Medical Specialties Commons^™

The Effect Of Omm On Opioid Users With Chronic Low Back Pain, Danielle Cooley, James Bailey, Deanna Janora, Catherine Fusco, Kishan Patel

Rowan-Virtua Research Day

In the United States, approximately 100 million adults are affected by chronic pain, which reduces their quality of life and productivity, while accounting for billions in health care costs and lost revenue. (1) Opioids are considered the gold standard in the pharmacological treatment for chronic pain conditions, and prescriptions for opiates/opioids increased by 400% from 1999 to 2010. (1,2) Although opioid treatment is warranted during postsurgical and active cancer pain, physicians still commonly overprescribe opioids, which has led to addiction, high deaths rates by overdose, and the spread of communicable diseases. (1)

Since chronic pain is sustained by noxious sensory …

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt

Rowan-Virtua Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and …

A Mathematical Investigation On Tumor-Immune Dynamics: The Impact Of Vaccines On The Immune Response, Jonathan Quinonez, Neethi Dasu, Mahboobi Qureshi

Rowan-Virtua Research Day

Mathematical models analyzing tumor-immune interactions provide a framework by which to address specific scenarios in regard to tumor-immune dynamics. Important aspects of tumor-immune surveillance to consider is the elimination of tumor cells from a host’s cell-mediated immunity as well as the implications of vaccines derived from synthetic antigen. In present studies, our mathematical model examined the role of synthetic antigen to the strength of the immune system. The constructed model takes into account accepted knowledge of immune function as well as prior work done by de Pillis et al. All equations describing tumor-immune growth, antigen presentation, immune response, and interaction …

A Rare Manifestation Of A Bleeding Tubulovillous Duodenal Polyp Presenting As An Upper Gastrointestinal Hemorrhage, Neethi Dasu, Yaser Khalid, Herman Suga, Michael Itidiare, Richard Walters

Rowan-Virtua Research Day

• Duodenal polyps are a group of polyps that are fairly uncommon to find on endoscopic evaluation (1).

• They are histologically classified according to mucin phenotype into intestinal and gastric subtypes; the intestinal-type polyps are morphologically subdivided into tubular and tubulovillous adenomas (2)

• We present a case of a 76-year-old male with recurrent hematemesis who was found to have an intestinal-type pedunculated tubulovillous adenoma (TVA) in the descending duodenum • An isolated occurrence of non-ampullary sporadic duodenal adenomas (SDA)’s are a rare finding and presentation as an upper GI hemorrhage is extremely uncommon (3)

• Furthermore, our patient’s …

What Are The Ods? A Case Of Osmotic Demyelination Syndrome Associated With Hemodialysis In End-Stage Renal Disease, Ellen Colleen Bradley, Yvette Wang

Rowan-Virtua Research Day

Osmotic demyelination syndrome (ODS) is the irreversible demyelination of the central pons, among other areas of the brain, that is most often associated with rapid correction of hyponatremia. Per contra, reversible ODS is a rare state that can be seen in patients with end-stage renal disease (ESRD) on hemodialysis (HD). This clinical case offers an alternative problem representation for acute altered mental status in a patient with ESRD on HD.

A Rare Case Of A Non- Functioning Pancreatic Neuroendocrine Tumor, Yaser Khalid, Neethi Dasu, Richard Gordon

Rowan-Virtua Research Day

Pancreatic neuroendocrine tumors (PNET) are very rare and represent about 1–2% of all pancreatic tumors. Non-functional PNET (NF-PNET) is incidentally discovered in most cases. Most NF-PNETs are found at an advanced stage because patients are mostly asymptomatic. We present a case of 32-yr-old female who initially presented with increasing abdominal girth, decreased mobility, and lower extremity swelling up to the hip and was found to have an advanced NF-PNET with metastatic disease to the pelvis and liver. There have been few studies directed toward early detection and management; Computed tomography (CT) is the imaging modality of choice as well as …

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz

Rowan-Virtua Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …

Maternal Morbidity Outcomes In Idiopathic Moyamoya Syndrome In New York State, Hajere J. Gatollari, Amelia K. Boehme, E. Sander Connolly, Alexander M. Friedman, Mitchell S.V. Elkind, Joshua Z. Willey, Eliza C. Miller

Rowan-Virtua Research Day

Background: Pregnancy is associated with an increased risk of stroke in young women. Idiopathic moyamoya syndrome (IMMS) is a rare condition characterized by progressive narrowing of large cerebral arteries resulting in flimsy collaterals prone to rupture or thrombosis. Data are limited on pregnancy outcomes in women with IMMS. We hypothesized that IMMS would be associated with increased pregnancy morbidity, including stroke.

