Medical Specialties Commons^™

Stability Of Plasma Glucose In Whole Blood Samples Collected In Sodium Fluoride Tube Vs. Sodium Heparin Plasma Separator Tubes, Ryan C. Braunberger, Magen Martinez, David G. Grenache

Quality Improvement/Patient Safety Symposium

Background: The concentration of plasma glucose is influenced by preanalytical variables such as delayed processing of whole blood. Glucose concentrations decrease by 5-7% per hour in whole blood due to glycolysis. This preanalytical loss decreases the diagnostic sensitivity of glucose when used to diagnose diabetes mellitus or gestational diabetes mellitus. Sodium fluoride (NaF) is commonly used to inhibit glycolysis in samples collected during oral glucose tolerance tests, but is inadequate as it does not stop glycolysis for two or more hours. Guidelines recommend blood samples be immediately immersed in an ice slurry and analyzed within 30 minutes of collection, but …

Providing High Reliability Care For Picu Patients With Pulmonary Hypertension: A Quality Improvement Project, Anjali Subbaswamy, Nicholas Tan, Iric Guthrie, Kelsey Fath, Cole Linzmeyer, Elizabeth Yakes Jimenez

Quality Improvement/Patient Safety Symposium

Providing High Reliability Care for PICU Patients with Pulmonary Hypertension: A Quality Improvement Project

Anjali Subbaswamy, MD; Nicholas Tan, DO; Iric Guthrie, MD; Kelsey Fath, MD; Cole Linzmeyer, DO; Elizabeth Yakes Jimenez, PhD, RDN, LD

Purpose: Pediatric patients with pulmonary hypertension (PHTN) are a high acuity, low frequency population, and are often admitted to the pediatric intensive care unit (PICU). To mitigate the risk of precipitating a potentially life-threatening pulmonary hypertensive crisis, health care staff need to take specific precautions. This quality improvement (QI) project aims to increase the number of inpatient PHTN patients for whom PHTN precautions are applied …

Anal Cancer Screening At Truman Health Services, Peter D. Tran, Harshdeep Babbar

Quality Improvement/Patient Safety Symposium

Anal Papanicoloau Screening at Truman Clinic

Anal cancer is a squamous cell cancer associated with human papillomavirus (HPV), the same virus that is associated with cervical cancer. Although vaccination against HPV has been shown to be effective in reducing overall rates of infection, the number of new anal cancer cases has been rising for many years. In HIV-infected men and women, the incidence is even higher of anal cancer than in the general population. Current rates in an HIV-infected MSM population have been estimated to be as high as 70-144 per 100,000, with some studies of HIV-infected individuals showing that …

Inflammatory Regulation Of Cns Barriers After Traumatic Brain Injury: A Tale Directed By Interleukin-1, Colleen N. Bodnar, James B. Watson, Emma K. Higgins, Ning Quan, Adam D. Bachstetter

Neuroscience Faculty Publications

Several barriers separate the central nervous system (CNS) from the rest of the body. These barriers are essential for regulating the movement of fluid, ions, molecules, and immune cells into and out of the brain parenchyma. Each CNS barrier is unique and highly dynamic. Endothelial cells, epithelial cells, pericytes, astrocytes, and other cellular constituents each have intricate functions that are essential to sustain the brain’s health. Along with damaging neurons, a traumatic brain injury (TBI) also directly insults the CNS barrier-forming cells. Disruption to the barriers first occurs by physical damage to the cells, called the primary injury. Subsequently, during …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Reporting And Analyzing Race And Ethnicity In Orthopaedic Clinical Trials: A Systematic Review., Ryan W. Paul, Donghoon Lee, Joseph Brutico, Fotios P. Tjoumakaris, Michael G. Ciccotti, Kevin B, Freedman

Rothman Institute Papers

BACKGROUND: The distinction between race and ethnicity should be carefully understood and described for demographic data collection. Racial healthcare differences have been observed across many orthopaedic subspecialties. However, the frequency of reporting and analyzing race and ethnicity in orthopaedic clinical trials has not been determined. Therefore, the primary purpose of this systematic review was to determine how frequently race and ethnicity are reported and analyzed in orthopaedic clinical trials.

