Medical Education Commons^™

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 …

Embryological Basis Of Polydactyly In 56 Years Old Male Patient, Sarayu M

Digital Journal of Clinical Medicine

Polydactyly is a common congenital hand deformity. The limb buds are the precursor structures of the limbs. Their formation begins in the 4th week, with the activation of mesenchymal cells in the somatic layer of lateral plate mesoderm. As mesenchyme cells enter the limb region, they secrete factors that induce the overlying ectoderm to form a structure called the apical ectodermal ridge (AER). Polydactyly is the congenital deformities which is seen in 1000 births. To observe and study the various type of polydactyly in relation to the preaxial polydactyly and postaxial polydactyly with other classification. So, thumb polydactyly is a …

Endoscopic Retrograde Cholangiopancreatography-Related Early Perforations: A Study Of Effects Of Procedure Duration, Complexity, And Endoscopist Experience, Mark Aloysius, Hemant Goyal, Tejas Nikumbh, Niraj James Shah, Ghassan M Hammoud, Pritesh Mutha, Mairin Joseph-Talreja, Savio John, Ganesh Aswath, Vaibhav Wadhwa, Nirav Thosani

Faculty, Staff and Student Publications

BACKGROUND: Perforations (Perf) during endoscopic retrograde cholangiopancreatography (ERCP) are rare (< 1%) but potentially fatal events (up to 20% mortality). Given its rarity, most data is through case series studies from centers or analysis of large databases. Although a meta-analysis has shown fewer adverse events as a composite (bleeding, pancreatitis, Perf) during ERCP performed at high-volume centers, there is very little real-world data on endoscopist and center procedural volumes, ERCP duration and complexity on the occurrence of Perf.

AIM: To study the profile of Perf related to ERCP by center and endoscopist procedure volume, ERCP time, and complexity from a national endoscopic repository.

METHODS: Patients from clinical outcomes research initiative-national endoscopic database (2000-2012) who underwent ERCP were stratified based on the endoscopist and center volume (quartiles), and total procedure duration and complexity grade of the ERCP based on procedure details. The effects of these variables on the Perf that occurred were studied. Continuous variables were compared between Perf and no perforations (NoPerf) using the Mann-Whitney U test …

Utilizing Stakeholder Input Within The Tennessee Heart Health Network To Improve Cardiovascular Health Outcomes In Tennessee, Abigail C. Bennett

Longitudinal Scholar's Project

Background: Tennessee ranks sixth nationwide for most deaths related to heart disease. The Tennessee Heart Health Network (TN-HHN), an initiative coordinated by the Tennessee Population Health Consortium (TN-PHC), was created to combat this issue. The TN-HHN is a statewide network of primary care practices, health systems, and academic centers committed to implementing patient-centered outcomes research (PCOR) approaches to demonstrably improve cardiovascular disease (CVD) health outcomes and health equity across Tennessee.

Objective: Evaluate stakeholder experiences in participating in the Network in an effort to assess partner satisfaction and improve the TN-HHN as a whole.

Methods: Eligible stakeholders were invited via …

Importance Of Geriatrics In Psychiatric Postgraduate Education, Dr Anand R, Dr Kishor M, Dr Murali M R

Digital Journal of Clinical Medicine

Introduction

To assess the importance of Geriatrics in Psychiatric postgraduate education

Methodology

Marks allotted in question papers from Geriatrics in Psychiatry postgraduate examination from a university for a 5-year period was evaluated.

Discussion

1-6% of entire theory evaluation was related to Geriatric mental health topics predominantly on dementia and related disorders.

Psychiatric Morbidity And Dental Problems Among Women From Institutional Care, Meghana Hanchate, Kishor M, Ashwini T S

Digital Journal of Clinical Medicine

No abstract provided.

Social Determinants May Limit The Success Of Pcsk9 Inhibitors, An Effective Treatment For Hyperlipidemia In Statin-Intolerant Patients, Abigail C. Kuplicki

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Moriarty PM, Thompson PD, Cannon CP, et al. Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: The ODYSSEY ALTERNATIVE randomized trial. J. Clin. Lipidol. 2015;9(6):758-769. https://doi.org/10.1016/j.jacl.2015.08.006

for a statin-intolerant patient with hyperlipidemia.

