Medical Specialties Commons^™

The Benefits Of Statins As Adjunct Therapy For Non-Pregnant And Non-Lactating Women Diagnosed With Pcos, Claire Barre

Capstone Showcase

Introduction: Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting about 20% of women in reproductive age. PCOS is associated with many health risks, one of which is an increased risk of cardiovascular and metabolic disorders. There is no set treatment plan to help decrease the risk of cardiometabolic diseases, but some standard recommended treatments include lifestyle changes, oral contraceptive pill (OCP), and metformin. The review analyzes the potential benefit of adding statins as an adjunct therapy (I) to decrease the cardiometabolic disease risk (O) in women diagnosed with PCOS (P) compared to the current recommended intervention (C). …

Efficacy Of Platelet-Rich Plasma (Prp) Injections Vs Topical Minoxidil In Adults With Androgenetic Alopecia, Yuan-Jane Qiu

Capstone Showcase

Androgenetic alopecia is a condition mediated by androgen (specifically DHT) and genetic factors that causes hair loss and thinning of the scalp in men and women. The hairs’ anagen phase is shortened and terminal hairs transition into vellus hairs. Although this condition is considered cosmetic in nature, it has psychologically detrimental effects. There are medical treatments available to prevent further hair loss but there is currently no cure. Topical minoxidil (Rogaine) is the most commonly used medication for androgenetic alopecia that stops hair loss and, in some cases, helps hair regrowth. However, it can cause an allergic contact dermatitis, local …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Effect Of Vegan Diet On Cardiovascular Health, Rachel Schottenfeld

Capstone Showcase

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of death globally, and in the United States, regardless of socioeconomic strata. Current diet guidelines in the US endorse the consumption of animal products, but research show retrospective, prospective and cross-sectional studies that a vegan diet is more effective at reducing BP, cholesterol, blood sugar levels, and body mass index (BMI) as compared to a non-vegan diet. This paper will focus on the benefits of a vegan diet (I) in reducing CVD risk (O) in adults (P) as compared to a non-vegan diet (C). It is the hope that increased focus …

The Use Of Continuous Positive Airway Pressure In Patients With Obstructive Sleep Apnea To Decrease The Risk And Progression Of Cardiovascular Disease, Haley Duncan

Capstone Showcase

Introduction: Cardiovascular disease is one of the most prevalent illnesses worldwide and the leading cause of death in the United States. Obstructive sleep apnea (OSA) has been found to be a risk factor correlated to cardiovascular disease and events. Treatment for OSA includes the use of continuous positive airway pressure (CPAP), but patients are often non-compliant due to discomfort. Therefore, the following clinical question arises: [P] In an adult patient (35-75 years old) diagnosed with OSA, [I] does the use of CPAP [C: compared to patients with OSA who do not use CPAP] [O]decrease the risk and/or progression of cardiovascular …

The Efficacy Of In Vitro Fertilization In Treating Infertility Due To Anovulatory Pcos In Comparison To Ovulation Induction Via Letrozole, Amanda Salay

Capstone Showcase

Abstract:

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder found in women of reproductive age that often causes infertility. The first-line treatment for infertility in anovulatory PCOS patients is ovulation induction. In vitro fertilization (IVF) is a third line treatment often used as a last resort. PCOS patients have higher failure risks of first- and second-line medications. Therefore, this review analyzes if adverse pregnancy outcomes (O) are reduced more with IVF (I) versus using letrozole for ovulation induction (C) in women aged 20-30 struggling with infertility due to anovulatory PCOS (P).

Methods: A literature search on Pubmed and EBSCOhost …

The Efficacy Of Combination Of Psychosocial Interventions And Pharmacotherapeutic Intervention Compared To Standard Care In Patients Age 16-40 Diagnosed With Schizophrenia When Looking At Functional Capacity, Lisa Roth

Capstone Showcase

Introduction: Schizophrenia is a complex mental illness that arises from a combination of genetic factors, brain chemistry, substance use and environmental factors that affects the way a person behaves, thinks, and perceives. Schizophrenia has no cure, but it has several options for treatment including antipsychotic medications, psychotherapy, and education. Medication is frequently prescribed, and there is little evidence of how often psychotherapy is practiced to properly treat negative symptoms. The combination of these symptoms can have an impact on the functional capacity of an individual; this means that they may have less of an ability to proceed in a typical …