Conclusion: Pregnancies within 1 year prior or any time after IMMS diagnosis did not have increased maternal morbidity compared to unexposed pregnancies after adjusting for age and clustering of women with multiple pregnancies. Prospective studies are needed to better …

Long-Term Safety Of Secukinumab In Patients With Moderate-To-Severe Plaque Psoriasis, Psoriatic Arthritis, And Ankylosing Spondylitis: Integrated Pooled Clinical Trial And Post-Marketing Surveillance Data., A Deodhar, Philip Mease, I B Mcinnes, X Baraliakos, K Reich, A Blauvelt, C Leonardi, B Porter, A Das Gupta, A Widmer, L Pricop, T Fox

Articles, Abstracts, and Reports

BACKGROUND: Secukinumab, a fully human immunoglobulin G1-kappa monoclonal antibody that directly inhibits interleukin (IL)-17A, has been shown to have robust efficacy in the treatment of moderate-to-severe psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) demonstrating a rapid onset of action and sustained long-term clinical responses with a consistently favorable safety profile in multiple Phase 2 and 3 trials. Here, we report longer-term pooled safety and tolerability data for secukinumab across three indications (up to 5 years of treatment in PsO and PsA; up to 4 years in AS).

METHODS: The integrated clinical trial safety dataset included data pooled from …

Getting To The Bottom Of Sciatic Neuropathy, Emilee E. Kurtz Do, Amogh M. Joshi Do, Travis F. Magdaleno Md, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Effects Of The Kcnq Channel Opener Ezogabine On Functional Connectivity Of The Ventral Striatum And Clinical Symptoms In Patients With Major Depressive Disorder, Aaron Tan, Sara Costi, Laurel S. Morris, Nicholas T. Van Dam, Marin Kautz, Alexis E. Whitton, Allyson K. Friedman, Katherine A. Collins, Gabriella Ahle, Nisha Chadha, Brian Do, Diego A. Pizzagalli, Dan V. Iosifescu, Eric J. Nestler, Ming-Hu Han, James W. Murrough

Publications and Research

Major depressive disorder (MDD) is a leading cause of disability worldwide, yet current treatment strategies remain limited in their mechanistic diversity. Recent evidence has highlighted a promising novel pharmaceutical target—the KCNQ-type potassium channel—for the treatment of depressive disorders, which may exert a therapeutic effect via functional changes within the brain reward system, including the ventral striatum. The current study assessed the effects of the KCNQ channel opener ezogabine (also known as retigabine) on reward circuitry and clinical symptoms in patients with MDD. Eighteen medication-free individuals with MDD currently in a major depressive episode were enrolled in an open-label study and …

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

A Refractory Case Of Severely Uncontrolled Eosinophilic Asthma On Maximal Therapy, William Ueng Mph, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Propofol Infusion Syndrome: A Serious Complication With A Commonly Used Drug In The Icu, Hernando Castillo Ms, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Brian Civic Md

Department of Medicine

No abstract provided.

The Miller-Fisher Variant Of Guillain-Barré Syndrome, Sagar Vadhar Do, Jaimin Patel Do, Kathryn Kass Md, N Shah Md

Department of Medicine

No abstract provided.

Rhabdomyolysis: An Unusual Presenting Symptom Of Hypothyroidism, Kourtney Erickson Do, Grace Berlin Do, Marie S. O’Brien Do

Department of Medicine

No abstract provided.

Stiff-Limb Syndrome: A Variant Of Stiff-Person Syndrome, Sagar Vadhar Do, Ethan S. Stern Do, Jaimin Patel Do, Keithan Sivakumar Md, Mba, N Shah Md

Department of Medicine

No abstract provided.

21st Century Clinical Trials: Rethinking Best Practices Challenges And Opportunities, William E Truog

Presentations

Panel discussion at the Pediatric Academic Societies 2019 annual meeting.

The Physiology And Hormonal Control Of Calcium, Phosphate And Vitamin D, Uri Alon

Presentations

Describes calcium, phophate, and vitamin D in the context of pediatric rickets.

The Effect Of Antihypertensive Dosing On Hypertension In Children With Chronic Kidney Disease, Benjamin A. Matta, Uri S. Alon, Tarak Srivastava, Bradley A. Warady, Darcy Weidemann

Posters

This study's objective was to determine the effect of antihypertensive dose on hypertension status in children with chronic kidney disease. This was the first quantitative analysis of antihypertensive dose expressed as a newly developed measure, cDDI, and is relationship with hypertension status in children with CKD.

The Effect Of Antihypertensive Dose On Blood Pressure Control In Children With Chronic Kidney Disease, Benjamin A. Matta

Presentations

This presentation describes a study to determine the effect of antihypertensive dosing on blood pressure control in children with chronic kidney disease. The original version of this presentation is a prezi show at https://prezi.com/view/4qluDL1gMKFELOf1nLVA/

Pelvic Examinations For Ovarian Cancer Screening In Asymptomatic Adult Women, Riann Sue Collar

Physician Assistant Scholarly Project Papers

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and if bimanual pelvic exams are not a valid screening tool for ovarian cancer, what are other screening methods available. Throughout reviewing peer reviewed articles …

Platelets To The Rescue? A Literature Review Of The Safety And Efficacy Of Platelet-Rich Plasma For Symptomatic Knee Osteoarthritis, Timothy Simonich

