Medical Specialties Commons^™

Aging And The Behavioral Problems Of Brain Injury, Paul F. Aravich, Marylin Copeland

Case Studies from Age in Action

Educational Objectives

1. List the various classes of brain injury.

2. Identify cognitive and emotional problems as among the most common and disabling complications of brain injury.

3. Assess challenges to successful aging with a brain injury.

4. Examine the consequences of inadequate systems of care for the challenging behaviors produced by brain injury.

Senior Meal Programs: Feeding A Crowd With Local Foods, Gordon Walker, Elyse Thierry

Case Studies from Age in Action

Educational Objectives

1. Examine reasons for an institutional meal program to consider incorporating local food.

2. Identify potential community partners who might assist in moving such a program forward and the mutual benefits.

3. Describe the possible changes that an institution’s local food program can foster in the community at large.

Cpr And Dnr Decision Making, Viki Kind

Case Studies from Age in Action

Educational Objectives

1. Examine the complexities of end-of-life care and obstacles to good DNR decision making.

2. Discuss CPR and its perceived vs. actual chances for success.

3. Demonstrate best practices for communicating about CPR.

4. Consider how the signing of the DNR is just one component of endof- life care.

Reverse Mortgages, Bruce Desimone

Case Studies from Age in Action

Educational Objectives

1. Describe mobility rates among older adults.

2. Define a reverse mortgage and Home Equity Conversion Mortgage (HECM), and their origins in Virginia.

3. Explain key HECM loan and counseling features.

4. Illustrate how these features may improve the lives of older Virginians.

Treatment Strategies In Acute Myelogenous Leukemia : Investigating Hsp90 And P53 As Targets, Jennifer M. Napper

Theses, Dissertations and Capstones

Acute myelogenous leukemia (AML) is the deadliest of the lymphatic and bone marrow cancers. Patients diagnosed with AML have a five year survival rate of 23.4%. AML is characterized by an accumulation of undifferentiated and functionless myeloid precursors in the bone marrow and blood. Heat shock protein 90 (Hsp90) inhibitors, such as 17-AAG, an analog of geldanamycin (GM), are currently undergoing phase I, and II and III clinical trials for various cancers with mixed results. I found distinct responses to 17-AAG treatment among the AML cell lines tested. I also discovered two mutant TP53 alleles in Kasumi-3 cells, an AML …

Genetic And Environmental Factors Suggest That Dietary Fatty Acid Content, Lipid Metabolism, And Bone Properties Are Key Regulators Of Myeloid Progenitor Cell Frequency, Melinda E. Varney

Theses, Dissertations and Capstones

Acute myelogenous leukemia (AML) and its precursors are the result of the dysregulation of hematopoiesis. Hematopoiesis proceeds in a stepwise manner, beginning with hematopoietic stem cells, continuing to develop into various stages of progenitor cells, and finally becoming fully functional blood cells. As this process goes awry, immature, functionless cells of the myeloid lineage proliferate out of control. Discerning how myeloid progenitor frequency is regulated allows for a better understanding of how the process may lose control. Hematopoiesis has been shown to depend on genetic and environmental factors. In this work, I have added to this knowledge base by providing …

The Expression And Function Of Hypoxia Inducible Factor-1Α In Human Melanoma, Sandeep S. Joshi

Theses, Dissertations and Capstones

Hypoxia inducible factor-1α (HIF-1α) protein, a key regulator of oxygen homeostasis, is stabilized under hypoxia and degraded under normal oxygen tension. Here, the human melanoma cells were found to express an elevated amount of HIF-1α mRNA and protein relative to normal human melanocytes under normoxic conditions. The amount of HIF-1α expressed is roughly correlated with the stage of melanoma from which the cell line was established. In addition, a splice variant mRNA of HIF-1α785 is expressed at higher levels than full-length HIF-1α mRNA in the more aggressive melanoma cells. This splice variant lacks part of the oxygen regulation domain. Ectopic …

Copd Care Coordination Program, Glenda Mccall

Nursing Theses and Capstone Projects

COPD is the fourth leading cause of death in the United States. Several studies confirm only 50% of COPD patients receive optimal care. The disease is greatly under-recognized and generally is not diagnosed until it is clinically apparent and moderately advanced. COPD is also a major resource consuming disease. Considering these facts, Mission Hospitals realized the opportunity to improve evidence based quality care for patients diagnosed with COPD as well as the development of a Care Coordinated Program to improve outcomes for the patient as well as the organization. The goal of the program is to provide correct, comprehensive, and …

2010 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center.

