Therapeutics Commons^™

Development Of A Durable And Low-Dose Universal Vaccine Against Swine Influenza A Virus, Erika Petro-Turnquist

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Swine Influenza A Virus (IAV-S) imposes a significant burden on the pork industry and poses a great threat to public health due to its zoonotic potential. Susceptibility to human, avian, and swine influenza make pigs the ultimate mixing vessels for reassorted influenza A virus strains. Current vaccination strategies induce short-lived and strain-specific responses against IAV-S. Further, the substantial genetic diversity of IAV-S necessitates consistent revaccination and updating of commercial vaccines. Computational platforms have recently emerged as a promising strategy to develop new-age vaccines against infectious diseases in livestock animals. Here, we describe a computationally derived set of vaccine immunogens, called …

The Effects Of Transcutaneous Electrical Nerve Stimulation On Pain And Function In Patients With Knee Osteoarthritis: A Critically Appraised Topic, P. Drake Short, Rileigh T. Ricken, Jennifer L. Volberding

Internet Journal of Allied Health Sciences and Practice

Purpose: Knee osteoarthritis (OA) is a common condition that impacts upwards of 40% of patients over the age of 70, and transcutaneous electrical stimulation (TENS) is a common treatment protocol. To date, there is no consensus on the effectiveness of TENS as a modality for knee OA. Thus, this critically appraised topic (CAT) aims to determine the impact of TENS on the pain and functional outcome of patients with knee OA. Methods: To assess the therapeutic efficacy of TENS, a systematic search of the available literature was conducted, focusing on pain and function in knee osteoarthritis. Online databases were searched …

Real-Life Experience On The Effect Of Sglt2 Inhibitors Vs. Finerenone Vs. Combination On Albuminuria In Chronic Kidney Disease, Mohamad Hanouneh, Dustin Le, Bernard G. Jaar, Christina Tamargo, C. Elena Cervantes

Division of Nephrology Faculty Papers

BACKGROUND: There have been several recent advances in the care of patients with chronic kidney disease (CKD), including the use of sodium glucose cotransporter 2 (SGLT2) inhibitors and selective mineralocorticoid receptor antagonists (MRAs). There are very few data reporting the outcomes of these treatments in real-world experience. The aim of this retrospective study is to report the effects of SGLT2 inhibitors, finerenone, and their combination in CKD patients in our community-based setting.

METHODS: Ninety-eight patients with CKD with an estimated glomerular filtration rate (eGFR) between 25 and 90 mL/min per 1.73 m² and a urine albumin-to-creatinine ratio (UACR) ≥ …

Neuroimaging Evaluation Of The Long Term Impact Of A Novel Paired Meditation Practice On Brain Function, Andrew B. Newberg, Nancy Wintering, Chloe Hriso, Faezeh Vedaei, Sara Gottfried, Reneita Ross

Marcus Institute of Integrative Health Faculty Papers

BACKGROUND: A growing number of advanced neuroimaging studies have compared brain structure and function in long term meditators to non-meditators. The goal is to determine if there may be long term effects on the brain from practicing meditation. In this paper, we present new data on the long term effects of a novel meditation practice in which the focus is on clitoral stimulation. The findings from such a study have implications for potential therapeutic uses with regard to various neurological or psychiatric conditions.

METHODS: We evaluated the cerebral glucose metabolism in 40 subjects with an extended history (>1 year …

Editorial: Management Of Pji/Ssi After Joint Arthroplasty, Li Cao, Javad Parvizi, Xiaogang Zhang, Xianzhe Liu, Wierd Zijlstra, Saad Tarabichi

Rothman Institute Papers

The management of periprosthetic joint infection (PJI) and surgical site infection (SSI) after joint arthroplasty poses a major challenge in orthopedic surgery. This Editorial provides an overview of the studies published in the special issue "Management of PJI/SSI after Joint Arthroplasty", summarizing the key findings from these studies, which cover a wide range of topics, including stringent preventive strategies, comprehensive diagnostic methods, and personalized treatment modalities. The authors concluded the editorial with their perspectives regarding the status quo of research in this field and future directions for research, such as the development of novel antibiotics, biofilm research, patient-specific risk factors, …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Early Outcomes Of Mr-Guided Sbrt For Patients With Recurrent Pancreatic Adenocarcinoma, Spencer Poiset, Sophia Shah, Louis Cappelli, Rani Anné, Karen Mooney, Maria Werner-Wasik, Talya Laufer, James Posey, Daniel Lin, Atrayee Mallick, Harish Lavu, Babar Bashir, Charles Yeo, Adam Mueller

Kimmel Cancer Center Faculty Papers

BACKGROUND: Local treatment options for locally recurrent pancreatic adenocarcinoma (LR-PAC) are limited, with median survival time (MST) of 9-13 months (mos) following recurrence. MRI-guided stereotactic body radiation therapy (MRgSBRT) provides the ability to dose escalate while sparing normal tissue. Here we report on the early outcomes of MRgSBRT for LR-PAC.

