Medical Specialties Commons^™

Secondary Stroke Prevention Education Project, Lauren Collie, Rn, Bsn, Pccn, Alyssa Brown, Rn, Bsn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Implementation Of A Team Discharge Approach To Improve Ecc Throughput, Julie Lisbin, Msn, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Implementing Bedside Report In The Emergency Care Center 2.0: A Quality Improvement Initiative, Alexandra Rowen, Bsn, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Bipap-Related Hapi In Dsu During The Covid-19 Pandemic, Carmyle Seville, Bsn, Rn, Pccn, Angelica Taneca, Bsn, Rn, Pccn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Difficult Iv Access (Diva) Tool’S Impact On Assisting Rns In Determining When To Call The Vascular Access Team (Vat) Rn For Assistance, Diane Dimarco Davis, Bsn, Rn, Va-Bc

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

The Vascular Access Team: Joey Guinto, BSN, RN, VA-BC; Chynna Vu, RN; SabelaBarrios, RN, VA-BC; Summer Cortinas, BSN, RN, VA-BC; Jeremy Tan, BSN, RN; Lynda Fenton, RN, VA-BC; VinhLe, RN, VA-BC

2020 American Heart Association Guidelines: Updates, Education, & Compliance In The Emergency Care Center And The Acute Care Setting, Laura Derr, Rn, Cen, Cn Iv

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

National Early Warning Score (News): Medical Surgical Unit Pilot, Electronic Hospital-Wide Roll-Out, And Unit Educational Case Studies, Leslie Farrington, Rn, Bsn, Ccrn, Mackenzie Brown, Rn, Bsn, Molly Cody, Rn, Bsn, Megan Greco, Rn, Bsn, Cecille Lamorena Bsn, Rn, Ccrn-K, Crystal Martinez, Rn, Bsn, Jacoba Walsh, Rn, Bsn, Elizabeth Winokur, Phd, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Improving The Chemotherapy Experience Through Telephone Communications: The Follow-Up Phone Call, Kathy Keener, Msn, Rn, Ocn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Impact Of Lymphopenia On Survival For Elderly Patients With Glioblastoma: A Secondary Analysis Of The Cctg Ce.6 (Eortc 26062-22061, Trog03.01) Randomized Clinical Trial, Andrew Song, Keyue Ding, Iyad Alnahhas, Normand J Laperriere, James Perry, Warren P Mason, Chad Winch, Chris J O'Callaghan, Johan J Menten, Alba A Brandes, Claire Phillips, Michael F Fay, Ryo Nishikawa, David Osoba, J Gregory Cairncross, Wilson Roa, Wolfgang Wick, Wenyin Shi

Department of Radiation Oncology Faculty Papers

Background: Lymphopenia may lead to worse outcomes for glioblastoma patients. This study is a secondary analysis of the CCTG CE.6 trial evaluating the impact of chemotherapy and radiation on lymphopenia, and effects of lymphopenia on overall survival (OS).

Methods: CCTG CE.6 randomized elderly glioblastoma patients (≥ 65 years) to short-course radiation alone (RT) or short-course radiation with temozolomide (RT + TMZ). Lymphopenia (mild-moderate: grade 1-2; severe: grade 3-4) was defined per CTCAE v3.0, and measured at baseline, 1 week and 4 weeks post-RT. Preselected key factors for analysis included age, sex, ECOG, resection extent, MGMT methylation, Mini-Mental State Examination, and …

Covid-19-Associated Pulmonary Aspergillosis: A Case Report From The Covid-19 Surveillance Program., Mohamad Belal Aldaas, Dylan Goldsmith, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

A 72-year-old male was brought to the hospital following a motorcycle crash and was admitted for multiple trauma management. His initial course of hospitalization was complicated by mild hypoxemia and altered mental status. Respiratory workup and imaging were consistent with SARS-CoV-2 pneumonia. He completed a five-day course of remdesivir and a ten-day course of dexamethasone. Twenty days later, he developed a low-grade fever. His chest computerized tomography (CT) showed gas and fluid containing parenchymal collection in the anteromedial right middle lobe measuring up to 4.8 cm, most consistent with a pulmonary abscess. Antimicrobial treatment was started.

