Medicine and Health Sciences Commons^™

A Systematic Review Of Diabetic Foot Infections: Pathogenesis, Diagnosis, And Management Strategies, Sabyasachi Maity, Noah Leton, Narendra Nayak, Ameet Jha, Nikhilesh Anand, Kamala Thompson, Danielle Boothe, Alexandra Cromer, Yaliana Garcia, Aliyah Al-Islam

School of Medicine Publications

Background: Diabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention.

Methods: The researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews …

Changes In Atherosclerotic Cardiovascular Disease Risk Scores In A Predominantly Black Cohort With Hiv And Associated Comorbidities: A Preliminary Study, Shana A B Burrowes, Erin Zisman, Lori E Fantry, Quoc Bui, Angela Wu, John Sorkin, Michael Miller, Shashwatee Bagchi

2020-Current year OA Pubs

INTRODUCTION: People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.

METHODS: We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined …

Stroke Severity, Caregiver Feedback, And Cognition In The Regards-Cares Study, Jason A Blake, D Leann Long, Amy J Knight, Burel R Goodin, Michael Crowe, Suzanne E Judd, J David Rhodes, David L Roth, Olivio J Clay

2020-Current year OA Pubs

BACKGROUND: Cognitive impairment after stroke is common and is present in up to 60% of survivors. Stroke severity, indicated by both volume and location, is the most consequential predictor of cognitive impairment, with severe strokes predicting higher chances of cognitive impairment. The current investigation examines the associations of 2 stroke severity ratings and a caregiver-report of poststroke functioning with longitudinal cognitive outcomes.

METHODS AND RESULTS: One hundred fifty-seven caregivers and stroke survivor dyads participated in the CARES (Caring for Adults Recovering From the Effects of Stroke) project, an ancillary study of the REGARDS (Reasons for Geographic and Racial Differences in …

Tracking The Prevalence And Emergence Of Sars-Cov-2 Variants Of Concern Using A Regional Genomic Surveillance Program, Ana Jung, Lindsay Droit, Binita Febles, Catarina Fronick, Lisa Cook, Scott A Handley, Bijal A Parikh, David Wang

2020-Current year OA Pubs

UNLABELLED: SARS-CoV-2 molecular testing coupled with whole-genome sequencing is instrumental for real-time genomic surveillance. Genomic surveillance is critical for monitoring the spread of variants of concern (VOCs) as well as discovery of novel variants. Since the beginning of the pandemic, millions of SARS-CoV-2 genomes have been deposited into public sequence databases. This is the result of efforts of both national and regional diagnostic laboratories. In this study, we describe the results of SARS-CoV-2 genomic surveillance from February 2021 to June 2022 at a metropolitan hospital in the United States. We demonstrate that consistent daily sampling is sufficient to track the …

Deltex Family E3 Ligases Specifically Ubiquitinate The Terminal Adp-Ribose Of Poly(Adp-Ribosyl)Ation, Matthew Kelly, Chase Dietz, Samuel Kasson, Yong Zhang, Michael J Holtzman, In-Kwon Kim

2020-Current year OA Pubs

Poly(ADP-ribose) polymerases (PARPs) are critical to regulating cellular activities, such as the response to DNA damage and cell death. PARPs catalyze a reversible post-translational modification (PTM) in the form of mono- or poly(ADP-ribosyl)ation. This type of modification is known to form a ubiquitin-ADP-ribose (Ub-ADPR) conjugate that depends on the actions of Deltex family of E3 ubiquitin ligases (DTXs). In particular, DTXs add ubiquitin to the 3'-OH of adenosine ribose' in ADP-ribose, which effectively sequesters ubiquitin and impedes ubiquitin-dependent signaling. Previous work demonstrates DTX function for ubiquitination of protein-free ADPR, mono-ADP-ribosylated peptides, and ADP-ribosylated nucleic acids. However, the dynamics of DTX-mediated …

