Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Mechanical Thrombectomy For Acute Ischemic Stroke In The Cardiac Catheterization Laboratory., Steven A Guidera, Sudhir Aggarwal, J Doyle Walton, David Boland, Roy Jackel, Jeffrey D Gould, Brooke Kearins, Joseph Mcgarvey, Yan Qi, Brian Furlong

Department of Radiology & Diagnostic Medical Imaging

OBJECTIVES: The aim of this study was to determine the feasibility of establishing a mechanical thrombectomy (MT) program for acute ischemic stroke in a community hospital using interventional cardiologists working closely with neurologists.

BACKGROUND: American Heart Association/American Stroke Association 2018 guidelines give a Class I (Level of Evidence: A) recommendation for MT in eligible patients with large vessel occlusion stroke. Improvement in neurological outcomes with MT is highly time sensitive. Most hospitals do not have trained neurointerventionalists to perform MT, leading to treatment delays that reduce the benefit of reperfusion therapy.

METHODS: An MT program based in the cardiac catheterization …

Music And Exercise On Brain With Dementia, Claudio Otero Iii

Student Scholar Showcase

No abstract provided.

Hoarding: Beyond The Mess, A Training For Mental Health Professionals, Kelsi Mcclaflin

Dissertations, Theses, and Projects

This literature review examines hoarding disorder with a close lens. This is a diagnosis that is new to licensed professionals across the helping professions. This training will allow participants to better understand what it means to be diagnosed with hoarding disorder, assessments that aid in detecting severity, best practices that are continually emerging, and the impact it can have on clients, their loved ones, and the community. This training takes a collaborative approach as an integrated way of treatment for all individuals involved in the process.

Keywords: hoarding, behaviors, treatment

Abstracts From The 26th Annual Health Care Systems Research Network Conference, April 8–10, 2020

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of community-based care delivery systems with a shared mission to improve health and health care through research. The network’s annual conference serves as a forum for attendees to disseminate study findings, stimulate collaborations, and share insights about conducting research in real-world care settings. Although this year’s live conference was cancelled to help slow the spread of COVID-19, the oral and poster abstracts accepted for presentation at HCSRN 2020 are published in this open access supplement to Volume 7, Issue 1 of the Journal of Patient-Centered Research and Reviews, the …

Reaching The Peak, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Champ's Triathlon Training Program, Rachael Sollman

OTD Capstone Projects

Champ's Triathlon Training Program was created to provide an adaptive fitness opportunity to the community of Nashville, TN. This program was specifically targeting children 8 to 15 years old diagnosed with Down's Syndrome and Cerebral Palsy, Gross Motor Function Classification Scale levels I, II, and III. Champ's Triathlon Training Program was an extension of the Champ's Tri My Best Triathlon hosted by a team of therapists and Vanderbilt's Pediatric Clinic, including Kelley Newman. The program aimed to increase the participants' strength, flexibility, and endurance through triathlon related activities such as running/walking, swimming, and biking. Outcomes of the program were to …

Alexithymia Symptoms Are Not Associated With Childhood Trauma Or Crhr1 Rs110402 Genotype, Emily Wiatr, Grace Sullivan, Scott Stoltenberg

Center for Brain, Biology, and Behavior: Faculty Publications

Alexithymia is associated with difficulties in emotional self-regulation, and alexithymia is specifically associated with an absence of emotional experience and cognition of emotion. Past research has indicated a potential association between alexithymia and the CRHR1 gene . Situational factors may also impact the expression of the CRHR1 gene within an individual. Berenbaum (1996) found associations between PTSD/childhood trauma and alexithymia. This study examined these associations using the Online Alexithymia Questionnaire-G2 (OAQ-G2) as well as DNA samples gathered from 657 participants at the University of Nebraska-Lincoln (72% women; 78.6% white; mean age= 20.34; standard deviation of 2.6). It was hypothesized that …

Elucidation Of The Mechanisms By Which Anesthetics Induce Blood-Brain Barrier Breakdown And Delirium In The Elderly, George A. Godsey Ii

