Medical Specialties Commons^™

Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), Olivia Heppell, Carlos Guerra Londono, Nilesh Gupta

Medical Student Research Symposium

Introduction: Upregulation of hypoxia-inducible factors (HIF) is an important pathological feature shared by clear cell renal cell carcinoma (ccRCC) and obstructive sleep apnea (OSA). However, it is unclear whether OSA alters the pathogenesis of ccRCC via HIF expression.

Methods: A retrospective cohort of adults undergoing nephrectomy for ccRCC was identified electronically (IRB#16040-1). The diagnosis of OSA was established with preoperative STOP-BANG scores or polysomnography. A consecutive sample of 20 individuals with and 20 without OSA was selected. Clinical characteristics and pathology results were reviewed. Resected tumor sections were immunohistochemically stained for HIF-1& HIF-2 at antibody dilutions of 1:150. Intensity and …

Epithelial And Mesenchymal Olfactory Stem Cells Gathered With Minimally-Invasive Micro-Brush, Tyler Petersen

Medical Student Research Symposium

Spinal cord injury (SCI) causes devastating lifestyle and financial consequences for the patient. Treatment strategies emphasize neuroprotection, but not regeneration. In this regard, stem cells are an innovative field of study that has the potential to regenerate neural tissue, thereby increasing a person’s ability to regain function. The purpose of this project is two-fold: to attain olfactory stem cells located in the nasal canal in a minimally-invasive way and to gather neural cells from the epithelium and mesenchymal cells in the lamina propria. Cells were gathered with sterile nasal micro-brushes, stored, and grown in flasks. After cells reached confluency, they …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

Racial Disparities In Palliative Care Utilization In The Covid-19 Pandemic, Margaret S. Bove, Benjamin Huber, Myles Hardeman, Daniel Harris, Areeba Jawed, Amber Comer

Medical Student Research Symposium

BACKGROUND

Palliative care is a vital resource for the critically or terminally ill. It has myriad benefits such as improved quality of life, reduced depressive symptoms, and decreased scarce resource utilization. Self-identified Black/African patients, however, are less likely to utilize advanced care directives or engage in hospice/comfort care measures and are more likely to prefer intensive treatment at the end of life. There is no research, however, on how the COVID-19 pandemic may have affected these trends.

METHODS

A retrospective cohort study of patients who experienced in hospital mortality or in hospital hospice due to COVID-19 between March 2020 – …

A Review Of The Efficacy Of Popular Eye Cream Ingredients, Hanin Hamie, Reem Yassine, Rajaa Shoukfeh, Dilara Turk, Farhan Huq, Meena Moossavi

Medical Student Research Symposium

Every year, there are new products on the market advertised to preserve a youthful appearance and reduce the signs of aging. One classic example is eye cream. Due to the periorbital region’s high susceptibility to damage from external factors, along with its tendency to demonstrate early signs of aging, periorbital skin is a common target for anti-aging therapy. While some of these ingredients have proven efficacious in clinical trials, others have not shown to be clinically significant. Various products contain different combinations, formulations, and doses of these ingredients. This review evaluates the efficacy of popular topical ingredients found in common …

A Systematic Review Of Digital Technology Use For The Treatment And Management Of Ptsd, Liam Browning, Arash Javanbakht, Imran Rashid

Medical Student Research Symposium

The COVID-19 pandemic led to rapid growth in telemental health services and investment in digital mental health technologies. Digital mental health technologies could expand access to mental health care in a time of increasing provider deficit by providing tools for expedited psychiatric symptom assessment and management. This systematic review explores the current evidence for the use of scalable digital treatment modalities, including virtual reality (VR), machine learning, wearables, mobile apps, and neurofeedback training in the diagnosis and treatment of PTSD. Our findings support the current literature suggesting VR interventions are efficacious for combat-related PTSD treatment and that conclusions of studies …

Clinical Pathway Using Arabic Written Medical Information To Improve Incontinence Healthcare Utilization, John F. Knapp, Codrut Radoiu, Emma Ross, Jack Vercnocke Md, Aron Liaw Md, Nivedita Dhar

