Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Effects Of An Apn-Led Amiodarone Clinic On Adherence To Recommended Monitoring Guidelines, Melissa Bartoszewicz

Evidence-Based Practice Project Reports

Evidence shows that patients receiving amiodarone therapy have not adhered to monitoring guidelines set forth by the Heart Rhythm Society. Uncertainty with responsibility for monitoring has led to the development of pharmacist-managed or multidisciplinary-managed outpatient amiodarone clinics. Some limitations have been identified in the pharmacist-managed outpatient clinics that may be overcome by advanced practice nurse (APN)-managed clinics. The purpose of this EBP project was to determine what effects an APN-led amiodarone clinic would have on adherence to amiodarone monitoring guidelines. Using the PICOT format, the clinical question was developed: Does enrollment in an amiodarone clinic compared with “usual care” change …

The Effect Of Telephone Follow-Up On Pain Experienced By Patients After Knee Replacement Surgery, Laurie J. Jones

Evidence-Based Practice Project Reports

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement …

Total Knee Arthroplasty Wear Is Caused By Malrotation And Excessive Laxity, Erik Woodard

Theses and Dissertations (ETD)

Total knee arthroplasty is a proven technique which combines specially designed components and surgical processes to treat cartilage degeneration and alleviate pain in arthritic knees. However, this technique is limited by component design and surgical precision. Due to these limitations, knee arthroplasty components will eventually wear out, causing rejection and necessitating the need for a replacement. For this reason, it would be beneficial to experts if the primary causes of this wear could be identified in order to minimize the number of replacements.

This study aims to determine if a correlation exists between instability of a knee joint and the …

Molecular Chaperone Tools For Use Against Neurodegenerative Diseases, Matthew Tinkham

Senior Honors Projects

A noted characteristic found in several neurodegenerative disorders, including Alzheimer’s Disease, Parkinson’s Disease, Huntington’s Disease and bovine spongiform encephalopathy, is the accumulation of amyloid plaques in the brain. Amyloid plaques contain deposits of fibrillar aggregates of misfolded proteins that disrupt normal functionality in neurons. Certain variants of these misfolded proteins are self-replicating; these self-replicating amyloids are termed prions (for infectious protein). We are interested in how protein misfolding contributes to amyloid formation and how molecular chaperone proteins can change the formation of amyloid deposits. Chaperone proteins function by catalyzing the proper folding of other proteins, the refolding of misfolded proteins, …

A Systematic Column Performance Comparison For The Confirmation Of Opioids Used In Pain Management By Lc-Ms, Derek Stallard

Undergraduate Honors Theses

In this study, three different chromatographic column chemistries (C18, Pentafluorophenyl (PFP), Hydrophilic Interaction Chromatography (HILIC)) were compared under optimal conditions to determine which stationary performed best in the separation and detection of a mixture of opioids using LC-MS. Furthermore, these stationary phases were examined in three different column technologies – traditional silica, porous shell, and porous polymer (PRP). The PRP column had the best peak shape for all 13 opioids and dominated for later-eluting compounds. In terms of column reproducibility, the Hamilton C18 column had the lowest %RSD values. The Kinetex HILIC produced the most theoretical plates and best resolution …

Make Your Garden Grow: Designing A Physical Activity Estimation Improvement Game, Ashish Amresh, Leigh Small

Publications

We present a novel game and virtual world based application that is aimed at improving the physical activity estimation skills of parents. It has been well established that lack of proper estimation of preschool children’s activity levels may be one of the main causes for childhood obesity. Childhood obesity has several long term health effects ranging from cardio-vascular disease to type II diabetes and obese preschool children are at risk for later life. We have developed an application that caters to both the parent and the child and uses a virtual garden as a fledgling ecosystem controlled both by the …

High-Dose Interleukin-2 Administration In The Oncology Medical-Surgical Setting – An Innovation To Impact Cost Efficiencies, Clinical Outcomes And The Ideal Patient Experience, Deidre L. Kutzler Rn, Megan L. Derr Rn

Patient Care Services / Nursing

No abstract provided.