Graduate School of Biomedical Sciences Theses and Dissertations

Delirium is a highly prevalent neuropsychiatric or neurocognitive disorder that presents a major problem to modern healthcare. Patients suffering from delirium normally have a worse prognosis, prolonged hospital stay, increased hospital cost, long-term cognitive impairment, and higher mortality rates. Many factors can predispose one to develop delirium, which makes treating this disorder a daunting task. Unfortunately, delirium is the most common psychiatric syndrome found in the hospital setting. In fact, a form of delirium known as postoperative delirium (POD) is one of the most common postoperative complications faced by elderly patients undergoing surgery.

POD is a major problem in modern …

Study Of Satisfaction Of Inpatient Discharge Based On Nurses’ Perceptions, Hong Lin

Dissertations and Theses

Patient satisfaction plays an important role in providing quality health care, and discharge satisfaction is part of overall patient satisfaction since it reveals how patients feel about their stay. In this paper, we evaluated inpatient discharge satisfaction based on nurses’ perceptions. An anonymous survey was used to evaluate how satisfied the patients were when being discharged from the acute care hospital with survey questions answered by nurses who work on medical-surgical floors. Data was collected from the questionnaires and analyzed using Excel.

Towards Wide Implementation Of Dance Therapy In Mental Health, Pin-Wen Chou

Dissertations and Theses

In recent years, Dance Movement Therapy (DMT) has been increasingly mentioned in the field of mental health counseling. Despite the progress of DMT in terms of studies showing its efficiency for various forms of mental health conditions such as depression and trauma, the implementation of DMT amongst mental health therapists is still not as widespread as other forms of therapies such as verbal and art therapies. In this project, we aim to determine the underlying causes of its low implementation by surveying a set of populations, specifically mental health patients, mental health therapists that do not specialize in dance/movement therapy, …

Physical Therapy With Adjunct Therapies In Patients With Chronic Pain And Disability Post-Motor Vehicle Accidents, Lakshmi Subramanian

Dissertations and Theses

This project is a thorough literature review of studies concerning physical therapy interventions in conjunction with adjunct treatments for patients post-motor vehicle accidents focused on the therapy’s efficacy as related to functional outcome measures. Physical therapy is frequently treatment of choice for patients after minor motor vehicle accidents. However, most patients seek concomitant therapies like acupuncture, chiropractic, epidural steroid injection, and psychological counselling. This paper seeks to gather data on the efficacy of different treatment modalities when used in conjunction with each other. Often patients are traumatised or develop anxiety about driving requiring counselling and therapy. The vast majority of …

Chronic Migraine: Role Of Cgrp Antagonists And Botox, Gabriella Hassan

Dissertations and Theses

Chronic migraine (CM) is characterized by the International Headache Society classification (ICHD-3) as headache that occurs for greater than or equal to 15 days a month, lasting 4 or more hours. For chronic migraine patients, the goal with prophylactic treatment is to prevent future attacks and reduce the migraine frequency and severity. OnabotulinumtoxinA is the most universally accepted medication for the treatment of chronic migraine; and if successful, reduces migraine frequency up to 50%. The goal of CGRP (Calcitonin-gene-related peptide) antagonists is to reduce the frequency of chronic migraines by targeting the CGRP protein that is elevated during a migraine …

Perception Of Healthcare Providers On Mirror Therapy For Stroke, Dhwani Kamlesh Doshi

Dissertations and Theses

Stroke is a very important health problem faced worldwide with high mortality and incidence. The majority of stroke survivors suffer temporary or permanent disabilities of which hemiparesis is one of the most common. Hemiparesis makes it difficult for patients to perform their activities of daily living and often they have declining quality of life. Mirror therapy (MT) is a an inexpensive, easy and safe intervention which has been proven to be very effective to improve the motor function in hemiparetic stroke. Despite this, it is not often employed. Hence, the purpose of this study was to explore the awareness and …

