Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Evolution Of Acute Ischemic Stroke Treatment As Supported By Clinical Trials, Savya S. Shukla, Brian F. Baigorri Md, Roberto I. Fourzali Md, Yafell Serulle Md

Radiology

No abstract provided.

The Use Of Propranolol In The Treatment Of Posttraumatic Stress Disorder, Tana M. Peterman, Alison L. Huet, Sarah E. Drake, Jamie L. Drees, Robert D. Raiff, B. Shane Martin

Pharmacy and Wellness Review

This article examines the rising issue of post-traumatic stress disorder (PTSD) and possible treatment options. PTSD is a behavioral disorder resulting from memory formation and association with a traumatic event. A search of the published literature reveals several positive studies and case reports suggesting that propranolol, a beta adrenergic receptor antagonist, may be useful for both treatment and prevention of PTSD. Additionally, current studies are being completed in different population groups to determine the overall effectiveness and mechanism by which propranolol is able to provide relief from certain symptoms common to the disorder. This article discusses the medical evidence and …

Role Of The Pharmacist In Improving Treatment For Children With Concurrent Gastrointestinal And Autism Spectrum Disorders, Whitney R. Henry, Kaitlin A. Sanders, Jenna L. Schaffner, Leslie M. Hart, Whitney N. Detillion, Anne F. Gentry

Pharmacy and Wellness Review

Over the last several years, a noteworthy association between gastrointestinal (GI) disorders and autism spectrum disorders (ASD) has been documented, although no large population-based studies exist. GI disorders in ASD children may stem from the underlying behavioral, communication, sensory or neurological issues intrinsic to the autistic disorder itself; therefore, the incorporation of alternative therapies, including behavioral modification, may be compelling treatment additions to the GI care traditionally recommended in children. To improve GI symptoms and quality of life in ASD children, a multidisciplinary approach is optimal, with pharmacists playing an active role in determining appropriate pharmacotherapy. Although there is a …

Options For Breast Cancer Prevention In High-Risk Patients, Ashley M. Overy, Lacey A. Shumate, Sarah M. Webb, Ashley E. Lehnert, Monica A. Weisenberger, Whitney N. Detillion, Andrew M. Roecker

Pharmacy and Wellness Review

Breast cancer is the most frequently diagnosed non-skin cancer in women, and one in eight women will develop breast cancer within their Iifetimes. Unfortunately, the strongest risk factors for breast cancer (i.e. age, family history, hormonal factors) are not easily modified. There is some evidence that chemopreventative drugs may be able to prevent breast cancer in high-risk patients. Tamoxifen and raloxifene have been shown to reduce the risk of breast cancer in high-risk women but may be associated with several serious adverse events. Clinical trials are currently in progress to determine if aromatase inhibitors are a viable alternative for breast …

Image Restoration Using Automatic Damaged Regions Detection And Machine Learning-Based Inpainting Technique, Chloe Martin-King

Computational and Data Sciences (PhD) Dissertations

In this dissertation we propose two novel image restoration schemes. The first pertains to automatic detection of damaged regions in old photographs and digital images of cracked paintings. In cases when inpainting mask generation cannot be completely automatic, our detection algorithm facilitates precise mask creation, particularly useful for images containing damage that is tedious to annotate or difficult to geometrically define. The main contribution of this dissertation is the development and utilization of a new inpainting technique, region hiding, to repair a single image by training a convolutional neural network on various transformations of that image. Region hiding is also …

Cellular Corrosion Of Cocrmo Total Knee Implants: Understanding Underlying Mechanisms Through Retrieval Analysis And Simulated Inflammatory Conditions, Griffin Heise

Theses and Dissertations (ETD)

Introduction. Total joint arthroplasty is considered one of the most beneficial aspects of modern orthopedic surgery. Due to the increase in population, obesity rates, and medical advances, total joint replacements have become more commonplace in the United States. Recently, a unique type of damage has been investigated in cobalt-chrome (CoCr) implants that remains poorly understood and highly controversial. Originally, it was believed that this damage type was caused by inflammatory cells directly attacking the metal surface, leading to damage of the oxide layer. However, damage caused by electrocautery tools has shown identical characteristics, leading some to believe this is the …

Validation Testing Of A Synthetic Spine And Upgraded Protocol For A Biomechanical Evaluation Of A Lumbar Spinal Orthosis, Daniel Hoyer

Theses and Dissertations (ETD)

