Medical Specialties Commons^™

Quality Review And Education As Method Of Improving Guideline Adherence For Medication Prescription And Outcomes Among Vascular Interventionalists Performing Non-Cardiac Vascular Surgeries, Alejandro Perez, Shih-Ting Chiu, A Manning, Brant W Ullery

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Background: Medical management of patients undergoing non-cardiac vascular procedures often sub-optimally follow evidence based guidelines. We hypothesized that feedback to practitioners in regards to outcomes and medications prescribed would improve care.

Methods: With conversion to new database in 2015 that allowed for more comprehensive tracking of vascular surgery outcomes, a decision was made to share these data with practitioners on regular basis as well as relay medications prescribed at discharge. Carotid and abdominal aortic surgeries were evaluated. The most frequent format for presentation of data was vascular morbidity and mortality conference. Medications included in presentations were antiplatelet and statin therapies. …

Process Improvement For Simethicone Use During Endoscopic Procedures, Airene D. Albutra, Mary Estelle De Vera, Sarah J. Wyrick

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No abstract provided.

Achieving Increased Quality Outcomes For Pediatric Oncology Through Psychosocial Screening: An Integrative Research Review, Kaitlyn Williams

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No abstract provided.

Gestational Diabetes Prevention, Shelly Johnson

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No abstract provided.

Trauma Pause, Melissa Leighty, Carol Reed, Lance Somerfield, Dawn Rohrbach

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No abstract provided.

The Effects Of Music Medicine On Reducing Distress, Anxiety, And Pain During Bone Marrow Biopsy Procedures, Betsy Hartman, Sharon Mast, Judy Delismon

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No abstract provided.

Improving Quality Of Patient Care By Reducing The Prevalence Of Surgical Site Infections, Gina Dashiell, Luanna Hansen

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No abstract provided.

Improving Ed Sepsis Bundle Compliance, Jen Selby

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No abstract provided.

Exploring The Effect Of Inpatient Diabetes Education On Readmission Rates, Cynthia Chun

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No abstract provided.

Complementary And Alternative Medicine Attitudes And Use In Caregivers Of Patients With Lung Cancer, Trisha Saul, Lorraine Evangelista, Jung-Ah Lee, Sangyhuk Shin, Michelle Fortier

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No abstract provided.

Ua12/2/1 College Heights Herald, Vol. 96, No. 2, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Collins, Michael. Rough Start – COVID-19
• Thornton, Maggie. What a WKU Student Learned from Her Experience with COVID-19
• Harkreader, Dylan & Debra Murray. Programs That Rely On Hands-on Learning Adapt to Virtual Courses
• Meyer-Thornton, Zane. Keep It Going
• Hurst, Courtney, Robin Lester & Trenton Peyton. What Is Intercultural Student Engagement Center?
• Sisler, Julie. WKU Grad Student: It’s On the Administration, Not the Students
• Kieser, Nick. Football Takes Precautions to Kick Off Season COVID-Free
• Warner, Casey: Setting Up – Football
• Gaylord, Kaden. Making It Safe to …

Quantification And Characterization Of Granulocyte Macrophage Colony-Stimulating Factor Activated Human Peripheral Blood Mononuclear Cells By Fluorine-19 Cellular Mri In An Immunocompromised Mouse Model, C Fink, M Smith, O C Sehl, J M Gaudet, T C Meagher, N A Sheikh, Jimmy Dikeakos, Michael Rieder, P J Foster, G A Dekaban

Paediatrics Publications

PURPOSE: The purpose of this study was to test fluorine-19 (19F) cellular magnetic resonance (MRI) as a non-invasive imaging modality to track therapeutic cell migration as a surrogate marker of immunotherapeutic effectiveness.

MATERIALS AND METHODS: Human peripheral blood mononuclear cell- (PBMC)-derived antigen presenting cell (APC) were labeled with a 19F-perfluorocarbon (PFC) and/or activated with granulocyte macrophage colony-stimulating factor (GM-CSF). Viability, phenotype and cell lineage characterization preceded 19F cellular MRI of PFC

RESULTS: A high proportion of PBMC incorporated PFC without affecting viability, phenotype or cell lineage composition. PFC

CONCLUSION: 19F cellular MRI is a non-invasive imaging technique capable of detecting …

Priority Outcomes In Critically Ill Children: A Patient And Parent Perspective, Nora Fayed, Saoirse Cameron, Douglas Fraser Md, Phd, Frcpc, Jill I Cameron, Samah Al-Harbi, Racquel Simpson, Maha Wakim, Lily Chiu, Karen Choong

Paediatrics Publications

BACKGROUND: Outcomes in pediatric critical care research are typically selected by the researcher.