METHODS: Patients with prior resection of pancreatic adenocarcinoma with local recurrence treated with MRgSBRT at a single tertiary referral center from 5-2021 to 2-2023 were identified from our prospective database. MRgSBRT was delivered to 40-50 Gy in 4-5 fractions with target and OAR delineation per institutional standards. Endpoints included local …

Postoperative Opioid Usage And Disposal Strategies After Arthroscopic Procedures In A Young Cohort: A Prospective Observational Study, William Johns, Emma Johnson, Joseph Brutico, Matthew Sherman, Kevin Freedman, William Emper, John Salvo, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Although several studies have noted that patients are routinely overprescribed opioids, few have reported usage after arthroscopic surgery.

PURPOSE: To determine opioid consumption and allocation for unused opioids after common arthroscopic surgeries.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: Patients between the ages of 15 and 40 years who were scheduled to undergo anterior cruciate ligament reconstruction (ACLR), labral repair of the hip or shoulder, meniscectomy, or meniscal repair were prospectively enrolled. Patients were prescribed either 5 mg hydrocodone-325 mg acetaminophen or 5 mg oxycodone-325 mg acetaminophen based on surgeon preference. Patients completed a daily opioid usage …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Clinical Outcomes For Va-Ecmo Patients Associated With Hyperlipidemia: An Analysis Of The National Inpatient Sample, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is considered the most advanced temporary life support which provides complete hemodynamic support in addition to gas exchange. There is limited data available on the impact of hyperlipidemia (HLD) on VA-ECMO patients. We sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes among these patients.

Methods: The NIS was searched for hospitalizations of adult VA-ECMO patients with and without a concomitant diagnosis of HLD for the years 2019 and 2020. The primary outcome was inpatient mortality.

Results:This study included 3,885 VA-ECMO patients, of which 1,082 (27.8%) patients had HLD. …

Outcomes Of Thoracic Endovascular Aortic Repair (Tevar) Procedure In Octogenarians, Nonagenarians And Centenarians: A Population-Based Study, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: Limited data exists for patients undergoing a thoracic endovascular aortic repair (TEVAR) procedure who are older than or equal to 80 years old (YO). This study sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes among these older patients.

Methods: The NIS was searched for hospitalizations of adults who underwent a TEVAR procedure in 2019 and 2020. The study compared those aged 80 YO and over to those younger than 80 YO. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS), and total hospital charges (TOTHCG).

Results: This study included …

Sex Differences In Outcomes Among Patients Undergoing Thoracic Endovascular Aortic Repair (Tevar) Procedure: A Retrospective Cohort Study, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: There is limited data about sex differences in patients undergoing a thoracic endovascular aortic repair (TEVAR) procedure. This study sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes by gender.

Methods: The NIS was searched for hospitalizations of adult patients who underwent TEVAR in 2019 and 2020. For this cohort, female patients were identified, and pregnant patients were excluded. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS), and total hospital charges (TOTHCG).

Results: This study included 696 patients who underwent TEVAR. 255 (36.6%) females were identified, of which, 7 …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Resection And Reconstruction Of Ewing Sarcoma Of The Cuboid Utilizing Vascularized Fibular Autograft: A Case Report, Brandon Cunha, Alexandre Arkader

Rowan-Virtua Research Day

Ewing Sarcoma (EWS) rarely presents in the bones of the foot, and particularly in the cuboid, making it an exceedingly rare occurrence. We present the case of a 7-year-old female diagnosed with EWS of the right cuboid, detailing the management and outcomes of this rare presentation. The patient, now almost 5 years post-initial local control, exhibits restored foot function, a normalized gait, and no evidence of disease recurrence. This case underscores the potential for preserving lower extremity function and improving postoperative quality of life in rare presentations of EWS through innovative reconstruction strategies.

Can Nutritional Supplements Benefit Patients Receiving Treatment For Neurodegenerative Disorders?, Russell Levi, Saad Ahmed, Zachary Harris

Rowan-Virtua Research Day

As the prevalence of neurocognitive disorders rises globally, developing new methodologies of prevention and treatment is crucial. This literature review examines the efficacy of adding nutritional supplements, specifically nootropics, with traditional pharmacological regimens on various neurocognitive and neurodegenerative disorders. Primary, peer-reviewed research, including both human and animal studies, was assesed to determine if there was a benefifical, minimal, or detrimental effect on symptom progression. The inclusion criteria focused on studies that evaluated the reduction in disease markers or symptoms following supplement use. The findings reveal that natural supplements generally support disease management. Significant improvements were noted with specific combinations like …

Case Report: Hidden Posterior Dislocation Of The Clavicular Head, David F. Koziel

Rowan-Virtua Research Day

Reported is a case of a 24-year-old male who presented with left shoulder pain and decreased range of motion of the same shoulder upon awakening, diagnosed with a posterior dislocation of the proximal clavicle, with the clavicular head residing in the mediastinum. In the conscious, ambulatory, young adult it is arguably much more common for major bony trauma involving the upper extremity and shoulder to present with pain, deformity, and a known mechanism. This is an example that lacks all three of these characteristics and highlights the importance of details in the physical examination as well as clinical gestalt.

