Medical Specialties Commons^™

Understanding The Perspectives And Attitudes Of 12-Step Participants Towards Medication-Assisted Treatment, Christopher Scott

Electronic Theses, Projects, and Dissertations

Background: The effects of living with a substance use disorder (SUD) are vast. Medication-assisted treatment (MAT) has grown increasingly popular as a recovery tool among substance users but does not align with the popular 12-step model, which demands complete abstinence from narcotics and mind-altering substances. Objective: The primary aim of this phenomenology study was to explore the perspectives and attitudes towards MAT among 12-step participants. The secondary aim was to compare the responses of treatment and non-treatment professionals. Methods: This study used non-probability sampling methods to recruit participants who reported regular participation in a 12-step program. Semi-structured …

Fatty Acid Concentrations In Preterm Infants Fed The Exclusive Human Milk Diet: A Prospective Cohort Study, Lindsay F Holzapfel, Jana P Unger, Pam Gordon, Heeju Yang, Joanne E Cluette-Brown, Laura A Gollins, Amy B Hair, Camilia R Martin

Faculty, Staff and Student Publications

OBJECTIVE: Quantify blood fatty acids and growth outcomes in preterm infants fed the exclusive human milk diet.

METHODS: A prospective cohort study of 30 infants 24-34 weeks gestation and ≤1250 g fed the exclusive human milk diet. Blood fatty acids were quantified at two time points. Comparisons were made using two-sample t-tests and Wilcoxon rank sum.

RESULTS: Donor human milk-fed (n = 12) compared to mother's own milk-fed infants (n = 18) from birth to after 28 days of life, had an increased interval change of linoleic to docosahexaenoic acid ratio (5.5 vs. -1.1 mole percent ratio, p = 0.034). …

Association Of Maternal Body Mass Index And Maternal Morbidity And Mortality, Mara J Dinsmoor, Lynda G Ugwu, Jennifer L Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa

Faculty, Staff and Student Publications

Objective: This study aimed to assess the association of maternal body mass index (BMI) with a composite of severe maternal outcomes.

Study design: Secondary analysis of a cohort of deliveries on randomly selected days at 25 hospitals from 2008 to 2011. Data on comorbid conditions, intrapartum events, and postpartum course were collected. The reference group (REF, BMI: 18.5-29.9kg/m2), obese (OB; BMI: 30-39.9kg/m2), morbidly obese (MO; BMI: 40-49.9kg/m2), and super morbidly obese (SMO; BMI ≥ 50kg/m2) women were compared. The composite of severe maternal outcomes was defined as death, intensive care unit (ICU) admission, ventilator use, deep venous thrombosis/pulmonary embolus (DVT/PE), …

Pediatric Upper Cervical Spine Trauma: A 10-Year Single Center Retrospective Study, Sazid Hasan, Muhammad Waheed, Shahrukh Naseer, Jad G. Khalil, Ehab S. Saleh

Posters

This study seeks to answer whether or not there is a significant association between mechanism of injury and patient age, and to elucidate any notable differences in overall outcomes based on various treatment modalities.

Accuracy Of Ora And Newer Generation Formulas For Iol Power Calculation After Prior Refractive Surgery, Raheel Khan, Mark Rolain

Posters

• Patients with cataracts have cloudiness of the lens that impairs vision.
• It must be replaced with a prosthetic lens however the lens’ refractive power has to be calculated using formulas to predict the kind of lens that will be implanted for best visual outcomes.
• Patients that have had prior refractive surgery of the cornea do not have as good refractive outcomes after cataract surgery.1
• The concern is that there is not a goldstandard formula that can be used for this population to predict the refractive power of the lens that should be implanted.
• Optiwave refractive analysis (ORA) is a new …

Coats And Coats-Like Retinopathy In Female Patients, Zara Saleem, Drew Scoles, Antonio Capone Jr

Posters

To report the presentation, stage, clinical characteristics, and course of female patients with Coats and Coats-like retinopathy.