The patient became hypoxic …

Exploring Perceived Importance Of A Novel Emergency Food Program During Covid-19 And Program Recipient Characteristics, Makenzie L. Barr, Kendra Oonorasak, Kristin Hughes, Lauren Batey, Kaela Jackson, Haley Marshall, Tammy Stephenson

Dietetics and Human Nutrition Faculty Publications

Following rising unemployment rates and consequent loss of income due to COVID-19, many people have been seeking meal assistance. This study examines the impact of a community-based free meal distribution program during the pandemic in Kentucky, reviewing characteristics of recipients of the program. Demographics, health behaviors, food insecure classification, and rating of importance of the meal program were collected. Qualitative feedback on the impact of the program was collected via open response. Of the 92 participants using the meal service, the cohort was female, Black, 43 years of age (43.5 ± 15.0 years), with a household income under 30,000 USD …

Psychological Autopsy Study And Risk Factors For Suicide In Muslim Countries, S M Yasir Arafat, Murad M. Khan, Vikas Menon, Syeda Ayat-E-Zainab Ali, Mohsen Rezaeian, Sheikh Shoib

Department of Psychiatry

Background: Suicide and risk factors have been poorly studied in the Muslim-majority countries that hinder the formulation of prevention strategies and affect suicide prevention eventually.
Objectives: We aimed at identifying and analyzing the psychological autopsy studies assessing the risk factors for suicide conducted in Muslim-majority countries.
Methods: We did a search to trace all the available psychological autopsy studies in the Muslim countries with the search term "psychological autopsy study in Muslim countries." We also checked the available bibliographies to identify the psychological autopsy studies in the Muslim countries so that all the possible studies could be included.
Results: Out …

A Novel Combination Chemotherapy Targeting Extramedullary Disease In Multiple Myeloma Following First-Line Treatment Failure, Ruaa M. Elteriefi, Nourelhuda Abbas Hamed, Omar Nasser Rahal, Faisal Musa

Conference Presentation Abstracts

Introduction:

Multiple Myeloma (MM), a plasma cell neoplasm that resides in the bone marrow’s intramedullary space.

Extramedullary disease (EMD) occurs when plasma cells extend through the bone cortex or via hematogenous spread to different organs.

This case of EMD of MM didn’t respond to the first line RVD regimen per NCCN guidelines which includes Lenalidomide (Revlimid), Bortezomib (Velcade), and Dexamethasone (Decadron). Therefore, new combination chemotherapy including Daratumumab, and Carfilzomib was initiated with excellent response.

Case description:

62-year-old female presenting to the oncologist for progressive right hip pain for 4 weeks. Initial hip x-ray and bone scan suspected malignancy. MRI showed …

Role Of Gut Microbiome In Covid-19: An Insight Into Pathogenesis And Therapeutic Potential, Ikram Hussain, Gabriel Liu Yuan Cher, Muhammad Abbas Abid, Muhammad Bilal Abid

Department of Pathology and Laboratory Medicine

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in an unprecedented global crisis. Although primarily a respiratory illness, dysregulated immune responses may lead to multi-organ dysfunction. Prior data showed that the resident microbial communities of gastrointestinal and respiratory tracts act as modulators of local and systemic inflammatory activity (the gut-lung axis). Evolving evidence now signals an alteration in the gut microbiome, brought upon either by cytokines from the infected respiratory tract or from direct infection of the gut, or both. Dysbiosis leads to a "leaky gut". The intestinal permeability then allows access to …

Epigenetic Regulation And Post-Translational Modifications Of Snai1 In Cancer Metastasis, Bo Dong, Yadi Wu

Pharmacology and Nutritional Sciences Faculty Publications

SNAI1, a zinc finger transcription factor, not only acts as the master regulator of epithelialmesenchymal transition (EMT) but also functions as a driver of cancer progression, including cell invasion, survival, immune regulation, stem cell properties, and metabolic regulation. The regulation of SNAI1 occurs at the transcriptional, translational, and predominant post-translational levels including phosphorylation, acetylation, and ubiquitination. Here, we discuss the regulation and role of SNAI1 in cancer metastasis, with a particular emphasis on epigenetic regulation and posttranslational modifications. Understanding how signaling networks integrate with SNAI1 in cancer progression will shed new light on the mechanism of tumor metastasis and help …

