Medical Specialties Commons^™

Letter From The Chief Of The Division Of Physical Therapy, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Below-Knee Amputations: A Review, Erika L. Garbrecht

UNM Orthopaedic Research Journal

At our institution, physicians from the orthopaedic department perform a considerable proportion of below-knee amputations. These amputations are performed to treat non-traumatic and traumatic injuries. However, the outcomes of amputation are not discussed as often in our educational experience as those of other procedures. The current review examines the current and relevant studies for indications and outcomes of patients with non-traumatic and traumatic conditions treated with below-knee amputations.

Midterm Results Of An Anatomical Radial Head Arthroplasty For Treating Fractures And Degenerative Joint Diseases Of The Radial Head, Gabriel Pertierra, Lauren L. Vernon, Francisco Rubio

UNM Orthopaedic Research Journal

Background: Radial head arthroplasty (RHA) is typically performed to restore elbow stability or function in patients with fractures or degenerative joint diseases. The procedure requires a specific operating technique to avoid complications such as overstuffing, capitellar erosion, stiffness, instability, micro motion, and loosening. It is difficult to restore native radial head function reliably.

Methods: We reviewed the medical records of 45 patients who underwent radial head arthroplasty using the ALIGN radial head implant (ALIGN Radial Head System, Skeletal Dynamics, Miami, FL) at our institution. A total of 15 patients met inclusion criteria and were contacted to complete a QuickDASH questionnaire, …

Clinical And Radiographic Comparison Between Patients With Achilles Midsubstance Ruptures And Achilles Sleeve Avulsions, Christopher L. Shultz, Matthew G. Wharton, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Simulated Method To Perform The Coleman Block Test In Educating Orthopaedic Residents Outside Of The Clinic, Taylor J. Polander, Erika L. Garbrecht, Amber L. Price, Paul J. Johnson, Richard A. Miller

UNM Orthopaedic Research Journal

No abstract provided.

Chronic Tenosynovitis Caused By Mycobacterium Avium-Intracellulare Of The Flexor Tendons In A 65-Year-Old Man: A Case Report, Kourosh M. Kolahi, Moheb S. Moneim

UNM Orthopaedic Research Journal

We report a rare case of Mycobacterium aviumintracellulare flexor tenosynovitis in the hand of a 65-year-old man. The patient reported no history of penetrating trauma but was an avid gardener and presented nearly 2 years after the onset of symptoms. Our case highlights the difficulty in diagnosing mycobacterial infections owing to their lack of classic clinical and laboratory findings. Our patient underwent successful surgical debridement followed by oral antibiotic therapy, initiated 4 weeks after the culture was positive for a slow-growing organism.

Brachial Artery Vasculitis And Associated Stenosis Presenting As Elbow Pain In A 16-Year-Old Soccer Player: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, James P. Toldi, Deana M. Mercer, Mark Langsfeld, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Chronic vascular occlusion in the upper extremity can result from repetitive trauma, atherosclerosis, proximal embolic events, hypercoagulable states, and systemic diseases such as collagen vascular disease and vasculitis. Considerable functional impairment can result from these maladies; however, sometimes the condition develops slowly with minimal effect on the patient. We describe a 16-year-old soccer player with slow-progressing elbow pain and loss of range in motion caused by brachial artery vasculitis and resultant brachial arterial stenosis. Although vascular insults and lesions rarely cause chronic vascular occlusion, physicians should consider this possibility in patients with localized pain or atrophy, especially if the condition …

The National School Lunch Program In Rural Appalachian Tennessee – Or Why Implementation Of The Healthy, Hunger Free Kids Act Of 2010 Was Met With Challenges: A Brief Report, Jodi L. Southerland, Taylor M. Dula, W. T. Dalton, Karen E. Schetzina, Deborah L. Slawson

ETSU Faculty Works

Purpose: The purpose of this study was to investigate challenges faced by high schools in rural Appalachia in implementing the Healthy, Hunger Free Kids Act of 2010 (HHFKA). Methodology: We used qualitative, secondary analysis to analyze a collection of thirteen focus groups and 22 interviews conducted in 2013-14 among parents, teachers, and high school students in six counties in rural Appalachian Tennessee (n=98). Results: Five basic themes were identified during the thematic analysis: poor food quality prior to implementation of the HHFKA school nutrition reforms; students’ preference for low-nutrient energy-dense foods; low acceptance of healthier options after implementation of the …

The Demands Of A Women's College Soccer Season, Jeremy A. Gentles, Christine L. Coniglio, Matthew M. Besemer, Joshua M. Morgan, Michael T. Mahnken

ETSU Faculty Works

No abstract provided.