Breaking Up Prolonged Sitting To Improve Cardiometabolic Risk: A Comparative Analysis Of Muscle Strengthening Exercise And Treadmill Walking, Grace E. Anderson

Honors College Theses

Purpose: To examine the effectiveness of brief bouts of treadmill walking and bodyweight-based muscular strengthening exercises to mitigate the effects of sedentary behavior on blood pressure, blood glucose, cognitive performance, and perceived fatigue. Methods: Healthy young adults (n = 9) completed 3 experimental trials consisting of 4-hour sedentary periods. The trials consisted of an uninterrupted sedentary period (control), treadmill walking every 30 minutes for 5 minutes, and bodyweight-based muscular strengthening exercises every 30 minutes for 5 minutes. Blood glucose was measured at baseline and every 30 minutes thereafter. Blood pressure and fatigue were measured at baseline and every hour thereafter. …

Fractionated Radiosurgery Associated With High Rates Of Local Control For Large Volume Intact Brain Metastases, Ryan Ko, Hong Ye, Peter Chen, Zachary Seymour, Kuei Lee, Inga Grills

Posters

Radiosurgery is a well-established treatment modality for patients with intact brain metastases, and there is a known impact of tumor size and volume on tumor control. Utilizing our single-institution database, we investigated outcomes for patients with intact brain metastases treated with FSR using LINAC or GK modalities.

Comparison Of Associated Autoimmune Disease Diagnoses In Myasthenia Gravis And Multiple Sclerosis Patients, Alecca Como, Jacob Keeley, Daniel Menkes

Posters

Autoimmune diseases often co-exist given the non-specific nature of the immune response. For example, myasthenia gravis [MG], a well-established autoimmune disease, has a 2.36-fold increased risk of developing thyroid diseases as compared to normal controls. 1,2 In contrast, multiple sclerosis [MS] is a disorder in which the immune system subserves an important pathogenic role, although there is insufficient evidence to definitively classify it as an autoimmune disease. 3,4 Since the etiology of MS has yet to be identified, and the specific autoimmune mechanism requires further elucidation, the comparison of its coassociated autoimmune diseases with that of a well-studied neuroautoimmune disease, …

Targeted-Sequencing Evaluation For Fzd4 Variants In Familial Exudative Vitreo-Retinopathy, Mary Drekh, Wendy Dailey, Vincent Le, Savyo Krikor, Kimberly A. Drenser, Kenneth P. Mitton

Posters

• The Familial hereditary vision loss disease may present with symptoms including retinal detachment, folding, neovascularization, or vitreous hemorrhage due to peripheral retina avascularity.
• The manifestation of FEVR genetically has been associated with a loss of function mutation of the Wnt/bcantenin-signaling pathway involving 7 genes (FZD4, NDP, CTNNB1, KIF11, LRP5, TSPAN12, and ZNF408). In our patient population of 72 individuals the distribution of FZD4 gene variants leading to FEVR has been recorded.
• The Frizzled4 gene (FZD4) codes for the G-coupled protein receptor and effects Wnt/b-cantenin-signaling pathway In endothelial cells.
• What frequency of FEVR from our patient pool will have FZD4 variants …

Physician-Patient Face Masking’S Influence On Post-Intravitreal Injection Endophthalmitis Rates, Conner Liddle, Antonio Capone Jr, Matthew Trese

Posters

Intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) medications and intravitreal steroids are standard treatment options for variety of retinal diseases. Serial IVIs are often required to achieve disease control, but IVIs are not without risk. Recognized serious complications of IVIs include but are not limited to retinal detachment, vitreous hemorrhage, and acute endophthalmitis.1 Although post-IVI endophthalmitis is uncommon, it is a feared complication because of the potential for irreversible vision loss. Given that IVIs are one of the most commonly performed medical procedures in the United States, it is essential to ensure that steps are taken to mitigate …

Ehealth Cancer-Related Fatigue Intervention Single Arm Study, Anne Fleischer, Samantha Gelhaus, Emily Flohre, Caroline Frazee, Mary I. Fisher, Carrie Pickering

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: Cancer related fatigue (CRF), a sense of physical, emotional and cognitive tiredness not relieved by rest, negatively affects function. Prevalence is reported to be 59-100% throughout the care continuum. Exercise and psychosocial interventions are supported as effective treatment options, yet barriers to personalized care include time and distance to travel for care. The purpose of this pilot study was to evaluate the effectiveness of personalized exercise prescribed by physical therapy (PT), and occupational goal setting and tasks prescribed by occupational therapy (OT) on physical function.

Number of Subjects: 16 adults with cancer and fatigue ≥4/10.

