Medicine and Health Sciences Commons^™

Port Site Metastasis After Robotic Assisted Laparoscopic Radical Prostatectomy: Diagnosis Via Prostate-Specific Membrane Antigen (Psma)-Targeted 18f-Dcfpyl Pet/Ct, Joon Yau Leong, Maria D'Amico, Courtney Capella, Leonard Gomella, Joseph Izes

Department of Urology Faculty Papers

We present a case of port site metastasis (PSM) that was identified in an 82-year-old man with an elevated prostate-specific antigen (PSA) to 3.9 ng/mL, concerning for biochemical recurrence after robotic-assisted radical prostatectomy, adjuvant radiation, and six months of androgen deprivation therapy with an undetectable PSA post-treatment over 10 years ago. A 2.1 cm solitary tracer avid nodule on the right lateral abdominal wall with no other evidence of recurrence or metastatic disease was found on prostate-specific membrane antigen (PSMA)–targeted ¹⁸F-DCFPyL PET/CT scan. The patient underwent local excision of this metastatic lesion, and final pathology revealed metastatic prostatic adenocarcinoma.

Tavr In Older Adults With Cardiogenic Shock: Current Practice And Future Direction, Min Ji Kwak, Jorge A Irizarry-Caro, Paola Rodriguez Martinez, James Going, Jessica Lee, Dana Giza, Nuzah Amjad, Ana Leech, Rachel Jantea, Renee Flores, Nahid Rianon, Abhijeet Dhoble

Faculty, Staff and Student Publications

Aortic stenosis (AS) is one of the most common types of valvular heart disease in older adults, with age being significantly associated with the development of AS. The transcatheter aortic valve replacement (TAVR) procedure, since it was first performed in 2002, has emerged as a preferred treatment option for patients who are at intermediate to high surgical risk due to advanced age or medical comorbidities. Older adults with severe AS may present with acute decompensated heart failure leading to cardiogenic shock (CS). Among patients 65 years and older with AS presenting for TAVR, 4.1% were reportedly in acute CS. Regardless …

Physical Activity And Body Image In Early Onset Cancer Patients, Madeleine Z. Pollard

Graduate Masters Theses

Abstract: Cancer is the leading cause of death among Americans under the age of 85 (Brown et al., 2012). There are increasing rates of cancer diagnoses in adults aged 18-49, which is described as an early onset (EO) diagnosis. Despite high survival rates (Lewis et al., 2021), EO cancer patients are at increased risk for long-term physical and psychological challenges associated with both the disease and its treatment (Haque et al., 2023). Cancer diagnosed during these critical periods of life can significantly impact self-perception and body image, which are critical to identity formation and quality of life (Castonguay, et al., …

The Mediation Effect Of Resilience And The Moderation Effect Of Hospital Magnet Status On The Relationship Between The Practice Environment And Turnover Intentions Among Acute Care Nurses, Elizabeth Fraser

Graduate Doctoral Dissertations

ABSTRACT

THE MEDIATION EFFECT OF RESILIENCE AND THE MODERATION EFFECT OF HOSPITAL MAGNET STATUS ON THE RELATIONSHIP BETWEEN THE PRACTICE ENVIRONMENT AND TURNOVER INTENTIONS AMONG ACUTE CARE NURSES

May 2025

Elizabeth Helena Fraser, B.S.N., Elms College

M.S.N., Emmanuel College

Ph.D., University of Massachusetts Boston

Directed by Professor Sun S. Kim

The U.S. healthcare system has long suffered a critical nursing shortage, intensified since the coronavirus disease 2019 (COVID-19) outbreak. The shortage is a complex national crisis compounded by the high turnover of qualified nurses. Turnover is when a nurse leaves an organization for another nursing position or leaves the profession …

Staff Education Program On Strategies To Manage Disruptive Patient Behavior, Lazare Ngah Shadzeka