Home-Based Primary Care: Impact On Cost And Patient Satisfaction, Sarah R. Tupper

All Graduate Theses, Dissertations, and Other Capstone Projects

The aging American population means more people will need healthcare than ever before. Many of these people are or will be Medicare beneficiaries who are predicted to be completely or mostly homebound at some point in time. This literature review was conducted to investigate Home-based Primary Care (HBPC) and whether or not this care delivery model has impacts on cost and patient satisfaction when compared to traditional outpatient encounters. A comprehensive and robust search of the literature was conducted using four different healthcare literature databases. Relevant articles were included if the site of care was ambulatory or office-based and if …

Body Composition Vs Athletic Performance In Volleyball, Elizabeth Decaro

Williams Honors College, Honors Research Projects

Objectives: The goal of this study was to determine if body composition affected athletic performance in the sport of volleyball at the University of Akron.

Methods: The study was conducted in the School of Sports Science & Wellness Education on the 3^rd floor of Infocision Stadium at the University of Akron using the computer containing the Bod Pod data for the women’s volleyball team.

Results: 20 subjects of the women’s varsity volleyball team were studied. The averages of each test were varied between the different skills tests in counter-movement vertical jump, approach vertical jump, block, broad jump, chin-ups, and …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

Effect Of Hemiepiphysiodesis On The Growth Plate: The Histopathological Changes And Mechanism Exploration Of Recurrence In Mini Pig Model., Jing Ding, Jin He, Zhi-Qiang Zhang, Zhen-Kai Wu, Fang-Chun Jin

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Hemiepiphysiodesis has been widely used to correct angular deformity of long bone in immature patients. However, there is a limited knowledge about the biomechanical effect of this technique on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal. We aimed to evaluate the biomechanical effect of hemiepiphysiodesis on the histopathological changes of the growth plate and the mechanism of recurrence of malformation after implant removal in Bama miniature pigs, and to explore the role of asymmetric stress during this procedure.

Methods: Eight 3-month-old male Bama miniature pigs sustained surgeries on the …

Practice Survey: Adherence Monitoring And Intervention In Pediatric Gastroenterology And Hepatology., Michele H. Maddux, Shawna Ricks, Julie A. Bass, James F. Daniel, Ellen Carpenter, Kimberely Radford

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.

Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.

Results: Practices varied greatly in terms of when and how …

Microtubule Imaging Reveals Cytoskeletal Deficit Predisposing The Retinal Ganglion Cell Axons To Atrophy In Dba/2j, Denis Sharoukhov, Festa Bucinca-Cupallari, Hyungsik Lim

Publications and Research

PURPOSE: Glaucoma is characterized by progressive loss of the retinal ganglion cells (RGCs) and their axons. Here we test an outstanding notion that microtubules (MTs) within RGC axons degrade before the loss of morphology (‘‘MT hypothesis’’).

METHODS: The integrity of axonal MTs was interrogated by intrinsic second-harmonic generation (SHG) microscopy. Using DBA/2J mice as a model of glaucoma and DBA/2J-Gpnmbþ as a nonglaucomatous control, the relationship between MT disruption and morphology was quantitatively examined as a function of age and sex in the fresh retinal wholemounts.