Low back pain (LBP) is highly prevalent in all walks of life. Standard conservative treatment methods may work for some, but others go on to have spinal injections, opioids, or surgical procedures to alleviate pain. The Distractive and Mobility-Enabling Orthosis (DMO) was developed to meet the need for a conservative, drug-free treatment method. In this research, the low back support test protocol for evaluating DMO success was upgraded with a new synthetic lumbar spine model. The latest generation of the DMO project was then evaluated using the new system in a laboratory setting and on a pilot physical therapy patient.First, …

Ulnar Collateral Ligament Reconstruction With Traditional Docking Compared To Novel Surgical Techniques, Kayley D. Guy, Brendon P. Mcdermott, Kaitlin Gallagher, Tyrone Washington

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Ulnar Collateral Ligament Reconstruction (UCLR) is a surgical procedure on one of the main ligaments that provides normal stability for the elbow joint against excessive valgus stress. Damage to this ligament is common in athletes performing overhead throwing activities, primarily baseball players, due to excessive valgus stress during the throwing motion. The most common form of treatment for this type of injury is reconstructive surgery of the ligament, especially if athletes wish to return to sport participation. This type of surgery is extremely invasive and requires extensive post-operative rehabilitation in order to facilitate return to play. To date, many …

A Multiple Comparison Study That Test The Validity Of Varian’S Rapidplan For Prostate Cancer Cases Based On Models Built From Outside Institution., La'rone Reid

Masters Projects

In radiation oncology treatment planning techniques and outcomes can differ from one institution to the next. With knowledge-based planning (KBP) the experience of larger institutions could help smaller institutions who may not have the opportunity to encounter certain types of cancer cases. However, this scenario is only true if the KBP software is consistent with its algorithmic output. Varian's KBP software called Rapid Plan (RP) will be analyzed for algorithmic consistency. This study investigates the validity and consistency of RP models from two different radiation oncology institutions, and compare data to determine RP quality, and consistency when planning prostate cancer …

Identification And Molecular Analysis Of Dna In Exosomes, Jena Tavormina

Dissertations and Theses (Open Access)

Exosomes are heterogeneous nanoparticles 50-150nm in diameter. Exosomes contain many functional cargo components, such as protein, DNA, and RNA. While protein and RNA exosome content has been extensively studied, very little work has been done to characterize exosomal DNA. Here, we demonstrate that exosomal DNA is heterogeneous and its packaging into exosomes is dependent on the cell of origin. Furthermore, through a rigorous assessment of various isolation methods, we identify Size Exclusion Chromatography (SEC) as the best method for the isolation of exosomal DNA for downstream applications. Additionally, we evaluate the methylation status of exosomal DNA and demonstrate that exosomal …

Standardized Reporting In Pancreatic Protocol Ct: Implementation Across 3 Community Hospitals, Jacob L. Miller, Kevin Carr, James Banks, Nisha Mani

Radiology

No abstract provided.

Improving Team-Based Decision Making Using Data Analytics And Informatics: Protocol For A Collaborative Decision Support Design, Don Roosan, Anandi Law, Mazharul Karim, Moom Roosan

Pharmacy Faculty Articles and Research

Background: According to the September 2015 Institute of Medicine report, Improving Diagnosis in Health Care, each of us is likely to experience one diagnostic error in our lifetime, often with devastating consequences. Traditionally, diagnostic decision making has been the sole responsibility of an individual clinician. However, diagnosis involves an interaction among interprofessional team members with different training, skills, cultures, knowledge, and backgrounds. Moreover, diagnostic error is prevalent in the interruption-prone environment, such as the emergency department, where the loss of information may hinder a correct diagnosis.

Objective: The overall purpose of this protocol is to improve team-based diagnostic …

Rapidly Recurrent Basilar Artery Thrombosis Treated With Emergent Mechanical Thrombectomies And Stenting, Mark Cohen, Amna Imran, Ankur Garg

Neurology

Acute basilar artery thrombosis (BAT) is a life-threatening condition that can be treated by emergent mechanical thrombectomy (EMT). Recurrent acute BAT is a rare phenomenon. Here we describe a case of rapid recurrent acute BAT that was treated each time by EMT and finally by emergent basilar artery stenting with good outcome

Creutzfeldt Jakob Disease: Progressive Neurological Decline, Christine Fayad Md, Scott J. Anderson, H. Alex Akhondi Md

Internal Medicine

No abstract provided.