Effects Of E-Cigarettes On The Lung And Systemic Metabolome In People With Hiv, Aline Zaparte, Courtney J. Christopher, Connie Arnold, Lauren Richey, Adairre Castille, Kyle Mistretta, Christopher M. Taylor, Huiyi Lin, Steve Nelson, John P. Kirwan, John W. Apolzan, Shawn R. Campagna, David A. Welsh

School of Medicine Faculty Publications

The popularity of e-cigarettes (vaping) has soared, creating a public health crisis among teens and young adults. Chronic vaping can induce gut inflammation and reduce intestinal barrier function through the production of the proinflammatory molecule hydrogen sulfide (H2S). This is particularly concerning for people with HIV (PWH) as they already face impaired immune function and are at a higher risk for metabolic dysregulation, diabetes, and chronic liver disease. Furthermore, PWH experience unhealthy behaviors, making it crucial to understand the systemic metabolic dysregulation and pathophysiological mechanisms associated with vaping in this population. Here, we employed liquid chromatography–mass spectrometry (LC-MS)-based metabolomics to …

An Unusual Case Of Refractory Hypoxia: The Many Ways Of Providing Oxygen, Saliha Erdem, Mir Babar Basir

Journal of Shock and Hemodynamics

This case report outlines the complex clinical course of a 26-year-old female patient who presented with altered mental status after an N-methyl-3,4-methylenedioxy-amphetamine overdose. The patient exhibited profound hemodynamic instability and respiratory failure. She subsequently developed shock, necessitating advanced life support measures, including veno-venous extracorporeal membrane oxygenation with a dual lumen right atrium to pulmonary artery cannula (ProtekDuo; LivaNova, London, UK) and Quadrox Oxygenator (Getinge, Wayne, NJ) system. This resulted in worsening hypoxemia, which was attributed to an increased left ventricular preload. In response, an intra-aortic balloon pump was used to decrease the left ventricle’s afterload. After balloon placement, the patient’s …

Taking Chances: Plagiarism In Manuscripts, Richard Alweis

Advances in Clinical Medical Research and Healthcare Delivery

The Editor-in-Chief reflects on why authors plagiarize after the journal received several manuscripts containing plagiarized work.

Novel Case Of Staphylococcal Scalded Skin Syndrome In A 26-Year-Old With A History Of Ichthyosis, Gunja S. Shah, Sarah Snyder, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Staphylococcal scalded skin syndrome (SSSS) is a bacterial toxin-mediated skin disorder that primarily affects neonates but rarely also presents in adults with underlying kidney disease. We present a case of a 26-year-old male with SSSS which was challenging to identify due to an underlying diagnosis of congenital epidermolytic ichthyosis. This case is novel as it is the first documented case of SSSS in an adult with ichthyosis. It highlights the unique challenge of recognizing cutaneous infections in patients with underlying skin disorders especially in the setting of a rural hospital without in-person dermatology coverage.

An Interesting Case Of Wunderlich Syndrome And Page Kidney, Megan Worthington, Nicholaus Monsma, Raj Pyne

Advances in Clinical Medical Research and Healthcare Delivery

We present a case of Wunderlich Syndrome and Page Kidney, a rarely reported combination. Wunderlich Syndrome, characterized by spontaneous renal hemorrhage without a history of trauma, is typically associated with Lenk’s triad of flank pain, mass, and hypovolemia. Page Kidney induced hypertension, a rare condition resulting from external renal compression associated with renin-mediated mechanisms. Our case demonstrates the importance in quick recognition and treatment as blood pressure changes can be fast and dramatic. Our case also has the added dimension of renin measurements. After the patients hypertension developed, his initial renin levels were within normal range, but they later showed …

Missing The Overlap, Rutwik Pradeep Sharma, Mohamed Mohamed Ahmed, Ryan Tam, Alexander T. Kusnik, Ali Jaan, Ari Chodos, Krishna Tangirala

