Diagnosis Commons^™

Rapid Analysis Of N-Nitrosamines In Urine Using Ultra High-Pressure Liquid Chromatography-Mass Spectrometry, S. Shinde, K. D. Croft, J. M. Hodgson, C. P. Bondonno

Research outputs 2022 to 2026

N-Nitrosamines, carcinogenic compounds present in dietary and environmental sources and formed endogenously, are believed to be linked with the presence of nitrate and nitrite, both within dietary sources and after intake. To fully evaluate this potential threat to human health, an accurate analytical method to measure N-nitrosamines in biological matrices is necessary. We report a simple, fast, selective mass spectrometry method to detect N-nitrosamines in human urine. Analysis of seven N-nitrosamines, N-nitrosodimethylamine (NDMA), N-nitrosomethylethylamine (NMEA), N-nitrosodiethylamine (NDEA), N-nitrosopiperdine (NPIP), N-nitrosopyrrolidine (NPYR), N-nitrosodi-N-propylamine (NDPA) and N-nitrosodi-N-butylamine (NDBA) in urine was quantitated using Ultra High-Pressure Liquid Chromatography-tandem Mass spectrometry (UHPLC-MS/MS). A Sorbent …

Focused Assessment With Sonography Exams Vs Ct Scan, Anne Kresge, Charlotte Mueller, Briar Tures

Physician Assistant Capstones, 2020-current

Blunt trauma is a common reason patients present to the emergency department. Providers must evaluate these patients quickly to get them the correct treatment, especially for intra-abdominal bleeding. Focused assessment with sonography for trauma (FAST) exams are growing in use to evaluate trauma patients for free fluid in the abdomen. To be valuable to emergency providers, it must be known how FAST exams compare to the gold standard evaluation, computed tomography (CT) scans. Searches were done on Pubmed and Scopus databases using terms “focused assessment with sonography for trauma” and “FAST exam CT blunt abdominal trauma.” Limits were added to …

Paper-Based Ratiometric Sensor Array For Pathogenic Bacterial Species Identification, Aayushi Laliwala

Theses & Dissertations

Bacterial infections are the leading cause of mortality worldwide due to the lack of accurate diagnosis of the pathogens causing infections. Currently, microbiological and molecular techniques are used to identify pathogenic bacteria. However, these techniques have limitations as they are time-consuming, cost-inefficient, and require trained personnel. Therefore, timely and precise identification of pathogenic bacteria is crucial for public safety. Our lab previously synthesized a fluorescent sensor array (3-hydroxyflavone derivatives) encapsulated in hyaluronic acid-based nanoparticles to identify bacterial species and recognize their Gram status. Though promising, this technique was relatively time-consuming and required high sample and volumes.

To overcome these limitations, …

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

Variability In Provider Assessment Of Sepsis And Potential Of Host Response Technology To Address This Dilemma—Results Of An Online Delphi Study, Chadd K. Kraus, Hollis R. O’Neal, Nathan A. Ledeboer, Todd W. Rice, Wesley H. Self, Richard E. Rothman

School of Medicine Faculty Publications

Potentially septic patients have a huge clinical and economic impact on hospitals and often present to the emergency department (ED) with undifferentiated symptoms. The triage of these patients is complex and has historically relied heavily upon provider judgment. This study aims to evaluate the consistency of provider judgment and the potential of a new host response sepsis test to aid in the triage process. A modified Delphi study involving 26 participants from multiple specialties was conducted to evaluate provider agreement about sepsis risk and to test proposed actions based on the results of a sepsis test. The participants considered case …

Raman Spectroscopic Analysis Of Human Serum Samples Of Convalescing Covid-19 Positive Patients, Hugh Byrne, Naomi Jackson, Jaythoon Hassan

Articles

Rapid screening, detection and monitoring of viral infection is of critical importance, as exemplified by the rapid spread of SARS-CoV-2, leading to the worldwide pandemic of COVID-19. This is equally the case for the stages of patient convalescence as for the initial stages of infection, to understand the medium and long terms effects, as well as the efficacy of therapeutic interventions. Optical spectroscopic techniques potentially offer an alternative to currently employed techniques of screening for the presence, or the response to infection. In this study, the ability of Raman spectroscopy to distinguish between samples of the serum of convalescent COVID-19 …

