Medical Specialties Commons^™

Pregnancy-Related Delusional Beliefs In Midlife And Late-Life Women: A Case Series, Dyuksha Arora, Ashita Adarsh, Kishor M. Manohar Rao, Anand R, Soumya Rajshekar Patil, Akshatha Cj

Digital Journal of Clinical Medicine

Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series.

Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months …

One Airway, One Disease In Pregnancy: A Prospective Observational Study On The Correlation Between Upper And Lower Airway Inflammation In Pregnant Women, Durga K, Yuvarajan S

Digital Journal of Clinical Medicine

Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.

Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.

Methods: We …

Comparision Of Buprenorphine Versus Butorphanol As An Adjuvant To Intrathecal Hyperbaric Bupivacaine For Elective Infraumbilical Surgeries : A Randomised Control Study At A Tertiary Care Hospital, Mandya, Surabhi C A, Dr. Kiran A V. Associate Professor, Dr. Shivakumar G Pofessor And Hod, Umesh N P

Digital Journal of Clinical Medicine

Introduction: Spinal anaesthesia is the most popularly performed procedure in the field of anaesthesiology. Hyperbaric bupivacaine, the local anaesthetic most commonly used, has limitation as its effect lasts only for 1.5-2 hours. Hence a lot of adjuvants have been tried to enhance the analgesic effect of bupivacaine.^[2] Opioids remain the mainstay among the various adjuvants to local anesthetics in spinal anaesthesia primarily by virtue of its various properties such as reducing the dose of local anaesthetic, minimizing side effects, and prolonging the duration of anaesthesia.^[3]

Aim: This study aims to compare the sensory and motor characteristics …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

The Association Between Obstetric Violence And Postpartum Depression Among Latina Women In The United States: An Integrative Review, Natalia Alameda

Scripps Senior Theses

Obstetric violence, a structural form of gender-based violence, involves abuse, mistreatment, or neglect by healthcare providers during obstetric care. It is often associated with childbirth trauma and may result in physical and psychological harm to mothers and children, including postpartum depression. Postpartum depression is a major depressive episode occurring during pregnancy or within four weeks following delivery. While these concepts are often studied independently, few studies examine their intersection, particularly among Latina women in the United States. To address this gap, an integrative literature review was conducted to explore the association between obstetric violence and postpartum depression among Latina women. …

Inpatient Utilization Among Medicaid Members With Substance Use And Serious Mental Illness In Oregon, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Multimodal Wearable Intelligence For Dementia Care In Healthcare 4.0: A Survey, Po Yang, Gaoshan Bi, Jun Qi, Xulong Wang, Yun Yang, Li Da Xu

Information Technology & Decision Sciences Faculty Publications

As a new revolution of Ubiquitous Computing and Internet of Things, multimodal wearable intelligence technique is rapidly becoming a new research topic in both academic and industrial fields. Owning to the rapid spread of wearable and mobile devices, this technique is evolving healthcare from traditional hub-based systems to more personalised healthcare systems. This trend is well-aligned with recent "Healthcare 4.0" which is a continuous process of transforming the entire healthcare value chain to be preventive, precise, predictive and personalised, with significant benefits to elder care. But empowering the utility of multimodal wearable intelligence technique for elderly care like people with …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

The Role Of Social Isolation In Shaping Health Outcomes In Older Adults: A Regional Analysis, Vince Falco, Lynn Wiles, Jonathan Romero, Leorey Saligan

Ellmer School of Nursing Faculty Publications

Social isolation is a critical public health concern in older adults and is linked to a range of adverse health outcomes across diverse sociodemographic groups. This study investigated the associations between social isolation with physical and mental health of older adults residing in Hampton Roads, a racially diverse region in Southeastern Virginia, home to a large population of senior military veterans. Secondarily, the study explored how social determinants of health (SDoH) and comorbid medical conditions influenced the relationship of social isolation with physical and mental health of these seniors. Physical and mental health were measured using the Patient-Reported Outcomes Measurement …

The Role Of Doulas In The Health Care Continuum For Pregnant People With Substance Use Disorder: Perspectives Of Patients, Doulas, And Healthcare Providers, Dashaunda Taylor, Derek A. Chapman, Caitlin E. Martin, Cynthia C. F. Romero, Gerard Moeller

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives/Goals: The goals of this research are to 1) determine the prevalence of perinatal doula services use in Virginia, with a focus on individuals with substance use disorders (SUD), 2) evaluate awareness of doulas among pregnant and postpartum people with SUD, and 3) assess provider knowledge and interaction with doulas for the care of this population. Methods/Study Population: Both quantitative and qualitative methods will be used to evaluate patient and healthcare provider knowledge regarding doula services and the patient–doula–healthcare provider relationship. Surveys and semi-structured interviews will be administered to doulas, pregnant and postpartum women, and healthcare providers in this mixed-methods …

Ketamine Infusion Treatment For Depression, Isabella Schwing

Capstone Showcase

Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.

Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …

The Quality-Of-Life Benefits And Risk Of Isotretinoin (Accutane) In Acne Treatment: A Systematic Review, Noelia Valencia Zuniga

Honors Undergraduate Theses

Acne vulgaris is a prevalent dermatological condition, particularly affecting adolescents and young adults. While often treated as a cosmetic issue, acne can significantly impair a patient's mental health and overall quality of life (QoL). Isotretinoin, commonly known as Accutane, is widely regarded as the most effective treatment for severe and persistent acne. However, its use is controversial due to a range of potential side effects, including psychiatric symptoms, teratogenicity, and other systemic complications. To better understand the risk-benefit profile of isotretinoin in acne treatment, we conducted a systematic review, focusing on the QoL benefits and risks associated with its use. …

Opioid Usage And Non-Opioid Alternatives In Septorhinoplasty: A Narrative Review, Robert M. Frederick, Eric Dobratz

Department of Otolaryngology (ENT) Faculty Publications

Background and Objective: Opioids are routinely prescribed following septorhinoplasty and oftentimes surgeons prescribe a larger number of tablets than patients require. Considering the high risk of developing opioid dependence and risk of diversion, it is imperative that surgeons practice safer, evidence-based prescribing habits. This review is intended to detail the current state of opioid usage after septorhinoplasty, focusing on articles that show pertinent and practice-altering findings. This will allow surgeons to reflect on their prescribing patterns and make evidence-based decisions to improve them.

Methods: A literature search was performed in November 20, 2024 via PubMed using keywords such as ‘opioid …

Study Of Maternal And Fetal Outcomes In Pregnancy Complicated By Thyroid Disorders, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Background:

Thyroid disorders, particularly hypothyroidism, are common during pregnancy and can significantly impact both maternal and fetal outcomes. Despite advancements in screening and treatment, thyroid dysfunction in pregnancy often remains underdiagnosed, especially in low-resource settings. This study aimed to evaluate the prevalence, outcomes and effective management strategies of thyroid dysfunction during pregnancy.

Objectives: To evaluate the prevalence and outcomes of thyroid dysfunction, including both hypothyroidism and hyperthyroidism, during pregnancy, and their associated maternal and fetal complications.

Methods: This prospective observational study included 281 pregnant women with thyroid disorders attending antenatal care at JSS Hospital, Mysuru, from August 2022 …

Primary Polydipsia In A Case Of Genetic Behavioral Variant Frontotemporal Dementia, Yesenia Cantu, Taryn White, Gabriela Austgen, Christine Rizk, Olaoluwa O Okusaga, Melissa B Jones

Faculty, Staff and Students Publications

No abstract provided.

Poststroke Impulsivity: A Narrative Review, Melissa B Jones, Dakota E Broadway, Malena Gimenez-Zapiola, Ricardo E Jorge

Faculty, Staff and Students Publications

In this narrative review, the authors examine the multidimensional nature and presentations of impulsivity after stroke. Impulsivity manifests as immediate or premature responses, impaired delayed gratification, perseverance despite punishment, and other displays of impaired emotional and behavioral regulation. The literature on the assessments, outcomes, and treatment of patients with these various manifestations after a cerebrovascular injury is reviewed. Findings from case reports indicate that poststroke impulsivity may manifest across neurobehavioral syndromes that are not well defined in the psychiatric nomenclature, such as alien hand syndrome and atypical impulse control disorders. Overall, impulse control disorders appear to be rare poststroke. Therapeutic …

Critiques Of The Cass Review: Fact-Checking The Peer-Reviewed And Grey Literature, Kathleen Mcdeavitt, J Cohn, Stephen B Levine

Faculty, Staff and Students Publications

The Cass Review's final report, published in April 2024, made recommendations to the UK's National Health Service regarding structuring of services for minors with gender-related distress. It recommended cautious use of hormonal interventions in this population and use of research protocols. Some clinician-researchers disagree with the Cass Review's recommendations and have written critiques. A critique of the Cass Review posted on Yale Law School's website in July 2024 has received extensive media coverage. Its references identified three other critiques. In these papers, there were multiple claims that were incorrect or that lacked essential clarification/contextualization. These claims involved (1) the Cass …

Correction: Health-Related Quality Of Life After Neonatal Treatment Of Symptomatic Tetralogy Of Fallot: Insights From The Congenital Cardiac Research Collaborative, George T Nicholson, Jeffrey D Zampi, Andrew C Glatz, Bryan H Goldstein, Christopher J Petit, Yun Zhang, Courtney E Mccracken, Athar M Qureshi, Caren S Goldberg, Jennifer C Romano, Mark A Law, Jeffery J Meadows, Shabana Shahanavaz, Sarosh P Batlivala, Shiraz A Maskatia, Asaad Beshish, Michael L O'Byrne, R Allen Ligon, Kathryn O Stack, Hala Q Khan, Shalin Parekh, Dawn L Ilardi

Faculty, Staff and Students Publications

No abstract provided.

