Medical Specialties Commons^™

Calpain-Mediated Protein Targets In Cardiac Mitochondria Following Ischemia–Reperfusion, Ling Li, Jeremy Thompson, Ying Hu, Edward J. Lesnefsky, Belinda Willard, Qun Chen

Internal Medicine Publications

Calpain 1 and 2 (CPN1/2) are calcium-dependent cysteine proteases that exist in cytosol and mitochondria. Pharmacologic inhibition of CPN1/2 decreases cardiac injury during ischemia (ISC)–reperfusion (REP) by improving mitochondrial function. However, the protein targets of CPN1/2 activation during ISC–REP are unclear. CPN1/2 include a large subunit and a small regulatory subunit 1 (CPNS1). Genetic deletion of CPNS1 eliminates the activities of both CPN1 and CPN2. Conditional cardiomyocyte specific CPNS1 deletion mice were used in the present study to clarify the role of CPN1/2 activation in mitochondrial damage during ISC–REP with an emphasis on identifying the potential protein targets of CPN1/2. …

Evidence-Based Cardiovascular Magnetic Resonance Cost-Effectiveness Calculator For The Detection Of Significant Coronary Artery Disease, Ankur Pandya, Yuan-Jui Yu, Yin Ge, Eike Nagel, Raymond Y. Kwong, Rafidah Abu Bakar, John D. Grizzard, Alexander E. Merkler, Ntobeko Ntusi, Steffen E. Peterson, Nina Rashedi, Juerg Schwitter, Joseph B. Selvanayagam, James A. White, James Carr, Subha V. Raman, Orlando P. Simonetti, Chiara Bucciarelli-Ducci, Lilia M. Sierra-Galan, Victor A. Ferrari, Mona Bhatia, Sebastian Kelle

Radiology Publications

Background
Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs.

Methods
We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR …

Wses/Gais/Wsis/Sis-E/Aast Global Clinical Pathways For Patients With Skin And Soft Tissue Infections, Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola De’Angelis, Samir Delibegovic, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, Fausto Catena

Surgery Publications

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.

Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.

An extensive non-systematic review was conducted using the PubMed and MEDLINE …

Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe

Master of Science in Nursing Theses and Projects

Infection in the dialysis access of a patient can be detrimental to the health of a dialysis patient. For this reason, infection control is extremely important in the outpatient hemodialysis setting. The goal of this project is to prevent infection during dialysis treatment initiation. This goal will be achieved during a 5-week project in which staff of an outpatient hemodialysis unit will be directly observed and then educated on the importance of infection control during treatment initiation. Staff will be given education on areas that need improvement regarding infection control during treatment initiation. The staff will be able to use …

Innovative Use Of Ehr To Support Admission Screening For Emerging Pathogens, Patricia Dumonceaux Msn, Rn, Cic, Phn, Carolyn Harlander-Zimny, Elizabeth Kiffmeyer, Ellen Simonson, Tamara Welle

Nursing Posters

• CentraCare hospitals were the first in Minnesota to identify a patient with Candida auris (C. auris), an emerging pathogen.
• 2018 Centers for Disease Control and Prevention (CDC) and state health department recommended adoption of enhanced admission screening process to allow for early identification of patients at risk of being colonized with C. auris/Carbapenem-Resistant Organisms (CROs).
• C. auris, a fungus, and CROs, comprised of organisms from the Enterobacteriaceae family resistant to carbapenems, are emerging multidrug resistant pathogens. Emphasis on identification and early isolation of at-risk patients decreases risk of transmission.

Perioperative Glucose Monitoring Protocol, Nicole Helgeson

Nursing Posters

Currently, there is no established glucose management protocol for our surgical patients. Poor outcomes related to hyperglycemia may include increased morbidity/mortality, surgical site infection (SSI), sepsis, renal, and cardiac concerns. The purpose of this protocol is to improve the care and outcomes for surgical patients through a consistent standardization of glucose management.

Physiology-Based Education For Patients With Type 2 Diabetes, Becca Barry, Cara Marie Gabriel, Brenna Lynn Olson

All Electronic Theses and Dissertations

Type 2 diabetes (T2DM) is a multisystemic disease that affects more than 370 million people worldwide and costs the U.S. Healthcare System over $245 billion per year (Kahn et al., 2013; Powers et al., 2015). Current diabetes education serves as a beneficial intervention method in the prevention and limitation of disease complications. Nevertheless, the current education regimen does not adequately convey the physiological reasoning behind those recommendations. Creating an educational tool that provides patients with physiological reasoning behind diabetes and treatment methods was needed to improve diabetes understanding. Neighborhood HealthSource expressed a need for easily understandable and accessible pathophysiology-based T2DM …

Lower Extremity And Trunk Electromyographic Muscle Activity During Performance Of The Y-Balance Test On Stable And Unstable Surfaces., Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

Background: The Star Excursion Balance Test (SEBT) has been used as a rehabilitation exercise. To improve its efficacy, efficiency, and method variations, the Y-Balance Test (YBT) with anterior (A), posterolateral (PL), and posteromedial (PM) directions of the SEBT has been recommended. Electromyographic activity has been reported to change when the same task is performed on various surfaces.