A Close Call - Donald Halke Iii, Ms-Iii, Justin Guthier

Voices from the Floor

No abstract provided.

Pregnancy Associated Breast Cancer: An Analysis Of Fetal Treatment Risk, Melissa Barnett

The Science Journal of the Lander College of Arts and Sciences

There are several viable treatment options for patients with PABC considered un-harmful to fetal development. Trastusumab, or Herceptin, targets HER2 protein and successfully combats aggressive breast cancer. In standard doses, it appears to be safe to the fetus even when administered during the first trimester. A likely side effect of Herceptin is anhydramnios, which can be monitored for throughout the stages of a pregnancy (Shrim et al. 2008). Anthracyclines, commonly used in chemotherapy, appear to be non-toxic, and have been used to successfully cure PABC patients in their second and third trimester. However, first trimester spontaneous abortions are documented to …

Expectations Of Pain Relief Utilizing Epidural Analgesia, Kelly Powell Morris

Nursing Theses and Capstone Projects

This study describes patient expectations and actual pain relief reported by patients experiencing childbirth while utilizing epidural analgesia as their method of choice to reduce the pain associated with childbirth using a quantitative descriptive design. Data were collected using the Expectations of Pain Relief Utilizing Epidural Analgesia Questionnaire. The sample (N=17) consisted of first-time mothers delivering at an acute community hospital who were participants in the county's Nurse-Family Partnership Program. The questionnaire, developed by the researcher, was distributed to participants by their Nurse-Family Partnership Registered Nurse during a routine postpartum home visit during the three month study time span. The …

2009 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center. This report has a focus on acute lymphoblastic leukemia.

The Power Of Empowerment: An Icf-Based Model To Improve Self-Efficacy And Upper Extremity Function Of Survivors Of Breast Cancer, Mary Insana Fisher, Dana Howell

Physical Therapy Faculty Publications

Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often negatively impact the function of the arm, and quality of life and upper extremity function does not always return to a prediagnosis level. Survivors of breast cancer may also experience feelings of diminished self-efficacy related to functional deficits resulting from their physical limitations. The International Classification of Functioning (ICF) provides a framework for rehabilitation practitioners to address physical and psychological impairments, activity limitations, and participation restrictions. Patient outcomes may be improved by fostering self-efficacy through empowerment. This paper explores how the ICF model and …

Implementing The 2005 American Heart Association Guidelines, Including Use Of The Impedance Threshold Device, Improves Hospital Discharge Rate After In-Hospital Cardiac Arrest, Ken Thigpen, Scott Davis, Roberta Basol, Peggy Lange, Sandeep Jain, John Olsen, Bernard Erickson, Timothy Schuchard, Tom P. Aufderheide

Articles

OBJECTIVE:

To determine the impact of the 2005 American Heart Association cardiopulmonary resuscitation (CPR) guidelines, including use of an impedance threshold device (ITD), on survival after in-hospital cardiac arrest.

METHODS:

Two community hospitals that tracked outcomes after in-hospital cardiac arrest pooled and compared their hospital discharge rate before and after implementing the 2005 American Heart Association CPR guidelines (including ITD) in standardized protocols. In CPR we used the proper ventilation rate, allowed full chest-wall recoil, conducted continuous CPR following intubation, and used an ITD. We compared historical control data from a 12-month period at St Cloud Hospital, St Cloud, Minnesota, …

A Bland–Altman Comparison Of The Lead Care® System And Inductively Coupled Plasma Mass Spectrometry For Detecting Low-Level Lead In Child Whole Blood Samples, Christina Sobin, Tanner Schaub, Natali Parisi, Eva De La Riva

Selected Works Temporary Series

Chronic childhood lead exposure, yielding blood lead levels consistently below 10 μg/dL, remains a major public health concern. Low neurotoxic effect thresholds have not yet been established. Progress requires accurate, efficient, and cost-effective methods for testing large numbers of children. The LeadCare® System (LCS) may provide one ready option. The comparability of this system to the “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS) for the purpose of detecting blood lead levels below 10 μg/dL has not yet been examined. Paired blood samples from 177 children ages 5.2–12.8 years were tested with LCS and ICP-MS. Triplicate repeat tests …

Identifying Factors Associated With Falls In Postmenopausal Breast Cancer Survivors: A Multi-Disciplinary Approach, Kerri M. Winters-Stone, Britta Torgrimson, Fay Horak, Alvin Eisner, Lillian Nail, Micahel C. Leo, Steve Chui, Shiuh-Wen Luoh