Materials and Methods: Over …

The Effect Of Using A Meal Tracking Smartphone Application In Overweight And Obese Adolescents With Prediabetes Or Type 2 Diabetes To Improve Bmi And Hba1c, Lauren Torhorst

Evidence-Based Practice Project Reports

Obesity has become one of the most common chronic pediatric illnesses worldwide and is closely linked to the onset of prediabetes and subsequent Type 2 Diabetes (T2D); therefore, preventing and treating childhood obesity has become a high priority (Hampl et al., 2023). The purpose of this Evidence-Based Practice (EBP) project is to lower Glycosylated Hemoglobin A1c (HbA1C) and Body Mass Index (BMI) in overweight and obese youth with prediabetes and T2D using a meal tracking smartphone application. The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was utilized to pilot this project between two pediatric endocrinology offices located in Southeast Wisconsin. …

Evaluating Blood Pressure Methods In Non-Traumatic Intracerebral Hemorrhage: A Two-Site Prospective Observational Study, Desiree Cihelka

Theses and Dissertations (ETD)

Purpose. Blood pressure (BP) management is difficult and complex in the treatment of acute non-traumatic intracerebral hemorrhage (ICH). Despite mean arterial pressure (MAP) being the most reliable measure of noninvasive automatic oscillometric (NIBP) in clinical practice, clinicians instead rely on systolic and diastolic blood pressure (SBP and DBP) values to guide clinical practice. Given the widespread use of NIBPs for obtaining BP values in the acute care setting, we determine the agreement between SBP, DBP, and MAP measured by NIBP, manual cuff, and Arterial lines (A-lines) in patients with ICH. Study Aims. To understand the agreement between SBP, DBP, and …

Methenamine Prophylaxis Reduces Recurrent Urinary Tract Infections, Salwan Al Hani, Matthew Sims

Posters

• Recurrent urinary tract infections (UTIs) are the most common outpatient infection in the US and are often managed with antibiotics in clinical practice.
• A recurrent UTI is defined as 2 or UTIs each 6 months or 3 or more UTIs each year.
• Methenamine is an antiseptic compound approved by the FDA to prevent rUTIs but is seldom used in clinical practice.
• Under acidic conditions, methenamine is converted to 6 molecules of formaldehyde, a compound which prevents bacterial growth.
• This study seeks to determine the effectiveness of methenamine for prevention of recurrent UTIs.

The Hiv Care Continuum - A Quality Improvement Project To Reconnect With Hiv-Positive Patients Lost To Follow-Up Care, Kate Romero, Janet Lombardi, Carmen Demarco, Paul C. Johnson

Posters

• Human Immunodeficiency Virus (HIV): incurable illness transmitted through sex, blood, and trans placentally • Consistent management of HIV prevents progression to AIDS.
• 2013 study à HIV-positive patients who failed to attend their follow-up visit within 4-6 months of the prior visit were more likely to have virologic failure.
• Not much published on barriers to care, but one prior study found barriers shown in Figure 2 below – What are barriers to care faced by HIV-positive patients in Southeast Michigan?

Hiv Diagnosis And Linkage To Care In The Emergency Department, Gabrielle Rowlison, Christopher F. Carpenter

Posters

• It is estimated that 1.2 million people are living with human immunodeficiency virus (HIV) in the United States, and that 14% of this population are unaware of their status.
• Approximately 40% of community transmissions happen between people who do not know they have HIV.
• Current CDC recommendations are that anyone seeking treatment for a sexually transmitted infection (STI) be routinely screened for HIV.
• The Emergency Department (ED) is an ideal place to test for HIV, especially in areas with underinsured populations and high rates of ED visits.
• The HIV testing rate in Corewell Health (CH) East’s ED was previously found …

Near-Surface Dose Correlates With Moist Desquamation And Unplanned Reconstructive Surgery In Patients With Implant-Based Reconstruction Receiving Postmastectomy Radiation Therapy, Patrick Thrasher, Ronald Levitin, Bryan S. Squires, Allison J. Hazy, Michael J. Maywood, Anthony P. Delise, Muayad F. Almahariq, Nayana Dekhne, Lauren Oliver, Peter Y. Chen, Kailee J. Walters, Diane Dudley, Joshua T. Dilworth

Posters

Postmastectomy radiation therapy (PMRT) utilized as part of a breast cancer treatment regimen reduces the risk of disease recurrence in appropriately selected patients.1,2,3,4,5 However, PMRT increases risk of radiationrelated toxicities that can interfere with breast reconstruction post-mastectomy.6 Following mastectomy, implant-based reconstruction can increase patient satisfaction and quality of life7,8; complications induced by PMRT such as infection and tissue contracture, though, increase risk for implant loss and may ultimately require further surgeries for the patient.