Advances in Clinical Medical Research and Healthcare Delivery

A 43-year-old female presented with painful obstructive jaundice, a mixed pattern of elevation of liver injury markers and neutrophilic leukocytosis. Evaluation with endoscopic retrograde cholangiopancreatography (ERCP) was unremarkable. The antimitochondrial antibody (AMA) titers were elevated. She was discharged on ursodeoxycholic acid (UDCA) for Primary Biliary Cirrhosis (PBC) but was readmitted for worsening symptoms. The patient's liver biopsy results suggested Overlap syndrome (Primary Biliary Cirrhosis-Autoimmune hepatitis). She was then given corticosteroid therapy concurrently with UDCA after which she improved and remained asymptomatic. In conclusion, we would like to report this atypical presentation of overlap syndrome and hope the medical community learns …

Pembrolizumab Induced Hyponatremia. A Case Report, Mouna Reghis, Taanvi Gowdar, Arjun Sekar

Advances in Clinical Medical Research and Healthcare Delivery

Hyponatremia is the most common electrolyte abnormality inpatient. Medications are a common cause of this. Cancer treatment has evolved with immune check point inhibitors replacing conventional chemotherapy agents. Pembrolizumab, which is a program cell death receptor-1 ligand has been shown to cause endocrinopathies. We describe a case of hyponatremia due to pembrolizumab

Case Report Of Unilateral Dysphagia In The Context Of A Classical Type Of Eagle Syndrome, Ryan Tam, Stephen D. Howard, Timothy Ehmann, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

A patient presents with unilateral, right-sided dysphagia and generalized facial symptoms following past surgical history of tonsillectomy that is consistent with an underdiagnosis of Eagle Syndrome. The elongation of the styloid process likely impinged on the glossopharyngeal and vagus nerves resulting in symptoms. Given the lack of recognition of the disease, this case report describes the presentation of Eagle Syndrome to encourage physicians to consider this disease as part of a broader differential diagnosis.

Peer Support For Second Victims In The Healthcare Setting, Levi Gangi

Advances in Clinical Medical Research and Healthcare Delivery

Adverse and traumatic events happen regularly in healthcare settings, and often they create a clinician “second victim” who struggles with feelings of guilt, isolation, doubt, and incompetence. Research has shown that clinicians desire support in the wake of such adverse events, but that factors such as stigma, culture of perfection, and lack of an available structured peer program limit the support that might be offered. Healthcare institutions contract with EAP (employee assistance program) agencies to provide counseling for employees, but it is more likely that a second victim will seek out or welcome help first from a peer who shares …

Post Anesthesia Care Unit Comprehension Safety Program Quality Improvement Project On De-Escalation Of Patients, Mary M. Gaukler Giannavola, Basil George Verghese, Deborah Maier

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Violence within the healthcare setting has risen significantly, and has crossed into areas where staff are less prepared to manage and deescalate challenging patient encounters. This lack of preparedness and confidence has led to increased staff stress, burn out, and can potentiate poor patient outcomes.

Methods:

A pre/post-simulation quality improvement project was performed within a tertiary hospital Post-Anesthesia Care Unit in Upstate New York to evaluate the effect of simulation on feelings of confidence and preparedness in patient de-escalation with PACU nurses and patient care technicians. The project evaluation included the Thackrey’s Clinician Confidence in Coping with Patient Aggression …

Cocaine As A Rare Cause Of Cholecystitis, Abdullah A. Orakzai, Osama Sherjeel Khan, Mustafa Shah, Syeda Sarah Raza, Mehr A. Orakzai, Muhammad H. Sharif

Advances in Clinical Medical Research and Healthcare Delivery

Cholecystitis, inflammation of the gallbladder, is diagnosed in approximately 200,000 people in the US each year. Cocaine is an illicit drug that is wildly abused in the US, GI complications such as acute pancreatitis, colitis, bowel perforation, mesenteric ischemia, and biliary tree obstruction have been reported in limited studies. To the best of our knowledge, there are no reported cases of cocaine-induced cholecystitis and no established treatment plans to date, however, we strongly believe that our patient’s cocaine use resulted in cholecystitis. Hence, we wanted to shed some light on the possible side effects of cocaine on the gall bladder.