Unmasking A Silent Threat: Early Detection Of Elevated Hbco Levels When The Story Doesn’T Add Up, Anna M. Delancy, Eric Maddock, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Carbon monoxide (CO) is difficult to detect in the surrounding environment due to its colorless, odorless, and tasteless properties. Patients acutely poisoned with CO can have a myriad of presentations including headache, dizziness, and critical illness— all with a mortality rate up to 3%. When concerned for CO poisoning, blood co-oximeter testing should be performed, with treatment surrounding the idea of providing supplemental oxygen The efficacy of hyperbaric oxygen (HBO) treatment remains unclear. Here we describe an atypical scenario of a patient ultimately found to have CO poisoning, and the importance of early identification and treatment of this elusive diagnosis …

Clinical Outcomes For Cardiac Ablation In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

Background

Cardiac ablation is a therapeutic intervention aimed at correcting abnormal heart rhythms by disrupting electrical pathways in the heart, using techniques such as radiofrequency or cryoablation. Despite its effectiveness, there is a scarcity of data regarding the outcomes of cardiac ablation specifically among elderly patients. Previous studies have highlighted the complexities and challenges associated with managing cardiac arrhythmias in the elderly population, emphasizing the need for further investigation into treatment outcomes in this demographic.1,2 Therefore, this study aimed to investigate in-hospital outcomes among elderly patients who underwent cardiac ablation using data from the National Inpatient Sample (NIS) Database.

Methods …

Sex Differences In Outcomes Among Patients Who Underwent Cardiac Ablation: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

Background Cardiac ablation, encompassing radiofrequency and cryoablation modalities, is a therapeutic intervention targeting abnormal heart rhythms by disrupting electrical pathways within the heart. Despite its widespread use, research focusing on sex-specific outcomes among patients undergoing cardiac ablation remains limited. Understanding potential sex differences in treatment response and outcomes is crucial for optimizing patient care and outcomes.1,2 Therefore, this retrospective cohort study aimed to analyze the national inpatient sample database to assess in-hospital outcomes among patients undergoing cardiac ablation, specifically focusing on sex disparities.

Methods Data from the National Inpatient Sample (NIS) Database for the years 2019 and 2020 were utilized …

National Inpatient Sample Analysis: Examining Clinical Outcomes In Cardiac Ablation Patients With Hyperlipidemia, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

Background Cardiac ablation, utilizing radiofrequency or cryoablation, is a therapeutic approach for correcting abnormal heart rhythms by disrupting specific electrical pathways within the heart. Despite the growing utilization of cardiac ablation, limited research exists on the impact of hyperlipidemia, a prevalent cardiovascular risk factor, on outcomes in patients undergoing this procedure. Previous studies underscore the importance of understanding how comorbid conditions, such as hyperlipidemia, influence the efficacy and safety of cardiac ablation.1,2 Consequently, this study aimed to leverage the national inpatient sample database to investigate in-hospital outcomes among cardiac ablation patients with hyperlipidemia.

Methods Data from the National Inpatient Sample …

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …

Case Report: Diverticulitis Involving A Meckel’S Diverticulum, Samuel M. Thalathoti, Russell A. Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with abdominal pain and was diagnosed with diverticulitis involving a Meckel‘s Diverticulum. The differential diagnosis of abdominal pain is vast, in this age group includes, but is not limited to appendicitis, diverticulitis, cholecystitis, and small bowel obstruction. In the absence of complicated features, conservative management with oral antibiotics and close outpatient follow is advised. However, in the case of complicated diverticulitis and a rare manifestation such as a Meckel’s Diverticulum, careful management is indicated.