METHODS: The top 10 journals by impact factor in the field of orthopaedics were manually screened from 2015 to 2019. All randomized controlled trials related to orthopaedics and assessing clinical outcomes …

Deep Learning Predicts Chromosomal Instability From Histopathology Images, Zhuoran Xu, Akanksha Verma, Uska Naveed, Samuel F. Bakhoum, Pegah Khosravi, Olivier Elemento

Publications and Research

Chromosomal instability (CIN) is a hallmark of human cancer yet not readily testable for patients with cancer in routine clinical setting. In this study, we sought to explore whether CIN status can be predicted using ubiquitously available hematoxylin and eosin histology through a deep learning-based model. When applied to a cohort of 1,010 patients with breast cancer (Training set: n = 858, Test set: n = 152) from The Cancer Genome Atlas where 485 patients have high CIN status, our model accurately classified CIN status, achieving an area under the curve of 0.822 with 81.2% sensitivity and 68.7% specificity in …

Enhanced Arthrocentesis Of The Flexed Knee With Pneumatic Compression, Sumir Brahmbhatt, Maheswari Muruganandam, Ahsan Iqbal, David Cisneros, Adnan Kiani, Nicole Suzanne Emil, Sharon Nunez, William Hayward, Philip Band, Wilmer Sibbitt Jr.

Quality Improvement/Patient Safety Symposium

Background/Objective: To explore an alternative to standard extended knee arthrocentesis using pneumatic compression of the flexed knee.

Methods: Using a paired sample design, 41 consecutive effusive knees underwent arthrocentesis in the flexed knee position first without and then with pneumatic compression of suprapatellar bursa. Arthrocentesis success and fluid yield in milliliters (ml) were measured. For comparison 41 consecutive patients who had undergone extended knee arthrocentesis without and with compression were also studied.

Results: Successful diagnostic arthrocentesis (≥ 3 ml) of the effusive flexed knee was 85% (35/41) without compression and increased significantly to 100% (41/41) with pneumatic compression (p=0.027). Synovial …

Reiki For Recovery: Incorporating Japanese Health Practices To Increase Contemporary Resiliency In American Health, Leif Peterson

Master's Projects and Capstones

The Japanese health practice of Reiki attempts to maximize the latent ability of the human system to heal itself. The Reiki system, established over a century ago, combines multiple Asian health traditions, experimenting with practices that maximize the natural processes of the body to perform its own repairs. Reiki encourages healthy behaviors that balance the mind and body, return the human system to a lowered stress level, and allow for an optimal recovery state for the patient. This paper illustrates how this Japanese health-affirming method can be integrated and utilized within existing health and medical practices. An area that is …

Improving Patient Experience And Staff Workflow During Ed To Inpatient Interfacility Transfers, Jonathan Nakagawa

Master's Projects and Capstones

ED overcrowding has been an issue for Facility X pre-COVID19 and has been exacerbated following the first shelter in place mandate around March 2020. Facility X had proposed to increase the amount of interfacility transfers (IFT) to mitigate overcrowding and, hopefully, improve patient outcomes. 2020 Census data had shown that patient satisfaction scores and Nurse Daily Engagement scores were down; leading Facility X to believe that there can be improvements made to the IFT workflow and communication. Patient interviews also revealed that not all patients were satisfied with how they were treated during the IFT process. This quality improvement project …

Emerging Role Of Fascin-1 In The Pathogenesis, Diagnosis, And Treatment Of The Gastrointestinal Cancers., Bojana Ristic, Jonathan Kopel, Syed A A Sherazi, Shweta Gupta, Sonali Sachdeva, Pardeep Bansal, Aman Ali, Abhilash Perisetti Md, Hemant Goyal

PCI Publications and Projects

Gastrointestinal (GI) cancers, including esophageal, gastric, colorectal, liver, and pancreatic cancers, remain as one of the leading causes of death worldwide, with a large proportion accounting for fatalities related to metastatic disease. Invasion of primary cancer occurs by the actin cytoskeleton remodeling, including the formation of the filopodia, stereocilia, and other finger-like membrane protrusions. The crucial step of actin remodeling in the malignant cells is mediated by the fascin protein family, with fascin-1 being the most active. Fascin-1 is an actin-binding protein that cross-links filamentous actin into tightly packed parallel bundles, giving rise to finger-like cell protrusions, thus equipping the …