The Role Of Osteopathic Manipulative Treatment In Neonatal Abstinence Syndrome, Kathryn Workman, Andrea M. Bodine, Md, Victoria Tuttle, Do

Advances in Clinical Medical Research and Healthcare Delivery

Context: The United States opioid epidemic has been an ongoing public health crisis. Nationally, maternal opioid use resulted in 82% increase in Neonatal Abstinence Syndrome (NAS), from 2010 to 2017. The opioid withdrawal process of NAS can lead to somatic dysfunctions. Osteopathic Manipulative Treatment (OMT) may decrease muscular and fascial strain in the body and provide relaxation to the NAS neonate.

Objectives: The objectives of this study were to compare the length of hospital stay (LOS) of NAS neonates who received OMT, and neonates given standard medical care without OMT and to evaluate the change in weight of the two …

Intrathecal Bupivacaine And Clonidine For Refractory Hyperhidrosis In Spinal Cord Injury, Soun Sheen, Hemant Kalia

Advances in Clinical Medical Research and Healthcare Delivery

Introduction: Autonomic dysreflexia (AD) in spinal cord injury (SCI) can present as hyperhidrosis due to sudomotor dysfunction. There are no standard treatment guidelines for refractory hyperhidrosis due to persistent noxious stimulation.

Case: A 58-year-old female with C7 ASIA-A quadriplegia was admitted to the hospital in 2018 for T7-8 discitis. Discitis acted as a noxious stimulus manifesting clinically as autonomic dysreflexia. On average, she experienced 50-60 sweating episodes every day. She underwent serial stellate ganglion blocks with >75% improvement which provided 9 months of continued relief. Patient transitioned to intrathecal bupivacaine 2.5mg/ml + Clonidine 200mcg/ml with the catheter tip located at …

Ada News - 08/05/2024, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Analyzing Hiv/Aids Trends And Disparities In The Bronx: A Comparative Study With Nyc Boroughs, Caleb Adjei

CUNY Mexican Studies Institute

This study analyzes changes in reported HIV/AIDS cases over time in the Bronx, identifying the racial/ethnic groups and neighborhoods most affected by the disease. The Bronx consistently exhibits the highest rate of new HIV diagnoses among New York City’s boroughs, with Latino/Hispanic and Black populations being disproportionately impacted. Key neighborhoods like High Bridge-Morrisania, Crotona-Tremont, and Fordham-Bronx Park have the highest case concentrations. Despite advancements in healthcare and treatments like antiretroviral therapy, disparities persist. The findings highlight the need for targeted interventions to support the most affected communities and address the underlying social determinants contributing to the disparities in HIV/AIDS diagnoses.

National Institutes Of Health: Clinical Research & Clinical Practice Skills In Occupational Therapy, Arianna Z. Cook

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Dance For Sensory Regulation To Increase Positive Classroom Behaviors, Breland Paline, Cassandra Nelson

Summer 2024 OTD Capstone Symposium

Children have a primary occupation of play; however, children who are of elementary school age, 5-11 years old, also have a primary occupation of education. Through literature reviews, it has been found that dance can increase positive classroom behaviors such as creativity, classroom participation, and emotional regulation. A needs assessment was completed to gather a baseline of classroom behavior and information regarding the target population. Based on responses from the needs assessment, this program was curated for first-grade, second-grade, and third-grade classes. Classroom teachers completed a pre-survey related to student behaviors in the classroom, such as before and after physical …

Understanding Athletes’ Experience When Transitioning To Life Beyond Sport: A Pilot Study, Alyssa L. Moore

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

It’S More Than Skin Deep: Evaluating Mental Health Care In Dermatology Settings, Emma Kraft

Theses and Graduate Projects

Background: There is a high prevalence of mental health comorbidities in those with dermatologic conditions given the visible nature of many conditions. However, mental health often fails to be addressed due to lack of mental health education, stigma around mental health, and lack of mental health resources for patients. Purpose: This research study aims to assess how patients and providers experience and address mental health in dermatology settings. Methods: A systematic literature review was performed analyzing the relationship between dermatologic conditions and mental health. Additionally, a survey was conducted to assess how dermatology providers approach mental health in dermatology settings. …