Walden Dissertations and Doctoral Studies

The practice concern was the absence of a consistent method of providing structured training on the management of disruptive patient behaviors to staff in a mental health ambulatory care clinic. This clinical gap is important because it heightens the risk of workplace violence, staff burnout, and suboptimal patient care outcomes. The doctoral project practice-focused question was, How does a focused staff education program on dealing with disruptive patient behavior impact nursing staff abilities and confidence in an outpatient clinic setting? Thus, the purpose of this doctoral nursing project was to develop and implement a staff education program aimed at enhancing …

Enhancing Health Literacy In Adolescents At A Homeless Shelter, Raymond Don N. Razon, Lauren Snedeker, Janice Ou, Chau V. Nguyen, Makenna Johnston, Ruweyda Salim, Garett W. Walters

Nursing Leadership in Community Engagement Projects

Enhancing Health Literacy in Adolescents at a Homeless Shelter

Over the past two months, our group of seven Seattle Pacific Nursing Students collaborated with a local nonprofit homeless shelter for families. After meeting with the agency’s health services coordinator, we decided to focus on the teen population and enhance their health literacy. This choice was due to our population primarily not being exposed to the American healthcare system. Our team gathered information from the teens and found that nutrition, sleep, and mental health were of particular interest. Based on this, we planned and implemented a health literacy intervention tailored to …

Hazing Prevention Education, Elianna Mielbrecht, Sky Agpawa, Ceirra Dean, Joseph Arinaza, Moses Hart, Lily Speakman, Hana Maow

Nursing Leadership in Community Engagement Projects

Hazing Prevention Education

Hazing in higher education is often hidden behind a culture of secrecy, tradition, or team-building. It includes any unwanted physical, emotional, or psychological activities that a person undergoes before joining a group that has clear lasting impacts on the person’s health, regardless of willingness to participate (H.R.5646 - Stop Campus Hazing Act, 2024; Boyer, A., n.d.). Seven nursing students partnered with a university’s campus security office in Seattle, Washington. This department is responsible for maintaining a safe and respectful campus environment, making it a key stakeholder in hazing prevention efforts.

Guided by the Stop Campus Hazing Act …

Comparison Of Thrombectomy Alone Versus Bridging Thrombolysis In A Us Population Using Regression Discontinuity Analysis, Youngran Kim, Sergio Salazar-Marioni, Rania Abdelkhaleq, Ananya Iyyangar, Diogo C. Haussen, Jonathan A. Grossberg, Jaydevsinh N. Dolia, Ameer E. Hassan, Wondwossen G. Tekle, Hamzah Saei

School of Medicine Publications

The role of intravenous thrombolysis (IVT) in combination with endovascular thrombectomy (EVT) for the treatment of large vessel occlusion acute ischemic stroke has been evaluated exclusively outside the US, in randomized clinical trials which failed to demonstrate non-inferiority of skipping IVT. Because practice patterns and IVT dosing differ within the US, and prior observational US-based cohorts suggested improved clinical outcomes in patients who received IVT before EVT, a US-based evaluation is needed. This is a quasi-experimental study of a large US cohort using a regression discontinuity design (RDD) that enables the estimation of causal effects when randomization is not feasible. …

Breast And Ovarian Cancers’ Incidence Trends Among Iraqi Women During 2012–2022 And Their Relationship To Fertility Patterns, Jasim Naeem Al-Asadi

Sultan Qaboos University Medical Journal

Objectives: This study aimed to estimate the incidence trends of female breast cancer (BC) and ovarian cancer (OC) among women in Iraq and their relation to fertility patterns. Methods: This retrospective study utilised the Iraqi Cancer Registry annual reports for the years 2012–2022 and the World Bank data for Iraqi crude birth rate and total fertility data for the years 1992–2002. Simple linear regression analysis examined the relationship between these variables and incidence rates of BC and OC. Results: A total of 63,446 women were newly diagnosed with BC from 2012–2022. The overall age standardised incidence rate …

Louisiana: The Canary In The Climate Coal Mine, Barry D. Keim

Journal of the Louisiana Public Health Association

No abstract provided.