OBJECTIVES: (1) To identify outcomes prioritized by patients and their families following a critical illness and (2) to determine the overlap between patient-centered and researcher-selected study outcomes.

METHODS: An exploratory descriptive qualitative study nested within a longitudinal cohort study conducted in 2 pediatric intensive care units (PICUs). Participants were purposively sampled from the primary cohort to ensure adequate demographic representation. Qualitative descriptive approaches based on naturalistic observation were used to collect data and analyze results. Data were coded by using the International Classification of Functioning, Disability, and …

New Aspects Of The Epigenetics Of Pancreatic Carcinogenesis., Murat Toruner, Martin E. Fernandez-Zapico, Christopher Pin

Paediatrics Publications

Pancreatic cancer remains among the deadliest forms of cancer with a 5 year survival rate less than 10%. With increasing numbers being observed, there is an urgent need to elucidate the pathogenesis of pancreatic cancer. While both contribute to disease progression, neither genetic nor environmental factors completely explain susceptibility or pathogenesis. Defining the links between genetic and environmental events represents an opportunity to understand the pathogenesis of pancreatic cancer. Epigenetics, the study of mitotically heritable changes in genome function without a change in nucleotide sequence, is an emerging field of research in pancreatic cancer. The main epigenetic mechanisms include DNA …

Ppe Compliance And Knowledge Among Healthcare Staff, Beatrice Hagert, Nicole Krummel

Nursing DNP Projects

Abstract

Problem: One of the most important steps in infection prevention is the use of personal protective equipment (PPE) to protect patients and staff from infectious agents; yet, research indicates that PPE compliance remains suboptimal in many healthcare institutions.

Purpose: To identify the effect of a multidisciplinary education campaign on PPE compliance and knowledge among healthcare workers (HCWs) on a rehabilitation unit of a large, midwestern teaching hospital.

Methods: This project utilized pre-intervention observational audits and a survey to determine baseline PPE compliance and knowledge on the piloted units. A post-intervention survey was sent to HCW to assess for a …

Musculoskeletal Tumours Throughout History And Beyond: Clinical Features, Imaging, Staging And Biopsy, Akbar Jaleel Zubairi, Obada Hussein Hasan, Mohammad Mustafa, Masood Umer

Section of Orthopaedic Surgery

Background: Over the last century, there has been a remarkable development in the study of bone and soft tissue sarcomas. This is primarily due to the improved knowledge of the nature of these lesions and the improved imaging technology. In literature there are many protocols that are being used and all of them have reported various advantages and disadvantages of each technique used. However, there is no set guideline and whatever has been proposed has been developed on the basis of the experience of different centres and different surgeons.
Objective: The current systematic review was planned to thoroughly evaluate the …

Cerebellar Mutism Syndrome After Surgical Resection Of Posterior Fossa Neoplastic Lesions, Saqib Kamran Bakhshi, Rida Mitha, Naureen Mushtaq, Muhammad Shahzad Shamim

Section of Neurosurgery

Cerebellar Mutism Syndrome (CMS) is a well-described clinical entity that complicates surgeries for posterior fossa tumours; more so in children than adults. This review focuses on the current understanding of CMS, its incidence and risk factors. Incidence showed a variable range in retrospective studies due to variety of definitions. Risk factors can be classified as either modifiable including surgical technique, or non-modifiable which include tumour related factors. A positive correlation has been associated between tumour pathology, brain stem invasion and size of tumour at time of presentation with development of CMS.

Localizing An Occult Insulinoma By Selective Calcium Arterial Stimulation Test: First Ever Experience And A New Dimension To Diagnosis In Pakistan, Muhammad Owais Rashid, Sumerah Jabeen, Zareen Kiran,, Khurram Minhas, Muhammad Azeemuddin, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Insulinomas are rare, usually benign, solitary tumours accounting for 60% of islet cell tumours. These tumours can be difficult to localize preoperatively due to their small size. We present a challenging case of a 40 year old male with frequent hypoglycaemic spells and endogenous hypoglycaemia who presented as a diagnostic dilemma. Patient had an occult insulinoma with inconclusive CT Abdomen, MRI Abdomen and Octreotide scan. The final localization of the tumour was made by selective arterial calcium stimulation testing (SCAT), done for the first time in Pakistan at Aga Khan University Hospital. This was followed by successful distal pancreatectomy as …

Vitamin D Usage Among Pakistani Population - Too Much Of A Good Thing, Bhagwan Das, Sarah Nadeem

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.

