Therapeutics Commons^™

A Comparison Of The Upper Limb Lift Test Between Women With Breast Cancer And Healthy Control Subjects, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Physical Therapy Faculty Publications

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore.

Background: Objective measures of upper limb (UL) function specific to breast cancer survivors (BC) are limited. Motion, strength, and muscular endurance are measurable components of UL function. A clinical test that quantifies these components is needed.

Purpose: This study compares the Upper Limb Lift Test (ULLT) between women with BC and healthy control subjects (HC) at baseline, 1-3 months, and 12+ months post-operatively enrolled in a prospective surveillance trial with early intervention. A secondary purpose was to validate the ULLT by comparing findings to self-reported …

Correlation Matrix Analysis Identifies Gene Signatures Of Immune Cell Subsets And Their Interactions In Follicular Lymphoma, Jason R. Westin

Dissertations and Theses (Open Access)

There are important but ill-defined interactions between benign immune cell subsets and neoplastic B cells within follicular lymphoma (FL). Using the novel technique of correlation matrix analysis (CMA) of publicly available FL whole-tumor gene expression profiling (GEP) data, we have identified signatures of immune cell subsets. Overall survival correlated most highly with a model using signatures of macrophages, T cells, and stroma, which was able to add significantly to existing clinical prognostic tools. From our own data of a cohort of 43 FL tumors sorted into B-cell and non-B cell (NB) fractions for GEP, CMA of the tumor infiltrating NB …

Site-Specific Immunomodulator: A Novel Treatment For Crohn's Disease, Brian Bressler, Kevin P. Bethel, Ralf Kleef, Sophie L. Reynolds, Simon Sutcliffe, David W. Mullins, Hal Gunn

Dartmouth Scholarship

We investigated the mechanism of action, safety, and efficacy of the Site-Specific Immunomodulator (SSI) QBECO, a novel immunotherapy for Crohn’s disease (CD). Using human monocytic THP-1 cells, we demonstrate that SSI QBECO (derived from the common colon bacteria E. coli) activates macrophages to an M1 phenotype (associated with enhanced capacity to eliminate bacteria and activate innate immune responses). We assessed SSI QBECO in a compassionate use protocol of ten adult patients with active CD. Patients with moderate to severe clinical symptoms receiving conventional CD treatments and/or complementary therapies were included, except patients receiving anti-TNF medications. SSI QBECO was self-administered subcutaneously …

The Association Between Critical Thinking And Scholastic Aptitude On First-Time Pass Rate Of The National Physical Therapy Examination, Daniel W. Suckow, C. Jayne Brahler, Betsy Donahoe-Fillmore, Mary Insana Fisher, Philip A. Anloague

Physical Therapy Faculty Publications

Objectives: 1) To investigate the relationships among critical thinking (CT) abilities, overall academic performance in the Doctorate of Physical Therapy (DPT) program as measured by cumulative grade point average (GPA), and National Physical Therapy Examination (NPTE) licensure scores, and 2) To determine if NPTE scores were significantly different between groups of students who were classified as having low, moderate or high CT abilities.

Background: It is well-established that physical therapy practice requires good clinical reasoning skills. Passage of the NPTE is required for licensure. Research to date has been mixed as to whether CT abilities or GPA can predict success …

Oncology Section Edge Task Force On Prostate Cancer Outcomes: A Systematic Review Of Clinical Measures Of Strength And Muscular Endurance, Mary Insana Fisher, Claire Davies, Genevieve Colon, Hannah Geyer, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Strength deficits are a common morbidity following treatment for prostate cancer. Accurate assessment of strength and muscular endurance following prostate cancer treatments is essential to identify deficits and plan rehabilitation.

Purpose: To identify strength and muscular endurance outcome measures that possess strong psychometric properties and are clinically useful for examination of men treated for prostate cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies of tools used to assess strength and muscular endurance were included if they reported psychometric properties, were clinically feasible methods, performed on adults, and published in the English language. Each outcome …

Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

With the expectations of accountability by consumers and third party payors for the efficacy of physical therapy practice, there has been a significant increase in the push to develop outcome measures in rehabilitation. One type of these measures, patient-reported outcome measures (PROs), are becoming increasingly more common in clinical practice. The American Physical Therapy Association’s Guide to Physical Therapist Practice 3rd edition includes outcomes assessment as an integral part of the Patient and Client Management model, and delineates that appropriate tests and measures depend upon established psychometric properties of the measurement.1 The Section on Research formed the Evidence Database to …