In Patients With Mild To Moderate Alzheimer’S, Does Music Therapy Help To Decrease Mood Disturbances When Compared To Those Not Participating In Music Therapy?, Lauren Bauer

Capstone Showcase

Abstract:

Introduction: Affecting both memory and cognitive abilities, Alzheimer’s disease is a growing problem as the baby boomer population ages. Clinical trials for new medications fail or are slow going, researchers have sought alternatives to alleviate symptoms for patients of this disease. This paper will address the effect of music therapy on mood disturbance in patients with Alzheimer’s disease.

Method: A literature search was completed in November of 2019 using PubMed, EBSCO Search, ScienceDirect, and Google Scholar. Six articles were chosen based on relevance to the research question, study design, outcome, and results.

Results: Based on review, music …

The Effects Of Psychological Intervention On Pregnant Women With Elevated Cortisol Levels And Adverse Birth Events, Megan Mellon

Capstone Showcase

Elevated levels of stress, anxiety, and depression during pregnancy are thought to influence cortisol levels. Dysregulations in cortisol, as a byproduct of the hypothalamic-pituitary axis, have been associated with preterm birth and adverse birth outcomes. Studies have demonstrated poorer long-term effects of antenatal stress on child neurodevelopment, temperament, and cognition. Psychological interventions of cognitive behavioral therapy (CBT), mindfulness, and gratitude have shown to have a positive effect on psychological wellbeing across various populations. The purpose of this literature review was to analyze a collection of randomized-controlled trials to conclude if psychological interventions during pregnancy for women with elevated levels of …

The Efficacy Of Platelet-Rich Plasma Administration For Rotator Cuff Tears, Angela Bekampis

Capstone Showcase

Despite advancing surgical techniques for rotator cuff tears (RCTs), the recovery from surgery is often painful and the rate of re-tear remains high. The use of platelet-rich plasma (PRP) is being studied as an adjunct therapy in order to increase the success of treatment. The goal of this study is to consolidate and compare the results of previous research to determine whether the use of PRP had significant benefit in the treatment of RCTs. Therefore the research question was: in adults (18+) diagnosed with a partial or full-thickness rotator cuff tears, does the use of PRP as an adjuvant treatment …

Acupuncture Therapy In The Treatment Of Osteoarthritis Of The Knee, Reece Bartell

Capstone Showcase

Abstract

Introduction: Osteoarthritis (OA) is a chronic condition that affects the joints of the body, most commonly the knees; it has the potential to cause debilitating pain, and stiffness and decrease quality of life. The current management involves lifestyle modifications of a healthy diet and exercise as well as analgesics like NSAIDs or acetaminophen to manage symptoms. Long-term use of these medications has been associated with many side effects affecting the GI and CV system. This review analyzes the use of acupuncture therapy (I) for symptom management (O) in patients aged 60-80 years old suffering from mild to moderate …

Efficacy Of Myo-Inositol In The Treatment Of Polycystic Ovarian Syndrome (Pcos), Rachel Mathews

Capstone Showcase

Polycystic ovarian syndrome (PCOS) is a disorder that results from insulin resistance. Symptoms include chronic anovulation, polycystic ovaries, acne, hirsutism, and infertility. Although there is currently no cure for PCOS, treatments such as metformin, clomiphene citrate, and reproductive assistive techniques (IVF) have been used to target specific symptoms. Recent research has suggested that myo-inositol may be beneficial in the treatment of PCOS. Therefore, this review analyzes the addition of myo-inositol (I) in adult patients with PCOS (P) compared to current methods such as metformin, clomiphene citrate, and assisted therapies alone (C) in improving ovulation and fertility (O). A literature search …

Brooke-Spiegler Syndrome: Familial Cylindromatosis, A Rare Variant Of A Rare Familial Syndrome., Harsh Patel, William Naber, Austin Cusick, Craig Oser