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Stigma And Patient-Controlled Analgesia: Trust Is The Essential Ingredient Of Successful Patient Education In The Patient-Doctor Relationship, Trey D. Vanaken

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Van Beers EJ, Van Tuijn CFJ, Nieuwkerk PT, et al. Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial. Am J Hematol. 2007;82(11):955-960. https://doi.org/10.1002/ajh.20944.

for a patient with recurrent vaso-occlusive crisis secondary to Sickle Cell Disease.

Evaluating The Use Of Cheaper, Less Effective Medications In Patients With Cost-Based Medication Nonadherence, Muneer F. Hasso

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Sangaralingham LR, Sangaralingham SJ, Shah ND, Yao X, Dunlay SM. Adoption of Sacubitril/Valsartan for the Management of Patients With Heart Failure. Circ Heart Fail. 2018;11(2):e004302. https://doi.org/10.1161/circheartfailure.117.004302

for a patient with low medication adherence rates due to the high out-of-pocket costs of newer medications.

E-Cigarette Or Vaping Use-Associated Lung Injury (Evali) In A Hispanic Male During The Covid-19 Pandemic, Juan C. Naranjo, Muhammad Jamal, Aramide Tijani, Fatimah Bello

Research Colloquium

Background: Electronic cigarette or vaping product use–associated lung injury established the relationship between vaping products and lung injury. Overlapping clinical manifestations may mimic those of other respiratory conditions including COVID-19. Multiple radiographic findings including diffuse, bilateral, ground-glass infiltrates with lower-lobe predominance, eosinophilic pneumonia, and diffuse alveolar damage have been described. It is important to consider this as an alternative diagnosis, particularly in patients with respiratory symptoms and a history of vaping in the last 90 days due to increased risk of COVID-19 infection and worse outcomes.

Case presentation: A 25-year-old male with a history of polysubstance abuse and frequent E-cigarette …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Neuroimaging Manifestatations In Covid-19 And Its Sequelae, Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogenic virus in late 2019, infecting millions of people with severe pulmonary infections. It spread worldwide in a short time and became a pandemic, after which the World Health Organization (WHO) declared it a public health emergency. Central nervous system involvement by COVID-19 is already an established entity in the literature. The aim of this study was to evaluate in detail the acute and delayed neurological manifestations of COVID -19.

RESULTS: COVID-19 infection can cause various neurologic manifestations and imaging findings. The most common neuroradiological abnormality is cerebrovascular …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

Association For Academic Surgery/Society Of University Surgeons Research Awards Are Highly Successful In Fostering Future Surgeon-Scientists, Oluyinka O Olutoye, Taylor Lee, Anjali Degala, Jessica L Mueller, Allan M Goldstein, Sundeep G Keswani, Lily S Cheng

Faculty, Staff and Students Publications

BACKGROUND: The surgeon-scientist brings a unique perspective to surgical research. The Association of Academic Surgeons and Society of University Surgeons foster the development of surgeon-scientists through foundation awards to residents and junior faculty. We sought to evaluate the academic success of surgeons who received an Association for Academic Surgery/Society of University Surgeons award.

METHODS: Information was collected for individuals who received a resident or junior faculty research award from the Association for Academic Surgery or Society of University Surgeons. Google Scholar, Scopus, and the National Institutes of Health Research Portfolio Online Reporting Tools: Expenditures and Results were used to assess …

A Review On Anatomical And Surgical Importance Of Mammary Gland, Sneha Jm Sneha Jm Dr, Pushpa Nb Dr, Vidya Cs Dr, Manjappa M Dr

Digital Journal of Clinical Medicine

ABSTRACT

The mammary gland is an exocrine gland present in female mammals responsible for the production and secretion of milk during the process of lactation. It is mainly composed by epithelial cells and adipocytes. The features that make mammary gland unique are 1) its highly plastic properties displayed during pregnancy, lactation and involution (all steps belonging to the lactation cycle) and 2) its requirement to grow in close association with adipocytes which are absolutely necessary to ensure mammary gland development at puberty and remodelling during the lactation cycle. (Georgia colleluori, Jessica perugini, Giorgio barbatelli, and saverio cintr (2021).