Hypothesis/Purpose: To compare the EMG activity of trunk and LE muscles during the performance of the YBT on stable and unstable surfaces.

Study Design: Cross-Sectional study.

Methods: Healthy adults with no history of chronic ankle instability were recruited for the study. …

Comparing Intravenous And Inhalation Anesthetics For Intraoperative Anesthesia In Adult Patients With An Acute Traumatic Brain Injury, Natasha K. Moody

Nurse Anesthesia Student Capstones

As research and science has progressed to further analyze the effects of anesthetics on cerebral physiology, the margin of safety for each anesthetic is reassessed to enhance patient outcomes and recovery. The purpose of this review is to strategically examine and provide updated information on the impact of specific anesthetics administered during the intraoperative period as it applies to patients with acute traumatic brain injury (TBI). In efforts to preserve the cerebral physiology of the patient, current research has identified benefits of administering intravenous over inhalation anesthetics to reduce secondary injuries that have been linked to chronic TBI, morbidity, and …

The Impact Of Dexmedetomidine Use In Patients Over The Age Of 60 Undergoing General Anesthesia On Postoperative Delirium Incidence, Elaina Branco

Nurse Anesthesia Student Capstones

Postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) are of concern in the elderly population undergoing an anesthetic due to increased mortality and decreased quality of life that can ensue. Sui et al. (2021) reported a 15-50% incidence of POD in elderly surgical patients. Dexmedetomidine is a highly selective, alpha-2 agonist with sedative, analgesic, and anxiolytic properties that mimics a sleep-like state and causes bradycardia and hypotension but not respiratory depression. Dexmedetomidine has neuroprotective properties, including anti-apoptosis and anti-inflammation (Wu et al., 2019). A current review of the literature revealed that dexmedetomidine use can decrease POD incidence in the aged …

The Effect Of Clonidine On Hyperbaric Bupivacaine And Opioid In Cesarean Section Women Under Spinal Anesthesia, Novisi Abba

Nurse Anesthesia Student Capstones

Pain is undoubtedly one of the most undesirable outcomes associated with cesarean section in parturients. The most effective post-cesarean section pain relief option should prioritize maternal, fetal, and neonatal safety, with minimal to no medication transfer to the fetus and neonate. In obstetric anesthesia, neuraxial approaches, with the inclusion of adjuncts like clonidine for pain management may provide some additional benefits. Consequently, obstetric anesthesia practitioners have increasingly used intrathecal clonidine to alleviate post-cesarean section pain. This manuscript examines whether intrathecal clonidine, when combined with hyperbaric bupivacaine and/or opioids (fentanyl and/or preservative-free morphine), has a sustained analgesic effect in parturients following …

Do The Benefits Of Sugammadex Outweigh Its Higher Cost Compared To Neostigmine?, Ashley Mcdonald

Nurse Anesthesia Student Capstones

Neuromuscular blocking agents (NMBAs) are frequently utilized in anesthetic practice to relax the vocal cords in preparation for endotracheal intubation and to facilitate optimal operating conditions for various surgical procedures. Residual muscle paralysis in the postoperative period is a serious consequence of NMBAs that can lead to severe consequences including airway obstruction, hypoxia, reintubation, aspiration, and pneumonia. Neuromuscular blockade (NMB) is overcome either by spontaneous recovery or, in most cases, with the use of a reversal agent. Two of the most common reversal agents are neostigmine, a cholinesterase inhibitor, and sugammadex, a modified gamma-cyclodextrin. Of the two medications, sugammadex is …

The History Principles And Purpose Of The Academy Of Applied Osteopathy, Academy Of Applied Osteopathy

Stanley Kimball, D.O. Collection

Academy of Applied Osteopathy brochure detailing the history, objectives, platform, future, finance, and membership information for the organization.

Working Paper For Proposed New England College Of Osteopathic Medicine, New England Foundation For Osteopathic Medicine

Stanley Kimball, D.O. Collection

The Working Paper for Proposed New England College of Osteopathic Medicine describes plans for the creation and structure of a new college of Osteopathic Medicine created by the New England Foundation for Osteopathic Medicine.