A Prospective Observational Study Of Antihemophilic Factor (Recombinant) Prophylaxis Related To Physical Activity Levels In Patients With Hemophilia A In The United States (Space), Barbara A. Konkle, Doris V. Quon, Leslie Raffini, Michael Recht, Vlad C. Radulescu, Shannon L. Carpenter, Amy L. Dunn, Mei Lu, Maureen Watt

Pediatrics Faculty Publications

Introduction: High collision-risk physical activity can increase bleeding risk in people with hemophilia A, as can increasing the time between factor VIII (FVIII) administration and physical activity. FVIII prophylaxis may be tailored to planned activities to prevent activity-related bleeding.

Aim: To explore the relationship between physical activity levels, FVIII infusion timing, and occurrence of bleeding in patients with severe/moderately severe hemophilia A without FVIII inhibitors receiving antihemophilic factor (recombinant) (rAHF; ADVATE^®; Baxalta US Inc., a Takeda company, Lexington, MA, USA).

Methods: SPACE was a 6-month, prospective, multicenter, observational outcomes study (NCT02190149). Enrolled patients received an eDiary application and …

Tardive Dyskinesia In Older Persons Taking Antipsychotics, Leslie Citrome, Stuart H Isaacson, Danielle Larson, Daniel Kremens

Department of Neurology Faculty Papers

Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by the use of dopamine receptor-blocking agents (DRBAs), a category of medications that includes first-and second-generation antipsychotics (APs) and agents such as metoclopramide that are used for the treatment of nausea and gastrointestinal dysmotility. While TD can affect people of all ages, older age is associated with increased risk of TD and also with the emergence of TD occurring after shorter treatment durations and lower dosages of DRBAs. TD is characterized by involuntary movements that include the face, limbs, and trunk, and is associated with increased comorbidities, social stigmatization, and impaired …

Athletic Training Educators’ Perceptions Of Interprofessional Education And Educational Strategies Used To Infuse Ipe Within Athletic Training Programs: A Mixed Methods Approach, Christina Orozco Nevers

Seton Hall University Dissertations and Theses (ETDs)

BACKGROUND: As athletic trainers (ATs) educators and professionals we recognize the importance of preparing our students to practice as part of an interprofessional team and acknowledge that this training must begin while they are in the academy. Although there is lots of information about interprofessional education (IPE) in various other healthcare professions (HCPs), there is limited information about how AT educators are infusing IPE into the curriculum. To maximize the development of interprofessional teaming practices in healthcare we must first understand the most effective ways to infuse IPE in AT professional programs given how compact the curriculum is. Educators must …

Current State Of Pediatric Obesity: Management Trends In An Outpatient Pediatric Clinic, Susan Edlibi, Ryan Rogers, Dina Abdo, Charity Owusu-Asare, Reem Wassef, Mary Coffey, Lihua Qu, Aimee Pollak, Stacey Shubeck, Kerry Mychaliska

Conference Presentation Abstracts

Background: The prevalence of pediatric obesity has increased over the last 30 years resulting inan earlier onset of obesity-related comorbidities. The greatest acceleration of Body Mass Index(BMI) in children has been reported to occur between the ages of 2 and 6 and is associated with anincreased risk of sustained obesity in adulthood. Objectives: The purpose of this study is to assess the characteristics of overweight (BMI at orabove 85th percentile) pediatric patients and current management trends in a single academicoutpatient clinic setting. Design/Methods: This IRB approved retrospective study conducted a chart review of pediatricpatients that presented to an outpatient clinic …

Pharmacologic And Clinical Considerations Of Nalmefene, A Long Duration Opioid Antagonist, In Opioid Overdose., Amber N. Edinoff, Catherine A. Nix, Tanner D. Reed, Elizabeth M. Bozner, Mark R. Alvarez, Mitchell C. Fuller, Fatimah Anwar, Elyse M. Cornett, Adam M. Kaye, Alan D. Kaye

School of Medicine Faculty Publications

No abstract provided.