Medical Student Research Symposium

Introduction and Objective: Metro Detroit holds ~13% of all Arabic speakers in the U.S.A. and 91% of those in Michigan. Evidence supports that patients who do not speak the local language have poor access to healthcare. This study describes our preliminary experience of managing Arabic only speaking women with bothersome stress urinary incontinence (SUI) from May 2022 to October 2023. These women routinely request same-sex interpreters, which is not always possible, leading to a lack of detailed translation. A potential solution is to use Arabic written medical information (AWMI). The purpose of the study was to retrospectively look at the …

An Educational Intervention Differentiating Pressure Injuries From End-Of-Life Wounds, Alicia Perez Varela, Annette Callis

Providence Nursing Research Conference 2023 – Present

Background

End-of-life (EOL) wounds are identified in the literature as Kennedy Terminal Ulcers (KTU), Skin Failure (SF), Trombley-Brennan Terminal Tissue Injury (TB-TTI), and SCALE (Skin Changes at Life’s End). EOL wounds have a similar appearance to pressure injuries (PIs) with a fundamentally different etiology. The misclassification of EOL wounds as PIs results in increased Hospital Acquired Pressure Injuries (HAPI), hospital fines, and less-than-optimal EOL wound management.

Purpose

To examine the effectiveness of an educational intervention on EOL wounds in increasing nurse confidence in providing End-of-Life Care (EOLC) and differentiating PIs from EOL wounds.

Methods

This quasi-experimental study used the 28-item …

Management Of Sepsis With The Quick Sequential Organ Failure Assessment, Jeanna Adams

Providence Nursing Research Conference 2023 – Present

Abstract

Background:

Sepsis can be a source of morbidity and mortality particularly when there are delays in treatment. Early identification may improve time to antimicrobial administration. The quick Sequential Organ Failure Assessment (qSOFA) is an evidence-based practice screening tool that, when in used in conjunction with the Systemic Inflammatory Response Syndrome (SIRS) criteria can enhance recognition and treatment of sepsis. On a suburban Southern California hospital Neurological/Telemetry Unit the qSOFA is automatically calculated in the electronic medical record (EMR) but the bedside nurses were unaware of its availability and value. In addition, sepsis was not being identified in a timely …

An Evidence-Based Skin Management Improvement Project In The Intensive Care Unit, Chelsea Lannoo

Providence Nursing Research Conference 2023 – Present

Background:

Pressure injuries have detrimental effects on patients healing and outcomes and are costly to organizations due to payment programs. Pressure injuries are largely preventable if appropriate interventions are implemented early. In our ICU, post-pandemic monitoring showed increases in hospital-acquired pressure injuries (HAPIs) and consults for medical device HAPIs were increasing. Rounds with wound care department indicated lack of staff compliance with recommended preventive practices. Some issues reported were the use of diapers and excessive linens, failure to use scheduled turning for patients, lack of prevention related to medical devices

Purpose:

The goal of this skin-care management project is …

Using A Virtual, Case-Based Approach To Developing Clinical Competency In Hospice, Melissa Robinson, Sasha Holden, Tara Poulsen

Providence Nursing Research Conference 2023 – Present

Background:

There has been a shift in nursing education away from a teacher-centered approach that is focused on requiring learners to memorize large amounts of content to a concept-based approach that is learner-centered and focuses on the development of critical thinking, clinical judgment, and problem-solving skills (Giddens et al., 2020). Conceptual learning requires learners to connect facts and exemplars to concepts through active learning experiences such as completing case studies or problem-solving activities (Baron, 2017). This allows learners to ‘practice’ thinking and apply new knowledge to clinical practice.