Ambulatory and Primary Care Articles

Brooke-Spiegler Syndrome (BSS) is a rare autosomal dominant familial disorder resulting in dermatologic neoplasms of copious nodular appendages. Here, we report a case of Familial Cylindromatosis (FC), a subtype of BSS, in a patient with the largest cylindroma of 7.4 × 5.6 × 3.8 cm on the scalp. The patient had undiagnosed cylindromas growing for 36 years at presentation; however, he did not seek out healthcare evaluation. Excision and pathologic investigation of three large masses from different body sites determined a shared phenotype of cylindromas. Subsequent evaluation of the patient's son separately, after primary patient excision, confirmed cylindroma development as …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Treatment-Resistant Hypercalcemia From Ectopic Pth Hypersecretion Suspected Secondary To Disseminated Ovarian Cancer, Alexander M. Balinski, Neil J. Khatter, Jeffrey M. Gold, Krishna S. Pothugunta, Vamshi K. Garlapaty, Steven M. Rankin, Christopher A. Thornburn, Jamal Abu-Khaled

Articles

Hypercalcemia of malignancy (HCM) can present secondary to hypersecretion of parathyroid hormone (PTH)-related protein (PTHrP) from malignant tumors, but rare cases of HCM have also been documented due to inappropriate PTH secretion from ectopic neoplasms. Here, we report an unusual case of HCM due to hypersecretion of PTH suspected secondary to a disseminated mucinous ovarian adenocarcinoma. A 45-year-old female presented with severe hypercalcemia and significant elevations in both PTH and PTHrP two weeks after total abdominal hysterectomy with bilateral salpingo-oophorectomy and suboptimal debulking of a newly discovered left ovarian mucinous adenocarcinoma with numerous metastases. Ectopic PTH secretion was highly suspected …

Psychosocial Preoperative Preparation In A Non-Children's Hospital Without Child Life Supports, Haley M. Fricke

EWU Masters Thesis Collection

On average, 6 million children undergo general anesthesia for surgery annually in the United States (Shah et al., 2021).Anesthesia can be one of the most stress provoking experiences, with 40% to 60% of children displaying emotional and behavior stress before surgery (Boles, 2016). Psychosocial preoperative preparation in pediatrics has been seen to lower children’s stress levels, enhance understanding, increase compliance, decrease length of time in recovery, and decrease analgesic use (Aranha et al., 2017; Al-Yateem et al., 2016; Dolidze et al., 2013; Tunney & Boore 2013; Wenstrom et al., 2011). The purpose of this exploratory case study was to better …

The Association Of Abo Blood Groups And Trauma Outcomes: A Retrospective Analysis Of 3779 Patients., Michael W Sauder, Timothy W Wolff, Aimee K Lariccia, M Chance Spalding, Urmil B Pandya

Trauma and Acute Care Articles

BACKGROUND: There is currently a lack of understanding regarding the link between ABO blood types with outcomes of traumatically injured patients. The purpose of this study was to determine the association of ABO blood types with outcomes in traumatically injured patients separated by injury type.

METHODS: This retrospective study evaluated trauma patients at an urban, Level 1 trauma center from January 1, 2017, through December 31, 2017. Patients were excluded if they were pregnant or < 16 years old. Recorded outcomes included: ABO blood group, mortality, Injury Severity Score (ISS), race, injury type, mechanism of injury, and complications. Data analysis was performed using descriptive statistics including Chi-squared, Kruskal-Wallis, and

RESULTS: A total of 3779 patients were included in this study. No significant differences were present in mean age or ISS between blood types. In …

Low-Temperature Gas Plasma Combined With Antibiotics For The Reduction Of Methicillin-Resistant Staphylococcus Aureus Biofilm Both In Vitro And In Vivo, Li Guo, Lu Yang, Yu Qi, Gulimire Niyazi, Jianbao Zheng, Ruobing Xu, Xusong Chen, Jingye Zhang, Wang Xi, Dingxin Liu, Xiaohua Wang, Hailan Chen, Michael G. Kong

Electrical & Computer Engineering Faculty Publications

Biofilm infections in wounds seriously delay the healing process, and methicillin-resistant Staphylococcus aureus is a major cause of wound infections. In addition to inactivating micro-organisms, low-temperature gas plasma can restore the sensitivity of pathogenic microbes to antibiotics. However, the combined treatment has not been applied to infectious diseases. In this study, low-temperature gas plasma treatment promoted the effects of different antibiotics on the reduction of S. aureus biofilms in vitro. Low-temperature gas plasma combined with rifampicin also effectively reduced the S. aureus cells in biofilms in the murine wound infection model. The blood and histochemical analysis demonstrated the biosafety of …