Effect Of Sars-Cov2 On Adolescent Phq-9 Screening Result, Aimee Pollak, Kerry Mychaliska, Stacey Shubeck, Olufunke Adeyemo, Anisah Hashmi, Mara Rubenstein, Leah Ludwig

Conference Presentation Abstracts

Background: The SARS-COV2 pandemic created numerous stressors for adolescents. Prior studies have shown an increased risk for self-reported depression symptoms in pediatric patients after trauma. . Objectives: This study compares the rates of newly diagnosed adolescent depression, and self-reported depression symptoms, in an outpatient clinic during the pandemic as compared to pre-pandemic. Design/Methods: This IRB approved study involved a retrospective chart review of adolescents aged 12-17 who attended an academic clinic between January 1, 2018 and March 22, 2020.Included were adolescents aged 12 to 17 who completed a PHQ-9 questionnaire at their annual wellness visit, without a prior diagnosis or …

A Prospective Observational Study Of Antihemophilic Factor (Recombinant) Prophylaxis Related To Physical Activity Levels In Patients With Hemophilia A In The United States (Space)., Barbara A. Konkle, Doris V. Quon, Leslie Raffini, Michael Recht, Vlad C. Radulescu, Shannon L. Carpenter, Amy L. Dunn, Mei Lu, Maureen Watt

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: High collision-risk physical activity can increase bleeding risk in people with hemophilia A, as can increasing the time between factor VIII (FVIII) administration and physical activity. FVIII prophylaxis may be tailored to planned activities to prevent activity-related bleeding.

Aim: To explore the relationship between physical activity levels, FVIII infusion timing, and occurrence of bleeding in patients with severe/moderately severe hemophilia A without FVIII inhibitors receiving antihemophilic factor (recombinant) (rAHF; ADVATE®; Baxalta US Inc., a Takeda company, Lexington, MA, USA).

Methods: SPACE was a 6-month, prospective, multicenter, observational outcomes study (NCT02190149). Enrolled patients received an eDiary application and …

Norovirus Protease Structure And Antivirals Development, Boyang Zhao, Liya Hu, Yongcheng Song, Ketki Patil, Sasirekha Ramani, Robert L Atmar, Mary K Estes, B V Venkataram Prasad

Faculty, Staff and Students Publications

Human norovirus (HuNoV) infection is a global health and economic burden. Currently, there are no licensed HuNoV vaccines or antiviral drugs available. The protease encoded by the HuNoV genome plays a critical role in virus replication by cleaving the polyprotein and is an excellent target for developing small-molecule inhibitors. The current strategy for developing HuNoV protease inhibitors is by targeting the enzyme's active site and designing inhibitors that bind to the substrate-binding pockets located near the active site. However, subtle differential conformational flexibility in response to the different substrates in the polyprotein and structural differences in the active site and …

A Selective Antibiotic For Lyme Disease, Nadja Leimer, Xiaoqian Wu, Yu Imai, Madeleine Morrissette, Norman Pitt, Quentin Favre-Godal, Akira Iinishi, Samta Jain, Mariaelena Caboni, Inga V Leus, Vincent Bonifay, Samantha Niles, Rachel Bargabos, Meghan Ghiglieri, Rachel Corsetti, Megan Krumpoch, Gabriel Fox, Sangkeun Son, Dorota Klepacki, Yury S Polikanov, Cecily A Freliech, Julie E Mccarthy, Diane G Edmondson, Steven J Norris, Anthony D'Onofrio, Linden T Hu, Helen I Zgurskaya, Kim Lewis

Faculty, Staff and Student Publications

Lyme disease is on the rise. Caused by a spirochete Borreliella burgdorferi, it affects an estimated 500,000 people in the United States alone. The antibiotics currently used to treat Lyme disease are broad spectrum, damage the microbiome, and select for resistance in non-target bacteria. We therefore sought to identify a compound acting selectively against B. burgdorferi. A screen of soil micro-organisms revealed a compound highly selective against spirochetes, including B. burgdorferi. Unexpectedly, this compound was determined to be hygromycin A, a known antimicrobial produced by Streptomyces hygroscopicus. Hygromycin A targets the ribosomes and is taken up by B. burgdorferi, explaining …