Osteopathy And The Profession Of Medicine, Anna G. Tinkham D.O.

Stanley Kimball, D.O. Collection

Letter written to the Atlantic monthly in response to an article critical of osteopathy written by Dr. Channing Frothingham.

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were …

Hydroxyapatite Toothpaste On Caries Prevention In Children, Samantha Richardson, Kelly Vaughan

Dental Hygiene Student Scholarship

Are Hydroxyapatite Toothpastes The Answer To Fluoride Free Patients?

Richardson, Samantha 1 and Vaughan, Kelly 2

Dental Hygiene Program, Virginia Commonwealth University

Abstract:

Objectives/Aims: With the rising trend to become more clean with our ingredient lists, we are facing more patients refusing fluoride treatments and fluoridated toothpastes. This trend has been prevalent in our younger generations due to parents only wanting the purest natural ingredients for their children and now declining fluoride application. The goal of this literature is to find a safe alternative toothpaste that will be just as effective as fluoride.

Methods: This review of literature has been …

Mitochondrial Redox Environments Predict Sensorimotor Brain-Behavior Dynamics In Adults With Hiv., Rachel K. Spooner, Brittany K. Taylor, Iman M. Ahmad, Kelsey Dyball, Katy Emanuel, Jennifer O'Neill, Maureen Kubat, Susan Swindells, Howard S. Fox, Sara Bares, Kelly L. Stauch, Matthew C. Zimmerman, Tony W. Wilson

Journal Articles: Infectious Diseases

Despite virologic suppression, people living with HIV (PLWH) remain at risk for developing cognitive impairment, with aberrations in motor control being a predominant symptom leading to functional dependencies in later life. While the neuroanatomical bases of motor dysfunction have recently been illuminated, the underlying molecular processes remain poorly understood. Herein, we evaluate the predictive capacity of the mitochondrial redox environment on sensorimotor brain-behavior dynamics in 40 virally-suppressed PLWH and 40 demographically-matched controls using structural equation modeling. We used state-of-the-art approaches, including Seahorse Analyzer of mitochondrial function, electron paramagnetic resonance spectroscopy to measure superoxide levels, antioxidant activity assays and dynamic magnetoencephalographic …

Optimization Of An Automated Algorithm For Analysis Of Spontaneous Rhythmic Bladder Contractions During Urodynamics Testing, Isabelle Pummill, Rui Li, Zachary Cullingsworth, Adam Klausner, John Speich

Summer REU Program

No abstract provided.

Nonpharmacological Practices For Reducing Agitation In Persons With Dementia, Meghan L. Farkas

Commonwealth Scholars Program

1 in 11 people aged 45 years and older experience subjective cognitive decline, with nearly a third identifying a decline in the ability to participate in social activities, work, or volunteering. There are twelve modifiable risk factors that can either increase or decrease an individual's possibility of developing Dementia. This can include excessive alcohol consumption, head injury, air pollution, lower education level, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact. These modifiable risk factors may prevent or delay up to 40% of dementias. Furthermore, many risk factors cluster around inequalities, which occur particularly in Black, …

What Matters Most: Cna Perspectives On Workforce Education, Professional Identity And Age-Friendly Care, Shannon Arnette, Annie Rhodes, Kimberly Ivey, Christian Bergman, Leland "Bert" Waters

Case Studies from Age in Action

Learning Objectives

1. Identify the gaps in current Certified Nursing Assistant (CNA) training in relation to Delirium, Dementia(s), and Depression (3D’s).

2. Identify CNA learning preferences.

3. Review the constructed tele-education training sessions that incorporate age-friendly care and What Matters Most (WMM) to participants in regards to the 3D’s.

4. Increase the CNAs’ competency and level of comfort working with individuals living with the 3D’s.

Recognizing And Responding To Abuse In Later Life: Feedback From Virginia’S Frontline, Sarah A. Marrs, Courtney O'Hara

Case Studies from Age in Action

Learning Objectives

1. To describe a research project aimed at understanding the recognition of and response to abuse in later life in the greater Richmond area

2. To discuss the structural factors that contribute to underidentification and under-resourcing of services that address abuse in later life

3. To discuss the relationship between ageism and abuse in later life

Coping With Macular Degeneration: Three Case Studies, Ajit D. Tiwari

Case Studies from Age in Action

Educational Objectives

1. Learn about the diagnosis and available treatments for Age Related Macular Degeneration (AMD).

2. Explain the differences between Dry and Wet AMD.

3. Understand the impact of vision loss on the lives of older adults.

Adult-Onset Alexander Disease Uncovered In A Previously Healthy Patient Presenting With Acute Stroke-Like Symptoms, Usaamah M. Khan, Matthew Barrett, Alex Dworetz Do