RESULTS: The mean SHG density (i.e., the mean SHG intensity per thickness) was significantly …

Risk Factors For Short- And Long-Term Outcomes In Children With Stec-Hus/D, Judith Sebestyen Vansickle, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Background. Hemolytic uremic syndrome (HUS) is one of the common causes for acute kidney injury in childhood. Objective. The goals of our study were to identify risk factors for short-term complications and long-term outcomes of chronic kidney disease (CKD) in Shiga toxin-producing Escherichia coli (STEC)-HUS and other diarrhea positive (D+) HUS. Methods. Retrospective chart review was obtained of 58 pediatric patients treated for STEC-HUS and other D+ HUS between February 2002 and January 2011. Results. Thirty-three patients (56.9%) required dialysis. Dialysis was more likely initiated if a patient was a female (P < .012), oliguric (urine output < 0.5 mL/kg/h, P < .0005), or hemoglobin (HGB) level >10 g/dL …

Current Approaches And New Developments In The Pharmacological Management Of Tourette Syndrome., Julio Quezada, Keith A. Coffman

Manuscripts, Articles, Book Chapters and Other Papers

Tourette syndrome (TS) is a neurodevelopmental disorder of unknown etiology characterized by spontaneous, involuntary movements and vocalizations called tics. Once thought to be rare, TS affects 0.3-1% of the population. Tics can cause physical discomfort, emotional distress, social difficulties, and can interfere with education and desired activities. The pharmacologic treatment of TS is particularly challenging, as currently the genetics, neurophysiology, and neuropathology of this disorder are still largely unknown. However, clinical experience gained from treating TS has helped us better understand its pathogenesis and, as a result, derive treatment options. The strongest data exist for the antipsychotic agents, both typical …

Does The Use Of Prophylactic Probiotics Prevent Antibiotic-Associated Diarrhea In Adults Using One Or More Antibiotics?, David E. Castillo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine if the use of probiotics can prevent the incidence of antibiotic-associated diarrhea (AAD) in adults using one or more antibiotics.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language published between 2013 and 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed and Cochrane databases.

OUTCOME MEASURED: All three studies defined diarrhea as the passage of three or more loose stools in a 24-hour period. All the studies used the Bristol …

Improving Aav Transduction Efficiency In Retinal Bipolar Cells For Optogenetic Vision Restoration, Shengjie Cui

Wayne State University Dissertations

Recombinant adeno-associated virus (AAV) vectors are the most promising vehicles for therapeutic gene delivery to the retina. We are developing AAV-mediated expression of optogenetic tools in surviving inner retinal neurons as a potential strategy to restoring vision after the death of photoreceptor cells in retinal degeneration. Targeting optogeneitc tools, such as channelrhodopsin-2 (ChR2), to retinal bipolar cells (RBCs) is particularly attractive. In particular, our lab has recently developed an optimized mGluR6 promoter-based virus vector that can mainly target ChR2 to rod bipolar cells. However, AAV-mediated transduction efficiency in RBCs is relatively low. The transduction efficiency could be affected by a …

Inflammation In The Pathogenesis Of Diabetic Retinopathy, Haoshen Shi

Wayne State University Dissertations

The general purpose of these studies is to investigate inflammation in diabetic retinopathy in an effort to identify key intervention points to develop as treatments. Firstly, we showed that the neuropeptide VIP displayed protective immunoregulatory effects on retinal endothelial cells cultured under high glucose conditions. This effect was carried out, in part through the VPAC2 receptor.

Next, we studied the β-adrenergic receptor agonist, Compound 49b, and its effect on the pro-resolving RvD1 pathway. Compound 49b was previously shown to suppress both inflammatory and apoptotic responses in DR. We demonstrated that Compound 49b rescued the high glucose-induced decrese in RvD1 and …

Integrative Medicine In Primary Care, Ashley M. Bjornerud

Physician Assistant Scholarly Project Papers

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, integrative medicine is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.

The review of the literature on IM analyzed studies in primary care settings in all parts of the world. Definitions of IM and CAM are evaluated. Defining what IM is and how to incorporate this approach in …

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Papers

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Hernandez Emmanuel

Physician Assistant Scholarly Project Papers

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Early diagnosis and identification of rotator cuff injuries are paramount for the appropriate treatment to be facilitated. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and is a challenging procedure. Historically, treatment options have been limited …

The Neuroprotective Effects Of Targeted Temperature Management On Post-Cardiac Arrest Patients, Timothy Hovde

Physician Assistant Scholarly Project Papers

Novel methods of ensuring survival following cardiac arrest and resuscitation are of supreme importance to the medical community. Targeted temperature management (TTM) has become increasingly utilized pre-hospital, in emergency departments, and within intensive care units to increase the likelihood of survival to hospital discharge. TTM has further been used to attempt to improve neurological functioning. The efficacy and mechanism behind TTM remains poorly understood. In several patient populations it also remains unproven. The purpose of this study is to assess the physiological mechanism, survival, neurological recovery and methodology of TTM use and implementation.