Digital Dentistry- The Future Of Oral Health, Vidhi Shah

Dissertations and Theses

Background and objective: In the digital world, dentistry appears to be at least a decade behind in adopting the latest technologies in comparison to consumer electronics, biomedical engineering and aeronautics. However, recently, dental professionals have experienced the evolution of the dental profession as technological growth. Digital dentistry is the future of dentistry, and it will be essential to adopt and integrate technology into practice to improve the quality of care. The new generation of digital dentistry opens the exploration of innovations and advancement in technologies which will dramatically impact and improve all of dentistry. The objective of this paper is …

The Effectiveness Of Transfer Learning Systems On Medical Images, James Boit

Masters Theses & Doctoral Dissertations

Deep neural networks have revolutionized the performances of many machine learning tasks such as medical image classification and segmentation. Current deep learning (DL) algorithms, specifically convolutional neural networks are increasingly becoming the methodological choice for most medical image analysis. However, training these deep neural networks requires high computational resources and very large amounts of labeled data which is often expensive and laborious. Meanwhile, recent studies have shown the transfer learning (TL) paradigm as an attractive choice in providing promising solutions to challenges of shortage in the availability of labeled medical images. Accordingly, TL enables us to leverage the knowledge learned …

Can The Kanban Technique Reduce Medical Errors?, Juhi Hegde

Dissertations and Theses

This study discusses common medical errors and the extent of harm caused in the United States and explores the application of the Kanban technique of Lean Management in the healthcare industry to reduce medical errors. It also describes various scenarios of how the visual scheduling/ signaling system has been incorporated for continuous process improvement in the clinical and non-clinical sectors of the industry based on several review articles. Furthermore, a survey study was performed in order to assess whether ‘Kanban Visual Management System’ utilization in healthcare has the ability to reduce medical errors. A convenience sample of healthcare providers was …

Analysis Of Delays In Processing Times In An Ophthalmology Clinic, Kai Yung Natalie Lui

Dissertations and Theses

Efficiency is an important component of any medical practice. It facilitates quality care, reduction in wait time, patient and staff satisfaction, and decreased cost. The purpose of this study was to identify bottlenecks in the current processing system in the Eye Center at Hershey Penn State Medical Center. Data was obtained about patients arriving at the clinic for ancillary tests such as visual field testing and retinal imaging. Analysis of this data revealed a statistically significant longer average length of visit for patients who received testing in comparison to those who did not. However, due to the small sample size …

Managing Chronic Pain Through Advancements In Transcranial Brain Stimulation Technology Currently Used For Depression, Ashley N. Skinner

Honors Thesis

The purpose of this thesis is to bring attention to alternatives to using analgesics or painkillers and potentially addictive opioid analgesics. Transcranial Magnetic Stimulation (TMS) has been proven successful in treating medication-resistant depression. This literature review will look at the links between pain and depression and examine adaptations to TMS coils in hopes of being able to stimulate the regions of the brain that interpret pain. By looking at current advancements in TMS, we can work towards adapting TMS to stimulate deeper regions. The final section of this thesis will examine how making these alternatives more popular will impact pain …

Design, Development And Evaluation Of Dual Drug Nanomedicine For Non-Small Cell Lung Cancer, Elham Hatami

Theses and Dissertations (ETD)

Resistance to conventional chemotherapy is a big challenge in the treatment of cancer including non-small cell lung cancer (NSCLC). A combination of natural chemo sensitizer agents with chemotherapy offers unique advantages over monotherapy alone. However, free unbound drugs, (in combination or as a single agent), lack tumor-targeted accumulation and therefore can be easily eliminated from the patient body. Moreover, some drugs are hydrophobic, and their organic solvents cause in vivo toxicity, thereby limiting their capability in clinical translation. Herein, dual loaded biocompatible and biodegradable nanoparticles (NPs) using Gemcitabine (Gem)a pyrimidine nucleoside antimetabolite and Gambogic acid (GA) (a highly hydrophobic chemo …

