Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Relationship Of Patient Self-Administered Copd Assessment Test To Physician Standard Assessment Of Chronic Obstructive Pulmonary Disease In A Family Medicine Residency Training Program, Jessica E. Burchette, Ivy A. Click, Leigh Johnson, S. Alicia Williams, Brett Tyler Morgan

Journal of Patient-Centered Research and Reviews

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient’s life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient self-administered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians’ assessment of the …

Endovascular Management Of Free Floating Common Carotid Thrombi, Kevin Carr Md, Zachary Thwing Md, Ravishankar Shivashankar Md, Yafell Serulle Md

Radiology

• The incidence of symptomatic free-floating thrombi of the common carotid artery (CCA) is as low as 0.24-5% incidence in stroke victims. Patients are predisposed to a prothrombotic state
• Historical management options were limited to surgical and medical options both with individual attendant risk profiles
• Large thrombi can present with various degrees of clinical severity
• The endovascular approach is a viable tool to manage these patients

Community Stroke Practice Experience With Small Vessel Thrombectomy, Kevin Carr Md, Zachary Thwing Md, David Pasquale Md, Ravishankar Shivashankar Md, Yafell Serulle Md

Radiology

• Emergent endovascular revascularization is currently mainstay for patients presenting with emergent Large Vessel Occlusion (LVO) of the intracranial circulation
• Stroke symptoms affecting smaller vessels can carry significant morbidity
• Newer technologies and greater experience with the endovascular approach make treatment for small vessel occlusions increasingly more manageable
• This is more relevant in patients presenting outside the tPA window with poor collateral circulation
• We present our technical institutional experience with the endovascular management of acute occlusions of the M2-M3 MCA, A1-A2 ACA and P1-P2 PCA territories.

The Wet Bridge Transfer System: An Novel In Vitro Tool For Assessing Exogenous Surfactant As A Pulmonary Drug Delivery Vehicle, Brandon J. Baer

Western Research Forum

Background:

Due to its complex branching structure, direct drug delivery to the remote areas of the lung is a major challenge. Consequently, most therapies, such as those treating pulmonary infection and inflammation, must utilize large systemic dosing, with the potential for adverse side effects. A novel alternative strategy is to use exogenous surfactant, a material capable of distributing throughout the lung, as a pulmonary drug delivery vehicle.

Objective:

Utilize an in vitro transferring system to assess exogenous surfactant (BLES) as a pulmonary delivery vehicle for different therapeutics.

Methods:

An in vitro technique was developed to simultaneously study surfactant delivery and …

A Rapid Viability And Drug‑Susceptibility Assay Utilizing Mycobacteriophage As An Indicator Of Drug Susceptibilities Of Anti‑Tb Drugs Against Mycobacterium Smegmatis Mc2 155, Gillian Catherine Crowley, Jim O'Mahony, Aidan Coffey, Riona G. Sayers, Paul D. Cotter

Department of Biological Sciences Publications

Background: A rapid in-house TM4 mycobacteriophage-based assay, to identify multidrug resistance against various anti-tuberculosis drugs, using the fast-growing Mycobacterium smegmatis mc² 155 in a microtiter plate format was evaluated, based on phage viability assays. Methods: A variety of parameters were optimized before the study including the minimum incubation time for the drugs, phage and M. smegmatis mc² 155 to be in contact. An increase in phage numbers over 2 h was indicative that M. smegmatis mc² 155 is resistant to the drugs under investigation, however when phage numbers remained static, M. smegmatis mc² 155 found to …

Investigating Neuroinflammation And Demyelination In The Nervous System Of Twitcher Mice By The Use Of Immunohistochemistry, Irene Wilson

Natural Sciences and Mathematics | Biological Sciences Master's Theses

Neuroinflammation and demyelination are the hallmark lesions of the Twitcher mouse—the model of Krabbe Disease. By analyzing hemibrains and sciatic nerves via immunohistochemistry, we supported the microglial hypothesis that early activation of microglial cells, macrophages, and globoid cells in the nervous system of Twitcher mice results in specific cellular polarization states that may contribute to myelin loss. The influx of activated macrophages seen in both the central and peripheral nervous systems at days 21 and 17, respectively, accounted for this polarization. Using selected M1 and M2 markers, YKL-40, and GPNMB and CD206, respectively, we proved that microglial cells and macrophages …

Provider Education And Rapid Antigen Detection Test Use In An Academic Pediatric Clinic, Steven Dahl

Research Days

No abstract provided.

The Effect Of Antihypertensive Medications Dosing On Blood Pressure Control And Left Ventricular Hypertrophy In Children With Chronic Kidney Disease, Benjamin A. Matta

Research Days

No abstract provided.