Physician Assistant Scholarly Project Papers

Osteoarthritis (OA) of the knee is one of the most common joint disorders in the United States with rising prevalence due to obesity and an aging population. Regarding non-surgical approaches to management, there has been growing interest in the use of intra-articular injections (IAI) of Platelet Rich Plasma (PRP). However, there has been a lack of strong evidence to support its use in clinical practice guidelines. In this literature review, two search methods were utilized in an effort to, first, inform clinicians about PRP and, second, to shed light on recent clinical control trials regarding the safety and efficacy of …

Fertility Options For Women With Endometriosis: In Vitro Fertilization Versus Surgical Excision Or Ablation, Jenny L. Brown

Physician Assistant Scholarly Project Papers

Endometriosis negatively affects the fertility of many women of reproductive age worldwide. Some women with endometriosis are able to conceive without reproductive assistance, while others require medical intervention. In vitro fertilization and surgical management are available and widely used in the treatment of endometriosis associated infertility. In vitro fertilization has been found to be effective in women with stages I-IV endometriosis, with varying degrees of success at each stage. These varying results may be due to oocyte quality and availability as well as endometriosis location. Surgical excision and/or surgical ablation of endometriosis/endometriomas may also improve chance of successful pregnancy but …

Benefits Of 3d Breat Tinisynthesis Combined With 2d Digital Mammography In Screening Women For Breast Cancer, Danielle M. Swanson

Physician Assistant Scholarly Project Papers

Breast cancer screening imaging options have progressed greatly over the years in sensitivity, specificity, and image quality. According to DynaMed Plus, in 2012 there were 522,000 deaths by breast cancer and 1,677,000 total cases of breast cancer documented (Dynamed, 2018). For years, traditional screening for breast cancer involved 2D digital mammography which obtains two views of each breast. With advances in technology, the use of 3D breast tomosynthesis has become an advantageous addition to routine breast cancer screening protocols at many health care facilities. My literature review of articles was found in PubMed, DynaMed Plus, Cochrane Library, and Clinical Key …

A Comparison Of Pharmacologic Interventions In Pregnant Women With Opioid Use Disorder, Catherine M. Bopp

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine which pharmacotherapeutic agent, methadone or buprenorphine, leads to better outcomes in cases of pregnant mothers with opioid use disorder (OUD). Outcomes considered are maternal compliance, neonatal abstinence syndrome severity, and neonatal length of hospital stay. In the review, PubMed, Clinical Key, Cochrane Database of Systematic Reviews, and DynaMed Plus were searched. Key terms searched were “methadone, buprenorphine, pregnancy”, “opioids, pregnancy”, “neonatal abstinence syndrome” and “medication assisted treatment, pregnancy”. Articles were narrowed with applications of filters for articles in the past fifteen years and by use of the English …

A Bilingual Approach To Pediatric Occupational Therapy: The Importance Of Communication Between Providers & Spanish-Speaking Families In Northwest Arkansas, Emily Ann Davidson

World Languages, Literatures and Cultures Undergraduate Honors Theses

Due to the demographic demands of Northwest Arkansas and the prevalence of disparities in health care, this study aims to assess the current practices, perceived need, and willingness to provide bilingual Spanish-English outpatient pediatric occupational therapy options in Northwest Arkansas. The hope of this study is to better inform pediatric occupational therapy providers of the growing need for bilingual services so that they may respond appropriately in order to better serve Latino and Spanish-speaking patients and their families or caregivers.

Education As Important Predictor For Successful Employment In Adults With Congenital Heart Disease Worldwide., Maayke Sluman, Maayke Sluman, Silke Apers, Judith Sluiter, Karen Nieuwenhuijsen, Philip Moons, Philip Moons, Koen Luyckx, Koen Luyckx, Adrienne Kovacs, Adrienne Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Hsiao-Ling Yang, Jamie Jackson, Paul Khairy, Stephen Cook, Raghavan Subramanyan, Luis Alday, Katrine Eriksen, Mikael Dellborg, Mikael Dellborg, Malin Berghammer, Malin Berghammer, Eva Mattsson, Andrew Mackie, Samuel Menahem, Maryanne Caruana, Kathy Gosney, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Berto Bouma, Barbara Mulder

Psychology Faculty Works

Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort. Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models. Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate …

The Effects Of Tracheal Occlusion On Wnt Signaling In A Rabbit Model Of Congenital Diaphragmatic Hernia, Martina Mudri, Shane A. Smith, Christina Vanderboor, Jacob Davidson, Timothy R.H. Regnault, Andreana Bütter

Paediatrics Publications

Purpose: Tracheal occlusion (TO)reverses pulmonary hypoplasia (PH)in congenital diaphragmatic hernia (CDH), but its mechanism of action remains poorly understood. Wnt signaling plays a critical role in lung development, but few studies exist. The purpose of our study was to a)confirm that our CDH rabbit model produced PH which was reversed by TO and b)determine the effects of CDH +/− TO on Wnt signaling. Methods: CDH was created in fetal rabbits at 23 days, TO at 28 days, and lung collection at 31 days. Lung body weight ratio (LBWR)and mean terminal bronchiole density (MTBD)were determined. mRNA and miRNA expression was determined …

Asthma Care In The Emergency Department And Urgent Care Center, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.