Medical Specialties Commons^™

Comparing Efficacy Of Denosumab To Bisphosphonates In Fragility Fractures, Ronald Toledo Cardoso

Theses and Graduate Projects

Background: Osteoporosis is a disease of the bones with decreased bone mineral density and bone mass, leading to poor bone quality/structure, increasing the risk of fragility fractures. Pharmacological treatment is recommended to decrease risk of fractures. Current first line treatment is with bisphosphonates; however, alternative treatment includes denosumab. Both bisphosphonates and denosumab are antiresorptive drugs but differ in mechanism of action. Bisphosphonates remain as first line treatment.

Purpose: The purpose of this literature review is aimed at the PICO question in adults with osteoporosis, what is the efficacy of denosumab compared to bisphosphonates in decreasing the risk of …

Stroke Prevention In Patients With Non-Valvular Atrial Fibrillation: The Watchman Device Versus Warfarin, Emma Delaney

Theses and Graduate Projects

Atrial fibrillation is a common heart arrhythmia that leads to an increased risk of stroke. Warfarin was the original anticoagulant that would be used as the treatment for atrial fibrillation. However, there are people who have contraindications to anticoagulation or are a high fall risk and shouldn’t be on Warfarin. The Watchman Device was originally designed in 2005 as a way to close the left atrial appendage where clots are usually present with atrial fibrillation. The watchman may be a superior way to help reduce the risk of stroke compared to the traditional use of Warfarin. Purpose: Literature review …

What Alternative Models Are Effective In Improving Health Outcomes In Children With Obesity In The United States?, Kelsey Reineke

Theses and Graduate Projects

Background: Obesity in children has increased at an alarming rate in the past three decades and has been associated with multiple comorbidities. This literature review has been focused on pediatric obesity management research utilizing Family-Based Therapy, community-centered interventions, behavioral modifications, and implementations for management within the Primary Care setting.

Purpose: There has not been an established standard of care for children suffering from obesity. This investigation was focused on the question; What alternative models are effective in improving health outcomes in children with obesity in the United States?

Methods: A comprehensive literature review was conducted using Pub …

Effective Pharmacological And Non-Pharmacological Treatments For Sleep Disturbances And Fatigue In Patients Who Have Experienced A Mild To Severe Traumatic Brain Injury, Mika Muras

Theses and Graduate Projects

Background: In the United States alone, an estimated 1.5 million people sustain a head injury every year.1 With improved recognition of traumatic brain injuries by healthcare providers, the number of patients diagnosed with a traumatic brain injury (TBI) is only increasing. Unfortunately, many patients who sustain a TBI, regardless of the severity, experience sleep disturbances, insomnia, fatigue, and daytime sleepiness.

Purpose: For the purposes of this systematic review, the focus will be primarily on the comparison of nonpharmacological treatments of sleep disturbances or fatigue secondary to a TBI. In addition, the focus will include recent studies on pharmacological …

Dual Antiplatelet Therapy With Ticagrelor Vs Clopidogrel In Patients With Acute Coronary Syndrome, Binh Vu

Theses and Graduate Projects

Background: Dual antiplatelet therapy (DAPT) is an effective secondary prevention and an essential component of treatment after patients suffering from acute coronary syndrome (ACS). Recently, clinicians rapidly switched to DAPT with ticagrelor as the preferred treatment option after it was introduced in 2011. Compared to clopidogrel, ticagrelor is not a prodrug and does not require metabolic activation to inhibit the platelet P2Y12 receptor. It is the first reversible oral P2Y12 receptor antagonist; and its effect on platelet inhibition is more pronounced compared to clopidogrel.

Purpose: The purpose of this comprehensive review was to evaluate the efficacy and safety …

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

A Review Of Monoclonal Antibody Regimens In Small Cell Lung Cancer Compared To Chemotherapy Standard Of Care, Rachael St. Clair

Theses and Graduate Projects

Background: Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor closely linked to tobacco use. Chemotherapy with platinum-etoposide is the current standard of care, with positive initial response rates and subsequently high rates of recurrence and death. Monoclonal antibodies are a therapeutic drug class attempting to block suppression of T cell activation, enabling a stronger immune response.