Operative Management Of Symptomatic, Metachronous Carotid Body Tumors Involving The Skull Base And Its Neurological Sequelae, Roberto G. Aru, Rony K. Aouad, Justin F. Fraser, Amanda M. Romesberg, Kevin W. Hatton, Sam C. Tyagi

Otolaryngology--Head & Neck Surgery Faculty Publications

A 44-year-old morbidly obese woman with a history of right carotid body tumor (CBT) resection presented with a symptomatic, nonfunctional, left Shamblin-III CBT. Abutment of the skull base precluded distal internal carotid artery control for arterial reconstruction, favoring parent vessel sacrifice after an asymptomatic provocative test. She underwent CBT resection with anticipated sacrifice of cranial nerves X and XII and the common carotid artery and its branches, developing baroreceptor failure syndrome and sequelae of cranial nerve sacrifice. When facing a symptomatic, metachronous CBT abutting the skull base, upfront operative intervention with adjuvant radiation for residual tumor optimizes curative resection.

Explicit Training To Improve Affective Prosody Recognition In Adults With Acute Right Hemisphere Stroke, Alexandra Zezinka Durfee, Shannon M. Sheppard, Erin L. Meier, Lisa Bunker, Erjia Cui, Ciprian Crainiceanu, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Difficulty recognizing affective prosody (receptive aprosodia) can occur following right hemisphere damage (RHD). Not all individuals spontaneously recover their ability to recognize affective prosody, warranting behavioral intervention. However, there is a dearth of evidence-based receptive aprosodia treatment research in this clinical population. The purpose of the current study was to investigate an explicit training protocol targeting affective prosody recognition in adults with RHD and receptive aprosodia. Eighteen adults with receptive aprosodia due to acute RHD completed affective prosody recognition before and after a short training session that targeted proposed underlying perceptual and conceptual processes. Behavioral impairment and lesion characteristics were …

Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, Md

Rothman Institute Papers

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability.

Study Design: Systematic review; Level of evidence, 4.

Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the …

A Randomized Trial To Improve Adherence To Follow-Up Eye Examinations Among People With Glaucoma, Benjamin E Leiby, Sarah E. Hegarty, Tingting Zhan, Jonathan S Myers, L Jay Katz, Julia A Haller, Michael Waisbourd, Christine Burns, Meskerem Divers, Jeanne Molineaux, Jeffrey Henderer, Charles Brodowski, Lisa A Hark

Department of Pharmacology and Experimental Therapeutics Faculty Papers

INTRODUCTION: Appointment nonadherence is common among people with glaucoma, making it difficult for eye care providers to monitor glaucoma progression. Our objective was to determine whether the use of patient navigators, in conjunction with social worker support, could increase adherence to recommended follow-up eye appointments.

METHODS: A randomized, controlled trial evaluated the effectiveness of an intervention that used patient navigators and social workers to improve patient adherence to follow-up eye care compared with usual care. Participants with glaucoma and other eye diseases (N = 344) were identified at primary care clinics in community settings through telemedicine screening of imaging and …

Can An Amino Acid Mixture Alleviate Gastrointestinal Symptoms In Neuroendocrine Tumor Patients?, Aman Chauhan, Satya Das, Rachel Miller, Laura Luque, Samuel N. Cheuvront, James Cloud, Zach Tarter, Fariha Siddiqui, Robert A. Ramirez, Lowell B. Anthony

Internal Medicine Faculty Publications

Background: Neuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models.

Methods: A retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval.

Results: Ninety-eight NET patients who …

Pi3k/Mtor Dual Inhibitor Pf-04691502 Is A Schedule-Dependent Radiosensitizer For Gastroenteropancreatic Neuroendocrine Tumors, Zeta Chow, Jeremy Johnson, Aman Chauhan, Tadahide Izumi, Michael Cavnar, Heidi L. Weiss, Courtney M. Townsend Jr., Lowell B. Anthony, Carrigan Wasilchenko, Matthew L. Melton, Jörg Schrader, B. Mark Evers, Piotr G. Rychahou

Markey Cancer Center Faculty Publications

Patients with advanced-stage gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have a poor overall prognosis despite chemotherapy and radiotherapy (e.g., peptide receptor radionuclide therapy (PRRT)). Better treatment options are needed to improve disease regression and patient survival. The purpose of this study was to examine a new treatment strategy by combining PI3K/mTOR dual inhibition and radiotherapy. First, we assessed the efficacy of two PI3K/mTOR dual inhibitors, PF-04691502 and PKI-402, to inhibit pAkt and increase apoptosis in NET cell lines (BON and QGP-1) and patient-derived tumor spheroids as single agents or combined with radiotherapy (XRT). Treatment with PF-04691502 decreased pAkt (Ser473) expression for up …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …

Biomarkers Of Thrombo-Inflammatory Responses In Pulmonary Embolism Patients With Pre-Existing Versus New-Onset Atrial Fibrillation., Dimpi Patel, Amir Darki, Debra Hoppensteadt, Iman Darwish, Mushabbar Syed, Yevgeniy Brailovsky, Jawed Fareed

Division of Cardiology Faculty Papers

Pulmonary embolism (PE) patients have an increased prevalence and incidence of atrial fibrillation (AF). Because comorbid AF increases risk of morbidity and mortality, we sought to investigate the role of thrombo-inflammatory biomarkers in risk stratifying patients who experience an acute PE episode. Study participants were enrolled from a Pulmonary Embolism Response Team (PERT) registry between March 2016 and March 2019 at Loyola University Medical Center and Gottlieb Memorial Hospital. This cohort was divided into 3 groups: PE patients with a prior diagnosis of AF (n = 8), PE patients with a subsequent diagnosis of AF (n = 11), and PE …

Covid-19 Newsletter (Vol. 72), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Mircorrnet: Machine Learning-Based Integration Of Mirna And Mrna Expression Profiles, Combined With Feature Grouping And Ranking., Malik Yousef, Gokhan Goy, Ramkrishna Mitra, Christine M. Eischen, Amhar Jabeer, Burcu Bakir-Gungor

Department of Cancer Biology Faculty Papers

A better understanding of disease development and progression mechanisms at the molecular level is critical both for the diagnosis of a disease and for the development of therapeutic approaches. The advancements in high throughput technologies allowed to generate mRNA and microRNA (miRNA) expression profiles; and the integrative analysis of these profiles allowed to uncover the functional effects of RNA expression in complex diseases, such as cancer. Several researches attempt to integrate miRNA and mRNA expression profiles using statistical methods such as Pearson correlation, and then combine it with enrichment analysis. In this study, we developed a novel tool called miRcorrNet, …

Normal Versus Half-Normal Saline In The Treatment Of Children With Diabetic Ketoacidosis, Amal G. Mohamed, Nada M. F. Elsayed, Raya A. M. Saleh, Sally R. Eid

Journal of Medicine in Scientific Research

Objective This study aims to determine the effect of 0.9% saline (NS) versus 0.45% saline (half NS) on blood pressure and serum electrolytes in children with diabetic ketoacidosis. Patients and methods This is a cross-sectional prospective comparative study carried out on 105 patients (1–18 years) from those admitted to the pediatric ICU of Al-Zahraa University Hospital from March 2017 to August 2019. Cases were divided into three groups (35 in each group). Group I patients received a shock, deficit, and maintenance therapy with NS. Group II patients received a shock therapy NS along with deficit and maintenance therapy with half …

Postoperative Astigmatism After Small-Incision Cataract Surgery With Sclera Tunnel Suturing And Without Scleral Tunnel Suturing: A Comparative Study, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Background and aim Cataract represents a significant socioeconomic burden and a public health concern, as it is the leading cause of blindness worldwide. Small-incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. There have been many improvements and changes in SICS's technique since its development, including changes in the site and size of the incision. Patients and methods This study was conducted aiming to study postoperative astigmatism after SICS with or without scleral tunnel suturing. This study was performed on 100 eligible eyes in 59 consecutive patients. Identical surgical methods were used in …

A Case Of Positive Covid-19-Infected Patient With Retinal Detachment And A Large Macular Hole: A Case Report, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Retinal detachment (RD) associated with macular hole accounts for 0.5% of RD. Here, we describe a rare case of RD and a large macular hole in a patient tested positive for COVID-19 in Sohag Teaching Hospital, Sohag, Egypt.