Analysis Of Ptv Margins For Vmat Treatment Of Rectal Cancers Utilizing Prone Bellyboard Device., Ben Armbuster

Masters Projects

Utilization of a bellyboard device reduces small bowel dose for patients receiving radiation therapy for rectal cancer. The reduction of small bowel dose with the bellyboard is even more significant in intensity modulated radiation therapy rectal treatments, as opposed to conventional 3D treatments. However, there is evidence of increased setup variation with prone bellyboard positioning, especially in pitch and roll. The purpose of this study is to determine the margin needed between the clinical target volume and the planning target volume to adequately account for these setup variations when planning volumetric modulated arc therapy rectal cases utilizing the bellyboard device. …

The Usefulness Of The Left Atrial Dilation Rate In Determining Severity Of Heart Failure, Laura B. Snyder

Senior Theses

Hypertension and vascular stiffness are two physiological conditions that strain the left ventricle (LV) and cause it to gain muscle mass. Eventually, the LV is unable to fill correctly and the patient develops Heart Failure with a preserved Ejection Fraction (HFpEF). Clinically, a patient’s left atrium (LA) area is measured as a diagnostic parameter of HFpEF severity. However, this doesn’t offer a prognosis or threshold of LA size necessitating hospitalization because of variation in patient demographics, genetics, and lifestyle which affect rates of HFpEF progression.

Since there are no medications or effective treatment options for HFpEF patients, there is a …

A Case Of Pacemaker Syndrome Mimicking A Heart Failure Exacerbation, Seline Haci, Som Aftabizadeh, Senthil Thambidorai, Karan Gupta, Ahsan Khan, Aman Patel, Kimberly Wilson, Anand Subramanian

Cardiology

No abstract provided.

Functional Blockade Of E-Selectin In Tumor-Associated Vessels Enhances Anti-Tumor Effect Of Doxorubicin In Breast Cancer, Yoshihiro Morita, Macall Leslie, Hiroyasu Kameyama, Ganesh L R Lokesh, Norihisa Ichimura, Rachel Davis, Natalie Hills, Nafis Hasan, Roy Zhang, Yuji Kondo, David G Gorenstein, David E Volk, Inna Chervoneva, Hallgeir Rui, Takemi Tanaka

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Chemotherapy is a mainstay of treatment for solid tumors. However, little is known about how therapy-induced immune cell infiltration may affect therapy response. We found substantial CD45+ immune cell density adjacent to E-selectin expressing inflamed vessels in doxorubicin (DOX)-treated residual human breast tumors. While CD45 level was significantly elevated in DOX-treated wildtype mice, it remained unchanged in DOX-treated tumors from E-selectin null mice. Similarly, intravenous administration of anti-E-selectin aptamer (ESTA) resulted in a significant reduction in CD45+ immune cell density in DOX-treated residual tumors, which coincided with a delay in tumor growth and lung metastasis in MMTV-pyMT mice. Additionally, both …

Management Of Childhood Migraine By Headache Specialist Versus Non-Headache Specialists, Kelly Valentini, Radhika Gutta, Gunjanpreet Kaur, Ahmad Farooqi, Lalitha Sivaswamy

Medical Student Research Symposium

This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of pediatric migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians. A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018. Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed …

Single Vs. Multiple Laparoscopies: Pain Status One Year Post-Hysterectomy For Chronic Pelvic Pain, Ghadear Shukr, Madeleine R. Gonte, Victoria Webber, David Eisenstein

Medical Student Research Symposium

Despite the prevalence of chronic pelvic pain (CPP)— affecting one in seven women in the U.S.— its cause is often unknown. As such, an evaluation of our current approaches to the work-up of CPP is warranted. Laparoscopy is considered a gold standard tool in the evaluation of CPP with 40% of all laparoscopies in the U.S. performed for this condition [1]. However, limited data exists portraying the clinical importance and outcomes for repeat diagnostic laparoscopies. This is a retrospective case-control study to determine the incidence of multiple laparoscopies for CPP over the past 10 years, and to compare outcomes between …

