Medical Specialties Commons^™

Postoperative Deep Vein Thrombosis And Pulmonary Embolism After Ankle Fusion In A Patient With Hemophilia A: A Case Report, Christopher P. Bankhead, Michael J. Hopson, Richard A. Miller

UNM Orthopaedic Research Journal

Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are uncommon postoperative complications of operative procedures for treating injuries of the foot and ankle. Because the disorder of hemophilia A prevents blood clotting and increases bleeding, patients with this condition have been even less likely to develop DVT and PE. We present a 36-year-old man with hemophilia A in whom operative ankle fusion for treating hemophilic arthropathy of the left ankle led to DVT and PE. After decreasing dosage of antihemophilic medication and administering enoxaparin, the symptoms improved and the patient was discharged from the hospital on postoperative day 5. …

Idiopathic Thrombocytopenic Purpura In A 21-Year-Old Collegiate Football Player: A Case Report, James A. Leinhart, Shane P. Cass, Matthew A. Tennison, Ronica A. Martinez, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Muscle cramps are commonly observed in collegiate athlete-patients; however, the condition may be a symptom of severe disorders. In particular, idiopathic thrombocytopenic purpura (ITP) may be a possible diagnosis and involves a decreased number of platelets in the bloodstream. We describe a 21-year-old collegiate player of American football with initially presented with cramping of the neck, abdomen, and forearms. Although findings of physical examination were normal, results of laboratory tests indicated ITP, and the patient was hospitalized for 3 days until the platelet count increased. Because the levels continued to decrease at 6-month followup, splenectomy and use of rituximab agents …

Metasynchronous Rupture Of Both Achilles Tendons In A Patient Undergoing Statin Therapy: A Case Report, Paul J. Johnson, Richard A. Miller

UNM Orthopaedic Research Journal

In treating cholesterol-related cardiovascular diseases, statins are commonly used as preventative medication and are associated with few side effects. However, recent studies have described a connection between statins and development of tendinopathy. Similar research has noted bilateral rupture of the Achilles tendon, a rare injury, in patients undergoing statin therapy. We describe a 74-yearold man undergoing statin (ie, simvastatin) therapy who presented with pain and swelling in the right ankle after exertional-type activity. Magnetic resonance imaging confirmed a rupture of the Achilles tendon, with rupture of the left Achilles tendon identified 5 weeks later without any obvious trauma-related event. Nonoperative …

Notable Findings Of A Preparticipation Examination In An 18-Year-Old Volleyball Player: A Case Report, Stuart J. Lisle, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

The preparticipation examination (PPE) is commonly performed to screen for potentially detrimental health conditions in competitive athletes to help decrease rates of morbidity and mortality associated with participation in sports. However, the significant clinical impact of PPE in the United States has yet to be determined. We describe an 18-year-old female athlete who presented with dizziness and a right-sided limp at 8 days after initial injury. Findings of PPE examination indicated that she had unknowingly sustained a concussion during a volleyball match and continued to play, which resulted in injury to the right foot. Despite abnormal findings of magnetic resonance …

Spare-Parts Technique For Concurrent Treatment Of Ectrodactyly Of The Feet And Syndactyly Of The Hands In A 2-Year-Old Boy: A Case Report, Brielle K. Payne, Mary E. Logue, Selina R. Silva, Deana M. Mercer

UNM Orthopaedic Research Journal

Syndactyly is the most frequently occurring congenital malformation of the limbs. Although common, few studies have reported treating syndactyly using Z-plasty with and without full-thickness grafting. We present a 2-year-old boy who presented to our clinic with ectrodactyly of the feet and simple complete syndactyly of two fingers on each hand. After ectrodactyly reconstruction, we used the excess foot skin to cover finger defects. The patient recovered well postoperatively, with matching skin and no trouble with hair growth. Use of a spare-parts technique can help avoid complications associated with harvesting grafts from other donor sites. The results reinforce the importance …

Becoming A Hand Surgeon, Moheb S. Moneim

UNM Orthopaedic Research Journal

No abstract provided.