Purpose: The current predicament in SCLC treatment is determining if monoclonal antibodies have any effect on overall survival. Chemotherapy briefly suppresses SCLC, but given its rapid progression and recurrence, it is necessary to investigate alternative treatments. The following literature review …

Thermal Ablation As An Alternative To Standard Breast Conserving Surgery In The Treatment Of Invasive Ductal Carcinoma Of The Elderly, Dani Ducharme

Theses and Graduate Projects

An aging population means an inevitable increase in cancer diagnoses, and thus, a novel solution is needed to address this looming problem. Within the field of breast cancer, thermal ablation has emerged as a promising alternative to surgical excision. As a minimally invasive treatment, it significantly reduces the morbidity and mortality for geriatric patients, as well as healthcare costs overall.

The purpose of this analysis is to understand the utility of thermal ablation for the treatment of invasive ductal carcinoma. Specifically in the context of elderly patients, it is determined if this treatment modality is superior to traditional breast conserving …

Immunotherapy Versus Chemotherapy: Which Treatment Offers Better Survival To Adults With Advanced Melanoma?, Nadeline Abro

Theses and Graduate Projects

Background: Melanoma is the most serious type of skin cancer that can lead to metastasis. The main treatment for melanoma is surgical removal — a wide excision. Patients with advanced melanoma require further treatment such as chemotherapy or immunotherapy due to the concern of continuous spread.

Purpose: Literature review of studies to examine if patients with advanced melanoma, treated with immunotherapy, enjoy better overall survival rates than patients treated with chemotherapy?

Methods: A comprehensive literature review was conducted using using the search terms <(advanced melanoma) AND (immunotherapy)) AND (chemotherapy)) AND (skin cancer)>. Inclusion criteria were studies that were related to immunotherapy and chemotherapy among advanced melanoma patients. Exclusion …

Can Exercise Be An Alternative Treatment Option For Depression, Walker Rogers

Theses and Graduate Projects

As most people know, exercise has always been beneficial for our overall health. No matter which exercise program it is, they all provide some sort of benefit. A growing problem has been depression as more and more people are being diagnosed. Since normally, most people would be prescribed SSRIs, I wanted to find out if there were alternative options. I sought to determine if exercise can be an alternative treatment option for depression. A comprehensive literature review was conducted using the websites PubMed, NCBI, Science Direct, & Academic Search Premier and using the search terms depression, anxiety, exercise, yoga, resistance …

Investigating The Relationship Between Mental Health And Co- Morbidity Management During The Covid-19 Pandemic: A Literature Review, Alejandra Soto

Theses and Graduate Projects

Background: The COVID-19 pandemic caused many disruptions to millions of lives, especially with the enforcement of government shutdowns, isolations, and social distancing. These measures lead to increased anxiety and depression in the general population. With many high- risk patient populations having chronic comorbidities, accessing routine medical care and supplies became difficult during the pandemic.

Purpose: How has mental health affected the management of pre-existing comorbidities during the COVID-19 pandemic?

Methods: A comprehensive literature review was conducted using the research engine PubMed using the search terms: “pandemic”, “COVID-19”, “comorbidities”, “mental health”, “morbidity”, and “mortality”. Inclusion criteria were studies …

3d And Bio-Printing As An Efficient And Safe Alternative To Traditional Methods And Materials In Cardiovascular Diseases, Angela Asare-Ose

Theses and Graduate Projects

Background: Cardiovascular diseases are the leading cause of death globally. Therefore, there is the need for more resources to be poured into the research of more treatment options, diagnostic methods and preventative steps for patients. Though several technological advancements are being made in the world of medicine, it is not a bad idea to look at other avenues that have great potential to improve patient outcomes in cardiovascular diseases. 3D and bioprinting, though a relatively new technology in the world of medicine, is showing a promising future. It is already being applied in the field of orthopedic surgery and …

The Use Of Nuclear Medicine In Detecting And Treating Mental Health Diseases, Jena Simmons, Gina Capitano, Walter Kierzkowski

Medical Imaging Senior Posters

Mental health disorders affect over 792 million people around the world, and a leading cause for disability. Mental health disorders include a plethora of conditions that affect mood, thinking and behavior, including but not limited to, depression, dementia, anxiety, autism, and schizophrenia. The most common method of diagnosis is a psychological evaluation, which can lack accuracy if performed as the only method of diagnosis. Nuclear Medicine helps aid in diagnosis of these disorders in conjunction with psychological testing. Brain scans can help determine if there is a pathogenic cause for the symptoms. Brain scans are done utilizing Positron Emission Tomography …

When Should Screening Mammograms Begin?, Michaela Cragle, Lynn Blazaskie

Medical Imaging Senior Posters

When Should Screening Mammograms Begin?