Validity And Test-Retest Reliability Of A Digital Dynamic Visual Acuity Test Of Vestibular Function, Lydia F. Grunstra, Courtney D. Hall, Kara D. Stressman

Undergraduate Honors Theses

The vestibular system senses head motion and facilitates gaze stabilization, allowing for clear vision during movement. The vestibulo-ocular reflex (VOR) causes the eyes to move opposite head motion, thus maintaining focus on a target. Consequently, uncompensated loss of vestibular function leads to reduced VOR function resulting in dizziness, nausea, and visual disturbance. Different testing methods have been developed to measure VOR loss. These tests generally require bulky, expensive equipment, and must be performed by a trained examiner. A newly developed digital form of the dynamic visual acuity (DVA) test requires less equipment, is cost-effective, and may be performed at home …

Temporal Artery Pseudoaneurysm In A Pediatric Patient, Gowri Gowda, Donald Mendoza, Amanda Tullos, Jessica Zagory, Malachi Sheahan

School of Medicine Faculty Publications

Superficial temporal artery pseudoaneurysms are an uncommon vascular pathology that can present after head or facial trauma. Furthermore, they are rarely reported in the pediatric population. Ultrasound can be a useful tool in the diagnosis because it is easily accessible and can be rapidly acquired. We report a case that demonstrates the utility of ultrasound in the diagnosis of a superficial temporal artery pseudoaneurysm.

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Using Digital Assessment Technology To Detect Neuropsychological Problems In Primary Care Settings, David J Libon, Emily Frances Matusz, Stephanie Cosentino, Catherine C Price, Rod Swenson, Meagan Vermeulen, Terrie Beth Ginsberg, Adaora Obiageli Okoli-Umeweni, Leonard Powell, Robert Nagele, Sean Tobyne, Joyce Rios Gomes-Osman, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Screening for neurocognitive impairment and psychological distress in ambulatory primary and specialty care medical settings is an increasing necessity. The Core Cognitive Evaluation™ (CCE) is administered/scored using an iPad, requires approximately 8 min, assesses 3- word free recall and clock drawing to command and copy, asks questions about lifestyle and health, and queries for psychological distress. This information is linked with patients' self- reported concerns about memory and their cardiovascular risks.

METHODS: A total of 199 ambulatory patients were screened with the CCE as part of their routine medical care. The CCE provides several summary indices, and scores on …

Left Juxtaposition Of The Right Atrial Appendage: Pitfalls In Diagnosis, Kanya Singhapakdi, Wesam Sourour, Thomas Kimball

School of Medicine Faculty Publications

Several congenital anomalies of the right atrial appendage (RAA) have been described including aneurysm, herniation (in association with a pericardial defect), and left juxtaposition. The left juxtaposition of the RAA (LJRAA), first described by Birmingham in 1893 and subsequently introduced by Dixon in 1954, is usually associated with complex cardiac malformations such as obstruction of the left ventricular outflow tract. In this case report, we will describe an unusual variant of LJRAA in the absence of any other cardiac defects, which was initially misinterpreted as an aortic dissection. The correct diagnosis was made after careful reinterpretation and the use of …

Tachycardia Therapy Outcomes Of Ischemic Versus Nonischemic Cardiomyopathy On Cardiac Resynchronization Therapy: A Propensity Score-Matched Analysis, Jahanzeb Malik, Muhammad Awais, Muhammad Shabbir, Amer Rauf, Shehzad Zaffar, Azmat Hayat, Amin Mehmoodi

Journal of Community Hospital Internal Medicine Perspectives

Objective This investigation aimed to investigate differences between dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) patients treated with cardiac resynchronization therapy with defibrillator (CRT-D) for tachycardia therapy-related outcomes as well as mortality during follow-up of at least 1 year. Methods Seventy-eight patients with DCM (n=42) and ICM (n=36) with implantation or upgradation to CRT-D were included in this study and analyzed for incidence of non-sustained ventricular tachycardia (NSVT), non-sustained ventricular fibrillation (NSVF), defibrillator therapies, anti-tachycardia pacing (ATP), and mortality. Results DCM was the underlying etiology in 42 (53.84%) and ICM in 36 (46.15%). Time to first therapy was numerically longer …