Anti-Gd2 Etoposide-Loaded Immunoliposomes For The Treatment Of Gd2 Positive Tumors, Brandon S. Brown

Dissertations and Theses (Open Access)

Systemic chemotherapeutics remain the standard of care for most malignancies even though they frequently suffer from narrow therapeutic index, poor serum solubility, and off-target effects. Monoclonal antibodies that specifically bind antigens overexpressed on many tumors such as the ganglioside, GD2, can be conjugated to drug-loaded liposomes to create a targeted drug delivery system. In this study, we have encapsulated etoposide, a topoisomerase inhibitor effective against a wide range of cancers, in surface modified liposomes decorated with anti-GD2 antibodies. We characterized the properties of the liposomes using a variety of methods including dynamic light scattering, electron microscopy, and Fourier transformed infrared …

Phage Display Library Screening For Psa-/Lo Prostate Cancer Cell-Binding Peptides, John R. Moore

Dissertations and Theses (Open Access)

Prostate cancer (PCa) is one of the leading malignancies affecting men worldwide. Our lab focuses on understanding the molecular mechanisms underlying prostate carcinogenesis and developing therapeutics that target the cells responsible for driving PCa and mediating therapy resistance. My master thesis research employs a phage display library screening technology aiming to identify peptides that preferentially home in to undifferentiated PCa cells, which our lab has previously demonstrated to be intrinsically resistant to castration.

There is now evidence that a population of cells in PCa possesses characteristics associated with stem cells; these cells are referred to as cancer stem cells (CSCs). …

Predicting Targeted Drug Combinations Based On Pareto Optimal Patterns Of Coexpression Network Connectivity, Nadia M. Penrod, Casey S. Greene, Jason H. Moore

Dartmouth Scholarship

Molecularly targeted drugs promise a safer and more effective treatment modality than conventional chemotherapy for cancer patients. However, tumors are dynamic systems that readily adapt to these agents activating alternative survival pathways as they evolve resistant phenotypes. Combination therapies can overcome resistance but finding the optimal combinations efficiently presents a formidable challenge. Here we introduce a new paradigm for the design of combination therapy treatment strategies that exploits the tumor adaptive process to identify context-dependent essential genes as druggable targets. We have developed a framework to mine high-throughput transcriptomic data, based on differential coexpression and Pareto optimization, to investigate drug-induced …

Eculizumab In The Successful Treatment Of Postpartum Hemolytic Uremic Syndrome - A Case Report, Craig A. Mackaness Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Force And Power Development In Free Weight Resistance Training Vs. Band Resistance Training, Joseph Jablonski

Morehead State Theses and Dissertations

A Thesis Presented to the Faculty of Health, Wellness, and Human Performance of the College of Science and Technology Morehead State University in Partial Fulfillment of the Requirements for the Degree Master of Arts by Joseph Jablonski on April 16, 2014.

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Defining Obesity: An Argument For The Social Environment Perspective, Meghan Mcinnis

Annual Undergraduate Conference on Health and Society

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, …

Refining Best Practices For The Diagnosis Of Autism: A Comparison Between Individual Healthcare Practitioner Diagnosis And Transdisciplinary Assessment., Jessica Rae Stewart, Debra C. Vigil, Erika Ryst, Wei Yang

Nevada Journal of Public Health

The purpose of this study is to compare the diagnostic decision-making of individual healthcare practitioners against that of a transdisciplinary team. Despite national recognition of transdisciplinary assessment as the gold standard diagnostic approach, autism is most frequently diagnosed by individuals working independently in a variety of disciplines. The current study examined how closely these individual practitioners make diagnoses matching that of a transdisciplinary team. Twenty professionals from five different disciplines viewed videotape clips of fifteen children previously assessed by a transdisciplinary team. Results confirmed that individual healthcare practitioners matched the transdisciplinary team diagnosis on average only 65.6% of the time. …

Medial Tibial Stress Syndrome, Jacqueline Knowles

Thinking Matters Symposium Archive

The purpose of this project is to examine an exercise-­‐based approach to rehabilitating an athlete with medial tibial stress syndrome. It presents specific exercises that can be used, and focuses on resolving the core of the problem instead of just addressing the symptom. This review attempts to provide a long-­‐term solution rather than providing a quick fix.