A-803467, A Tetrodotoxin-Resistant Sodium Channel Blocker, Modulates Abcg2-Mediated Mdr In Vitro And In Vivo, Nagaraju Anreddy, Atish Patel, Yun-Kai Zhang, Yi-Jun Wang, Suneet Shukla, Rishil J. Kathawala, Priyank Kumar

Touro College of Pharmacy (New York) Publications and Research

ATP-binding cassette subfamily G member 2 (ABCG2) is a member of the ABC transporter superfamily proteins, which has been implicated in the development of multidrug resistance (MDR) in cancer, apart from its physiological role to remove toxic substances out of the cells. The diverse range of substrates of ABCG2 includes many antineoplastic agents such as topotecan, doxorubicin and mitoxantrone. ABCG2 expression has been reported to be significantly increased in some solid tumors and hematologic malignancies, correlated to poor clinical outcomes. In addition, ABCG2 expression is a distinguishing feature of cancer stem cells, whereby this membrane transporter facilitates resistance to the …

Research Round-Up: Manual Muscle Testing, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

Manual muscle testing was developed in response to the need to assess muscle strength losses during the polio outbreak in early part of the 20th century. The development of this original method is credited to Wilhelmine Wright and Robert W. Lovett, MD. Wright presented this method in 1912 in the Boston Medical Surgical Journal, and Lovett expanded the description of the testing method in 1916 in the Journal of the American Medical Association. The development of quantifying muscle strength by rating force generated against external resistance was an important development in objectifying assessment methods of the time.

Today, manual muscle …

Evaluation Of A Vancomycin Dosing Protocol And Pharmacokinetic Parameters In Burn Patients, T. A. Walroth, K. A. Lavery, S. Erdman, N. R. Buening, D. R. Foster, Kendra M. Damer, R. Sood

Scholarship and Professional Work – COPHS

Published abstract from the 47th American Burn Association Annual Meeting. Chicago, IL April 2015.

Joint Attention Intervention With Assisting Parent­ Mediated Techniques To Increase A Toddler With Autism Spectrum Disorders' Use Of Joint Attention: A Single Case Study, Rebecca Schulz

All Graduate Theses, Dissertations, and Other Capstone Projects

Attention Intervention (JAI) conducted by graduate researcher, parent, and caregiver, would change the use of joint attention (JA) by a three-year-old suspected of having Autism Spectrum Disorder (ASD). The participant was a three-­year-­old child suspected of having ASD. Intervention was conducted twice per week for 30-45 minute duration by the student graduate researcher at a university clinic under the supervisor of Dr. Bonnie Berg, CCC­SLP. The parent and child's caregiver were trained in JAI and implemented the intervention daily in the home environment. The author's research question was, "Will the use of a JAI parent­mediated intervention model increase the JA …

Oncology Section Edge Task Force On Breast Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Mary Insana Fisher, Jeannette Lee, Claire Davies, Hannah Geyer, Genevieve Colon, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care.

Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

The Effect Of Music Therapy Interaction On Child And Parental Preoperative Anxiety In Parents Of Children Undergoing Day Surgery, Christopher R. Millett

Theses and Dissertations--Music

Young children who experience high levels preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Music therapy interventions addressing a variety of procedural outcomes have been met with success. The purpose of this study was to investigate the comparative effectiveness of two music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers.

A total of 40 pediatric patient and caregiver dyads were included in …

Development Of A Thin-Film Porous-Microelectrode Array (P-Mea) For Electrical Stimulation Of Engineered Cardiac Tissue., Hiren Vrajlal Trada 1977-

Electronic Theses and Dissertations

Electrical stimulation has been increasingly used by research groups to enhance and increase maturation of cells in an engineered cardiac tissue (ECT). Current methods are based on using off-the-shelf wires or electrodes to deliver a stimulus voltage to the in-vitro tissue in culture medium. A major issue with this approach is the generation of byproducts in the medium due to the voltage levels required, which are typically in the range of 5V-10V. No solution currently exists that can accomplish electrical stimulation of cells in an ECT at a low voltage level. Therefore, in this study a novel, porous, thinfilm, microelectrode …

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Cassandra Dawley, Charles Dowd, Irina Fedulow, Miranda Carlson, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Nicole Christine, Angela Serrani