Five Lessons Learned During Residency And Fellowship Interviews, Drew K. Newhoff

UNM Orthopaedic Research Journal

No abstract provided.

The Groundwork And Legacy Of Our First Chair, George E. Omer Jr, Md, 1970–1990, Thomas A. Decoster

UNM Orthopaedic Research Journal

No abstract provided.

My Chair Story: Listening With Leadership, 2006–Present, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

No abstract provided.

Trends In Vaccination Rates Amongst Young Children And The Factors Affecting Parent Decisions, Kaitlyn C. Baldridge, Janna Bjoin, Katherine Pool

All Electronic Theses and Dissertations

Problem: Throughout the United States, there has been an increasing trend in the number of parents refusing to vaccinate their children. Studies have shown that since the upward trend of refusal to vaccinate has started, there has been an increase in outbreaks of preventable diseases. In Minnesota, there have been no studies to evaluate how many parents are refusing vaccinations for their children or the reasons why. Purpose: This study will evaluate how many parents with children ages five and under are choosing to vaccinate their children or refusing vaccination, and the reasons behind their choice to vaccinate or not. …

The Knowledge And Attitude Of Bethel's Undergraduate Population On Sun Protective Behaviors, Sarah R. Beddow, Chelsea V. Domeier, Karien Wilson

All Electronic Theses and Dissertations

OBJECTIVES: To compare the attitude and knowledge of health science majors versus non-health science majors of the Bethel University undergraduate population. BACKGROUND: Despite public education about the use of sunscreen and skin cancer protection, researchers are still finding a gap in public knowledge. Sun exposure education is crucial and must happen during childhood and adolescence because these are the times people receive the most UV exposure. Repeat sunburns during childhood can double an individual's risk of developing melanoma in adulthood. METHODS: This was a pre-experimental design single evaluation via a survey. The following research questions were investigated in our research …

Antihypertensive Medication Adherence In The Twin Cities, Jacob J. Clairmont, Taylor J. Cunningham, Krista M. Nauman

All Electronic Theses and Dissertations

A retrospective study of antihypertensive medication adherence was conducted on patients’ demographics data at Eastside Health Clinic in St. Paul, MN. The study sought to determine whether or not interventional means were needed to improve adherence to antihypertensive medication based on serial blood pressure measurements collected over the course of 6 clinic visits. The study found that patients were consistently more non-adherent than adherent in every category assessed, yet there was an overall decrease in mean systolic and diastolic blood pressure. Based upon these findings, it can be concluded that while individual adherence rates were imperfect for each demographic category …

Knowledge Of Behaviors That Contribute To A Healthy Pregnancy In Women Aged 18-25, Sarah K. Coffey, Rebecca Jennings

All Electronic Theses and Dissertations

Knowledge of behaviors that contribute to a healthy pregnancy may enhance the overall pregnancy experience. However, there are currently no studies that evaluate where discrepancies exist between current recommendations of behaviors contributing to healthy pregnancies and knowledge of those behaviors in women ages 18-25. The objective of this study was to determine where those discrepancies exist. Survey data of women’s knowledge was compared to current recommendations set forth by the American College of Obstetricians and Gynecologists (ACOG). The behaviors assessed included alcohol consumption, cigarette smoking, sleeping, caloric intake, exercise, caffeine intake, weight gain, and folic acid intake. This knowledge was …

An Analysis Of Immunization Understanding In Undergraduate Students At Bethel University, Jeff Dahlquist, Steven D. Lindblom

All Electronic Theses and Dissertations

This investigation studied the level of understanding of the nature of immunizations and vaccine preventable diseases in undergraduate students at Bethel University. Immunization literature demonstrates a significant lack of understanding in the general population in relation to the nature of vaccine preventable diseases and the immunizations used to counter them. Furthermore, the literature concludes that such a grossly inadequate understanding of the nature of vaccine preventable diseases may precipitate dire epidemiological consequences. This investigation was a pre-experimental design and utilized a short questionnaire administered one time to a sample population of 171 subjects over 18 years of age who were …