Evaluation Of The Role Of Microvascular Pathology On Peripheral Artery Disease, Constance Mietus

Theses & Dissertations

Background: Peripheral Artery Disease (PAD) begins with atherosclerotic narrowing of arteries, including those that supply the legs. Individuals with PAD experience pain during walking, which becomes increasingly limiting. Studies from our group and others have shown that a myopathy is present in the skeletal muscle of PAD patients, and is characterized by myofiber degeneration, fibrosis, and remodeling of vessels ranging from 50 – 150 mm in diameter. However, microvascular pathology, particularly of the smallest microvessels (5 – 15 mm in diameter) remains poorly characterized. Furthermore, little is known about the relationships between microvascular architecture, microperfusion, and patient walking performance. We …

Development Of A Long-Acting Nanoformulation Of Dolutegravir For Prevention And Treatment Of Hiv-1 Infection, Brady Sillman

Theses & Dissertations

Dolutegravir (DTG) is a potent human immunodeficiency virus type 1 (HIV-1) integrase strand-transfer inhibitor (INSTI) with a high barrier to viral drug resistance. However, opportunities to improve its profile abound. These include extending the drug’s apparent half-life, increasing penetrance to “putative” viral reservoirs, and reducing inherent toxicities. These highlight, in part, the need for long-acting, slow effective release antiretroviral therapy (LASER ART) delivery schemes. A long-acting (LA) DTG was made by synthesizing a hydrophobic and lipophilic prodrug encased with poloxamer (P407) surfactant. This modified DTG (MDTG) reduced systemic metabolism and polarity, increased lipophilicity and membrane permeability, improved encapsulation, and formed …

Arthroscopic Medial Meniscus Transplant Utilizing A Multi-Technique Fixation, Elizabeth Ford, Michael Defrance, Sean Mcmillan

Rowan-Virtua Research Day

Arthroscopic medial meniscus transplantation can be a daunting procedure for even the most skilled surgeon. While all-inside suture fixation devices have improved, the ability to successfully perform this procedure via arthroscopy is reliant upon the surgeon's ability to utilize a variety of fixation techniques. Based upon the review of the literature, this paper is the first of it's kind describing the methodology and algorithm for completing an arthroscopic medial meniscus transplant using four techniques.

A Rare Manifestation Of A Bleeding Tubulovillous Duodenal Polyp Presenting As An Upper Gastrointestinal Hemorrhage, Neethi Dasu, Yaser Khalid, Herman Suga, Michael Itidiare, Richard Walters

Rowan-Virtua Research Day

• Duodenal polyps are a group of polyps that are fairly uncommon to find on endoscopic evaluation (1).

• They are histologically classified according to mucin phenotype into intestinal and gastric subtypes; the intestinal-type polyps are morphologically subdivided into tubular and tubulovillous adenomas (2)

• We present a case of a 76-year-old male with recurrent hematemesis who was found to have an intestinal-type pedunculated tubulovillous adenoma (TVA) in the descending duodenum • An isolated occurrence of non-ampullary sporadic duodenal adenomas (SDA)’s are a rare finding and presentation as an upper GI hemorrhage is extremely uncommon (3)

• Furthermore, our patient’s …

Acute Promyelocytic Leukemia: A Case Study Correlating Cytogenetic Abnormality With Prognosis, Alyssa Lamond, Theresa Tellier-Castellone

Senior Honors Projects

Advancements in medical technology today have positively impacted the diagnosis, treatment, and prognosis of cancers. Particularly acute promyelocytic leukemia (APL) has completely improved from having the poorest prognosis to one of the best. Acute promyelocytic leukemia is a malignant disease of hematopoietic tissue classified by WHO as leukemia with >20% blasts from the myeloid lineage, specifically promyelocytes. Determined in 1976, FAB classified AML subtypes M1-M7, with APL being M3. Specific characteristics classify the subtype of AML, with each resulting from a different genetic abnormality. The focus of APL diagnosis, treatment, and prognosis occurs around the known PML-RARα fusion gene. Flow …

Simulating Alternative Tuberculosis Diagnosis Methods In Underdeveloped Countries, Luke Turner

Industrial Engineering Undergraduate Honors Theses

Tuberculosis is the deadliest infectious disease in the world; it is especially rampant in underdeveloped countries because they do not have the infrastructure, technology, or funding to properly combat the infection. However, the development of portable point-of-care diagnosis machines can reverse this epidemic as they far surpass conventional laboratory identification. The question now is where to place these machines, which is a difficult decision with a lack of data. Therefore, a flexible simulation model is created to test the implementation of these machines with different countries and configurations. The simulation tests the baseline model and three proposed implementations of the …