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

Sarcopenic Obesity, Pathogenesis, And Treatment With A Focus On Exercise And Protein Intake, Yasemin Karaağaç

Journal of Mind and Medical Sciences

Sarcopenic obesity involves the co-occurrence of sarcopenia and obesity, yields more health risks than either condition alone, thus requiring prevention and treatment for healthy aging. In this review, the literature on the diagnosis of sarcopenic obesity, the mechanisms of its pathogenesis and treatment with emphasis on exercise and dietary protein were revised. Changes in body composition and sex hormones with age, myocellular mechanisms, inflammation, oxidative stress, physical inactivity, and insufficient protein intake are the main factors associated with the pathogenesis of sarcopenic obesity. Treatment targets weight loss while preserving muscle mass and function. Promising approaches involve high-protein and low-calorie diets …

A Rare Case Of Tricuspid Atresia Absent Pulmonary Valve Diagnosed On Fetal Echocardiography, Wesam Sourour, Shannon K. Powell

School of Medicine Faculty Publications

• TA absent PV is a rare congenital heart anomaly. • TA absent PV is associated with a poor prognosis. • TA absent PV can be successfully diagnosed on fetal echocardiography.

A Novel, Minimally Invasive, Paper-Based Biomarker Assay For Molecular Diagnosis Of Preeclampsia, Tomi Taiwo

Harrisburg University Research Symposium: Highlighting Research, Innovation, & Creativity

Preeclampsia is a severe pregnancy condition marked by high blood pressure and proteinuria that can strike at any point throughout pregnancy or immediately after birth. Although the exact cause of this disease is unknown, there are several symptoms associated. The goal of this study is focused on the evaluation of biomarker-based assays for molecular diagnosis of the condition in a sensitive and timely manner. This project involved the use of an immunoassay, fabricated serum samples, and a paper-based assay to assess the strength of the presence of the placental growth factor (PlGF). This was done to facilitate a proof-of-concept mechanism …

Left Pulmonary Artery Occlusion Following Device Closure Of Patent Ductus Arteriosus In Premature Infants, Jesus C. Jaile, Ernest Siwik, Sergio Bartakian

School of Medicine Faculty Publications

Background: Device closure of a patent ductus arteriosus (PDA) is rapidly evolving, with the Amplatzer Piccolo Occluder (Abbott) receiving US Food and Drug Administration approval and becoming the first device approved for PDA closure in patients ≥700 g. We report on the first known cases of complete left pulmonary artery (LPA) occlusion following Piccolo closure of a PDA in premature infants. Methods: Retrospective chart analysis of PDA closures. Results: We have performed over 50 cases of Piccolo device closure of the PDA in preterm neonates in the past 2 years, with these 2 cases representing our only complications (4%). This …

Unusual Inflammatory Presentation For Locally Advanced Papillary Thyroid Carcinoma, Ana I. Vargas, Samuel K. Snyder

Research Symposium

Background: Thyroid cancer usually presents as a thyroid nodule. If the history implies rapid growth of the nodule, new onset hoarseness or presence of ipsilateral cervical lymphadenopathy then it should raise concern for malignancy. Deep neck infection/inflammation has rarely been reported as initial presentation and these patients are potentially misdiagnosed.

Case Presentation: We present a 56-year-old male who comes to clinic for evaluation of left neck nodule. He started two weeks prior with sudden neck swelling associated with erythema and pain in his lower neck that caused choking sensation and swallowing discomfort, he was prescribed Bactrim and prednisone with improvement …

Using Cartesian Coordinate Systems To Create, Classify, And Retrieve Biomedical Time-Series: Applications To 24-Hour Ambulatory Blood Pressure Monitoring, Antonio Garcia, Gladys E. Maestre, John Blangero, Jesus D. Melgarejo, Julio Facelli

Research Symposium

Background: Ambulatory Blood Pressure Measurement (ABPM) allows physicians to monitor blood pressure variability under everyday living conditions and predicts clinical outcomes better than conventional blood-pressure measurement. ABPM can demonstrate mean arterial pressure (MAP) behavior over 24 hours relevant to clinical practice, such as nocturnal hypertension or increased blood pressure variability. We hypothesized that individuals with the same cardiovascular health status would have the same MAP signal (MAPs) waveform.