Availability Of Pain Medications For Npo Patients, Anna Augustin Do, Kyle Borodunovich Do, Sean Quinonez Do, Furqan Haq, My Myers Md

Family Medicine

In recent years, the opioid epidemic has been a key catalyst in changing the medical standards for treating both acute and chronic pain. Instead of relying heavily on narcotics for pain management, practitioners are not encouraged to adapt a non-pharmacologic, non-opioid approach to analgesia. While many guidelines have been set to standardize outpatient pain management, the rules surrounding inpatient analgesia are limited or lacking.

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Bout Vs. Non-Bout Physical Activity Minutes As Predictors Of Waist Circumference In College Students, Valerie Olijar, Matt Scott, Brooke Ferraro, Elizabeth Edwards, Trent Hargens

Showcase of Graduate Student Scholarship and Creative Activities

Physical activity recommendations to reduce all cause mortality consist of 10 minute bouts of a moderate-vigorous intensity, for a total of 150 min/week. This study investigates if those 10 minute bouts really matter. We found that step count was the best predictor of waist circumference. This finding supports many new technological devices that use step counts as a form of measuring activity. It provides support that the more steps you take, the likelier you will have a small waist.

Resistant Hypertension: Renal Denervation Or Pharmacovigilance? Insights From A Renal Denervation Screening Program, Marcin Ojrzanowski, Jarosław D Kasprzak, Jan Zbigniew Peruga, Małgorzata Kurpesa, Łukasz Jankowski, Sonu Sahni, Michał Plewka

Touro College of Osteopathic Medicine (New York) Publications and Research

BACKGROUND: With emerging new therapeutic concepts including renal denervation (RDN), there is a renewed interest in resistant hypertension (ResH). Among patients suspected of having ResH, a definitive diagnosis needs to be established.

OBJECTIVES: This study presents observations from a standardized single-center screening program for RDN candidates, including medical therapy modification and reassessment.

MATERIAL AND METHODS: All patients referred to our center for RDN underwent a standardized screening protocol. Candidates were recruited from among patients receiving no less than 3 antihypertensive drugs, including diuretics with office blood pressure (BP) >140/90 mm Hg. The assessment included 2 measurements of BP and ambulatory …

Safe And Effective Use Of A Hands-Free Intracorporeal Retractor For Suture-Based Liver Retraction During Minimally Invasive Bariatric Procedures: Results Of A Large Case Series, Roger De La Torre, Matthew Sappington, Tom Smith, Jeremy Bryner, David Mantilla, J Stephen Scott

General Surgery

Background

Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate operative view and working space. Conventional approaches utilize a mechanical retractor that requires a dedicated incision, may cause liver damage, and often requires an assistant. This study evaluated the safety and efficacy of hands-free intracorporeal retractors in a large series of subjects undergoing laparoscopic bariatric surgery. This method eliminates the need for a subxiphoid incision, enables full surgeon autonomy, and allows for adjustments throughout the procedure.

Methods

Retrospective chart review identified all subjects at a single hospital undergoing bariatric surgery between September 2017-March 2019 …

Creating An Interprofessional Collaborative Research Opportunity For Physical And Occupational Therapy Students, Anne Fleischer, Mary Insana Fisher, Shirley P. O'Brien

Physical Therapy Faculty Publications

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional …

Artificial Intelligence And The Challenge For Rural Medicine, James Denvir

Marshall Journal of Medicine

Recent advances in artificial intelligence, machine learning, and deep learning are beginning to have an impact on everyday experiences, from natural language processing used in automated telephone call centers to semi-autonomous vehicles. These techniques have also been applied to medical care. In this editorial we discuss applications of AI to medicine and argue for a proactive approach to include rural medicine in this paradigm shift.

A Novel Polyelectrolyte Multilayer Nanofilm-Based Synthetic Bioresorbable Antimicrobial Matrix Accelerated Healing Of Chronic Wounds In A Prospective Clinical Evaluation, Sarah Waterman Manning Md, David A. Humphrey, Michael J. Schurr, Eric C. Crawford, Gaurav Pranami, William Shillinglaw, Lorinda K. Baker, Michael J. Schurr

General Surgery

No abstract provided.

Double Pylorus: Case Report Of Atypical Presentation, Christopher Lozano Orpiano Do, Gurjeet Kang Do, Michael Quinn Do, Lakshminarasimhan Venu Md, Joseph Staffetti Md

Gastroenterology

Introduction: Double pylorus is a rare endoscopic finding that has been reported in 0.001% to 0.4% of upper gastrointestinal endoscopies, consisting of a gastroduodenal fistula extending from the prepyloric gastric antrum to the duodenal bulb through an accessory channel. In the majority of cases, it is a complication when peptic ulcers erode and create a fistula between the duodenal bulb and the distal stomach. It usually presents on the lessor curvature of the gastric antrum and on a superior wall of the duodenal bulb. It is commonly an endoscopic finding, since clinical presentation is similar to other peptic diseases.