Data Visualization Of Treatment Outcomes For Tuberculosis Patients, Joy Jenkins

Industrial Engineering Undergraduate Honors Theses

Tuberculosis is an infectious disease, and different treatments have been discovered over the years. However, patients may develop various drug resistance levels that affect the likelihood of becoming cured or dying. In this study, we sought to employ data visualization to explore the relationship between treatment trajectory, as indicated by smear and culture results in the follow-up tests and patient outcomes. A large sample of patients have been broken down by demographics including age, gender, and drug resistance status. Sankey diagrams were used to visualize the pathway progression of the patients over time split between two time periods- months 0-6 …

Seeing Eye To Eye: A Machine Learning Approach To Automated Saccade Analysis, Maigh Attre

Honors Scholar Theses

Abnormal ocular motility is a common manifestation of many underlying pathologies particularly those that are neurological. Dynamics of saccades, when the eye rapidly changes its point of fixation, have been characterized for many neurological disorders including concussions, traumatic brain injuries (TBI), and Parkinson’s disease. However, widespread saccade analysis for diagnostic and research purposes requires the recognition of certain eye movement parameters. Key information such as velocity and duration must be determined from data based on a wide set of patients’ characteristics that may range in eye shapes and iris, hair and skin pigmentation [36]. Previous work on saccade analysis has …

Correlation Between Myostatin And Lean Muscle Mass In Older Adults, Mishann Luedders

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Correlation Between Myostatin and Lean Muscle Mass in Older Adults.

Luedders, M., Gray, M., Patton, S., Washington, T., Binns, A. Exercise Science Research Center, University of Arkansas, Fayetteville, AR.

Background: Our older adult population is growing exponentially and with it, the number of falls and debilitating injuries that afflict their population grows as well. A fall brings with it many possible injuries, healthcare costs, fear and increased mortality. There seems to be a lack of preventative measures in our healthcare system to help protect our elders. One possible measure is a simple blood test that looks at the level of …

Quality Improvement: Implementing A Foot Exam To Improve Care For Patients With Diabetes Mellitus, Emily Paprocki, Ryan Mcdonough, Tiffany Musick, Joseph Cernich

Posters

The American Diabetes Association guidelines recommend an annual foot exam in patients with type 1 and 2 diabetes who are ten years old or older and who have been diagnosed with diabetes at least five years. Quality improvement tools were used to improve the care provided to our patients by implementing an annual food exam.

Left Atrial Model, Borna Sobati, Sarah Porello, Tess Pate

Biomedical Engineering

The objective is to produce an electrophysiological model of an adult human left atrium. This model will be used to test mapping probe catheters used for locating cardiac arrhythmias against current technology used in practice. Dr. Chris Porterfield requested this model and other physicians or probe catheter manufacturers may also use this product in the future. Dr. Porterfield also discussed the possibility of future senior project groups using the model as a bench test for designing new catheter tips. The model will precisely simulate electrical behaviors of the heart in normal as well as arrhythmic conditions. Ideally, the model will …

Novel Mechanisms And Biomarkers In Alcohol-Induced Organ Injury., Christine E. Dolin

Electronic Theses and Dissertations

Background. Ethanol (EtOH) consumption is known to affect multiple organs; this is unsurprising, as the concentration of EtOH in the blood at relevant doses reaches the millimolar range. The overarching goal of this dissertation was to elucidate mechanisms of alcohol-induced organ injury, specifically the effects of alcohol on the hepatic extracellular matrix (ECM) proteome, the alcoholic hepatitis (AH) plasma peptidome, and the effects of alcohol on the renal cortex proteome and transcriptome. Methods. Mice were pair-fed ethanol-containing liquid diet chronically, and then some mice were administered lipopolysaccharide (LPS). Liver sections from these mice were processed in a series of increasingly …

Self-Reported Outcomes Following Cholecystectomy For Pediatric Hyperkinetic Biliary Dyskinesia, Charlene Dekonenko, Joseph A. Sujka, Robert Michael Dorman, Tolulope A. Oyetunji, Shawn D. St Peter

Posters

The aim of this study is to determine if children with hyperkinetic biliary dyskinesia have resolution of symptoms after laparoscopic cholecystectomy at our institution.

Conclusion: Cholecystectomy for hyperkinetic biliary dyskinesia may or may not improve symptoms. Further research should focus on pathophysiology of the disease in order to create an evidence-based definition of biliary dyskinesia in children to determine who will benefit from cholecystectomy.

The Effect Of Antihypertensive Dosing On Hypertension In Children With Chronic Kidney Disease, Benjamin A. Matta, Uri S. Alon, Bradley Warady Md, Tarak Srivastava, Darcy Weidemann

Posters

Background

Hypertension (HTN) is a highly prevalent and major risk factor for poor cardiovascular and renal outcomes in chronic kidney disease (CKD). Previous research suggests that HTN is underdiagnosed and undertreated in children with CKD. To our knowledge no studies have investigated the effect of antihypertensive (antiHTN) dose on blood pressure (BP) control in this population.