Literature review was utilized to assess the …

Pre-Participation Physical Examination: Are Current Cardiovascular Recommendations Enough?, Steven Jacob Pietrusza

Physician Assistant Scholarly Project Papers

Inclusion of screening electrocardiograms (EKGs) during pre-participation physical examination has been a topic of debate for some time. There is unquestioned usefulness in the ability of a well-trained health care provider in using EKG to identify cardiac abnormalities. Further, there have been several contemporary EKG criteria published that increase specificity and sensitivity of detection of disease. However, these criteria do not account for athletes less than 14 years of age, and that demographic represents a large portion of patients seeking pre-participation screenings in the United States. The lack of research into pediatric cardiac remodeling secondary to activity, coupled with the …

Allergen Specific Immunotherapy And The Effect On Allergy Induced Asthma, Cord Tanner Landrum

Physician Assistant Scholarly Project Papers

Allergies are a major public health problem affecting over 300 million people worldwide (Asamoah et. al). An allergic response can occur when a harmless substance, such as tree pollen, is inhaled into the body and mistakenly identified as a harmful substance. Antibodies then bind to the allergen causing a release of chemicals that leads to symptoms such as nasal congestion, runny nose, itchy eyes or skin reactions. For some people, this reaction can also affect the lungs and airways leading to asthma symptoms.

This review analyzes articles from PubMed, Cochran, Clinical Key and references found from UpToDate articles to assess …

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Posters

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Superior Capsular Reconstruction In The Active Population With A Massive Irreparable Rotator Cuff Tear, Emmanuel Hernandez

Physician Assistant Scholarly Project Posters

The prevalence of rotator cuff tears is a leading cause of upper extremity functional disability and affects people across the lifespan. The primary age groups that are diagnosed include young adults as well as the elderly population. Approximately one-fifth of rotator cuff tears (RCT) are diagnosed as “massive” and prove to be difficult for orthopedic surgeons to repair. If the massive RCT is also diagnosed as “irreparable”, surgical intervention is technically difficult and can be extremely challenging. Historically, treatment options have been limited for the young population to invasive surgical intervention or conservative measures such as physical therapy and pharmacologic …

Actual Vs. Perceived Hiv Testing Norms, And Personal Hiv Testing Uptake: A Cross-Sectional, Population-Based Study In Rural Uganda, Jessica M. Perkins, Viola N. Nyakato, Bernard Kakuhikire, Pamela K. Mbabazi, H. Wesley Perkins, Alexander C. Tsai, Sv Subramanian, Nicholas A. Christakis, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV testing is an essential part of treatment and prevention. Using population-based data from 1664 adults across eight villages in rural Uganda, we assessed individuals’ perception of the norm for HIV testing uptake in their village and compared it to the actual uptake norm. In addition, we examined how perception of the norm was associated with personal testing while adjusting for other factors. Although the majority of people had been tested for HIV across all villages, slightly more than half of men and women erroneously thought that the majority in their village had never been tested. They underestimated the prevalence …

Testosterone And The Adult Male, Alex Straftis

Calvert Undergraduate Research Awards

Abstract

In the last 15 years, prescription testosterone sales have increased almost threefold. Testosterone is a powerful hormone, which has both physiological and behavioral effects on the adult male. These effects vary over a man’s life course and social ecology. In a natural setting, testosterone reaches a peak during early adulthood, declines gradually over midlife, and has exponential drops after the age of 70. Increasing testosterone, through testosterone replacement therapy (TRT), past early adulthood, is an evolutionary novel circumstance for an adult male. To gauge these effects, and the motivations that initiated them, this study conducted a preliminary text analysis …