Mitigating Damage From Healthcare Ransomware Attacks, Neil J. Nusbaum

Journal of the Louisiana Public Health Association

No abstract provided.

Wildfire Impacts On New Orleans Air Quality: October 2024, Saheba Cuccia, Daniel Harrington, Mohamed Mohamed, Evrim Oral, Md Shahinoor Rahman, Barry D. Keim, Adrienne Katner

Journal of the Louisiana Public Health Association

Background: This brief report presents data characterizing air quality throughout the New Orleans area in the hours before, during and after the Carson Six fire in DeSoto National Park, Mississippi (October 2024). Fine, respirable particulate matter (PM2.5) is the air pollutant of greatest concern to public health from wildfire smoke as it can travel deep into the lungs and enter the bloodstream, where it can have a detrimental effect on the respiratory and cardiovascular systems. Methods: Ambient air concentration measurements were collected continuously using the AirBeam3 sensor at five locations throughout the New Orleans area during the month of October …

Louisiana Public Health Association Conducts Research On Extreme Heat, Sundée Winder

Journal of the Louisiana Public Health Association

No abstract provided.

Investigating Biomarkers Linking Tobacco Use With Cadiovascular Disease Occurrence, Kennedy Dorsey, Nubaira Rizvi, Donald Mercante, Micahel D. Celestin Jr., Tung-Sung Tseng, Qingzhao Yu

Journal of the Louisiana Public Health Association

Background: Smoking has been associated with negative cardiovascular health outcomes. We analyzed data from The Population Assessment of Tobacco and Health (PATH) Study to investigate whether certain biomarkers collected were related to both cardiovascular disease (CVD) occurrence and cigarette or ecigarette use. Methods: A total of 6,473 participants were grouped into cigarette users, e-cigarette users, and non-users. Among them, 6,020 (93%) developed CVD and 453 (7%) did not over PATH Study Waves 1 to 5. All participants were adults, had valid tobaccouse and biomarker data, and no pre-existing CVD prior to Wave 1. We conducted mediation analysis using nonlinear multiple …

Vol 5 May '25 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Vol 5 May '25 Cover, Publishing, And Table Of Contents, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Defining Homelessness Through Lived Experiences And Service Providers' Perspectives: Implications For Public Health In New Orleans, Janaki Sundaresan, Kathryn T. Kampa, Katherine Andrinopoulos

Journal of the Louisiana Public Health Association

No abstract provided.

Louisiana's "Don't Say Gay" Law Threatens Youth Sexual Health Nationwide, Patrick Dicken, Isabelle Jouce, Breon Wise, Cara Ramos, Taylor Fitzpatrick-Schmidt

Journal of the Louisiana Public Health Association

No abstract provided.

Caring For The Incarcerated Patient: Provider Perceptions Of Quality Of Care In The State Of Louisiana, Haley Beavers Khoury, Olivia K. Sugarman, Andrea Armstrong, Bruce Reilly, Ashley Wennerstrom

Journal of the Louisiana Public Health Association

Background: As of December 2023, there were roughly 28,000 people held in state custody in Louisiana. Prior research and litigation have documented challenges with healthcare service delivery within prisons, but less is known about the higher acuity care incarcerated people receive at state-contracted hospitals. Methods: Between November 2020 and January 2021, authors conducted semi-structured interviews with a convenience sample of Louisiana healthcare professionals about their experiences of providing incarcerated people care at hospitals. Interviews were audio-recorded and transcribed verbatim. Authors used applied thematic analysis techniques to synthesize qualitative data and identify themes. Results: Nine health professionals with diverse roles and …

Consideration Of Anesthesia Techniques For Deep Brain Stimulation Implantation In The Treatment Of Drug-Resistant Epilepsy: A Narrative Review, Alan D. Kaye, Benjamin Esneault, Shreya Deshpande, Joseph Wentling, Shahab Ahmadzadeh, Pooja Potharaju, Sahar Shekoohi