Impact Of A Global Pandemic On Surgical Education And Training- Review, Response, And Reflection, Sabah Uddin Saqib, Omair Saleem, Amna Riaz, Qamar Riaz, Hasnain Zafar

Section of General Surgery

The catastrophic effects of the coronavirus disease-2019 global pandemic have revolutionised human society. The unprecedented impact on surgical training needs to be analysed in detail to achieve an understanding of how to deal with similar situations arising in the foreseeable future. The challenges faced by the surgical community initiated with the suspension of clinical activities and elective practice, and included the lack of appropriate personal protective equipment, and the self-isolation of trainees and reassignment to coronavirus patient-care regions. Together, all these elements had deleterious effects on the psychological health of the professionals. Surgical training irrespective of specialty is equally affected …

Heritability Of Ocular Traits In Hispanics, Aaron T. Gomez, Gladys E. Maestre, Jesus D. Melgarejo, Vincent P. Diego, Nicholas B. Blackburn, Juan B. Yepez, Michele Petitto, Felipe A. Murati, Rosa V. Pirela, Carlos A. Chavez, Winston Lee, Lama A. Al-Aswad, Matthew P. Johnson, Joseph H. Lee, John Blangero

MEDI 9331 Scholarly Activities Clinical Years

Purpose: The burden of glaucoma disease among Hispanics is significantly higher than in their white counterparts. It remains unclear to what extent these differences are determined by genetic factors in Hispanics. We therefore examined a highly inbred family population-based cohort in Venezuela to estimate the proportion of genetic contribution of ocular traits relevant to glaucoma disease.

Methods: A subset of 67 participants ≥40y from the Maracaibo Aging Study (MAS) with family pedigree were randomly included. The papillary retinal nerve fiber layer (RNFL) and macular thickness were measured with Spectralis Domain-OCT. Heritability analyses (h², expressed as %) …

Antibiotic Stewardship In Skin And Soft Tissue Infections, Shah Z. Ali, Jose Campo Maldonado

MEDI 9331 Scholarly Activities Clinical Years

Antibiotic use during inpatient hospitalizations have a significant impact on both patient care and healthcare costs. Using data collected over a one month period in 2019 from inpatient hospitalizations, we aim to determine the most common indicated uses for vancomycin and piperacillin-tazobactam, along with the average days of therapy for their use in treating skin and soft tissue infections.

Spinal Cord Mri Analysis Techniques In Post-Stroke Patients, Sarvani Uppati, Sravani Mannuru, Kelsey Baker

MEDI 9331 Scholarly Activities Clinical Years

Stroke, also termed cerebral infarction, results in neurodegeneration and neuroinflammation in the brain at area of the infarct and peri-infarct regions. Recent research has shown involvement of alternate motor pathways of the spinal cord in disease progression. Creating optimal techniques to study spinal cord MRI can give way to higher prognostic methods and enhanced treatment modalities in post-stroke patients. Here, we will review current research proposing various spinal cord MRI analysis techniques in different neurological conditions that can be applied to analyzing post-stroke spinal cord.

Improving Ob Trauma Care Using A Standardized Protocol, Johanna Renee Ridley, Madeline Elaine Huff, Abaigeal Thompson

MEDI 9331 Scholarly Activities Clinical Years

Introduction

Timely evaluation of a pregnant woman experiencing trauma has significant implications. To optimize trauma care for obstetrical patients, our Level I Trauma Center at Doctors Hospital at Renaissance initiated a Standard Operating Procedure (SOP) which puts an OBGYN at bedside within 15 minutes of arrival. This involves calling an ‘OB Trauma Alert’ and arranging expedited travel to the center. We performed a quality improvement initiative to evaluate operational compliance.