PMRT is delivered based on treatment plans that are optimized to provide appropriate radiation dosages to tissues along the chest wall while simultaneously limiting exposure of …

The Impact Of Patch Placement Using Fluoroscopy Guidance On Outcome Of Electrical Cardioversion Of Atrial Fibrillation, Joshua France, Luai Madanat, Nolan Shoukri, Daniel Walsh, Ilana Kutinsky, Sujana Gundlapalli, Abhay Bilolikar, Anil Kumar Anil, Brian Williamson, Elvis Cami, Michael Gallagher, Richard Bloomingdale, David E. Haines, Nishaki Mehta

Posters

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and is Conclusions increasing in prevalence, especially as the population ages.1 Proper management of AF is imperative to prevent long-term complications including hemodynamic impairment and thromboembolic events which result in significant morbidity, mortality, and health care cost.2 Electrical cardioversion (EC) is frequently used to restore sinus rhythm in patients with AF.3, 4 However, it can be unsuccessful in up to 10-12% of patients.5 Despite the increased utilization of EC for the treatment of AF, guidelines provide little procedural guidance on methods to maximize EC success rates. Current European and American …

Hypofractionated Regional Nodal Irradiation In Breast Cancer, Joseph Salib, Allison Hazy, Joshua T. Dilworth

Posters

• In women with breast cancer requiring whole breast irradiation therapy (WBI), current guidelines endorse moderately hypofractionated whole breast irradiation (HWBI), which includes a shorter, 3-4-week regimen of radiation with a higher dose per daily fraction in comparison to conventional whole breast irradiation (CWBI), which includes a 5-6.5-week regimen.
• Patients with certain risk factors may benefit from treatment to the regional lymph nodes (RNI), which include the ipsilateral axillary, internal mammary and supraclavicular chains.
• Some centers have been slower to adopt short-course treatment when regional lymph nodes also require treatment (H-RNI), despite a reduction in the number of treatments for the …

Clinical Outcomes Of Hypofractionated Whole Breast Irradiation In Early Stage, Biologically High-Risk Breast Cancer, Eva Leung, Benjamin D. Willen, Thomas J. Quinn, Muayad F. Almahari, Peter Y. Chen, Maha Saada Jawad, Gregory S. Gustafson, Michelle Ka Yan Wu, Joshua T. Dilworth

Posters

• Whole breast irradiation (WBI) has been used in the treatment of breast cancer patients after partial mastectomy.
• There has been increasing utilization of hypofractionated whole breast irradiation (HWBI), defined as a larger daily dose and fewer fractions compared to conventionally fractionated whole breast irradiation (CWBI). However, HWBI for patients with early-stage, biologically high-risk breast cancer remains relatively low.
• We define biologically high-risk breast cancer as either triple negative (estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2 (Her-2) negative), Her-2 amplified, and/or patients with a high-risk multigene assay.
• The 2018 ASTRO guidelines form the basis for treating breast cancer patients with …

The Effects Of Untreated Reflux On The Incidence Of Feeding Difficulties In Neonates, Anne Grossbauer, Anya Costeloe, Prasad J. Thottam

Posters

• Gastroesophageal reflux (GERD) is the involuntary regurgitation of gastric contents into the esophagus and commonly occurs in infants.
• It is associated with various consequences related to feeding difficulty, such as feeding resistance, oral aversion, dysphagia, laryngomalacia, and failure to thrive.2
• There is a paucity in the literature regarding the incidence rate of feeding difficulties in latepreterm and full-term neonates in the neonatal intensive care unit (NICU).
• Many NICUs employ the use of anti-reflux medications, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2As), to treat GERD.3
• The use of these medications is debated and variable due to perceived …

Clinical Differences In Isolated Post-Capillary Pulmonary Hypertension And Combined Pre- And Postcapillary Pulmonary Hypertension, Emily Schneider, Bhavinkumar D. Dalal

Posters

PULMONARY HYPERTENSION (PH) = RESTING MEAN PULMONARY ARTERY PRESSURE (MPAP) > 20 MMHG.

The World Health Organization recognizes five groups of pulmonary hypertensions:

• • Estimated that > 50% of patients with left heart disease are also affected by pulmonary hypertension.1
• 1 in 4 Americans will develop heart failure in their lifetime.
• Gold standard for diagnosis of PH is a right heart catheterization (RHC).3
• Global burden of PH remains unknown as this illness is poorly surveilled and cases remain underestimated.4,5

Barriers To Mental Health Treatment Among Medical Students: Preclinical Vs. Clinical Years, Urvashi Singh, Agnes Wrobel

Posters

Our study aims to:

• Investigate medical students’ attitudes towards seeking assistance from mental health professionals.
• Compare the importance of various barriers that deter help-seeking in preclinical vs. clinical years of medical education.