Objective

To determine the effect of antiHTN dose on HTN status in children with CKD.

Methods

Study population: 255 participants studied in the Chronic Kidney Disease in Children (CKiD) study at their 3rd visit, taking at least 1 antiHTN drug.

Cumulative Drug Dose Index …

Suffering In Silence: Is Gastroparesis Underdiagnosed?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this introduction to Volume 6, Issue 2, the editor-in-chief of the Journal of Patient-Centered Research and Reviews offers additional comment to the clinical review of diabetic gastroparesis authored by Farmer and colleagues (p. 148), regarding the problem of undiagnosed disease. Increased awareness of this entity and appropriate questioning regarding symptoms of diabetic gastroparesis in the primary care setting may prevent the “suffering in silence” experienced by many patients with this complication.

Diabetic Gastroparesis: Perspectives From A Patient And Health Care Providers, Adam D. Farmer, Caroline E. Bruckner-Holt, Susanne Schwartz, Emma Sadler, Sri Kadirkamanthan

Journal of Patient-Centered Research and Reviews

Gastroparesis is defined as a delay in gastric emptying in the absence of mechanical obstruction in the stomach. Gastroparesis has a number of causes, including postsurgical, secondary to medications, postinfectious, idiopathic, and as a complication of diabetes mellitus, where it is underrecognized. The cardinal symptoms of diabetic gastroparesis are nausea, early satiety, bloating, and vomiting. Diabetic gastroparesis is more common in females and has a cumulative incidence of 5% in type 1 diabetes and 1% in type 2 diabetes. It is associated with a reduction in quality of life and exerts a significant burden on health care resources. The pathophysiology …

Prognosis Of Patients With Aki After Percutaneous Mechanical Thrombectomy: A Retrospective Cohort Analysis, Hongchuan H. Coville Md, Tien-Min Lee Md, Hong Liang, Paul Alfino Md, Christopher Bray Md, Matthew Calestino Md

Internal Medicine

Percutaneous Mechanical Thrombectomy (PMT) is an endovascular procedure utilized in both arterial and venous thrombosis. Acute kidney injury (AKI) has been recognized as one undesired sequela of PMT. There is no study to investigate the outcomes in this specific patient population.

Prophylactic Use Of Lmwh Vs Ufh In Pe Patients, Kyleigh Grieshaber, Barbara Mcclaskey

Posters

As a result of deep vein thrombosis (DVT), a pulmonary embo­lism (PE) can occur which creates a blockage in the body’s pulmonary circulation, leading to cell death. PE is the third leading cause of death in the U.S., while being the most common, most preventable cause of death in hospitalized patients. Understanding the signs and symptoms of PE is essential in order to save patients’ lives. The objective of this research study was to compare the prophylactic use of Unfractionated Heparin (UFH) and Low Molecular Weight Heparin (LMWH) in patients effected with PE. Information for this research project was gathered …

Case Presentation On Congestive Heart Failure And Pulmonary Edema, Tetiana Soloviova, Denise Aris

Publications and Research

No abstract provided.

Abstracts From The 25th Annual Health Care Systems Research Network Conference, April 8–10, 2019, Portland, Oregon

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of nonprofit health systems with embedded research departments whose scientists are dedicated to public domain research. The network’s annual conference serves as a forum for research teams to disseminate study findings, stimulate new collaborations, and share insights about conducting research in real-world care settings. Abstracts accepted for presentation at HCSRN 2019 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official scientific journal of the conference.

Pediatric Erythromelalgia Treated With Epidural Ropivacaine Infusion, Caroline E. Lee, Kelly Paulk, Kristen Garvie, Elizabeth Grieshaber, Jeffrey Carter, Brian Ball

School of Medicine Faculty Publications

No abstract provided.

The Effect Of Sepsis On Cerebral Microvascular Blood Flow, Laura Mawdsley, Mamadou Diop, Chris G. Ellis

Western Research Forum

Background: Sepsis is a dysregulated host response to infection that affects 18 000 000 people worldwide, and over 325 000 000 dollars are spent treating sepsis in Canada every year. One of the symptoms of severe sepsis is an altered mental state, which is accompanied with a measured decrease in oxygen levels in the skeletal muscle microvasculature. It is hypothesized that his altered mental state is due to a lack of oxygenated blood reaching the brain.

Hypothesis: After the onset of sepsis, microvascular cerebral blood flow and oxygen levels in the blood will decrease. Onset of decreased blood flow in …