Pneumocephalus – Epidural Injection Nightmare, Mohammad A. Rattu, Frank A. Wheeler

Rowan-Virtua Research Day

Pneumocephalus (pneumatocele or intracranial aerocele) is defined as the presence of air in the intracranial space and most commonly occurs after a traumatic event (most commonly head or facial injury), epidural injection, cranial surgery, However, it may also be spontaneous. Classified into simple and tension types, the presentation varies based on severity and progression. Pneumocephalus with onset less than 72 hours prior to presentation is defined as acute, in contrast to a delayed presentation greater than the given timeframe. Symptoms vary based on the amount of air that is present as well as the exact location within the cranial cavity. …

Brief Review: The Refeeding Syndrome, Jose Gerald Aragon, Mohammed A. Rattu, Alex Gechlik, Nicholas Coan, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Here we briefly review the definition, epidemiology, pathophysiology, clinical risk scenarios, prevention and treatment of the refeeding syndrome. Refeeding syndrome is a condition which arises when a severely malnourished individual has been restarted with increased nutrition in a relatively short period of time. The refeeding process can lead to shifts in a number of fluids and electrolytes. The hallmark feature is hypophosphatemia. The true incidence of refeeding syndrome is unknown. This is said to be partly due to the lack of a universally accepted definition. Populations that are likely to experience this syndrome include patients with maladaptive eating disorders, chronic …

Clostridium Perfringens Sepsis From A Hepatic Abscess With Hemolysis And Renal Failure, Requiring Hemodialysis, Joel Collins Ii, Katelyn Courtney, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The prognosis of sepsis caused by Clostridium perfringens is extremely poor, with a mortality rate of 70%-100%. Management includes antibiotic regimens specific to toxin production as well as source control via surgical or interventional mechanisms. We report a case of a 64-year-old male who presented with right upper quadrant (RUQ) abdominal pain and was diagnosed with Clostridium perfringens bacteremia with associated acalculous cholecystitis, hepatic abscess, and acute renal failure requiring hemodialysis. It is felt that early hemodialysis was an associated factor in the patient's survival.

A Systematic Review On Belimumab’S Effectiveness, Improved Health Outcomes And Quality Of Life In Patients With Lupus Syndromes, Emily Meale, Alexandra Fontaine

Rowan-Virtua Research Day

Autoimmune diseases are prevalent disorders that many individuals within the United States suffer from. Systemic lupus erythematosus (SLE) is a common autoimmune disease that has a high incidence in women of child-bearing age. Management for lupus depends on the anatomical location SLE manifests, the severity of disease, and the tolerance that one has for certain adverse effects. Glucocorticoids are commonly used to manage lupus. Currently, long term glucocorticoid usage is associated with devastating adverse effects, so current treatment options aim to mitigate corticosteroids use to improve quality of life while maintaining favorable health outcomes. New management for SLE include biologics …

Investigation Of The Utility Of A Ptsd Coaching Mobile App To Address Mental Health Services Demand In A Primary Care Clinic: Analysis Of Caps-5 Measures, Sindhura Nemani, Danielle Rae Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

The COVID-19 pandemic affected countless people globally, resulting in a greater need for mental health professionals and resources¹. The demand for mental health care is soaring yet the limitation of resources has strained the healthcare system, making it challenging to help patients in a timely manner². This poster represents a snapshot of a larger project that is striving to investigate an intervention to help bridge the gap between patient need and prompt referral through a warm handoff approach and use of the PTSD Coach mobile application as well as exploring patients’ satisfaction^3,4,5,6,8,9. In this …

Using Fmri To Assess Effectiveness Of Olanzapine Treatment For Schizophrenia, William Kyle Copenhaver, David F. Lo, Hanna Rothenberg, Eeshan Khurana, Valerie Rome, Uzayr Wasif, Don D. Shamilov

Rowan-Virtua Research Day

Schizophrenia is a complex mental illness with neurobiological underpinnings and misconceptions about violence. Schizophrenia is associated with high levels of creativity and structural traits like fewer D2 receptors. Patients face reduced life expectancy due to cardiovascular diseases and cope through smoking and sedentariness. Treatment involves pharmacological antipsychotics like olanzapine and nonpharmacological approaches. Olanzapine works by antagonizing D2 receptors but has side effects like weight gain and diabetes risk. fMRI is used to study treatment mechanisms and predict response, but research on olanzapine's brain network effects is limited.

Dense Colon Scarring After Infliximab For Acute Severe Ulcerative Colitis, Rahul Patel, Sriya Vutukuru, Neethi Dasu, Charles Snyder

Rowan-Virtua Research Day

Introduction: Infliximab is a monoclonal antibody against tumor necrosis factor alpha used in the treatment of ulcerative colitis. It has been shown to be efficacious in patients with moderate to severe ulcerative colitis and/or those who have failed intravenous steroids. We present a unique finding of profoundly dense colonic scarring after a year of infliximab therapy in a patient with acute severe ulcerative colitis.

Case: A female in her early 60s presented to the hospital with a three month history of rectal bleeding and intermittent fevers. A colonoscopy was done which demonstrated severe Mayo 3 left-sided colitis, consistent with a …

Management Strategies For Traumatic Injuries In Pregnant Women: A Comprehensive Literature Review, Jaylyn D. Thompson, Jenna Zappetti, Clarence Julian Clark Ii

Rowan-Virtua Research Day

Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics.

Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen.

Results: Every woman with …