Conclusion

The …

The Effectiveness Of Disinfection Protocols In Medical School Osteopathic Manipulative Medicine Labs., Harrison A. Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: In light of the COVID-19 pandemic, healthcare-associated infections have taken center stage. Healthcare has adjusted workflows to accommodate for more robust disinfecting regiments to help protect the community. This has resulted in the need for medical institutions to reevaluate the current disinfection protocols down to the student level. The osteopathic manipulative medicine (OMM) laboratory provides an optimal avenue for assessing the effectiveness of medical students' ability to clean examination tables. With OMM laboratories having a high level of interaction, adequate disinfection is important for the health and safety of students and teaching faculties.

OBJECTIVES: This study will evaluate the …

Implementation Of A Virtual Interprofessional Icu Learning Collaborative: Successes, Challenges, And Initial Reactions From The Structured Team- Based Optimal Patient-Centered Care For Virus Covid-19 Collaborators, Simon Zec, Nika Zorko Garbajs, Yue Dong, Ognjen Gajic, Christina Kordik, Lori Harmon, Marija Bogojevic, Romil Singh, Yuqiang Sun, Vikas Bansal, Linh Vu, Kelly Cawcutt, John M. Litell, Sarah Redmond, Elly Fitzpatrick, Kirstin J. Kooda, Michelle Biehl, Neha S. Dangayach, Viren Kaul, June M. Chae, Aaron Leppin, Mathew Siuba, Rahul Kashyap, Allan J. Walkey, Alexander S. Niven

Jefferson Hospital Staff Papers and Presentations

IMPORTANCE: Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes. OBJECTIVES: The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices. DESIGN, SETTING, AND PARTICIPANTS: This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method …

Unilateral Agenesis Of Adnexa, Srinidhi Govindarajan, Poornima M Associate Professor, Rashmi H.S., Aishwarya Bhat

Digital Journal of Clinical Medicine

No abstract provided.

Creating A Data Dictionary For Pediatric Autonomic Disorders, Jeffrey R Boris, Hasan Abdallah, Shelley Ahrens, Gisela Chelimsky, Thomas C Chelimsky, Philip R Fischer, John E Fortunato, Raewyn Gavin, Janice L Gilden, Renato Gonik, Blair P Grubb, Kelsey M Klaas, Erin Marriott, Lauren E Marsillio, Marvin S Medow, Lucy Norcliffe-Kaufmann, Mohammed T Numan, Erin Olufs, Laura A Pace, Paul T Pianosi, Pippa Simpson, Julian M Stewart, Sally Tarbell, Natalie R Van Waning, Debra E Weese-Mayer

Faculty, Staff and Student Publications

PURPOSE: Whether evaluating patients clinically, documenting care in the electronic health record, performing research, or communicating with administrative agencies, the use of a common set of terms and definitions is vital to ensure appropriate use of language. At a 2017 meeting of the Pediatric Section of the American Autonomic Society, it was determined that an autonomic data dictionary comprising aspects of evaluation and management of pediatric patients with autonomic disorders would be an important resource for multiple stakeholders.

METHODS: Our group created the list of terms for the dictionary. Definitions were prioritized to be obtained from established sources with which …

Educating And Improving Collegiate Athlete Sunscreen Use, Julia Pederson

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to prospectively evaluate the ability to alter the behavior of young adults by providing sunscreen education and thereby reduce their risk of skin cancer from sun exposure. Twenty-three collegiate athletes ages 18 to 21 years old who were on the university softball team were enrolled. These student athletes were then educated about the impact of daily sun protection and risk factors. The goal was to observe an increase in sunscreen use and increase sun exposure awareness.

Background: Skin cancer is the most frequently diagnosed cancer in …

A Case Of Dock8 Deficiency Treated With Dupilumab, Melissa Anderson, Brandon D. Newell, Hugo Escobar, Erin Stahl, Nikita Raje

Research Days

Background: Dedicator of cytokinesis 8 gene (DOCK8) deficiency is an immune disorder associated with autosomal recessive hyper-IgE syndrome, characterized by elevated IgE levels, atopic dermatitis, and predisposition to recurrent skin and lung infections.

Objectives/Goal: A 12-year-old male presented to Immunology clinic for DOCK8 deficiency. He was diagnosed in infancy due to diffuse papulopustular eruption positive for candidiasis and known family history. Past medical history included severe eczematous dermatitis, asthma, interstitial lung disease, food allergies, and poor growth, with cutaneous HSV and fungal infections, HSV keratitis, and MRSA bacteremia. Family history was notable for two siblings with DOCK8 deficiency, both deceased. …

Association Between Remote Monitoring And Interstage Morbidity And Mortality In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal

Research Days

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation.