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Alexander Disease is a rare, often fatal, leukoencephalopathy of early childhood associated with a heterozygous mutation of the glial fibrillary acid protein (GFAP) gene. Adult-Onset Alexander Disease (AOAD) is an exceptionally rare leukoencephalopathy that often presents with slowly progressive brainstem and cervical cord dysfunction features. Acute onset of AOAD has only ever been reported three times in the literature. We report a case of acute onset AOAD in a patient that presented with bulbar symptoms and left hemiplegia initially concerning for acute stroke.

Patient And Provider-Level Factors That Underlie Alcohol Use Disorder Treatment Offer And Acceptance In Veterans With Cirrhosis, Nikki Duong

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Background: Untreated alcohol use disorder (AUD) is associated with poor cirrhosis outcomes. We evaluated factors associated with AUD treatment discussions and initiation in the Veterans Health Administration.

Methods: Chart reviews were conducted for veterans with International Classification of Diseases codes for both cirrhosis and AUD who were receiving care at one of three large medical centers in 2020. Factors associated with a 1-year offer of AUD treatment and its acceptance were assessed using regression models, which included as covariates demographic characteristics, comorbidities, and depression, as measured by the patient health questionnaire (PHQ-2) from the electronic health record.

Results: The cohort …

Characterizing Abdominal Pain In Patients With Gastroparesis, Dylan Vainer, Henry Parkman, Dariush Shahsavari

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

TITLE: CHARACTERIZING ABDOMINAL PAIN IN PATIENTS WITH GASTROPARESIS

AUTHORS (LAST NAME, FIRST NAME): Vainer, Dylan¹; Shahsavari, Dariush²; Parkman, Henry P.²

INSTITUTIONS (ALL): 1. Section of Gastroenterology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States. 2. Temple University Health System Inc, Philadelphia, PA, United States.

ABSTRACT BODY: Introduction: Patients with gastroparesis (Gp) typically present with nausea, vomiting, and early satiety. Abdominal pain can be present in Gp. The cause of abdominal pain in patients with Gp is often unknown. In patients whose predominant symptom is abdominal pain, other causes of abdominal pain …

Firearm Curriculum For Pediatric Residents Improves Safe Storage Counseling, Hannah Hollon Md, Darina Dinov Do, Benjamin Sandifer Md, Scott Risney Md, Heemali Kamdar Do, Christopher Ferrante Do, Leroy Thacker Phd, Michael S. Ryan Md, Mehp, Elizabeth Wolf Md, Mph

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Objectives

Firearms are the leading cause of death among children and adolescents. Despite evidence to support physician training in firearm safety counseling, formal curricula are limited in pediatric residency programs. We sought to develop and implement a resident-led, feasible, sustainable, and impactful firearm safety curriculum for pediatric residents.

Methods

A firearm safety curriculum was developed by pediatric residents using Kern’s curriculum development framework and delivered to their peers at a single academic center from 2019 - 2020. The three-part series included workshops on basic firearm safety counseling principles, case-based practice, and advocacy training and a gun lock program in collaboration …

Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap

Theses, Dissertations and Capstones

Introduction: Obesity was defined as a Body Mass Index (BMI) over the 95th percentile as determined by the Centers for Disease Control and Prevention (CDC). Childhood obesity has been a worldwide concern, but has disproportionately affected the socioeconomically disadvantaged, racial/ethical minorities, and rural children. The presence of Adverse Childhood Experiences (ACEs) contributed to social and health problems. ACEs included the areas of domestic violence, mental illness, neighborhood violence, parent or guardian death, divorce or separation, parent or guardian incarceration, and substance misuse.

Purpose of Study: The purpose of this research was to compare the ACEs scores with childhood …

Current And Novel Neuroregenerative Therapies, Arrin Brooks

Theses, Dissertations and Capstones

Underlying the physical and cognitive deficits consequent of many neuropathologies is one common factor, the loss of neurons. While neurodegenerative diseases, stroke, and traumatic brain injury arise from a variety of etiologies, they all ultimately result in injury and/or death of neuronal cells and concomitant functional deficits. In the present work we primarily focus on current and potential treatments for localized lesions, particularly those in the striatum of Parkinson’s disease (PD) or the cortex as in stroke. First, we discuss a new surgical technique for deep brain stimulator (DBS) placement, as DBS is a mainstay treatment for movement disorders including …

Research Annual Report Fy2022, Children's Mercy Kansas City

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.