The clinical education team is applying this knowledge to the current competency-based …

Effective Non-Pharmacological Pain Relief Interventions Among Neonates: An Integrative Research Review, Staci Shaw

Providence Nursing Research Conference 2023 – Present

Background:

Newborns encounter many painful events, including heel sticks, venous blood sampling, peripheral intravenous insertions, and more. Newborns cannot verbally express pain, and caregivers rely on changes in vital signs (increased heart rate, decreased oxygen saturations) behavior (long periods of inconsolable crying), and facial expressions to grade newborn pain. Pain management in neonates is critical to preserve neurodevelopment. Due to adverse effects of pharmacological pain management interventions in neonatal populations, non-pharmacological pain management interventions are often utilized in newborns, such as swaddling, non-nutritive sucking, kangaroo care, oral sucrose, holding, touching, music, and breastfeeding. However, the most effective pain management intervention, …

A Better Tool For Ed Fall Risk Assessments: The Monego-Barra Ed Fall Risk Assessment Tool (Moba), Roxanne Barra, Mary Waldo, Angela Graves, Jessica Monego

Providence Nursing Research Conference 2023 – Present

Background

The incidence of falls has been increasing in emergency departments (EDs), with some resulting in harm. In a large health care system in the Western United States, the Morse Fall Risk Assessment Tool (Morse) is used across care settings, despite not being validated in the ED. Other ED tools in the literature are the Memorial ED Fall Risk Assessment Tool (Memorial) and Kinder 1 Fall Risk Assessment Tool (Kinder). These three tools contain risk factors that may not be specific to EDs or are missing relevant factors. This led the researchers to create the Monego-Barra ED Fall Risk Assessment …

Comparison Of Data On Preterm Neonatal Growth Measures In The Neonatal Intensive Care Unit, Madison Baty, Emily Faerber, Cayenne Sirois

Providence Nursing Research Conference 2023 – Present

Background:

Extrauterine Growth Restriction (EUGR) has been defined as infant weight-for-age z-score (WAZ) of less than -1.28 standard deviations (SD), at discharge or 36–40 weeks (about 9 months) postmenstrual age. In 2018, the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition published indicators of neonatal malnutrition, including a decline in WAZ over time. Mild, moderate, and severe neonatal malnutrition is defined as a WAZ decline of 0.8-1.2 SD; >1.2-2 SD; >2 SD, respectively, and it is unclear how widely revised neonatal malnutrition indicators are being used.

Purpose/aim:

To investigate the sensitivity and specificity …

Adherence To Sb5195 Naloxone Distribution Requirements At Discharge From The Emergency Department, E Stewart, J Delfeld, J Mckay, J Corhei, Kailyn Elliot

Providence Nursing Research Conference 2023 – Present

Background: Washington State, mirroring a national crisis, experienced a surge in opioid-related deaths, with 17,502 fatalities from 2007 to 2021. This trend aligns with the U.S.'s broader opioid epidemic, marked by 70,000 drug overdose deaths in 2017, data show overdose deaths involving opioids increased from an estimated 70,029 in 2020 to 80,816 in 2021. Overdose deaths were from synthetic opioids, primarily fentanyl. In response, empowering registered nurses (RNs) in emergency departments (EDs) to issue Nurse-Initiated Orders (NIO) for patients to discharge from the hospital with physical naloxone pre-pack kits to be used in the community, an opioid antagonist, has …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

March 2024: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program

Special Pathogens Newsletters

REGION 10 SPECIAL PATHOGENS NEWSLETTER

Anchor: Melflufen Plus Dexamethasone And Daratumumab Or Bortezomib In Relapsed/Refractory Multiple Myeloma: Final Results Of A Phase I/Iia Study., Enrique M Ocio, Yvonne A Efebera, Roman Hájek, Jan Straub, Vladimir Maisnar, Jean-Richard Eveillard, Lionel Karlin, María-Victoria Mateos, Albert Oriol, Vincent Ribrag, Paul G Richardson, Stefan Norin, Jakob Obermüller, Nicolaas A Bakker, Luděk Pour

Oncology Articles

Melphalan flufenamide (melflufen), a first-in-class, alkylating peptide-drug conjugate, demonstrated clinical benefit in combination with dexamethasone in triple-class refractory multiple myeloma (MM). The phase I/IIa ANCHOR study evaluated melflufen (30 or 40 mg) and dexamethasone (40 mg with daratumumab; 20 mg followed by 40 mg with bortezomib; dose reduced if aged ≥75 years) in triplet combination with daratumumab (16 mg/kg; daratumumab arm) or bortezomib (1.3 mg/m2; bortezomib arm) in patients with relapsed/refractory MM refractory to an immunomodulatory agent and/or a proteasome inhibitor and who had received one to four prior lines of therapy. Primary objectives were to determine the optimal dose …

Trauma-Related Shame Predicts Daily Non-Medical Prescription Opioid Use Among Individuals With Ptsd Symptoms, Tanya C. Saraiya, Alyssa C. Jones, Teresa Lopez-Castro, Caitlyn O. Hood, Jessica Flores, Christal L. Badour

UK CARES Faculty Publications

Non-medical prescription opioid use (NMPOU) is the use of opioids without a prescription or in a way different from how they were prescribed and is the fourth most common type of drug use in the United States. Separate research has shown that trauma-related shame is linked to posttraumatic stress disorder (PTSD) and, respectively, opioid use. However, no study to date has empirically examined the association between trauma-related shame and NMPOU among individuals with PTSD symptoms. Forty adults with clinical or subclinical PTSD who reported engaging in NMPOU at least one day in the prior month before the study completed 28 …

Post-Dural Puncture Headache, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

A Novel System To Culture Human Intestinal Organoids Under Physiological Oxygen Content To Study Microbial-Host Interaction, Tatiana Y. Fofanova, Umesh C. Karandikar, Jennifer M. Auchtung, Reid L. Wilson, Antonio J. Valentin, Robert A. Britton, K. Jane Grande-Allen, Mary K. Estes, Kristi Hoffman, Sashirekha Ramani, Christopher J. Stewart, Joseph F. Petrosino

Food for Health: Publications

Mechanistic investigation of host-microbe interactions in the human gut are hindered by difficulty of co-culturing microbes with intestinal epithelial cells. On one hand the gut bacteria are a mix of facultative, aerotolerant or obligate anaerobes, while the intestinal epithelium requires oxygen for growth and function. Thus, a coculture system that can recreate these contrasting oxygen requirements is critical step towards our understanding microbial-host interactions in the human gut. Here, we demonstrate Intestinal Organoid Physoxic Coculture (IOPC) system, a simple and cost-effective method for coculturing anaerobic intestinal bacteria with human intestinal organoids (HIOs). Using commensal anaerobes with varying degrees of oxygen …

Severe Ataxia With Cognitive Impairment In A Young Child: A Case Report Of Pontocerebellar Hypoplasia, Soban Khan, Zeeshan Munawar, Zaid Waqar, Saad Ali, Bushra Khalid, Amina Sadiqa, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Adolescence is a period of rapid development and a variety of genetic disorders present during this time due to difficulties with motor and cognitive skills. A very rare group of diseases is genetic Pontocerebellar Hypoplasia, characterized by a developmentally small cerebellum that leads to ataxia and movement abnormalities. Here, we present a case of a young boy who presented with ataxia and falls.

Age-Stratified Mosaic Of Neuropathies: A Comprehensive Analysis Of The Prevalence And Patterns In Different Age Groups, Sana Ghous, Anjlee Shankar, Abdul Qadir Baloch, Dipanty Khastoori, Tahira Maqsood, Alam Ibrahim Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and Objective:

Neuropathies pose significant challenges in diagnosis and management due to their heterogeneous etiologies, varied clinical presentations, and differential prevalence across age groups. The objective of this study was to analyze the distribution of neuropathies among patients in various age brackets, highlighting prevalent neuropathic types and their clinical implications.

Methods:

From September 18, 2018 to September 17, 2019, 405 patients from Neurology Ward of Chandka Medical College Hospital in Larkana were included in this retrospective cross-sectional comprehensive analysis. Nerve conduction studies (NCS) of these patients were conducted in the electrophysiology department. The study cohort was stratified into …

Effects Of Maternal Subclinical Hypothyroidism On Neurodevelopment Of Offspring- An Animal-Based Study, Sabah Farhat, Syeda Sadia Fatima, Mehir Un Nisa Iqbal, Fazal Arain

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective:

Maternal subclinical hypothyroidism (SCH) during pregnancy is associated with adverse maternal and neonatal outcomes, including cognitive and neuropsychiatric effects. This study aimed to assess the impact of maternal SCH on young rats, examining behavioral and gross brain structure changes, and evaluating reversibility after levothyroxine treatment.