Anterior Cruciate Ligament Reconstruction: Which Graft Is Best To Prevent Re-Tear?, Katherine Ann Eslinger, Brittany Kapala, Noelle Kreofsky

All Electronic Theses and Dissertations

The three most widely used graft choices currently employed in anterior cruciate ligament (ACL) repair are: patellar tendon autograft, hamstring tendon autograft, and cadaver tendon allograft. The purpose of this study is to examine the efficacy of each of these 3 graft choices (patellar tendon autograft, hamstring tendon autograft and cadaver tendon allograft) and determine which graft is less prone to re-tear. The study was implemented using a quantitative design process. The patient data was obtained and analyzed via Facebook survey. All identifying patient information was removed. Patients were included based on whether or not their ACL reconstruction was performed …

Cardiovascular Strain In Overweight 5k Runners, Sara Geier, Polly Hendel

All Electronic Theses and Dissertations

Previous research is vast and varied regarding how exercise affects the physiology of the cardiac system. Many studies have found adverse effects to the heart in ultra-endurance athletes, but fewer studies have focused on overweight populations. Hamer and Boutcher (2006) observed abnormal post exercise cardiovascular changes in obese individuals when compared to individuals of normal body mass index (BMI) but, were unable to draw any definitive conclusions from the results. With Americans facing an obesity epidemic and healthcare providers increasingly prescribing regular exercise routines to combat it, definitive conclusions regarding the topic of healthy long-term exercise in overweight and obese …

Diabetes Education For The Hispanic Population, Nohemi I. Haben, Misty M. Schmitz

All Electronic Theses and Dissertations

The purpose of this study is to investigate the effects, if any, of utilizing Spanish language on the efficacy of an education program for type 2 diabetes among the Hispanic population in the twin-cities Minneapolis/St. Paul metro area. In the United States adult Hispanics over the age of twenty have a 5.2% higher incidence of type 2 diabetes than Non-Hispanic Whites, a number that keeps rising despite preventability. In this study, a diabetes education program was delivered in Spanish based on material developed by the Centers for Disease Control and Prevention and the National Diabetes Education Program. The program focused …

Minnesota Healthcare Barriers To The Medically Underserved, Ashley C. Hoffmann, Amanda Walters

All Electronic Theses and Dissertations

Quality medical services and patient oriented satisfaction are important factors in a healthcare setting. Barriers preventing such factors are more prevalent in medically underserved areas (MUAs) ( Brems, Johnson, Warner, & Roberts, 2006 ). The purpose of this study was to identify barriers in the care of patients within Minnesota MUAs. The study was conducted by an online survey emailed to Minnesota Academy of Physician Assistant (MAPA) members, and only members who were currently employed in a Minnesota MUA county had valid data collection. Twelve barriers to healthcare were listed on the survey and required the MAPA members to grade …

Dietary Supplements: A Consumer Profile Of Knowledge And Use, Sarah J. Kucera, Yen Nguyen

All Electronic Theses and Dissertations

Alternative medicine, in the form of dietary supplements, is appealing to Americans. Supplements have been marketed as being natural promoters of general well-being, healing, and disease prevention. Even with minimal regulation and research, the majority of supplement use is self-prescribed, fueling an industry last estimated at $32.5 billion in 2012. The study explored the degree of consumer knowledge with regards to regulation, appropriate indications and dosages, and potential adverse effects of various dietary supplements. The study also sought to evaluate the relationship between supplement knowledge and demographic information as well as the extent of discussion about supplement use with a …

Individual Physician Assistant's Spirituality And Job Satisfaction, Kyle J. Smisek, Kelsa L. Hovelson, Mali D. Langlie

All Electronic Theses and Dissertations

The factors that contribute to job satisfaction have been studied extensively. Additionally, in the healthcare setting, the influence of spirituality has been a topic of substantial research. However, few studies have researched a physician assistant’s individual spirituality and its influence on job satisfaction. The goal of this study was to first identify the effect, if any, between the spirituality of a PA and his or her perceived job satisfaction, and second, to determine where spirituality ranks among the various factors that influence job satisfaction. In addition, the study addressed whether there appears to be a connection between one’s spirituality and …