Medicolegal Issues In Neurology Practice In Pakistan, Ismail A Khatri, Maimoona Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

Neurology despite its challenges have made tremendous improvement in past few decades. At the same time, the rapid advancement of media and internet has changed the traditional doctor-patient relationship into one of a service provider-consumer relationship1. The health service is now considered a commodity, and has become prone to lack of trust and litigation. Medical professionalism is challenged by increasing commercialism and influence of legal system

Neurological Care And Training In The Times Of Covid-19: A Tertiary Care Center Experience, Lubna Ashraf Jafri, Maryam Javed, Ali Sajjad, Dureshahwar Kanwar, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Resilience in these challenging times of COVID-19 at a professional and personal level is cardinal. Trainees and faculty have had to adapt to this adversity with striking limitations on formal neurological, neurovascular and neurophysiological residencies and fellowships. The revision of schedules and reallocation of assignments to cope with the practical aspects in a teaching tertiary care hospital have been overbearing. Novel structural innovation, testing, communications and supervision to assure a modified yet impactful training educational programme is mandatory and the need of the hour. Healthcare service providers remain at the highest risk of acquiring COVID-19 worldwide. Urgent measures to educate …

Venous Stroke Secondary To Varicella Zoster Virus Infection, Asma Akbar Ladak, Salman Farooq

Pakistan Journal of Neurological Sciences (PJNS)

This is a case of cerebral venous sinus thrombosis (CVST) as a rare complication of varicella Zoster infection. A young male with no significant medical history presented with generalized tonic clonic seizures preceded by vesicular rash on the face diagnosed as Varicella zoster infection. The MRI showed bilaterial superficial hemorrhagic infarcts involving frontal and temporal lobes and MR Venogram was consistent with extensive CVST involving superioir sagittal, right transverse and superficial veins. After initial treatment with antiepileptic and anticoagulant, he showed marked improvement in symptomatology and made complete recovery subsequently with recanalization of sinuses seen on a follow up MRV …

Hepetatis C Virus A Rare Cause Of Cereberal Venous Sinus Thrombosis, Haris Majid Rajput, Iqra Athar, Neelma Naz Khattak, Anam Anis, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Cerebral venous sinus thrombosis is challenging condition because of its variability of underlying pathological causes. Numerous conditions can cause cerebral venous sinus thrombosis (CVST), and often more than one cause can be found in an individual patient. The causes leading to CVST can be classified into two broad categories; infective and non-infective. Among infective causes, chronic hepatitis C infection is considered as one of the extremely rare causes of cerebral venous sinus thrombosis.

Disease Modification Trials In Parkinsons Disease: A Review, Ramla Nayaib Hashmi, Ummul Kiram

Pakistan Journal of Neurological Sciences (PJNS)

Among the common neurological disorders worldwide, Parkinson’s disease has a major share. Currently, only symptomatic therapies are available for it without any approved neuromodulation drugs as all the previously done disease modification trials have failed. There is a dire need for such therapies. Disease modification trials include all types of intervention targeting the degeneration process which underlies the disease process and thus slows it down or the treatment aim to regenerate or replace the neurons which are lost. There are many reasons for the failure of trials. This review emphasize the need for disease modification trials, causes of failure of …

Cerebral Venous Sinus Thrombosis Associated With Coronavirus Infection (Covid-19), Sajid Hameed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome (SARS) caused by the SARS-CoV-2 coronavirus. Despite its primarily respiratory involvement, an increased propensity for systemic inflammation, neuroinvasion, and thromboembolic events has been reported. This systemic prothrombotic state may predispose to cerebral venous sinus thrombosis (CVST), which is an uncommon cerebrovascular disease with hypercoagulability as one of its important risk factors. We conducted a literature search using the PubMed electronic database and reviewed the published literature for a possible association of CVST with the COVID-19 disease.