Community Health Faculty Publications and Presentations

Objective—To identify neuromuscular, balance and vision factors that contribute to falls in recently treated breast cancer survivors (BCS) and explore links between fall risk factors and cancer treatment

Design—Case-control plus prospective observation

Setting—Comprehensive cancer center

Participants—BCS within two years chemotherapy completion and/or on adjuvant endocrine therapy (N=59; mean age: 58 yrs)

Intervention—not applicable

Main outcome measures—Objective measures of postural control, vision and neuromuscular function included 1) a sensory organization test (SOT), 2) a visual assessment battery, 3) muscle mass by DXA, and 4) neuromuscular function with strength by repetition maximum, power by timed stair …

A Program To Promote Physical Activity And Healthy Body Weight In An Adolescent Female: A Case Study, Katie Stoddard

Kinesiology and Public Health

A case study of an obese 14-year-old female was conducted to assess her body weight and dietary and physical activity habits. The purpose of this study was to promote weight loss through improved dietary practices and an increase in energy expenditure. This was done by monitoring and altering caloric intake and engaging in regular, vigorous physical activity. Furthermore, the subject increased health-related knowledge, developed new skills, and ultimately attempted behavior modification. From April to September 2009, the subject participated in a minimum of two supervised exercise sessions per week to increase her energy expenditure and to teach her strategies for …

Reducing Late Charges In Cardiovascular Services, Diane Rydzy Rn

Posters

• Late charges are charges that are “added” to a patient’s bill after the bill has been sent
• Late charges strain the system by making it necessary to “re-bill” the account
• In order to reduce late charges, it is necessary to understand how late charges occur

Research Note: Exploration Of Factors That Impede Door-To-Balloon Times, Erin Troby

Inquiry: The University of Arkansas Undergraduate Research Journal

When experiencing an acute myocardial infarction (AMI), more commonly known as a heart attack, patients need rapid treatment in order to open up and reestablish blood flow within the coronary artery. By far, the most common way to do this is an invasive procedure that allows a physician to inflate a tiny balloon into the plaque-filled area of the artery. The American College of Cardiology (ACC) and the American Heart Association (AHA) have established a 90-minute goal for this procedure, which means that, from the time a patient enters the door of the emergency department (ED), the medical team has …

Pharmacokinetics Of Cefuroxime Are Not Significantly Altered By Cardiopulmonary Bypass In Children, Chad A. Knoderer, Sarah A. Saft, Scott G. Walker, Daniel P. Healy, Kevin M. Sowinski

Scholarship and Professional Work – COPHS

Poster presented at: SPA/AAP PEDIATRIC ANESTHESIOLOGY 2010 - Winter Meeting; April 2010; San Antonio, TX.

Continuous Infusion Of Nafcillin For Sternal Osteomyelitis In An Infant After Cardiac Surgery, Chad A. Knoderer, Jennifer L. Morris, Elaine G. Cox

Scholarship and Professional Work – COPHS

We report the use of the continuous infusion of nafcillin for the treatment of an infant who had methicillinsusceptible Staphylococcus aureus sternal osteomyelitis not responsive to traditional nafcillin dosing. The patient was successfully treated with surgical debridement and the continuous infusion of nafcillin. To our knowledge, this is the first report describing the successful use of the continuous infusion of nafcillin to treat an infant who had sternal osteomyelitis after cardiac surgery.

Medication Use In Pregnant Women With Chronic Medical Conditions, Deborah S. Zeitlin

Scholarship and Professional Work – COPHS

Dr. Deborah Zeitlin addresses medication options for pregnant women with chronic conditions such as: hypertension, asthma, diabetes, and depression. Risks of medication use to the fetus are addressed.

Role Of Intrathecal Rituximab And Trastuzumab In The Management Of Leptomeningeal Carcinomatosis, Anthony J. Perissinotti, David J. Reeves

Scholarship and Professional Work – COPHS

OBJECTIVE: To review evidence for the use of intrathecal rituximab and trastuzumab in the management of leptomeningeal carcinomatosis.

DATA SOURCES: A search of MEDLINE (1966-July 2010) and International Pharmaceutical Abstracts (1970-July 2010) was performed using search terms intrathecal, trastuzumab, rituximab, and monoclonal antibody. Additionally, American Society of Clinical Oncology, San Antonio Breast Conference, American Association for Cancer Research, and American Society of Hematology meeting abstracts were searched.