"Wiser And Wider": An Analysis Of Dsd Treatment Protocol In The Netherlands And Practitioner And Patient Attitudes Towards Medical Care, Mel Ferrara

Independent Study Project (ISP) Collection

The main objective of this study is to assess current medical practices in the Netherlands for the treatment of disorders of sexual development (DSD) through interviews with both medical practitioners and individuals diagnosed with these conditions. Data was obtained qualitatively through personal interviews with a pediatric endocrinologist, pediatric urologist, ethicist, and four men who have been diagnosed with Klinefelter's Syndrome. This study examines how institutional protocol aligns with individual practitioner's perception of ideal treatment as well as their own conceptions of sex and gender. This data is juxtaposed with the personal experiences and perspectives of several men diagnosed with Klinefelter's …

Estimating Child Sleep From Parent Report Of Time In Bed: Development And Evaluation Of Adjustment Approaches, Timothy D. Nelson, Alyssa Lundahl, Dennis L. Molfese, Rachel N. Waford, Adrienne Roman, David Gozal, Victoria J. Molfese, Melissa C. Ferguson

Department of Psychology: Faculty Publications

Objective To develop and evaluate adjustment factors to convert parent-reported time in bed to an estimate of child sleep time consistent with objective measurement. Methods A community sample of 217 children aged 4–9 years (mean age = 6.6 years) wore actigraph wristwatches to objectively measure sleep for 7 days while parents completed reports of child sleep each night. After examining the moderators of the discrepancy between parent reports and actigraphy, 3 adjustment factors were evaluated. Results Parent report of child sleep overestimated nightly sleep duration by ~24 min per night relative to actigraphy. Child age, gender, and sleep quality all …

Comparison Of Functional Network Connectivity For Passive-Listening And Active-Response Narrative Comprehension In Adolescents, Yingying Wang, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty Publications

Comprehension of narrative stories plays an important role in the development of language skills. In this study, we compared brain activity elicited by a passive-listening version and an active-response (AR) version of a narrative comprehension task by using independent component (IC) analysis on functional magnetic resonance imaging data from 21 adolescents (ages 14–18 years). Furthermore, we explored differences in functional network connectivity engaged by two versions of the task and investigated the relationship between the online response time and the strength of connectivity between each pair of ICs. Despite similar brain region involvements in auditory, temporoparietal, and frontoparietal language networks …

Variability Of M-Mode Versus Two-Dimensional Echocardiography Measurements In Children With Dilated Cardiomyopathy., Caroline K. Lee, Renee Margossian, Lynn A. Sleeper, Charles E. Canter, Shan Chen, Lloyd Y. Tani, Girish S. Shirali, Anita Szwast, Elif Seda Selamet Tierney, M Jay Campbell, Fraser Golding, Yanli Wang, Karen Altmann, Steven D. Colan, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

M-mode and 2-dimensional (2D) echocardiographic imaging are routinely used to quantify left-ventricular (LV) size and function in pediatric patients with dilated cardiomyopathy (DCM). The reproducibility of and correlation between these techniques are unknown. This analysis sought to compare interreader, intrareader, and interacquisition reproducibility of M-mode versus 2D measurements in pediatric DCM patients. The Ventricular Volume Variability study of the Pediatric Heart Network is a multicenter, prospective, observational study assessing the course of chronic DCM in children. Two sonographers performed baseline image acquisitions locally, and two readers performed measurements at the echocardiographic core laboratory. One reader repeated measurements 1 month later. …

Improved Protocols For Vibrational Spectroscopic Analysis Of Body Fluids, Franck Bonnier, François Petitjean, Matthew Baker, Hugh Byrne