School of Medicine Faculty Publications

Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures, affecting millions worldwide. While anti-seizure medications serve as first-line treatment, approximately one-third of patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. Deep brain stimulation (DBS) has emerged as a promising therapy for DRE, particularly for patients who are ineligible for resective surgery. DBS involves stereotactic implantation of electrodes into target brain regions, such as the anterior nucleus of the thalamus (ANT), centromedian nucleus (CMT), and hippocampus (HC), to modulate aberrant neural activity and to reduce seizure frequency. Anesthesia plays a critical role in DBS implantation, influencing both patient safety and …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Methylation Risk Score Of C-Reactive Protein Associates Sleep Health With Related Health Outcomes, Ziqing Wang, Danielle A Wallace, Brian W Spitzer, Tianyi Huang, Kent D Taylor, Jerome I Rotter, Stephen S Rich, Peter Y Liu, Martha L Daviglus, Lifang Hou, Alberto R Ramos, Sonya Kaur, J Peter Durda, Hector M González, Myriam Fornage, Susan Redline, Carmen R Isasi, Tamar Sofer

Faculty, Staff and Student Publications

C-reactive protein (CRP) reflects inflammation status and is linked to poor sleep, metabolic and cardiovascular health. Methylation (MRS) and polygenic risk scores (PRS) reflect long-term systemic inflammation, and genetically-determined CRP, respectively. To refine understanding of inflammation-linked sleep and health outcomes, we construct PRS-CRPs using GWAS summary statistics and a previously-developed MRS-CRP in the Hispanic Community Health Study/Study of Latinos. Via survey-weighted linear regression, we estimate associations between blood-, PRS-, and MRS-CRP, with multiple sleep and health outcomes (n = 2217). MRS-CRP and PRS-CRPs are associated with increasing blood-CRP level by 43% and 23% per standard deviation. MRS-CRP is associated with …

Spatiotemporal Calcium Signaling Patterns Underlying Opposing Effects Of Histamine And Tas2r Agonists In Airway Smooth Muscle, Stanley Conaway, Joshua Richard, Deepak A. Deshpande

Center for Translational Medicine Faculty Papers

Intracellular calcium (Ca²⁺) release via phospholipase C (PLC) following G-protein-coupled receptor (GPCR) activation is typically linked to membrane depolarization and airway smooth muscle (ASM) contraction. However, recent findings show that bitter taste receptor agonists, such as chloroquine (CQ), induce a paradoxical and potent relaxation response despite activating the Ca²⁺ signaling pathway. This relaxation has been hypothesized to be driven by a distinct compartmentalization of calcium ions toward the cellular periphery, subsequently leading to membrane hyperpolarization, in contrast to the contractile effects of histamine. In this study, we further investigate the spatiotemporal dynamics of Ca²⁺ signaling in …

Advanced Age Worsens Phenotypes Of Ocular Hypertension In Mice, Priyamvada M Pitale, Solomon E Gibson, Caroline C Keehn, Arman T Yazdian, Guofu Shen, Benjamin J Frankfort

Faculty, Staff and Students Publications

Glaucoma is a neurodegenerative disorder of the optic nerve and retinal ganglion cells (RGCs) and a major cause of blindness. The two most important risk factors for glaucoma are ocular hypertension (OHT) and advanced age. In this study, we explored the combined impact of aging and OHT on retinal neuronal and microvasculature health. We induced OHT using the bead-injection model in 12 week old (young) and 1.5 year old (old) mice and monitored intraocular pressure (IOP) for 2 weeks. We then explored vascular phenotypes, blood retinal barrier components, RGC counts, and electroretinogram (ERG) changes. Aged mice displayed reduced retinal microvasculature …

Impact Of A Sepsis Quality Improvement Initiative On Clinical And Operational Outcomes, Christopher B. Thomas, Benjamin Wyler, Claude M. D’Antonio, Mark Laperouse, Shannon Alwood, Kristen Richard, Alyse Grantham, Roya Sheybani, Matt G. Sorrells, Wei Jien Tan, James W. Teague, Hollis O’Neal, Tonya Jagneaux