Department Of Surgery Update, January 2016, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

2016-2017 Pediatric Subspecialty Trainees And Residents, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in allergy/immunology, child abuse pediatrics, child neurology, clinical child psychology, clinical cytogenetics & molecular genetics, clinical pharmacology, developmental-behavioral pediatrics, hospice Y palliative care, neonatal-perinatal medicine, pediatric cardiology, pediatric critical care medicine, pediatric dentistry, pediatric endocrinology, pediatric emergency medicine, pediatric ethics, child gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric otolaryngology, pediatric plastic surgery, pediatric pulmonology, pediatric radiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, pediatric residency and med/peds residency

Repeated Low-Dose Organophosphate Dfp Exposure Leads To The Development Of Depression And Cognitive Impairment In A Rat Model Of Gulf War Illness, Laxmikant Deshpande, Kristin Phillips

Neurology Publications

Approximately 175,000 to 250,000 of the returning veterans from the 1991 Persian Gulf War exhibit chronic multi-symptom illnesses that includes neurologic co-morbidities such as depression, anxiety and cognitive impairments. Amongst a host of causative factors, exposure to low levels of the nerve agent Sarin has been strongly implicated for expression of Gulf War Illness (GWI). Nerve agents similar to pesticides are organophosphate (OP) compounds. There is evidence from civilian population that exposure to OPs such as in agricultural workers and nerve agents such as the survivors and first-responders of the Tokyo subway Sarin gas attack suffer from chronic neurological problems …

Two Sampling Methods Yield Distinct Microbial Signatures In The Nasopharynges Of Asthmatic Children., Marcos Pérez-Losada, Keith A. Crandall, Robert J. Freishtat

Pediatrics Faculty Publications

Background

The nasopharynx is a reservoir for pathogens associated with respiratory illnesses, such as asthma. Next-generation sequencing (NGS) has been used to characterize the nasopharyngeal microbiome during health and disease. Most studies so far have surveyed the nasopharynx as a whole; however, less is known about spatial variation (biogeography) in nasal microenvironments and how sampling techniques may capture that microbial diversity.

Findings

We used targeted 16S rRNA MiSeq sequencing and two different sampling strategies [nasal washes (NW) and nasal brushes (NB)] to characterize the nasopharyngeal microbiota in 30 asthmatic children. Nasal brushing is more abrasive than nasal washing and targeted …

Different Vancomycin Immunoassays Contribute To The Variability In Vancomycin Trough Measurements In Neonates, Janko Samardzic, Anne Smits, Isabel Spriet, Ivan Soldatovic, Andrew Atkinson, Milica Bajcetic, John N. Van Den Anker, Karel Allegaert

Pediatrics Faculty Publications

Substantial interassay variability (up to 20%) has been described for vancomycin immunoassays in adults, but the impact of neonatal matrix is difficult to quantify because of blood volume constraints in neonates. However, we provide circumstantial evidence for a similar extent of variability. Using the same vancomycin dosing regimens and confirming similarity in clinical characteristics, vancomycin trough concentrations measured by PETINIA (2011-2012, n = 400) were 20% lower and the mean difference was 1.93 mg/L compared to COBAS (2012–2014, n =352 ) measurements. The impact of vancomycin immunoassays in neonatal matrix was hereby suggested, supporting a switch to more advanced techniques …

Baseline Results Of The Neuronext Spinal Muscular Atrophy Infant Biomarker Study, Stephen J. Kolb, Christopher S. Coffey, Jon W. Yankey, Kristin Krosschell, David Arnold, Mathula Thangarajh, +20 Additoinal Authors, Neuronext Clinical Trial Network

Neurology Faculty Publications

Objective

This study prospectively assessed putative promising biomarkers for use in assessing infants with spinal muscular atrophy (SMA).