Secondary Prevention Of Cardiovascular Diseases In India: Findings From Registries And Large Cohorts, Hasan Rehman, Ankur Kalra, Ajar Kochar, Angad S. Uberoi, Deepak L. Bhatt, Zainab Samad, Salim S. Virani

Section of Cardiology

Several registries and quality improvement initiatives have focused on assessing and improving secondary prevention of CVD in India. While the Treatment and Outcomes of Acute Coronary Syndromes in India (CREATE), Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF), and Trivandrum Heart Failure (THF) registries are limited to collecting data, the Tamil Nadu-ST-Segment Elevation Myocardial Infarction (TN-STEMI) program was aimed at examining and improving access to revascularization after an ST-elevation myocardial infarction (STEMI). The Acute Coronary Syndromes: Quality Improvement in Kerala (ACS-QUIK) study recruited hospitals from the Kerala ACS registry to assess a quality improvement kit for patients with ACS while the Practice …

Etiology Of Acute Undifferentiated Fever In Patients Presenting To The Emergency Department Of A Tertiary Care Center In Karachi, Pakistan, Noman Ali, Nadeem Ullah Khan, Shahid Shahid, Syed Mustahsan

Department of Emergency Medicine

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital.
Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever.
Results: A …

Efficacy And Safety Of First-Line Avelumab In Patients With Advanced Non-Small Cell Lung Cancer: Results From A Phase Ib Cohort Of The Javelin Solid Tumor Study., Claire F Verschraegen, Guy Jerusalem, Edward F Mcclay, Nicholas Iannotti, Charles H Redfern, Jaafar Bennouna, Franklin L Chen, Karen Kelly, Janice Mehnert, John C Morris, Matthew H Taylor, David Spigel, Ding Wang, Hans Juergen Grote, Dongli Zhou, Neru Munshi, Marcis Bajars, James L Gulley

Articles, Abstracts, and Reports

INTRODUCTION: Avelumab, an antiprogrammed death ligand-1 antibody, is approved as a monotherapy for treatment of metastatic Merkel cell carcinoma and advanced urothelial carcinoma, and in combination with axitinib for advanced renal cell carcinoma. We report the efficacy and safety of first-line avelumab in advanced non-small cell lung cancer (NSCLC).

METHODS: In a phase I expansion cohort of the JAVELIN Solid Tumor trial, patients with treatment-naive, metastatic, or recurrent NSCLC received 10 mg/kg avelumab intravenously every 2 weeks. Endpoints included best overall response, duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety.

RESULTS: Overall, 156 patients were enrolled …

Defining The Proteolytic Landscape During Enterovirus Infection., Mohsan Saeed, Sebastian Kapell, Nicholas T Hertz, Xianfang Wu, Kierstin Bell, Alison W Ashbrook, Milica Tesic Mark, Henry A Zebroski, Maxwell L Neal, Malin Flodström-Tullberg, Margaret R Macdonald, John D Aitchison, Henrik Molina, Charles M Rice

Articles, Abstracts, and Reports

Viruses cleave cellular proteins to remodel the host proteome. The study of these cleavages has revealed mechanisms of immune evasion, resource exploitation, and pathogenesis. However, the full extent of virus-induced proteolysis in infected cells is unknown, mainly because until recently the technology for a global view of proteolysis within cells was lacking. Here, we report the first comprehensive catalog of proteins cleaved upon enterovirus infection and identify the sites within proteins where the cleavages occur. We employed multiple strategies to confirm protein cleavages and assigned them to one of the two enteroviral proteases. Detailed characterization of one substrate, LSM14A, a …

Third-Generation Medium Cross-Linked Polyethylene Demonstrates Very Low Wear In Total Hip Arthroplasty., Omid Jalali, Travis S Scudday, Marie-Claire Fickenscher, Steven L Barnett, Robert S Gorab

Articles, Abstracts, and Reports

Background: Cross-linked polyethylene (XLPE) liners have shown lower wear rates than conventional polyethylene liners in total hip arthroplasty. The primary aim of our study was to report our most recent analysis of wear rates and clinical outcomes of a third-generation XLPE liner. Secondary aims were to investigate the rate of adverse events related to mechanical failure or oxidation of this liner.

Methods: A series of 266 total hip arthroplasties using a specific XLPE liner were retrospectively reviewed. Radiographs were examined to determine linear and volumetric wear rates and presence of osteolysis. Clinical outcomes, revision rates, mechanical failures, and risk factors …