Michaela Cragle

Lynn Blazaskie M.S., R.T. (R) (ARRT)

Abstract

Screening mammograms are imaging exams performed yearly to evaluate breast tissue. As women age, changes in breast tissue can be normal or can be an early sign of cancer. The age women should begin screening mammograms is not clear. According to literature it has created much controversy over the years. Most women begin the screening process at the age of 40, and even earlier depending on family history. Research groups from multiple institutions followed and evaluated women who received yearly mammograms. Most women were divided into …

Changes In Patterns And Outcomes Of Trauma Patients After Betterment In Law And Order Situation Of The City, Sabah Uddin Saqib, Hasnain Zafar

Section of General Surgery

Objective: To assess the impact of the law and order situation of a city on the pattern of traumatic injuries and the overall outcomes of trauma victims.
Methods: The retrospective study of prospective trauma surgery data was done at Aga Khan University Hospital, Karachi, and comprised data of patients with torso injuries before the improvement of law and order situation from January 2012 to March 2013 in Group A, and of those with similar injuries after the law and order situation improved in the city from January 2018 to March 2019 in Group B. The required data was collected by …

Water-Soluble Alternative To Simethicone To Safely Visualize Gi-Tract. Have We Found Our White Whale?, Teri Mallard, Sandra Roswell, Amarnath Ramakrishnan

All Poster Presentations

Purpose: To evaluate a safe alternative to simethicone, that aligns with the scope manufacturer recommendations, and eliminates GI bubbles to improve provider visualization.

Hypothesis: GI Ease will improve bubble scale scores to improve visualization of the GI tract and facilitate polyp detection.

Background: Multiple independent studies have shown that simethicone, even when highly diluted, remains in the endoscope working channel after all manual cleaning and reprocessing protocols have been followed correctly. Although simethicone effectively eliminates gas bubbles, it carries unacceptable risks. It is insoluble in water and alcohol, challenging to remove, and may foster biofilm build-up and microbial proliferation. Due …

Targeting L-Arginine Metabolism To Control Small Cell Lung Cancer Transformation, Robert L. Burns Jr.

Honors Undergraduate Theses

Cancer is known for its unregulated and mutagenic characteristics. The topic of targeting cancer by inhibiting the metabolic pathways it uses to thrive has been a focus of modern cancer research. Specifically, in lung cancer, the transformation from non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC) is a focus. This transformation often comes with a grimmer prognosis and reduced survival rate. This is primarily due to SCLC being resistant to epidermal growth factor receptor (EGFR) inhibitors. This frontline treatment for EGFR mutant NSCLC has shown to be quite effective until transformation to SCLC occurs. To further study …

Uterine Fibroid Prevalence And Health Care Disparities By County. Florida, 2010-2019, Saarah K. Sherifi

Honors Undergraduate Theses

Also known as uterine fibroids, leiomyomas occur in 70% of women. A uterine leiomyoma is a benign growth in the muscular wall of the uterus which, if left untreated, can grow, and affect surrounding organs, leading to complications, including hemorrhage and death. Symptomatic women often experience pain and debilitating menstrual cycles which, in turn, result in poor health, poor quality of life, and loss of income. Preventative and treatment services in Florida could benefit from the characteristics of women affected the most by this disease in the state. Thus, we describe the demographic characteristics and estimate the prevalence rate of …

The Impact Of Head And Neck Surgical Scars On Appearance And Acceptance Of Dermatography As A Cosmetic Intervention, Simcha Chaitoff

Honors Undergraduate Theses

Many surgical procedures in the head and neck regions produce visible scarring. The most common of these surgeries are tracheotomies and thyroidectomies. The recent COVID-19 pandemic has caused an increase in tracheotomy scars, particularly in those who survived severe infection with the disease and required long-term ventilation. Individuals with neck scars are at an increased risk of health consequences such as reduced quality of life, depression, and negative body image. Research on attitudes toward and reactions to individuals with such scarring is limited. The purpose of this study is to examine how people rate images of scarred individuals on personality …