Methods

The IRB deemed this project non-regulated research. Therefore, we reviewed obstetrical trauma admissions and subsequent deliveries of pregnant women >20 weeks presenting within 2 years before SOP implementation through …

Intense Monochromatic Photons Above 100 Kev From An Inverse Compton Source, Kirsten Deitrick, Georg H. Hoffstaetter, Carl Franck, Bruno D. Muratori, Peter H. Williams, Geoffrey A, Krafft, Balša Terzić, Joe Crone, Hywel Owen

Physics Faculty Publications

Quasimonochromatic x rays are difficult to produce above 100 keV, but have a number of uses in x-ray and nuclear science, particularly in the analysis of transuranic species. Inverse Compton scattering (ICS) is capable of fulfilling this need, producing photon beams with properties and energies well beyond the limits of typical synchrotron radiation facilities. We present the design and predicted output of such an ICS source at CBETA, a multiturn energy-recovery linac with a top energy of 150 MeV, which we anticipate producing x rays with energies above 400 keV and a collimated flux greater than 108 photons per second …

Solutions For Fermi Questions, January 2022: Question 1: Snow Volume; Question 2: Longbow Arrow Velocity, Larry Weinstein

Physics Faculty Publications

No abstract provided.

The Effect Of Implementing Ob Trauma Activation Standards On Maternal & Fetal Outcomes, Johanna Renee Ridley, Abaigeal Thompson

MEDI 9331 Scholarly Activities Clinical Years

The risk of trauma during pregnancy is not well established in the United States but is associated with significant morbidity and mortality. The overall goal of this study is to to initiate a formal ongoing process by which DHR can utilize objective measures to monitor and evaluate the quality of OB trauma services. We will use a Continuous Quality Improvement (CQI) approach to evaluate the effect of implementing an OB Trauma Activation Procedure, which places an OB team (obstetrician and labor RN) at the bedside within 15 minutes on maternal and fetal outcomes. 1,285 subjects were initially filtered to remove …

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

Thymectomy, Bryan Bennett, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Excerpt

Thymectomy is the resection of the thymus gland. This anterior mediastinal organ can enlarge as in myasthenia gravis and thymoma and harbor malignant cells such as in thymic carcinoma or neuroendocrine tumors. The first thymectomies were performed incidentally in conjunction with thyroidectomies for Grave disease by Garre and Sauerbruch, but it was not until Blalock and colleagues that multiple series were performed with adequate results.

This also included patients with myasthenia gravis but without thymomas. The gold standard approach for thymectomy is a median sternotomy or transsternal approach, but this has evolved to less invasive techniques such as upper …

Tisagenlecleucel Infusion In Patients With Relapsed/Refractory All And Concurrent Serious Infection., Erin Hall, Dwight E. Yin, Rakesh K. Goyal, Atif Ahmed, Grace S. Mitchell, Shawn D. St Peter, Terrie Flatt, Ibrahim A. Ahmed, Weijie Li, Richard J. Hendrickson, Keith August, Douglas Myers

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Tisagenlecleucel, an anti-CD19 chimeric antigen receptor T (CAR-T) cell therapy, has demonstrated durable efficacy and a manageable safety profile in pediatric and young adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) in the ELIANA pivotal trial and real-world experience. Experience from investigator-led studies prior to ELIANA suggests that infections and inflammatory conditions may exacerbate the severity of cytokine release syndrome (CRS) associated with CAR-T cell therapy, leading to extreme caution and strong restrictions for on-study and commercial infusion of tisagenlecleucel in patients with active infection. CRS intervention with interleukin (IL)-6 blockade and/or steroid therapy was introduced late in …

Automated Cervical Digitized Histology Whole-Slide Image Analysis Toolbox, Sudhir Sornapudi, Ravitej Addanki, R. Joe Stanley, William V. Stoecker, Rodney Long, Rosemary Zuna, Shellaine R. Frazier, Sameer Antani

Electrical and Computer Engineering Faculty Research & Creative Works

Background: Cervical intraepithelial neoplasia (CIN) is regarded as a potential precancerous state of the uterine cervix. Timely and appropriate early treatment of CIN can help reduce cervical cancer mortality. Accurate estimation of CIN grade correlated with human papillomavirus type, which is the primary cause of the disease, helps determine the patient's risk for developing the disease. Colposcopy is used to select women for biopsy. Expert pathologists examine the biopsied cervical epithelial tissue under a microscope. The examination can take a long time and is prone to error and often results in high inter-and intra-observer variability in outcomes. Methodology: We propose …