Articles

The applications of vibrational spectroscopy to the examination of human blood serum are explored. Although FTIR spectra can be recorded in aqueous solutions at (gelatin) concentrations as low as 100mg/L, the high-wavenumber region remains obscured by water absorption. Using Raman spectroscopy, high quality spectra of gelatine solutions as low as 10mg/L can be achieved, also covering the high-wavenumber regions. In human serum, spectral profiles are weak and partially obscured by water features. Dried deposits are shown to be physically and chemically inhomogeneous resulting in reduced measurement reproducibility. Concentration of the serum using commercially available centrifugal filter devices results in an …

Introducing And Evaluating 3d Digital Breast Tomosynthesis, Marie Hrinkonich, Susan Steigerwalt

Department of Radiology & Diagnostic Medical Imaging

No abstract provided.

Cone Beam Computertomography (Cbct) In Interventional Chest Medicine – High Feasibility For Endobronchial Real Time Navigation, Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Thomas Vogl, J. Francis Turner, Robert Browning, Bernd Linsmeier, Haidong Huang, Qiang Li, Kaid Darwiche, Lutz Freitag, Michael Simoff, Ioannis Kioumis, Konstantinos Zarogoulidis, Johannes Brachmann

Internal Medicine Faculty Publications

Introduction: Currently there are several advanced guiding techniques for pathoanatomical diagnosis of incidental solitary pulmonary nodules (iSPN): Electromagnetic navigation (EMN) with or without endobronchial ultrasound (EBUS) with miniprobe, transthoracic ultrasound (TTUS) for needle approach to the pleural wall and adjacent lung and computed tomography (CT)-guidance for (seldom if ever used) endobronchial or (common) transthoracical approach. In several situations one technique is not enough for efficient diagnosis, therefore we investigated a new diagnostic technique of endobronchial guided biopsies by a Cone Beam Computertomography (CBCT) called DynaCT (SIEMENS AG Forchheim, Germany). Method and Material: In our study 33 incidental solitary pulmonary nodules …

Molecular Pap Biomarkers For Cervical Cancer Risk Assessment In Thinprep® Clinical Specimens, Jennifer Taylor

Graduate School of Biomedical Sciences Theses and Dissertations

Approximately 500,000 patients are diagnosed with cervical cancer worldwide each year, thus making it the second most common cause of cancer-related deaths in women. Persistent high-risk human papillomavirus (HR-HPV) infections induce cervical dysplasia by increasing the expression of two viral oncogenes, E6 and E7. Utilization of the Papanicolaous smear test (Pap test) has contributed to a decrease in morbidity and mortality of cervical cancer; however, subjective analysis of cell morphology with a limited amount of cells has led to a substantial rate of false positive and false negative diagnoses. A more objective and sensitive diagnostic tool for the detection of …

A Rehabilitation Program For Lung Cancer Patients During Postthoracotomy Chemotherapy, Amy J. Hoffman, Ruth Ann Britnall, Alexander Von Eye, Lee W. Jones, Gordon Alderink, Lawrence H. Patzelt, Jean K. Brown

Peer Reviewed Articles

Objective: The objective of this pilot study was to describe the effects of a 16-week home-based rehabilitative exercise program on cancer-related fatigue (CRF), other symptoms, functional status, and quality of life (QOL) for patients with non-small cell lung cancer (NSCLC) after thoracotomy starting within days after hospital discharge and continuing through the initiation and completion of chemotherapy.

Materials and methods: Five patients with NSCLC completed the Brief Fatigue Inventory (measuring CRF severity) and the MD Anderson Symptom Inventory (measuring symptom severity) before and after thoractomy, and at the end of each week of the 16-week exercise program. Additionally, the Medical …

Radiation Exposure Of Patients By Cone Beam Ct During Endobronchial Navigation - A Phantom Study, Wolfgang Hohenforst-Schmidt, Rosemarie Banckwitz, Paul Zarogoulidis, Thomas Vogl, Kaid Darwiche, Eugene Goldberg, Haidong Huang, Michael Simoff, Qiang Li, Robert Browning, Lutz Freitag, J. Francis Turner, Patrick Le Pivert, Lonny Yarmus, Konstantinos Zarogoulidis, Johannes Brachmann

