizziness due to blood hyperviscosity. It is also essential to know accompanying diseases, routine medications, habits, and family histories of the patients. Patients with polycythemia commonly exhibit plethora. In vital sign examination, hypertension can be found in polycythemia vera. In …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Use Of Clinical Parameters And Strain Echocardiography To Predict Stenosis Severity Based On Gensini’S Score In Stable Coronary Artery Disease, Arif Sejati, Idrus Alwi, Muhadi Muhadi, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. In patient with stable coronary artery disease (CAD), severity of stenosis is closely related to prognosis. It is known that several clinical parameters and recently-developed strain echocardiography can predict severity of stenosis. Assessment of clinical parameters, altogether with strain echocardiography is expected to make better prediction. This study aim to determine whether clinical factors, i.e. age, sex, diabetes, typical angina, and history of myocardial infarction, and strain echocardiography parameter, i.e. global longitudinal strain (GLS), can predict severity of coronary artery stenosis measured with Gensini score,and to further develop a prediction model based on significant parameters. Methods. This is a …

Factors Associated With Preventable Emergency Department Visits For Nontraumatic Dental Conditions In The U.S., Pearl C. Kim, Wenlian Zhou, Shawn J. Mccoy, Ian K. Mcdonough, Betty Burston, Marcia Ditmyer, Jay J. Shen

Dental Medicine Faculty Research

This study was designed to examine national trends and evaluate social determinants of health that were associated with the provision of dental services in emergency rooms in the United States between 2007 and 2014. A pooled cross-sectional database of emergency department (ED) visits combined the 2007–2014 waves of the Nationwide Emergency Department Sample. A total of 3,761,958 ED visits with dental conditions were extracted and the principal diagnosis was identified. A series of modified Poisson regression models were used to assess the relationship between patient sociodemographic factors and hospital characteristics, and the likelihood of visiting the ED for a nontraumatic …