Using Methylene Blue Spray Intraoperatively To Perform Safe Thyroidectomy, Abdelrahman K. Abdelrahman, Esayed Elmokadem, Ihab Matar

Journal of Medicine in Scientific Research

Background Recurrent laryngeal nerve (RLN) injury and hypoparathyroidism are serious complications following thyroidectomy. Minimizing these complications is important to avoid a destructive life-long handicap. Aim Our goal was to decrease the incidence of intraoperative mishaps by spraying methylene blue dye on thyroid tissue and the tissues nearby. Patients and methods This is a prospective study that included 90 patients who underwent primary thyroid surgery for various thyroid diseases, with total thyroidectomy done in all. The patients were divided into two groups: methylene blue group included 45 patients who underwent surgery using methylene blue technique, and conventional group included 45 patients …

The Efficacy And Safety Of Ombitasvir/Paritaprevir/Ritonavir Plus Ribavirin In Hepatitis C Virus-Infected Patients With End-Stage Renal Disease On Regular Hemodialysis, Dalia Omran, Enass El Sayed, Muhammad M. A. Ghaffar

Journal of Medicine in Scientific Research

Background and aim Infection with hepatitis C virus (HCV) is an important cause of mortality and morbidity in patients with end-stage renal disease. Direct-acting antiviral drugs allow for the treatment of this group of patients. The current research aims to assess the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/RTV) combination therapy plus ribavirin in the treatment of HCV-infected Egyptian patients with chronic kidney disease stage V on regular hemodialysis. Patients and methods A total of 70 patients with chronic kidney disease stage V on regular hemodialysis with HCV infection were enrolled in this prospective cohort study, where 37 patients (group A) …

Evaluation Of Tissue Doppler Echocardiography In The Assessment Of Ventricular Function In Asthmatic Children, Amal G. Mohamed, Nada M. F. Elsayed, Safaa A. Mohammed, Sally R. Eid

Journal of Medicine in Scientific Research

Background Bronchial asthma is one of the commonest diseases in children. It not only affects the lung but also other organs, including the heart. Our study aims to assess the effect of bronchial asthma with varying degrees of severity on the ventricular function of the heart using tissue Doppler imaging. Patients and methods This is a case–control study that was performed at the Pediatric Department of Al-Azhar University Hospital and included 50 patients with bronchial asthma, who were compared with 50 age-matched and sex-matched healthy children as a control group. All children were subjected to full history taking, complete physical …

Selective Laser Trabeculoplasty In Silicone Oil-Induced Glaucoma, Hussam O. Elrashidy

Journal of Medicine in Scientific Research

Introduction One of the complications of using silicone oil is glaucoma. Selective laser trabeculoplasty (SLT) became an increasingly focused laser procedure for glaucoma because of its efficacy and minimal destructive effects on the surrounding tissues. The aim of our study is to analyze the efficacy of SLT on silicone oil-induced secondary glaucoma in terms of intraocular pressure (IOP). Patients and methods This is prospective study on 30 eyes of 30 patients with silicone oil-induced secondary glaucoma. The patients should have had no history of glaucoma or ocular hypertension before silicone oil injection. The patients were treated with laser at 360° …

Omentoplasty For Pelvic Defect Closure Following Abdominoperineal Resection In Lower Rectum Cancer, Amr A. Ella, Esayed Elmokadem, Ihab Matar

Journal of Medicine in Scientific Research

Background The perineal wound is considered an important source of postoperative morbidity and mortality following abdominoperineal resection (APR). Complications include wound dehiscence, infection, abscess, perineal herniation, radiation enteritis, persistent sinus, more nursing effort, prolonged hospital stay, and increase readmission with cost increase. Aim The aim of this study is to compare the result of conventional closure of pelvic defect following APR versus closure with omentoplasty. Patients and methods This study included 30 patients who underwent APR. The patients were divided into two groups: omentoplasty group included 15 patients who underwent pelvic defect closure using pedicle omental flap, and conventional group …

Functional Improvements Of Diabetic Macular Edema After Treatment With Ranibizumab, Hussam O. Elrashidy

Journal of Medicine in Scientific Research

Background Diabetic retinopathy and clinically significant macular edema are largely responsible for the irreversible, debilitating visual impairment. There is evidence suggesting that some of the diabetes-related visual abnormalities are due to neurodegeneration. Use of objective tests for early detection of retinal dysfunction of sight-threatening diabetic retinopathy would be of great value. Aim The aim was to study the functional improvements of macular functions after treatments with intravitreal injection of ranibizumab as detected with central visual field and multifocal electroretinogram (mfERG). Settings and design A prospective cohort interventional study that included 30 eyes of 30 patients. Materials and methods Prospective cohort …