Disease Prevention and Health Promotion Resources

Presentation proposing that standardized rehabilitation and wellness services be incorporated into cancer treatment as well as into a personalized plan of care to be carried out after cancer treatment ends. Proposal is based on research regarding evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment, evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment, and the underlying behavioral change theory for incorporation of a Cancer Survivorship Rehabilitation Algorithm which includes the use of rehabilitation and wellness services in the …

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary Insana Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott, Harold L. Merriman

Physical Therapy Faculty Publications

Lymphedema affects 3–58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at …

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Miranda Carlson, Nicole Christine, Charles Dowd, Cassandra Dawley, Irina Fedulow, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Angela Serrani

Disease Prevention and Health Promotion Papers

The first section of this report addresses the evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment. The second section investigates the evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment. The third section discusses the underlying behavioral change theory for incorporation of our Cancer Survivorship Rehabilitation Algorithm (Appendix 1), which details our proposed use of rehabilitation and wellness services in the continuum of cancer care and includes an outline for a survivorship care plan. This section also discusses …

The Kras/Mapk Pathway And Ligand Independent Activation Of Erα: Implications For The Treatment Of Endometrial Cancer, Kari Ring

Dissertations and Theses (Open Access)

Hormonal therapy remains a first line option for the treatment of recurrent endometrial cancer (EC), however, many tumors demonstrate de novo or acquired resistance. Member kinases of the PI3K/AKT and Ras/MAPK pathways activate estrogen receptor α (ERα) independent of estrogen, however, few studies have evaluated the role of the Ras/MAPK pathway in predicting response to hormonal therapy in EC. The aims of this project were to evaluate the role of ligand independent activation of ERα in EC and to explore therapeutic implications for the treatment of recurrent EC.

A xenograft model for recurrent EC was used to evaluate the effect …

Characterizing The Response Of Multidrug-Resistant Klebsiella Pneumoniae Species To The Application Of A Phage Cocktail, Steven Liu

Symposium

Project Summary: The application of bacteriophages to treat bacterial infections is known as phage therapy, which takes advantage of bacteriophage’s natural ability to infect and lyse bacterial hosts. Phages have been shaped by billions of years of evolution to be highly specialized deliverers of bactericidal agents to the cytoplasm of their target bacteria. Ever since discovery of bacteriophages in 1915, phage therapy was recognized as a potentially powerful tool for eliminating bacterial infections. The effectiveness of phage therapy can be increased by creating a mixture of multiple phages to target a wider variety of bacterial strains. Furthermore, phage therapy has …

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

Evidence-Based Practice Project Reports

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

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

Patient Care Services / Nursing

No abstract provided.

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

Department of Medicine

No abstract provided.

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

Peer Reviewed Articles

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

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

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

Pharmacy Faculty Articles and Research

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

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Ethical Dilemmas Posed In The Care Of Obese Patients In The Emergency Department, Arvind Venkat, Gregory Luke Larkin

Journal of Health Ethics

The rising prevalence of obesity represents a health care crisis. As the gateway to the health care system, the emergency department is the clinical setting where the difficulties posed by the care of obese patients are heightened. These difficulties include the increasing burden of obesity-related illnesses, the challenges posed in diagnostic evaluation and treatment and the known barriers to access to care seen in this patient population. The limitations posed by obesity on care in the emergency department, the one guaranteed access point for medical treatment, creates a series of ethical dilemmas for emergency physicians and the facilities in which …

Aqueous Maté Extract Decreases The Viability Human Breast Cancer Through Apoptosis And Cancer Repression, Kenisha Nisbett, Amina Sadik

College of Osteopathic Medicine (TUN) Publications and Research

Ilex paraguariensis, also known as Yerba Maté, is a subtropical plant native to South America. In various South American cultures, the leaves of Yerba Maté tree are roasted to make a traditional herbal tea. Several studies have been conducted to elucidate the beneficial effects of this beverage. A recent study has shown that saponins isolated from Yerba Maté extract induce apoptosis in human colon cancer cells, while another study indicated that the consumption of Maté tea causes higher incidence of esophageal cancer. Our study looked into the effects Yerba Maté extract had on human breast cancer cells. The findings …

Characterization Of Prophylactic Antiemetic Regimens In Pediatric Patients Receiving Moderately And Highly Emetogenic Chemotherapy, Jessica Degiacomo Pharmd, Kristin M. Held Pharmd, Bcop

Department of Pharmacy

No abstract provided.