School of Medicine Faculty Publications

Background/Objectives: Sepsis is a costly and life-threatening condition caused by a dysregulated host response to infection. Lack of a reliable, timely diagnostic for sepsis leads to under- and overdiagnosis, suboptimal outcomes, and strained hospital resources. Our Lady of the Lake Regional Medical Center (OLOLRMC) implemented a sepsis learning health program to evaluate and improve outcomes through standardized ED workflows and the incorporation of a novel sepsis diagnostic test. Methods: We report the results of the first year of experience following the implementation of the learning health initiative and sepsis testing. Data from the Epic EHR were analyzed across two groups: …

Opioid Use Disorder Within The Emergency Department: Not All Skin Infections Are Equal, Jennifer E. Pletcher

Graduate Doctoral Dissertations

The emergency department (ED) is where two health crises commonly converge, the opioid crisis and cellulitic infections while simultaneously being the front door to the healthcare system at large. The aim of this dissertation is to fill the gap in knowledge about specific skin and soft tissue injury and severe infection (SSTI) with comorbidity of opioid use disorder (OUD) (OUD SSTI) population and demonstrate inequities as compared to the SSTI and severe infection without OUD comorbidity (non-OUD SSTI) through the lens of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy. The Nationwide Emergency …

Enhancing Staff Knowledge On Fall Prevention For Elderly Patients In Home Care Settings, Through Staff Education Initiatives, Anna Ngwafu

Walden Dissertations and Doctoral Studies

Summary Falls are one of the leading causes of injury for older patients in homecare settings, affecting patient safety and quality of care. Patient falls contribute to morbidity, mortality, and healthcare costs. A fall often results in injuries which can be fatal. Over 30% of individuals who are 65 years or older experience falls on an annual basis. In these older adults, the leading cause of death is unintentional falls. Although there are evidence-based strategies for preventing falls, there are still gaps in staff knowledge. The purpose of the DNP project was to develop, implement, and evaluate a staff education …

3- And 4-Dimensional Flow Cmr In D-Transposition Of The Great Arteries After Atrial Switch Operation., Sara Santiaguel, Laura Schoeneberg, Ugonna Nwankwo, Jorge Rosado Gonzalez, Wilson King

Manuscripts, Articles, Book Chapters and Other Papers

A 19-year-old man with D-transposition of the great arteries and pulmonary stenosis underwent atrial switch operation and pulmonary valvotomy in infancy. He was lost to follow-up and presented with multiple respiratory infections. An echocardiogram was inconclusive due to poor windows. Cardiac magnetic resonance (CMR) was performed using ferumoxytol 3-dimensional whole heart and 4-dimensional flow pulse sequences, which demonstrated this patient's complex anatomy and physiology. CMR revealed severe pulmonary venous baffle obstruction. A 3-dimensional printed model was created from the CMR and provided key information for planning the complex catheterization approach required to stent the pulmonary venous baffle.

Cardiac Amyloid, The Great Imitator, Nolan R. Fox, Nicholas J. Fox, Emily Newman, Brian Osler, Eugene Storozynsky

Division of Cardiology Faculty Papers

BACKGROUND: Although endomyocardial biopsy (EMB) is the criterion standard for diagnosis of infiltrative cardiac disease, cardiac sarcoidosis (CS) or cardiac amyloid can be diagnosed noninvasively through both clinical suspicion and advanced imaging techniques of cardiac magnetic resonance imaging (CMR) or cardiac positron emission tomography (PET).

CASE SUMMARY: A 79-year-old man with mediastinal sarcoidosis presented with new chest pain and a right bundle branch block, raising concern for CS. CMR and cardiac PET also supported the diagnosis of CS, but EMB ultimately revealed transthyretin amyloid cardiomyopathy. The patient was started on tafamidis and showed improvement at 1-year follow-up.

DISCUSSION: This case …

Proceedings Of The 3rd Multidisciplinary Scientific Conference (Mdsc), Sultan Qaboos University

Sultan Qaboos University Medical Journal

No abstract provided.