STUDY SELECTION AND DATA EXTRACTION: Publications were reviewed for inclusion. Those reporting use of rituximab and trastuzumab intrathecally are reviewed and include 1 Phase 1 trial, 2 small prospective studies, 1 case series, …

Sputum Neutrophils As A Biomarker In Copd: Findings From The Eclipse Study, Dave Singh, Lisa Edwards, Ruth Tal-Singer, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

INTRODUCTION: The percentage of neutrophils in sputum are increased in COPD patients, and may therefore be a biomarker of airway inflammation. We studied the relationships between sputum neutrophils and FEV1, health status, exacerbation rates, systemic inflammation and emphysema, and long term variability at 1 year.

METHODS: Sputum samples were obtained from 488 COPD patients within the ECLIPSE cohort. 359 samples were obtained at baseline, and 297 after 1 year. 168 subjects provided samples at both visits. Serum interleukin-6 (IL-6), IL-8, surfactant protein D and C-reactive protein levels were measured by immunoassays. Low-dose CT scans evaluated emphysema.

RESULTS: Sputum neutrophil % …

Folic Acid And Neural Tube Defects, Rachel Leah Feinstein

The Science Journal of the Lander College of Arts and Sciences

The following is an excerpt of this article: Neural tube defects (NTD) are the most common types of birth defects. Research shows that folic acid taken periconceptionally greatly reduces the risk of having a NTD affected child. This paper will explain the role that folate plays in the metabolism, specifically in synthesizing methionine. It will bring evidence to show that methionine is crucial for normal neural tube development. In addition, it will explore the genetic factor involved in folate metabolism and possible folate deficiency.

The Peanut Allergy Epidemic, Rivky Sachs

The Science Journal of the Lander College of Arts and Sciences

Peanut allergy is one of the most predominant food allergies. It accounts for majority of the highly severe and fatal allergic reactions to food. Peanut allergy is generally detected early in life and is commonly associated with other atopic disorders such as asthma, eczema, and rhinitis. The prevalence and pervasiveness of peanut allergies is increasing worldwide, and most peanut allergic patients have lifelong sensitivities to peanuts (de Leon et al, 2008). Patients with severe allergies must stringently avoid any contact with peanuts and depend on intramuscular epinephrine (EpiPen) to counteract the reaction caused by intake of peanuts. Much research is …

Pulmonary Embolism Presenting With Sudden Respiratory Failure In Two Previously Stable Neonates, Joseph Werthammer, Audra Pritt, Laura Reechi, Linda Brown, Mahmood Heydarian

Pediatrics

Pulmonary artery embolism (PE) is a rare and life-threatening complication in the neonate. We describe two previously stable infants who incurred respiratory failure from PE. The first case is a late preterm infant with gastroschisis with autopsy confirmation of PE presumably as a result of a central venous line (CVL) with thromboembolism. The second case is an extreme low birth weight infant with sudden onset of respiratory failure, abnormal chest x-ray, disseminated intravascular coagulation (DIC), and echocardiographic confirmation of a thrombus at the junction of the superior vena cava and right atrium (SVC/RA) at the site of a previous CVL. …

Prieurianin Causes Weight Loss In Diet-Induced Obese Mice And Inhibits Adipogenesis In Cultured Preadipocytes, Ahmed Kablan, Rudel A. Saunders, Maria Szkudlarek-Mikho, Andrew J.B. Chin, Raul M. Bosio, Kazuyuki Fujii, Joseph I. Shapiro M.D., Khew-Voon Chin

Biochemistry and Microbiology

The global increase in the incidence of obesity has emerged as one of the most serious public health risks in recent years. Despite the enormity of the obesity pandemic, there are currently only two FDA-approved therapies for its treatment and these drugs exhibit modest effi cacy and have limiting side effects. Prieurianin is a plant limonoid product that deters feeding in insect larvae. We investigated in this study the effects of prieurianin on weight loss and adipogenesis. Our results showed that prieurianin causes weight loss by reducing energy intake in obese mice on highcalorie diet. We also found that prieurianin …

Laterality, Perception, And Action During The Size-Weight Illusion, Gavin Buckingham, Nathalie S. Ranger, Melvyn A. Goodale

Psychology Presentations

In the classic size-weight illusion (SWI), a small object will feel heavier than an larger object of equal weight (Charpentier, 1891). Individuals continue to perceive this illusory difference in weight long after their gripping and lifting forces have scaled to the actual, identical, mass of the illusion-inducing stimuli (Flanagan & Beltzner, 2000).

The independence of our weight perception and fingertip force application has only been quantified in the right hand of right-handers. The immunity to this perceptual illusion may be affected by manual asymmetries (e.g., Gonzalez, Ganel & Goodale, 2006).

We examined perception of heaviness and fingertip force scaling in …