Aerodigestive Sequelae And Triple Endoscopy After Congenital Tracheoesophageal Fistula Repair In Children, Whitney Jin, Eric H Chiou, Shailendra Das, Kathleen E Hosek, Elton M Lambert

Faculty, Staff and Students Publications

Children post-tracheoesophageal fistula (TEF) repair may present with chronic respiratory and gastrointestinal symptoms that can affect quality of life.

OBJECTIVE: To identify factors associated with positive findings on triple endoscopy following neonatal TEF repair.

STUDY DESIGN: Case series with retrospective review of patients.

SETTING: Tertiary care center aerodigestive program.

METHODS: Children with neonatally repaired congenital TEF who had a triple endoscopy between 2011 and 2022 were reviewed. The presence of chronic cough, recurrent pulmonary infections, lipid-laden macrophages (LLM), and airway and esophageal anomalies were among the variables analyzed. Chi-square and Kruskal-Wallis univariate analysis was performed.

RESULTS: The mean age was …

Zic1 Is A Context-Dependent Medulloblastoma Driver In The Rhombic Lip, John J Y Lee, Ran Tao, Zhen You, Parthiv Haldipur, Anders W Erickson, Hamza Farooq, Liam D Hendriske, Namal Abeysundara, Cory M Richman, Evan Y Wang, Neha Das Gupta, Jennifer Hadley, Melissa Batts, Christopher W Mount, Xiaochong Wu, Alex Rasnitsyn, Swneke Bailey, Florence M G Cavalli, Sorana Morrissy, Livia Garzia, Kulandaimanuvel Antony Michealraj, Abhi Visvanathan, Vernon Fong, Jonelle Palotta, Raul Suarez, Bryn G Livingston, Miao Liu, Betty Luu, Craig Daniels, James Loukides, Anne Bendel, Pim J French, Johan M Kros, Andrey Korshunov, Marcel Kool, Fernando Chico Ponce De León, Mario Perezpeña-Diazconti, Boleslaw Lach, Sheila K Singh, Sarah E S Leary, Byung-Kyu Cho, Seung-Ki Kim, Kyu-Chang Wang, Ji-Yeoun Lee, Teiji Tominaga, William A Weiss, Joanna J Phillips, Shizhong Dai, Gelareh Zadeh, Ali G Saad, László Bognár, Almos Klekner, Ian F Pollack, Ronald L Hamilton, Young-Shin Ra, Wieslawa A Grajkowska, Marta Perek-Polnik, Reid C Thompson, Anna M Kenney, Michael K Cooper, Stephen C Mack, Nada Jabado, Mathieu Lupien, Marco Gallo, Vijay Ramaswamy, Mario L Suva, Hiromichi Suzuki, Kathleen J Millen, L Frank Huang, Paul A Northcott, Michael D Taylor

Faculty, Staff and Students Publications

Transcription factors are frequent cancer driver genes, exhibiting noted specificity based on the precise cell of origin. We demonstrate that ZIC1 exhibits loss-of-function (LOF) somatic events in group 4 (G4) medulloblastoma through recurrent point mutations, subchromosomal deletions and mono-allelic epigenetic repression (60% of G4 medulloblastoma). In contrast, highly similar SHH medulloblastoma exhibits distinct and diametrically opposed gain-of-function mutations and copy number gains (20% of SHH medulloblastoma). Overexpression of ZIC1 suppresses the growth of group 3 medulloblastoma models, whereas it promotes the proliferation of SHH medulloblastoma precursor cells. SHH medulloblastoma ZIC1 mutants show increased activity versus wild-type ZIC1, whereas G4 medulloblastoma …

Screening For The Unseen: Depression Detection Through Phq-9 And Provider Education In Pain Management, Veronica Shaw

DNP Projects

Background: Depression leads to significant economic and health burdens, causing 200 million lost workdays and costing employers $17 to $44 billion annually (CDC, 2022). It accounts for 4.3% of the global disease burden and is a leading cause of disability worldwide (WHO, 2021). Chronic pain, affecting 20.9% of United States adults, often exacerbates depression, creating a vicious cycle of physical and emotional suffering (Rikard et al., 2023). Despite the availability of effective treatments, depression is frequently missed in primary care settings, with 50% of cases undiagnosed (Hawkes, 2019). Addressing both depression and chronic pain through improved screening and holistic care …

Introducing An Eating Disorder Protocol In The Pediatric Primary Care Setting, Brandi Bozarth

DNP Projects

Background: The incidence of eating disorders has been on the rise, often beginning in adolescence and continuing well into adulthood. Consequences of untreated disrupted eating patterns can affect multiple body systems and are responsible for thousands of deaths annually. Despite these facts, research and data regarding eating disorders in adolescent patients are severely deficient. There is also a lack of standardization regarding assessing eating disorders in the pediatric primary care setting, as there are no specific guidelines or screening processes recommended by the American Academy of Pediatrics for the detection of eating disorders.

Purpose: The purpose of this project is …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …