Medical Specialties Commons^™

Prehospital Emergency Medical Services Treatment Protocols: Aligning With National Best Practices, Zachary Ryan Charest

Online Theses and Dissertations

Many variances in prehospital Paramedic treatment protocols exist amongst Emergency Medical Service (EMS) Providers in the State of Kentucky. These differences lead to inconsistencies in quality of patient care delivered, reduce ease of mobility of providers and result in a decreased oversight from the Kentucky Board of EMS (KBEMS). To investigate the impact of protocol variances on patient care, a mixed methods study consisting of a convenience sample of Kentucky EMS prehospital Paramedic treatment protocols was collected and compared to the Kentucky state-wide treatment protocols. A literature review of best practices regarding EMS protocols was conducted. Of all protocols 81.9% …

Educational Professionals' Current Knowledge Of Concussions And Return To Learn Implementation Practice, Michelle Kuzma

Online Theses and Dissertations

Purpose of Project: The purpose of this study was to determine the knowledge level and return-to-learn concussion management guidelines for secondary school educational professionals.

Methods: Surveys were distributed to 1,334 middle and high school educational professionals. Surveys included questions regarding basic demographics, teaching and coaching experience, personal concussion experiences, general concussion knowledge, and knowledge of return-to-learn guidelines. Results: Survey response rate was 15.7% (N=210). The mean teaching experience was 13.9±8.6yr and 46.4% had previous or current coaching experience. Overall 25.8% of respondents had taken a class/clinic on concussion recognition. Of those that coached, only 49.0% took a class on concussion …

The Experiences Of Occupational Therapists Working On Interprofessional Primary Health Care Teams: A Case Study., Emma Blake Mcclellan

Online Theses and Dissertations

The aim of this research was to provide evidence on the integration of occupational therapy (OT) intervention in primary care from the perspective of OTs. Typical services provided, experience with team members, and the identified value of OT in primary health care was explored. OT possesses the expertise and skill set to address the most common chronic conditions that primary care providers treat by entry level educational preparation. OT services are based upon a holistic view of individuals creating an affective skill set to participate in and coordinate health care delivery for the client. Currently limited evidence is available to …

Final Thoughts, Hatim A. Omar

Pediatrics Faculty Publications

The work to establish the "Stop Youth Suicide Campaign (SYS)" has resulted in contact with many young adults. We realized that the most important thing for the kids was finding a caring person they can trust and talk to. This project has been a learning process for all involved. I learned that I can help and so can everyone else. This community and grassroots approach showed tangible results. It needs caring and dedication and most importantly desire to make a difference. It is hard work, but well worth it. Many people, including myself, are afraid of failure. I suffered every …

Community-Based Perceptions Of Emergency Care In Kenya, Morgan C. Broccoli, Emilie J.B Calvello, Alexander P. Skog, Benjamin W. Wachira, Lee A. Wallis

Emergency Medicine, East Africa

Access to quality emergency services is an essential component of the human right to health, but barriers to emergency care are found throughout Africa and the wider world. Data to support the development of emergency care are essential to improve access to care and further infrastructure development. We undertook this study to understand the community's emergency care needs and the barriers they face when trying to access care and to engage community members with developing high impact solutions to expand access to essential emergency services.

To accomplish this, we used a qualitative research methodology to conduct 59 focus groups with …

Expandable Total Humeral Replacement In A Child With Osteosarcoma, Eric R. Henderson, Jidi Gao, John Groundland, Odion Binitie, G. Douglas Letson

Orthopaedics and Sports Medicine Faculty Publications

Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient’s success indicates that expandable total humeral replacement is a viable option.

Surface Electromyography Of The Forearm Musculature During The Windmill Softball Pitch, D. Trey Remaley, Bryce Fincham, Bryan Mccullough, Kirk Davis, Charles Nofsinger, Charles Armstrong, Julie M. Stausmire

Orthopaedics and Sports Medicine Faculty Publications

Background: Previous studies investigating the windmill softball pitch have focused primarily on shoulder musculature and function, collecting limited data on elbow and forearm musculature. Little information is available in the literature regarding the forearm. This study documents forearm muscle electromyographic (EMG) activity that has not been previously published.

Purpose: Elbow and upper extremity overuse injuries are on the rise in fast-pitch softball pitchers. This study attempts to describe forearm muscle activity in softball pitchers during the windmill softball pitch. Overuse injuries can be prevented if a better understanding of mechanics is defined.

Study Design: Descriptive laboratory study.

Methods: Surface EMG …

Distal Spermatic Cord Peritoneal Stripping: An Adjunct Technique During Inguinal Orchiopexy, Hubert S. Swana, Rikin Patel, Mark A. Rich

Urology Faculty Publications

No abstract provided.

A Novel Approach For The Treatment Of Radiation-Induced Hemorrhagic Cystitis With The Greenlight™ Xps Laser, Daniel Roberto Martinez, Cesar E. Ercole, Juan Gabriel Lopez, Justin Parker, Mary K. Hall

Urology Faculty Publications

Introduction: The treatment of pelvic malignancies with radiotherapy can develop severe sequelae, especially radiation-induced hemorrhagic cystitis. It is a progressive disease that can lead to the need for blood transfusion, hospitalizations, and surgical interventions. This tends to affect the quality of life of these patients, and management can at times be difficult. We have evaluated the GreenLight Xcelerated Performance System (XPS) with TruCoag, although primarily used for management of benign prostatic hypertrophy (BPH), for the treatment of radiation-induced hemorrhagic cystitis.

Materials and Methods: After International Review Board (IRB) approval, a retrospective chart review was performed in addition to a literature …

A Nuclear Fraction Of Turnip Crinkle Virus Capsid Protein Is Important For Elicitation Of The Host Resistance Response, Sung-Hwan Kang, Feng Qu, Thomas J. Morris

Nebraska Center for Virology: Faculty Publications

The N-terminal 25 amino acids (AAs) of turnip crinkle virus (TCV) capsid protein (CP) are recognized by the resistance protein HRT to trigger a hypersensitive response (HR) and systemic resistance to TCV infection. This same region of TCV CP also contains a motif that interacts with the transcription factor TIP, as well as a nuclear localization signal (NLS). However, it is not yet known whether nuclear localization of TCV CP is needed for the induction of HRT-mediated HR and resistance. Here we present new evidence suggesting a tight correlation between nuclear inclusions formed by CP and the manifestation of HR. …

A Novel Codon-Optimized Siv Gag-Pol Immunogen For Genebased Vaccination, Catherine M. Crosby, Eric A. Weaver, Reeti Khare, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Simian immunodeficiency virus (SIV) is a robust pathogen used in non-human primates to model HIV vaccines. SIV encodes a number of potential vaccine targets. By far the largest and most conserved protein target in SIV is its gag-pol protein that bears many epitopes to drive multivalent immune T cell responses. While gag-pol is an attractive antigen, it is only translated after a frame shift between gag and pol with the effect that gag and pol are expressed at an approximate 10/1 ratio. The codon bias of native lentiviral genes are also mismatched with the abundance of tRNAs in mammalian cells …

Mobile Stroke Unit (Msu): The Future Of Acute Stroke Treatment, Waldo R. Guerrero

Neurosurgery and Brain Repair Faculty Publications

No abstract provided.

Financing Early Childhood Education: An Investment Into The Future, Shelina Bhamani

Department of Obstetrics & Gynaecology

No abstract provided.

Urine Neutrophil Gelatinase-Associated Lipocalin In Asphyxiated Neonates: A Prospective Cohort Study, Farida Essajee, Fred Were, Bashir Admani

Paediatrics and Child Health, East Africa

Background: Acute kidney injury (AKI) is the most common complication of perinatal asphyxia. Recent research indicates that urine neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI; yet, there is a paucity of data about its use in term neonates with perinatal asphyxia.

Methods: A prospective cohort study was conducted on 108 term babies in the new-born unit of Pumwani Maternity Hospital and Kenyatta National Hospital. Urine NGAL and serum creatinine were measured in 108 term asphyxiated neonates on days 1 and 3 of life.

Results: One-hundred and eight patients were recruited (male:female 1.4:1). At a cut-off of 250 …

Parenting Skills And Emotional Availability: An Rct, Aisha K. Yousafzai, Muneera A. Rasheed, Arjumand Rizvi, Robert Armstrong, Zulfiqar A. Bhutta

Paediatrics and Child Health, East Africa

Objective: To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children’s development and growth compared with either a nutrition intervention alone or the usual standard of care.

Methods: A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health …

World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Probiotics, Alessandro Fiocchi, Ruby Pawankar, Carlos Cuello-Garcia, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Shreyas Gandhi, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda-Ortiz, Susan Waserman, Juan José Yepes-Nuñez, Jan L. Brożek, Holger J. Schünemann

Paediatrics and Child Health, East Africa

Background: Prevalence of allergic diseases in infants, whose parents and siblings do not have allergy, is approximately 10% and reaches 20–30% in those with an allergic first-degree relative. Intestinal microbiota may modulate immunologic and inflammatory systemic responses and, thus, influence development of sensitization and allergy. Probiotics have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention.

Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations about the use of probiotics in the prevention of allergy.

Methods: We identified the most relevant clinical questions and performed a systematic review …

Treatment Of Exophytic Renal Cancer Smaller Than 3 Cm: Surgery Versus Active Surveillance., Costas D. Lallas, Edouard J. Trabulsi, Samuel D. Kaffenberger, Karim A Touijer

Department of Urology Faculty Papers

No abstract provided.

Anti-Nmda Receptor Encephalitis In A Patient With Previous Psychosis And Neurological Abnormalities: A Diagnostic Challenge, R. David Heekin, Maria C. Catalano, Alfred T. Frontera, Glenn Catalano

Neurology Faculty Publications

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder characterized by IgG autoantibodies directed against the NR1 subunit of the NMDA glutamate receptor. Psychiatric symptoms are common and include psychosis, mania, depressed mood, aggression, and speech abnormalities. Neurological symptoms such as seizures, decreased responsiveness, dyskinesias, and other movement abnormalities and/or autonomic instability are frequently seen as well. We present the case of a woman who was followed up at our facility for over 14 years for the treatment of multiple neuropsychiatric symptoms. Initially, she presented with paresthesias, memory loss, and manic symptoms. Nine years later, she presented to our facility again, …

Oral Health And The Elderly Talking Points, American Dental Association

Action for Dental Health

No abstract provided.

Vital Signs, Winter 2015, Boonshoft School Of Medicine

Vital Signs

A sixty page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Growing Up With Chronic Kidney Disease: What Parents And Children Really Want To Know, Uptal D. Patel, Debbie S. Gipson, Abiodun Aderogba Omoloja, Caitlin Wise Carter

Pediatrics Faculty Publications

Adolescents with chronic kidney disease have specific questions about how their disease will affect their quality of life, but they may not always bring this up with their nephrologist. This session is designed to provide pediatricians and pediatric nephrologists with practical information to provide to adolescents with chronic kidney disease and their families. All providers who care for adolescents with renal disease need to be equipped to educate this high risk population and help them navigate through this vulnerable period. This session is designed to explore issues related to athletic participation, academic performance, substance use and abuse and sexual and …

Controlled Laboratory Comparison Study Of Motion With Football Equipment In A Destabilized Cervical Spine: Three Spine-Board Transfer Techniques, Mark L. Prasarn, Marybeth Horodyski, Matthew J. Dipaola, Christian P. Dipaola, Gianluca Del Rossi, Bryan P. Conrad, Glenn R. Rechtine Ii

Orthopaedics and Sports Medicine Faculty Publications

Background: Numerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board.

Purpose: To test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model.

Study Design: Controlled laboratory study.

Methods: Five whole, lightly embalmed cadavers were fitted with shoulder pads and …

Specific N-Glycans Of Hepatocellular Carcinoma Cell Surface And The Abnormal Increase Of Core-Α-1, 6-Fucosylated Triantennary Glycan Via N-Acetylglucosaminyltransferases-Iva Regulation, Huan Nie, Xia Liu, Yubao Zhang, Tingting Li, Chao Zhan, Wenjuan Huo, Anshun He, Yuanfei Yao, Yu Jin, Youpeng Qu, Xue-Long Sun, Yu Li

Chemistry Faculty Publications

Glycosylation alterations of cell surface proteins are often observed during the progression of malignancies. The specific cell surface N-glycans were profiled in hepatocellular carcinoma (HCC) with clinical tissues (88 tumor and adjacent normal tissues) and the corresponding serum samples of HCC patients. The level of core-α-1,6-fucosylated triantennary glycan (NA3Fb) increased both on the cell surface and in the serum samples of HCC patients (p < 0.01). Additionally, the change of NA3Fb was not influenced by Hepatitis B virus (HBV)and cirrhosis. Furthermore, the mRNA and protein expression of N-acetylglucosaminyltransferase IVa (GnT-IVa), which was related to the synthesis of the NA3Fb, was substantially increased in HCC tissues. Knockdown of GnT-IVa leads to a decreased level of NA3Fb and decreased ability of invasion and migration in HCC cells. NA3Fb can be regarded as a specific cell surface N-glycan of HCC. The high expression of GnT-IVa is the cause of the abnormal increase of NA3Fb on the HCC cell surface, which regulates cell migration. This study demonstrated the specific N-glycans of the cell surface and the mechanisms of altered glycoform related with HCC. These findings lead to better understanding of the function of glycan and glycosyltransferase in the tumorigenesis, progression and metastasis of HCC.

Graduate Certificate In Medical Informatics, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Physical, Cognitive, Social And Mental Health In Near-Centenarians And Centenarians Living In New York City: Findings From The Fordham Centenarian Study, Daniela S. Jopp, Min-Kyung S. Park, Jonathan Lehrfeld, Michelle E. Paggi

Publications and Research

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators.

Methods: A total of 119 individuals aged 95 to 107 …

Role Of 5'Tg3'-Interacting Factors (Tgifs) In Vorinostat (Hdac Inhibitor)-Mediated Corneal Fibrosis Inhibition, Ajay Sharma, Nishant R. Sinha, Saad Siddiqui, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Purpose: We have previously reported that vorinostat, an FDA-approved, clinically used histone deacetylase (HDAC) inhibitor, attenuates corneal fibrosis in vivo in rabbits by blocking transforming growth factor β (TGFβ). The 5′TG3′-interacting factors (TGIFs) are transcriptional repressors of TGFβ1 signaling via the Smad pathway. The present study was designed to explore the expression of TGIFs in human corneal fibroblasts and to investigate their role in mediating the antifibrotic effect of vorinostat.

Methods: Human corneal fibroblast cultures were generated from donor corneas. RNA isolation, cDNA preparation, and PCR were performed to detect the presence of TGIF1 and TGIF2 transcripts. The cultures were …

Elderly Patient Adherence To Ocular Pharmaceuticals; Impact Of Educational And Physical Barriers, Lucky Wagner

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research was to assess and evaluate elderly patient's attitudes and behavior regarding educational and physical barriers and the impact on adherence to ocular pharmaceuticals. A 19 question survey was developed and in order to collect data. The survey was administered in person at the Edina Senior Center and the Burnsville Senior Center and online via Zoomerang survey software regarding elderly patient attitudes on educational and physical barriers and their impact on ocular pharmaceutical adherence. Findings from this study indicate elderly patients treating an ocular condition with ocular pharmaceuticals expressed strong agreement with improving upon both educational …

Impact Of Caregiving Role In The Quality Of Life Of Family Caregivers For Persons With Alzheimer's Disease, Supriya Sarkar

All Graduate Theses, Dissertations, and Other Capstone Projects

This study investigated quality of life of family caregivers of persons with Alzheimer's disease (AD). Caregiving is a strenuous and challenging job. Family caregivers experience poor quality of life after they take the role of caregiving which might be related to depression. Purpose of this study was to find if caregiving duration and depression has any role in affecting family caregivers' emotional, physical, and general health.

Data for this study were collected through electronic and mailed survey methods. The questionnaires completed by subjects: Medical Outcomes Study Short Form 36 (MOS-36) and Center for Epidemiologic Studies Depression Scale (CES-D). Descriptive statistics …

Determining The False Positive Rate Of A Concussion Battery In Healthy Division I Collegiate Athletes, Caitlynn S. Hellwig

College of Graduate Studies: Theses & Dissertations

Context: Athletic participation accounts for 1.6-3.8 million concussions, or mild traumatic brain injuries (mTBI) every year in the United States. Accurate assessment and diagnosis of concussions is critical to protect athletes from further injury. The Fourth International Conference on Concussion in Sport Consensus Statement recommends a multifaceted concussion assessment which includes symptom inventories, postural stability assessment, and neurocognitive testing. The accuracy of each test is vital in correctly diagnosing concussions. The Balance Error Scoring System (BESS), Standardized Assessment of Concussion (SAC), and Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) are among the most commonly used assessment tools by NCAA athletic …

Guidelines For The Initial Management Of Adults With Sepsis/Severe Sepsis/Septic Shock: 2015, Erfan Hussain, Bushra Jamil, Naseem Salahuddin

Department of Medicine

No abstract provided.