Internal Medicine Faculty Publications

Rationale: Cone Beam Computed Tomography imaging has become increasingly important in many fields of interventional therapies. Objective: Lung navigation study which is an uncommon soft tissue approach. Methods: As no effective organ radiation dose levels were available for this kind of Cone Beam Computed Tomography application we simulated in our DynaCT (Siemens AG, Forchheim, Germany) suite 2 measurements including 3D acquisition and again for 3D acquisition and 4 endobronchial navigation maneuvers under fluoroscopy towards a nodule after the 8th segmentation in the right upper lobe over a total period of 20 minutes (min). These figures reflect the average complexity and …

Vaccine-Preventable Diseases In Travelers, Edith Mirzaian, Jeffery A. Goad, Ani Amloian, Fady Makar

Pharmacy Faculty Articles and Research

Travel to the developing world is increasing among those from developed countries, placing them at risk for vaccine preventable and non-vaccine preventable diseases. From 2007-2011, the GeoSentinel Network reported 737 returned travelers with a vaccine preventable disease. While it is essential that clinicians use vaccines when available for a disease of risk, they should also be aware that the vast majority of diseases acquired by travelers are non-vaccine preventable. The vaccine preventable diseases can be divided into routine travel vaccines, special travel vaccines and routine vaccines used for travel. The routine travel vaccines include Hepatitis A and B, typhoid; special …

Utilizing Fast Spin Echo Mri To Reduce Image Artifacts And Improve Implant/Tissue Interface Detection In Refractory Parkinson’S Patients With Deep Brain Stimulators, Subhendra N. Sarkar, Pooja R. Sarkar, Efstathios Papavassiliou, Rafael Rojas

Publications and Research

Introduction. In medically refractory Parkinson’s disease (PD) deep-brain stimulation (DBS) is an effective therapeutic tool. Postimplantation MRI is important in assessing tissue damage and DBS lead placement accuracy. We wanted to identify which MRI sequence can detectDBS leads with smallest artifactual signal void, allowing better tissue/electrode edge conspicuity.

Methods. Using an IRB approved protocol 8 advanced PDpatientswere imagedwithinMRconditional safety guidelines at lowRF power (SAR ≤ 0.1 W/kg) in coronal plane at 1.5T by various sequences.The image slices were subjectively evaluated for diagnostic quality and the lead contact diameters were compared to identify a sequence least affected by metallic leads.

Results …

Variation In Feeding Practices Following The Norwood Procedure., Linda M. Lambert, Nancy A. Pike, Barbara Medoff-Cooper, Victor Zak, Victoria L. Pemberton, Lisa Young-Borkowski, Martha L. Clabby, Kathryn N. Nelson, Richard G. Ohye, Bethany Trainor, Karen Uzark, Nancy Rudd, Louise Bannister, Rosalind Korsin, David S. Cooper, Christian Pizarro, Sinai C. Zyblewski, Bronwyn H. Bartle, Richard V. Williams, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To assess variation in feeding practice at hospital discharge after the Norwood procedure, factors associated with tube feeding, and associations among site, feeding mode, and growth before stage II.

STUDY DESIGN: From May 2005 to July 2008, 555 subjects from 15 centers were enrolled in the Pediatric Heart Network Single Ventricle Reconstruction Trial; 432 survivors with feeding data at hospital discharge after the Norwood procedure were analyzed.

RESULTS: Demographic and clinical variables were compared among 4 feeding modes: oral only (n = 140), oral/tube (n = 195), nasogastric tube (N-tube) only (n = 40), and gastrostomy tube (G-tube) only …

Heart Attack And Kidney Attack: Evolution Of Lay And Clinical Terms For Spontaneous, Acute Organ Injury Syndromes, Claudio Ronco, Peter A. Mccullough, Pupulan Iyngkaran, Lakhmir S. Chawla

Anesthesiology and Critical Care Medicine Faculty Publications

No abstract provided.