Methods:

This experimental animal study was conducted at the Aga Khan University for a duration of 10 months. The study was approved by the Ethical committee for Animal Care and Use. Fourteen female Sprague Dawley rats were grouped into Treated (induced with SCH, treated with levothyroxine), Untreated (induced with SCH, no …

Use Of The 0.3-Tesla Mri Machine In Pakistan For Neurological Disorders In The Current Era: A Necessary Compromise Or A Counterproductive Exercise?, Wajid Jawaid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Beyond The Mosquito Sting: Guillain-Barre Syndrome Following Malarial Seasonal Surge, Sana Ghous, Alam Ibrahim Siddiqui, Abdul Rahman Soomro, Abu Bakar Shaikh, Sajjad Hussain Jalbani, Abdul Ghafoor Magsi

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective:

Malaria, a prevalent disease most commonly caused by Plasmodium vivax and falciparum, frequently leads to intricate neurological complications. The objective of this study was to study Guillain-Barre syndrome as a prevalent neurological manifestation of malaria.

Methods:

A cross-sectional observational study was undertaken at Neurology Department of Chandka Medical College Hospital in Larkana, from April 2023 to September 2023 during the seasonal peak of malaria. The study included 20 patients who met the specified criteria. SPSS version 23.0 was used for data analysis.

Results:

Among the 20 patients who developed Guillain-Barre Syndrome following malaria infection, 18 exhibited …

Interventions To Optimize Spinal Cord Perfusion In Patients With Acute Traumatic Spinal Cord Injury: An Updated Systematic Review, Nathan Evaniew, Benjamin Davies, Farzin Farahbakhsh, Michael G. Fehlings, Mario Ganau, Daniel E. Graves, James D. Guest, Radha Korupolu, Allan R. Martin, Stephen L. Mckenna, Lindsay A. Tetreault, Aditya Vedantam, Erika D. Brodt, Andrea C. Skelly, Brian K. Kwon

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Systematic review update.

OBJECTIVES: Interventions that aim to optimize spinal cord perfusion are thought to play an important role in minimizing secondary ischemic damage and improving outcomes in patients with acute traumatic spinal cord injuries (SCIs). However, exactly how to optimize spinal cord perfusion and enhance neurologic recovery remains controversial. We performed an update of a recent systematic review (Evaniew et al, J. Neurotrauma 2020) to evaluate the effects of Mean Arterial Pressure (MAP) support or Spinal Cord Perfusion Pressure (SCPP) support on neurological recovery and rates of adverse events among patients with acute traumatic SCI.

METHODS: We …

Nail-Plate Combination Treatment Of Ipsilateral Humeral Shaft And Distal Humerus Fractures - A Case Report., Mark Lagreca, Yash P Chaudhry, Thomas Falconiero, Thomas Muzzonigro, Daniel Lippe, Mitesh Shah

Orthopedic Surgery Resident Research

INTRODUCTION: Humeral shaft and distal humerus fractures have several different treatment options, including plate fixation and intramedullary nailing. Each has its own benefits, but typically, they are not used in conjunction. While nail-plate combinations (NPCs) have become more common in the lower extremity, literature on their use in upper extremity fractures remains scarce.

CASE REPORT: A 74-year-old right-hand dominant male presented after a fall with a closed left transverse midshaft humerus fracture and an associated supracondylar distal humerus fracture with intercondylar extension through a medial column. Due to the segmental nature of his injury, medial column plating was used in …

Issue 7: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls, Srinivasan Devanathan Md, Manuel Martinez Md

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 7

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. The content resides within critical care and pulmonary related topics and this information is compiled into four main formats.

1. Original Study Summaries: New research publications are read, reviewed, then concisely summarized for clinical interpretation with professional …

Epicondyle Fracture: Postoperative Management, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.