Objectives/Goal: We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period.

Methods/Design: Using the CHAMP database, we identified 610 infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with …

Early Onset Hypertension Objective Structured Clinical Examinations, Katrina Morace

Doctoral Projects

Hypertension is known as a condition in which raised blood vessel pressure persists. On a normal day, the pressure can rise and fall causing damage to the heart. When the pressure stays at higher readings, damage can be caused to the heart and can also lead to additional health problems. Another word for high blood pressure is hypertension. The blood is carried to all body parts from the heart by the arteries. The harder the heart pumps the higher the blood pressure (Centers for Diseases Control and Prevention [CDC], 2020). When hypertension is not diagnosed and treated at an early …

Procedural And Clinical Outcomes Of Dedicated Venous Stents In Acute And Chronic Venous Obstruction: A Retrospective Single Center Study, Guangming Tan, Madeleine G Yan, Bryan Py Yan

Journal of the Hong Kong College of Cardiology

Background Endovenous angioplasty with stenting is an accepted treatment for patient with venous obstruction. Dedicated venous stents have been developed to improve the efficacy and safety of the venoplasty procedure. We report the procedural as well as clinical outcomes of these new generation stents in the treatment of acute and chronic venous obstruction. Method This is a single centre retrospective cohort study of patients who received venous stenting for either acute or chronic venous obstruction. Baseline demographics, procedural details, clinical outcomes including 30 day all-cause mortality, 90 day primary patency rate, and change in Villalta score were reported. Result 41 …

Addressing The Health Needs Of The (D/D)Eaf And Hard Of Hearing Community, Zainab Krayem, Rachel Jeff-Macauley, Nicolette Falco, Vanesa Pizutelli

Rowan-Virtua Research Day

The term deaf refers to individuals with total or partial hearing loss. However, it encompasses much more, representing a culture—Deaf culture. The distinction in spelling is important: "Deaf," with an uppercase "D," refers to individuals born Deaf who have been raised within Deaf culture, while "deaf," with a lowercase "d," typically refers to those who lost their hearing later in life and may not have grown up in Deaf culture. People who identify as deaf, Deaf, or hard of hearing (d/D/hoh) are often mistakenly assumed to have cognitive impairments or are broadly categorized as disabled. However, many in the community …

The Effectiveness Of Cleaning Protocols In Medical School Omm Labs By Medical Students, Harrison Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua Research Day

In light of the COVID-19 pandemic, disinfection in healthcare has taken center stage. Healthcare has adjusted workflows to accommodate for more robust cleaning regimens to help protect the community. This has resulted in the need for medical institutions to reevaluate the current cleaning protocols down to the student level. Osteopathic Manipulative Medicine (OMM) lab provides an optimal avenue for assessing medical student’s examination table cleaning effectiveness. With OMM labs being an activity with a high level of interaction, the quality of examination table cleaning is important for the health and safety of students and teaching faculties. Our study highlights that …

End Of Life Symptom Management In The Emergency Department, Alice Chang, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The Emergency Department is at times the only place patients can turn to for symptom relief. In an aging population, this means that more patients are presenting to the ED towards the end of life (EOL). Emergency medicine (EM) prides itself as a specialty that handles disease-directed treatment for a variety of acute conditions. In contrast, palliative care (PC) is focused on improving the quality of life (QOL). It has become essential for EM physicians to care for patients who are not seeking life-sustaining measures, but instead quality of life interventions. Patients with serious illness, even hospice patients, present to …

Transforming Monterey Counties Food Environment, Geovanni Miron Solis

Capstone Projects and Master's Theses

The Blue Zones project was brought to Monterey County due to the high prevalence of type 2 diabetes. Nearly fifty percent of Monterey county are pre-diabetic or diabetic. The Blue Zones Project of Monterey County is a well being improvement initiative that works with local schools, worksites, restaurants and organizations to educate and promote healthier habits. The food sector of the project consists of individuals who work with restaurants and grocery stores here in Monterey County. The project serves Marina, Seaside, Monterey, Salinas, Pacific Grove, Gonzalez, King City, Soledad, Castroville, and Chular. A major issue the project wants to address …