Methods: This study reutilizes a data subset from the IDACO Consortium to create 24-hour MAPs. We assigned all the MAPs to data matrix X, performed principal components analysis (PCA) to X, and …

Pca-Clf: A Classifier Of Prostate Cancer Patients Into Patients With Indolent And Aggressive Tumors Using Machine Learning, Yashwanth Karthik Kumar Mamidi, Tarun Karthik Kumar Mamidi, Md Wasi Ul Kabir, Jiande Wu, Md Tamjidul Hoque, Chindo Hicks

School of Medicine Faculty Publications

A critical unmet medical need in prostate cancer (PCa) clinical management centers around distinguishing indolent from aggressive tumors. Traditionally, Gleason grading has been utilized for this purpose. However, tumor classification using Gleason Grade 7 is often ambiguous, as the clinical behavior of these tumors follows a variable clinical course. This study aimed to investigate the application of machine learning techniques (ML) to classify patients into indolent and aggressive PCas. We used gene expression data from The Cancer Genome Atlas and compared gene expression levels between indolent and aggressive tumors to identify features for developing and validating a range of ML …

Ciliochoroidal Melanoma Masquerading As A Conjunctival Nevus, Samantha Pastore, Konica Singla, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

The Role Of Molecular Thyroseq V3 Testing For Diagnosis And Management Of Indeterminate Thyroid Nodules., Ruth Delahunty

International Undergraduate Journal of Health Sciences

Worldwide, thyroid cancer is the 8^th most common malignancy (3^rd most common in women) and in recent years, there has been increased incidence of thyroid cancer worldwide. There is currently said to be a of thyroid nodules as of 2022. When it comes to the management of indeterminate thyroid nodules, clinical decision making can be challenging.

Thyroseq V3 testing may be used to determine the percentage probability of a thyroid nodule of being either malignant or benign, through a complex algorithm with next generation sequencing techniques, currently testing is done in the University of Pittsburgh and therefore is …

Peripheral Arterial Disease And Complications Of Total Knee Arthroplasty: Indications For Advanced Vascular Imaging And Minimally Invasive Soft Tissue Coverage Procedures, Kristopher Katira, Antony Martin, Anna Garbuzov, James Ferrer, Brian Chuong, Ross Parkerson, George Chimento

School of Medicine Faculty Publications

Soft tissue coverage of knee wounds can be challenging, in particular in the setting of peripheral arterial disease and knee arthroplasty complications. Options for soft-tissue coverage range from conservative wound care to invasive pedicled and free flaps. Unlike traditional wound coverage problems in plastic surgery patients, arthroplasty coverage decisions oblige surgeons to take into account the possibility of secondary orthopedic procedures. The two cases presented in this manuscript demonstrate the importance of vascular imaging, in particular angiography. In both cases, the workhorse medial gastrocnemius flap harvest could have resulted in critical limb ischemia. When secondary orthopedic revision is required at …

Demarcating Psychopathologies: Nosology, Validity, And The Taxonomic Problem In Psychiatric Medicine, Julia Zentz Kolak

Dissertations, Theses, and Capstone Projects

In this dissertation, I argue that the discussion surrounding the role of values in the conceptualization of mental disorders is reproduced in critical debates surrounding the issue of reliability and validity in a psychiatric nosology. In so doing, I oppose the conventional separation of the demarcation problem and the crisis of validity in psychiatric classification, arguing instead that they are inextricably linked. After drawing out the intersection between these literatures in the conceptual history of the DSM and its much-maligned transition to an etiologically neutral taxonomy of mental disorders, I consider Carl Hempel’s proposed conciliation between descriptive and theoretical systematization …

Unknown Rectal Lesions: A Case Of Severe Proctitis Secondary To Mpox In The Setting Of Concomitant Hiv, Syphilis, Hsv, And Chlamydia, Nicole Robertson Mph, James Crosby Do, Cynthia R. Young Md, Msc, Anne E. Sayers Md, Nicholas J. Van Sickles Md

ePublications of Emerging Medical Research Scholars

Introduction:

Mpox emerged as a public health crisis with limited research describing co-occurring HIV and sexually transmitted infections (STIs). We present a case of severe proctitis secondary to Mpox with concomitant HIV (Human Immunodeficiency Virus), syphilis, HSV (Herpes Simplex Virus), and chlamydia and review presentation, diagnosis, treatment, and prevention of Mpox with concurrent STIs.