Pulmonary Embolism In Pregnancy And Early Postpartum – Identifying Significant Variables To Improve Risk Stratification, Nida Haider, Bhavinkumar Dalal

Posters

• Pulmonary embolism (PE) resulting from deep vein thrombosis (DVT) is one of the leading causes of maternal deaths in developed countries1
• The causative Virchow triad (venous stasis, endothelial injury, and hypercoagulable state) is enhanced in pregnancy making pregnancy an independent risk factor1
• Due to significant overlap between normal physiological changes in pregnancy and clinical symptoms of PE, the threshold for CTPA, confirmatory imaging for PE with potentially harmful effects due to ionizing radiation, is low with increasing incidence of false positives2

Understanding Infectious Disease Consultation Role For Septic Patients In The Medical Intensive Care Unit, Marisa Stratelak, Cloe Nazeer, Bhavinkumar Dalal

Posters

• Sepsis is a medical emergency requiring immediate recognition and prompt treatment.
• 1 in every 3 hospitalized patients who die have sepsis1.
• The mortality rate for patients with severe sepsis in the intensive care unit (ICU) is 32.2%2.
• Early intervention with fluid resuscitation and intravenous antibiotics can reduce mortality rates by 7-9%3.
• Infectious disease (ID) consultation on antimicrobial therapy in the ICU is associated with reduced ICU mortality and ICU length of stay (LOS)4.
• Gaps in literature exist regarding frequency of ID consultation for septic patients in the ICU, including comparing outcomes of patients with and without ID consultation.
• It is …

Water-Soluble Contrast Challenge In The Management Of Pediatric Adhesive Small Bowel Obstruction: A Systematic Review, Max Fliegner, Daniel Finn, Spencer Wilhelm, Nathan Novotny, Anthony Stallion

Posters

Background: Adhesive small bowel obstruction (ASBO) is a serious complication of intra-abdominal surgery1 Water-soluble contrast (WSC) challenges have been used for medical management in the adult population2,3

Knowledge Gap: The therapeutic value of water-soluble contrast challenge in the pediatric population with ASBO is under-studied3,4

Research Question: Does administration of water-soluble contrast challenge reduce the need for surgery in pediatric patients with adhesive small bowel obstruction?

Patient Population Representation In Medical Education Textbooks: Gender Imbalance Of Diagnostic Images, Yasin Sahin, Abdul-Majid Khan, Nicolas Baker, Joshua Daniel, Jacob Keeley

Posters

Gender inequality: a longstanding issue that has been gaining overdue attention. Even within esteemed institutions such as medical schools, gender biases persist. Society trusts that those who attend medical school are given the knowledge needed to provide care and support during their most vulnerable moments as patients. While the education may be there, the “patients” may not be represented accurately. Future healthcare professionals must provide care for all patients, a diverse group encompassing all genders, ages, ethnicities, and backgrounds.

In 2019, the United States Census Bureau reported that the population was about 49% male and 51% female.¹ Therefore, medical students …

Quantitative And Comparative Analysis Of Dream Content In Parkinson’S Disease Patients Pre- And Postdeep Brain Stimulation, Sarvar Oreizi-Esfahani, Michael Staud

Posters

Parkinson’s Disease (PD) is a neurodegenerative disorder stemming from the loss of dopaminergic neurons in the substantia nigra, resulting in impaired neuronal activation which primarily affects the body’s motor function1. Common symptoms include tremor, rigidity, akinesia and loss of balance.

PD also exerts significant effects on sleep patterns. The Default Mode Network (DMN), a series of hubs in the brain with increased metabolic rate during rest, are implicated in the process of dreaming2. Differential activation of these regions may alter the content and quality of one’s dreams2. PD has been shown to impact the function of the DMN and as …

You’Re Testing My Patients: Clinicians’ Preferences For Structured Reporting And Measurement Data, Davit Melik, Adela Pouzar, Allan Brazier, Sayf Al-Katib

Posters

Radiological reports are a crucial part of patient care and management. Radiologists play a major role in patient care by interpreting imaging studies and making recommendations to referring physicians. 1,2,3 Although some physicians may prefer to initially interpret the imaging studies by themselves, radiologists’ reports have been shown to be significantly more accurate and detailed, which ultimately results in better patient care. 1,4,5,3 Thus it is important for radiology reports to be timely and as accurate as possible to improve overall patient care. The clarity of communication between radiologists and referring physicians in these reports remains an important factor in …