: Preoperative Patient-Centric Predictors Of Postoperative Outcomes In Patients Undergoing Arthroscopic Meniscectomy, Sreten Franovic, Noah Kuhlmann, Alexander Pietroski, Collin Schlosser, Luke Hessburg, Kelechi Okoroha, Vasilios Moutzouros, Eric Makhni

Medical Student Research Symposium

The Patient-Reported Outcomes Measurement Information System (PROMIS) is a valid and efficient means of collecting patient outcomes in patients with meniscal tears. The studies purpose was to define the minimally clinical important difference (MCID) for PROMIS domains following meniscectomy procedures. Secondary aims included determining the role of pre-operative PROMIS computer adaptive test (CAT) scores in predicting achievement of MCID following meniscectomy. Patients undergoing arthroscopic meniscectomy who completed PROMIS CAT forms for physical function (PROMIS-PF), pain interference (PROMIS-PI), and depression (PROMIS-D), from July 2017 to July 2019, at a single institution were utilized. MCID was calculated according to the distribution methodology, …

Application Of Laser Technology In The Non-Surgical Management Of Periprosthetic Joint Infection (Pji); Novel Insights From Peri-Implantitis, Kareem Giovanni Elhage, Mohamed Awad, Ahmad Hasan, Brendan Farley, Khaled Saleh

Medical Student Research Symposium

Introduction: The management of periprosthetic joint infection (PJI) is challenging, and its socio-economic impact is significant. Moreover, the incidence of MRSA and other resistant organisms are on the rise. Recently, laser technology has been incorporated into treatment protocols of dental peri-implantitis. This review explores the possibility of using laser technology to manage peri-implantitis.

Methods: This article will provide a detailed, comprehensive, and perspective review of the existing evidence of laser technology in management of dental peri-implantitis.

Results: Dental literature investigated the efficacy of several types of lasers. It was shown that diode lasers improved periodontal probing depth (PPD) and bleeding …

Impact Of Treatment Modality On Overall Survival In Localized Ductal Prostate Adenocarcinoma: A National Cancer Database Analysis, Chandler Bronkema, Sohrab Arora, Nikola Rakic, Akshay Sood, Deepansh Dalela, Jacob Keeley, Marcus Jamil, James O. Peabody, Craig G. Rogers, Mani Menon, Firas Abdollah

Medical Student Research Symposium

INTRODUCTION AND OBJECTIVE: Ductal adenocarcinoma is considered a rare histological variant of prostate adenocarcinoma (PCa). Given the rarity of this subtype, optimal treatment strategies for men with nonmetastatic ductal PCa is largely unknown. We aimed to describe the impact of surgery, radiotherapy, and systemic therapy on overall survival (OS) in men with nonmetastatic ductal PCa.

METHODS: We retrospectively selected 2209 cases of ductal PCa, diagnosed between 2004 and 2015, within the National Cancer Database (NCDB). Exclusion of metastatic patients yielded a total sample of 1993 individuals. Cox regression analysis tested the impact of treatment (surgery, radiotherapy, systemic therapy and no …

Us Guided Management Of Undifferentiated Dyspneic Patient In The Ed, Kaleigh Miller

Longitudinal Scholar's Project

Intro: Undifferentiated dyspnea can be a complicated presentation muddled by patient comorbidities and similar symptomology shared among etiologies. Some studies have shown increased mortality and length of stay in the hospital when incorrectly initially diagnosed in the ED. US has been shown more effective at differentiating these causes and improves diagnostic accuracy. This study will implement US exam upon initial exam of patient and chart time to diagnosis/treatment, length of stay in ED, length of stay in hospital admissions versus discharge rates, and 30 day mortality. ADHF and COPD/asthma patient differentiation will be the focus.

Methods: Prospective cohort study of …

The Successful Rehabilitation Of A Complicated Mva Patient: A Case Report, Mike Hansen, Eric Jonsvold, Stanley Poole, Mark Steinhauer

Physical Medicine & Rehabilitation

No abstract provided.