The Impact Of Endometriosis-Associated Pelvic Pain On The Social And Academic Wellbeing Of Women Enrolled In University, Ava E. Bettencourt

Honors Undergraduate Theses

Background: Endometriosis, a medical condition in which endometrial tissue lining grows outside of the uterus, affects approximately 10-15 percent of women of reproductive age. While research has shown that symptoms of endometriosis negatively affect quality of life in women, few studies have examined the impact of this condition specifically in college students who may be overwhelmed with the stress of school, living independently, and managing the symptoms of their endometriosis. Purpose: To examine the impact of endometriosis on academic and psychosocial factors in university students. Methods: Four college females completed the Pain Self-Efficacy Questionnaire (PSEQ), a 10-item survey used to …

Intractable Pediatric Epilepsy And Dietary Therapies: A Meta-Analysis Of Trials For Seizure Reduction, Victor Figueira M Dantas

Honors Undergraduate Theses

Objective: to compare dietary treatments and their effectiveness in reducing seizures through a systematic review and meta-analysis of clinical trials Methods: Using the PRISMA Method, the Primo database was searched to find peer-reviewed articles where researchers compared one treatment against another. The treatments of choice present in all studies are the Ketogenic Diet and the Modified Atkins Diet. Due to the nature of the experiments, the Ketogenic Diet was considered the control, as it was coined first. Results: Of the 450 articles identified, 378 met the primary peer review threshold and 190 were classified as Open Access. Eight met eligibility …

Mechanical Understanding And Optimization Of Template Guided Core Needle Biopsy, Isaac Girgis

Honors Undergraduate Theses

Prostate cancer is the second highest cause of cancer related deaths among men. According to the diagnostic pathway for prostate cancer, a prostate biopsy is performed if an individual showed signs of lesions through high prostate-specific antigen (PSA) concentration or suggestive digital rectal exam (DRE) results. The core biopsy mechanism involves inserting a beveled needle into the organ and removing a cylindrical fragment of tissue. Many factors affect the histological quality of the sample, including fragmentation, needle deflection, and needle insertion velocity. If a biopsy core is not clinically viable, an alternative core will need to be taken, resulting in …

Traumatic Morel-Lavallee Injury To The Abdomen After A Seatbelt Injury; A Rarely Documented Case With An Uncommon Subdermal Matrix Reconstruction, Austin Mccrea, Saptarshi Biswas

South Atlantic Division GME Research Day 2022

No abstract provided.

Changes In Injury Patterns Associated With Elevated Blood Alcohol Level, Isabella Moncada, Heather Rhodes, Nasser Mohammad, Nicole Pascarella, Christina Catlla, Saptarshi Biswas

South Atlantic Division GME Research Day 2022

No abstract provided.

A Fatal Case Of Ards: Concomitant Blastomycosis & Aspergillosis In An Immunocompetent Male, Hytham Rashid, Alexander Llop, Tusharkumar Pansuriya, Jayaram Turuvekere

Gulf Coast Division GME Research Day 2022

No abstract provided.

High Risk Newly Diagnosed Multiple Myeloma, Phebe Abraham, Cassie Robertson, Aswin Srinivasan, Murtaza N. Bhuriwala, Shan Guo

Gulf Coast Division GME Research Day 2022

No abstract provided.

Traumatic Dissection Of The Internal Carotid Artery After Blunt Cervical Trauma And Discussio Of Management Of The Same, Austin Mccrea, Valentino Piacentino, Saptarshi Biswas

South Atlantic Division GME Research Day 2022

No abstract provided.

Gallstone Ileus: A Case Report, Jarrett Koper, Liz Bowers, Jonathan Leggett

South Atlantic Division GME Research Day 2022

No abstract provided.

Triple Sars-Cov2, Influenza A & Influenza B Co-Infection, Feras Al-Moussally, Mohammed Rahhal, Rey Marrero, Roger Crouse

North Florida Division GME Research Day 2022

No abstract available.

Eliminating Repetitive Cbc Orders On The Resident Inpatient Service At Orlando Vahcs, Zara Bashir, Jorge Rodriguez, Ashlee Sidhu, Feras Al-Moussally, Brian Murr, Jorge Restrepo

North Florida Division GME Research Day 2022

No abstract available.