Case …

Size Matters: A Case Of Recurrent Proximal Esophageal Stenoses Treated With A Biliary Self Expanding Metal Stent (Sems), Sahityan Viswanathan, Timothy Dobin, Long T. Hoang

Gastroenterology

Esophageal stenosis after radiotherapy occurs in up to 15% of patients within three months of treatment. Endoscopic dilation remains the standard of care for cervical esophageal stenosis with refractory cases requiring stenting. Proximal stenosis poses a challenge as standard esophageal stents can cause cervicalgia and globus sensation due to their size and expansive force. We report on the usage of a biliary SEMS for a severe-recurrent stricture at the level of the proximal esophageal sphincter.

Not Just A Cyst: A Rare Presentation Of Luq Pain, Richard Henriquez, Isin Y. Comba Md, Sundeep Kumar Md, Khawaja Arsalan Bashir, Maria Wallis-Crespo Md, Lakhinder Bhatia Md

Gastroenterology

Lymphangioma is a benign congenital malformation of the lymphatic system that is relatively common in juvenile population. Rarely, it can be seen in adults and majority of the cases are reported in the head and neck region (70-75%). Typically, these malformations are asymptomatic. In this report, we present a rare case of splenic lymphangioma presenting with severe, intractable abdominal pain.

Iron Pill-Induced Gastropathy In Elderly Patients: A Case Series Report, Isin Y. Comba Md, Richard Henriquez, Sundeep Kumar, Ruthvik Srinvasa-Murthy, Maria Wallis-Crespo, Lakhinder Bhatia Md, Joshua Shultz

Gastroenterology

Introduction: Iron deficiency anemia is a global health problem with an estimated two billion cases worldwide. Oral iron supplementation is considered the first line treatment. However, recent studies favor the use of short-term IV iron especially in patients with drug tolerance and efficacy concerns. In this report, we present three cases of iron pill gastropathy in patient's whose clinical courses were complicated by gastric erosion, ulcer or gastrointestinal (GI) bleeding. All of our patients had a history of iron deficiency anemia and were being treated with oral ferrous sulfate.

Case Description/Methods: The first case involved a 72-year-old male with multiple …

A Unique Presentation Of Scurvy In The Modern Era, Anita Bhagavathula Do, Joanna Linsteadt Md, Sonam Jaggi Md

Internal Medicine

No abstract provided.

Point-Of-Care Ultrasound For The Pediatric Limp, Lucas Friedman Md

Pediatrics

Objectives

• Describe the technique and use of POCUS in the Limping Child
• Describe the use of POCUS in the diagnosis and treatment of Septic arthritis

Endoscopic Management Of A Surgical Clip Found Within The Common Bile Duct Following Remotely Performed Laparoscopic Cholecystectomy, Sheila Rastegari Do, Curtis Brewer Do, Long T. Hoang

Gastroenterology

Minimally invasive surgery with surgical clip placement has become the gold standard for management of cholecystitis and biliary colic due to its favorable safety profile and low rate of complications. Though generally safe, surgical clips may cause complications days to years after the cholecystectomy by migrating into the common bile duct and serving as a nidus for stone formation. To date, very few cases of this have been reported. While uncommon, this possibility should be considered in the differential diagnosis for choledocholithiasis with or without cholangitis post laparoscopic cholecystectomy.

Spontaneous Fungal Peritonitis: A Rare Complication Of Ascites Secondary To Right Heart Failure: A Case Report, Saaah Siddiqui Md, Dharti R. Patel Md, Arshad M. Iqbal Md, Ateeq Mubarik Md, Salman Muddassir Md, Fahad Zafar Md

Internal Medicine

•Spontaneous fungal peritonitis (SFP) is an infection defined as a neutrophil count (> 250 cells/mL) in the ascitic fluid with the evidence of positive fungal culture (1) while excluding other intra-abdominal infections. SFP is not as common as spontaneous bacterial peritonitis and has higher mortality rates due to late recognition and difficulty in differentiation between SFP and SBP. (1,2). The common risk factors that have shown to increase the mortality for SFP include hepatorenal syndrome, patient on SBP prophylaxis, elevated APACHE II scores on admission, and elevated lactate levels (2,3). Candida albicans and Candida glabrata are the two …