Methods

This prospective, multi-center natural history study targeted the enrollment of SMA infants and healthy control infants less than 6 months of age. Recruitment occurred at 14 centers within the NINDS National Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT) Network. Infant motor function scales and putative electrophysiological, protein and molecular biomarkers were assessed at baseline and subsequent visits.

Results

Enrollment began November, 2012 and ended September, 2014 with 26 SMA infants and 27 healthy infants enrolled. Baseline demographic characteristics of the …

A Technique Of Improved Medial Meniscus Visualization By Anterior Cruciate Ligament Graft Placement In Chronic Anterior Cruciate Deficient Knees, Christopher J. Vertullo, Lahann Wijenayake, Jane E. Grayson

Faculty Publications

It is customary to perform medial meniscus repair before anterior cruciate ligament (ACL) graft placement when undertaken as a combined procedure. However, in chronic ACL-deficient knees, intraoperative anterior tibiofemoral translation can cause the medial meniscus repair to be more technically challenging. Intraoperative anterior tibiofemoral translation can both reduce the visualization of the medial meniscus and make its reduction unstable. An operative sequence alteration of ACL graft placement and tensioning before medial meniscal repair improves medial meniscus visualization in chronically ACL-deficient knees by using the ACL graft’s ability to prevent anterior tibiofemoral translation. The technique sequence is as follows: (a) the …

An Efficient Basket Trial Design, Kristen Cunanan, Alexia Iasonos, Ronglai Shen, Colin B. Begg, Mithat Gonen

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

The landscape for early phase cancer clinical trials is changing dramatically due to the advent of targeted therapy. Increasingly, new drugs are designed to work against a target such as the presence of a specific tumor mutation. Since typically only a small proportion of cancer patients will possess the mutational target, but the mutation is present in many different cancers, a new class of basket trials is emerging, whereby the drug is tested simultaneously in different baskets, i.e., sub-groups of different tumor types. Investigators not only desire to test whether the drug works, but also to determine which types of …

Crhbp Polymorphisms Predict Chronic Pain Development Following Motor Vehicle Collision, S. D. Linnstaedt, A. V. Bortsov, A. C. Soward, R. Swor, D. A. Peak, J. Jones, N. Rathlev, D. C. Lee, R. Domeier, P. L. Hendry, S. A. Mclean

Journal Articles

Musculoskeletal pain (MSP) is a common sequela of traumatic stress exposure. While biologic factors contributing to chronic MSP after motor vehicle collision (MVC) have traditionally focused on tissue injury, increasing evidence suggests that neuro/stress/immune processes mediated by stress system activation may play a more dominant role. In a previous study we found that genetic variants in the hypothalamic-pituitary-adrenal (HPA) axis-related gene FKBP5 influence vulnerability to persistent MSP 6 weeks after MVC. In the present cohort study (n = 855) we evaluated whether genetic variants in several other important HPA axis-related genes, including the glucocorticoid receptor (NR3C1), corticotropin-releasing hormone receptor R1 …

Relationship Between Obesity And Clinical Outcome In Adults With Acute Myeloid Leukemia: A Pooled Analysis From Four Calgb (Alliance) Clinical Trials, J. J. Castillo, F. Mulkey, S. Geyer, J. E. Kolitz, W. Blum, B. L. Powell, S. L. George, R. A. Larson, R. M. Stone

Journal Articles

Obesity has been previously suggested as an adverse prognostic marker in patients with acute leukemia. To evaluate the relationship between obesity and clinical outcome, disease-free survival (DFS) and overall survival (OS), in patients with acute myelogenous leukemia (AML), including acute promyelocytic leukemia (APL), we performed a pooled analysis of four CALGB (Alliance) clinical trials. Our study included 446 patients with APL from CALGB 9710, and 1,648 patients between 18 and 60 years of age with non-APL AML from CALGB 9621, 10503, and 19808. Obesity was defined as BMI >/=30 kg/m(2) . Multivariate Cox proportional-hazard regression models were fitted for DFS …