An Empirical Pipeline For Personalized Diagnosis Of Lafora Disease Mutations, M. Kathryn Brewer, Maria Machio-Castello, Rosa Viana, Jeremiah L. Wayne, Andrea Kuchtová, Zoe R. Simmons, Sarah Sternbach, Sheng Li, Maria Adelaida García-Gimeno, Jose M. Serratosa, Pascual Sanz, Craig W. Vander Kooi, Matthew S. Gentry

Molecular and Cellular Biochemistry Faculty Publications

Lafora disease (LD) is a fatal childhood dementia characterized by progressive myoclonic epilepsy manifesting in the teenage years, rapid neurological decline, and death typically within ten years of onset. Mutations in either EPM2A, encoding the glycogen phosphatase laforin, or EPM2B, encoding the E3 ligase malin, cause LD. Whole exome sequencing has revealed many EPM2A variants associated with late-onset or slower disease progression. We established an empirical pipeline for characterizing the functional consequences of laforin missense mutations in vitro using complementary biochemical approaches. Analysis of 26 mutations revealed distinct functional classes associated with different outcomes that were supported by clinical …

Obsolete Or Essential? Gastrointestinal Decontamination In Severe Bupropion Ingestions: A Case Series, Alexandra Amaducci Do, Andrew F. Miller Do, Derek J. Fikse Do, Gillian A. Beauchamp Md

Department of Emergency Medicine

No abstract provided.

Hypercalcaemia Caused By Sunflower Seeds And Calcium Carbonate Supplements, Iqra Patoli, Mehrunissa Kazim, Saad Bin Jamil, Syed Hassan Abbas

Department of Medicine Faculty Papers

INTRODUCTION: Hypercalcaemia is commonly associated with malignancy or endocrinological disorders. However, sometimes it can occur due to increased oral intake of calcium. We present an interesting case of hypercalcaemia due to ingestion of sunflower seeds and calcium carbonate supplements.

CASE DESCRIPTION: We present the case of a 53-year-old man with history of T-cell lymphoma and gastroesophageal reflux disease who was brought to the emergency room due to altered mental status, nausea, vomiting and abdominal pain. His calcium level was 3.30 mmol/l (normal value 2.23-2.58 mmol/l). Imaging studies were unremarkable. The patient was hydrated with normal saline and calcium levels improved. …

Anticoagulation With Argatroban In A Patient With Heparin-Induced Thrombocytopenia And Renal Insufficiency Undergoing Orthotopic Heart Transplantation, Michael Stuart Green, Johann Mathew, Christopher R Hoffman, Henry Liu

Department of Anesthesiology Faculty Papers

Unfractionated heparin is the anticoagulant of choice for cardiac surgery that requires cardiopulmonary bypass. However, it can cause serious side effects like heparin-induced thrombocytopenia (HIT), an immune-mediated process where antibodies are directed against heparin and platelet 4 complexes. In such cases, alternative pharmacologic strategies are implemented to facilitate safe bypass conditions. A woman with severe decompensated heart failure was heparinized for intra-aortic balloon pump and subsequent LVAD placement. On day 6, a fall in platelets from 113,000 to 26,000 was noted. She was diagnosed with HIT. Heparin was discontinued and replaced with an argatroban infusion for the duration of her …

Substance Abuse Relapse Is Not About Willpower But Is The Culmination Of Psychological And Socioeconomic Stress, Paul A. Steffes

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the impact of non-judgmental listening on patient care outcomes.

The Efficacy Of A Sumatriptan And Naproxen Combination Pill In A Patient With Chronic Migraines Who Discontinued Triptan Therapy In The Past Due To A Self-Reported Poor Response To Sumatriptan Monotherapy, Ethan M. Cohen

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Mathew NT, Landy S, Stark S, et al. Fixed-dose sumatriptan and naproxen in poor responders to triptans with a short half-life. Headache. 2009;49(7):971-982. https://doi.org/10.1111/j.1526-4610.2009.01458.x

for a patient with chronic migraines who had self-reported poor response to sumatriptan monotherapy.