Case Presentation:

34-year-old male living with HIV (LWH) presenting with worsening rectal pain, multiple anal papules, and fever. His laboratory workup revealed simultaneous positive results for orthopoxvirus, chlamydia, and HSV-1 PCR. We initiated tecovirimat due to rectal involvement and uncontrolled pain. He subsequently developed lesions on …

Understanding The Factors Associated With Us Dermatology Resident Trainees’ Diagnostic Confidence And Skill For Skin Of Color Pathology, Alissa Jeanfreau, Kaylin Beiter, Deborah Hilton

School of Medicine Faculty Publications

Background: Inequities in dermatologic health outcomes translate to worsened clinical outcomes for minority groups. For example, despite a lower incidence of skin cancer overall, African Americans are diagnosed at later stages with greater degrees of lymph node involvement. This has been shown to lead to disproportionate mortality when compared to lighter skinned individuals. Medical education materials contain a significantly lower percentage of skin of color (SOC) images than of lighter skin and research has indicated lower diagnostic accuracy of dermatologic conditions in darker skin by U.S. medical students. The objective of this study was to explore U.S. resident dermatologists’ ability …

Outpatient Sexually Transmitted Infection Testing And Treatment Patterns In The United States: A Real-World Database Study, Rebecca Lillis, Louis Kuritzky, Zune Huynh, Rodney Arcenas, Avneet Hansra, Roma Shah, Baiyu Yang, Stephanie N. Taylor

School of Medicine Faculty Publications

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common notifiable sexually transmitted infections (STIs) in the United States. Because symptoms of these infections often overlap with other urogenital infections, misdiagnosis and incorrect treatment can occur unless appropriate STI diagnostic testing is performed in clinical settings. The objective of this study was to describe STI diagnostic testing and antimicrobial treatment patterns and trends among adolescent and adult men and women with lower genitourinary tract symptoms (LGUTS). Methods: We analyzed insurance claims data from the IBM® MarketScan® Research Databases. Patients included were between 14 and 64 years old with …

Determination Of Shigella Spp. Via Label-Free Sers Spectra Coupled With Deep Learning, Jia-Wei Tang, Jing-Wen Lyu, Jin-Xin Lai, Xue-Di Zhang, Yang-Guang Du, Xin-Qiang Zhang, Yu-Dong Zhang, Bin Gu, Xiao Zhang, Bing Gu, Liang Wang

Research outputs 2022 to 2026

Accurate discrimination of Shigella spp. sits in the core of shigellosis prevention and control. As a label-free method, surface enhanced Raman spectroscopy (SERS) is being intensively investigated for bacterial diagnostics. In this study, we developed a novel method for rapid and accurate discrimination of Shigella spp. via label-free SERS coupling with multiscale deep-learning method. In particular, SERS spectral deconvolution was used to generate unique barcodes, revealing subtle differences in molecular composition between Shigella spp. Four supervised learning models based on Random Forest (RF), Support Vector Machine (SVM), Convolutional Neural Network (CNN), and One-Dimensional Multi-Scale CNN (1DMSCNN) were constructed and assessed …

Reasoning The Voice: Toward A Diagnostic And Prescriptive Technique In The Teaching Of Singing, Carlos E. Santelli

LSU Doctoral Dissertations

Voice pedagogy literature often draws a parallel between a doctor’s ability to diagnose illness and prescribe treatment, and a voice teacher’s ability to identify vocal obstacles and design solutions. The core of these parallel procedures lies in an ability to utilize critical reasoning skills within highly specific contexts. Medical literature describes this as “clinical reasoning” and has studied it as a learned process. Voice pedagogy literature has traditionally described this as an innate process which is solely developed through experience. This document broadly examines the ways in which medical literature has broken down clinical reasoning into specific cognitive processes and …