Intouch Week Of August 5, 2024, New York Medical College

InTouch

• School of Medicine Class of 2028 Marks Start of Medical School Journey
• CDM Secures Grants to Expand Critical Emergency Training Programs
• NYMC SOM Student Senate Launches New Academic Year with Fresh Initiatives
• NYMC’s Center for Human Rights Helps Migrants Navigate the Asylum Process
• CDM Provided Summer Trainings

Education And Management Of Lymphedema, Alison Gillard, Rebecca King

Summer 2024 OTD Capstone Symposium

Lymphedema is a chronic and progressive condition whose incidence is increasing each year. This underserved population demonstrates frustration and confusion with self-managing symptoms.

This program aimed to compile evidence-based resources into an easily accessible format for the population to use as needed.

Educating Nursing Faculty In Mindfulness Practices To Reduce Students’ Anxiety Pre-Simulation, Virginia Gonzalez

Doctor of Nursing Practice Projects

This DNP project examines how mindfulness training for associate degree nursing faculty can enhance educator self-efficacy in implementing teaching methods that reduce anxiety among nursing students before simulation exercises. The primary issue identified is the lack of faculty training in pre-simulation facilitation practices, which is crucial for ensuring students are adequately prepared. Using a pre-test/post-test design, this initiative evaluated changes in educator mindfulness self-efficacy among 14 faculty members. Results indicated a significant improvement in self-efficacy scores. The pre-test mean score was 3.36, which rose to a post-test mean score of 4.60. These project results demonstrate that mindfulness training effectively enhanced …

A Quantitative Investigation Into Isotropic Variations Of Treatment Planning Isocenters To Model Patient Misalignment During Radiation Therapy Delivery And Its Impact On Evaluated Dose Metrics For Hypofractionated Dibh Left Breast Cancer Patients, Mckenzie Gemeiner

Masters Projects

Introduction

This research was conducted for carcinoma of the left breast without nodal involvement using the 3D deep inspiration breath hold (DIBH) treatment technique. Limiting dose to healthy tissues is crucial in radiation treatment planning. The impact of dosimetric uncertainty due to isotropic variations on constraints and goals is often overlooked. This study investigates dose metric differences due to inherent patient misalignment modeled by isotropic variations in treatment planning.

Methods

10 patient subjects were randomly selected with carcinoma of the left breast without nodal involvement, each using the 3D hypofractionated, deep inspiration breath hold (DIBH) technique. All plans had 24 …

Evaluating The Use Of A Standardized Prebriefing Tool With Novice Simulation Facilitators, Ciara Berry

Doctor of Nursing Practice Projects

The International Association for Clinical Simulation and Learning (INACSL) Best Practice Standards related to prebriefing recommends establishing a prebriefing plan to prepare the learners for a simulation activity. A simulation briefing should orient the learner, promote learner engagement, and reinforce psychological safety. The nursing faculty’s unfamiliarity with an established prebriefing tool at the clinical site and reliance on the single simulation educator resulted in self-guided briefings and reduced the faculty facilitators' competency. The quality improvement project aimed to reorient nursing faculty in an associate degree nursing program to a prebriefing tool available at the clinical site. After reorientation, the PI …

Debriefing Orientation For Novice Simulation Faculty, Cindy M. Carter

Doctor of Nursing Practice Projects

Faculty new to the simulation environment lack the knowledge, skills, and confidence to deliver proper debriefing methods. The Doctor of Nursing Practice (DNP) project’s problem is the need for a standardized, evidence-based debriefing process in the undergraduate RN program at the College of Nursing in Oklahoma. The study aims to follow the International Nursing Association for Clinical Simulation and Learning (INACSL) best practices to implement a debriefing simulation for novice faculty to improve faculty self-efficacy with the debriefing process (Decker et al., 2021). The DNP student evaluated faculty using pre-and post-tests containing questions from the Debriefing Assessment for Simulation in …