Investigative Techniques Commons^™

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

A Retrospective Study On The Associations Of Clinical Measures To Mortality In Pediatric Extracorporeal Membrane Oxygenation (Ecmo) Patients, Ammar F. Chauhdri, Ryan Davis Md, Christina Shanti Md, Michelle Veenstra Md, Megan Zacarias, Samantha Carranza, Laura Sansoterra, Nimr Assaf, Christian Hudson-Bradford Md, Elika Ridelman Phd

Medical Student Research Symposium

A Retrospective Study on the Associations of Clinical Measures to Mortality in Pediatric Extracorporeal Membrane Oxygenation (ECMO) Patients

Ammar Chauhdri; Ryan Davis, MD; Christina Shanti, MD; Michelle Veenstra, MD; Megan Zacarias; Samantha Carranza; Laura Sansoterra; Nimr Assaf; Christian Hudson-Bradford, MD; Elika Ridelman, PhD

Background: Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary support used in critically ill pediatric patients when conventional therapies fail, yet survival to discharge remains only ~50% nationwide. Prior studies have identified candidate mortality predictors and developed basic risk scores, but these models have limited accuracy and are often derived from registry-level or narrowly defined …

Effect Of Pre-Training Patients Using A Self-Directed Slideshow Presentation On Visual Field Reliability In First-Time Test Takers, Lillian M. Centlivre B.S., Derek Zahnleuter B.S., Rahul Babu B.S., Chaesik Kim, Kaitlin Ziadeh Md, Hanna Simmons Md, Vivian Rajeswaren Md, Aleskey Parker Williams Do, Jacob Im Md, Aleksey Mishulin Md, Faisal Ridha Al-Timimi Md, Hassan Tokko

Medical Student Research Symposium

Title: Effect of Pre-Training Patients Using a Self-Directed Slideshow Presentation on Visual Field Reliability in First-Time Test Takers

Authors: Lillian Centlivre BS, Derek Zahnleuter BS, Rahul Babu BS, Chaesik Kim BSEE, Kaitlin Ziadeh MD, Hanna Simmons MD, Vivian Rajeswaren MD, Aleksey Parker Williams DO, Jacob Im MD, Aleksey Mishulin MD, Faisal Ridha Al-Timimi MD, Hassan Tokko MD

Background: Visual field (VF) testing is essential for detecting glaucoma, but reliability is limited by patient inexperience and poor fixation. Prior studies report VF test reliability around 59%, primarily attributed to increased fixation loss (FL). Other studies note 75.9% reliability using training videos …

Postmarketing Safety Of Bimekizumab For Hidradenitis Suppurativa: An Early Pharmacovigilance Analysis Using The United States Food And Drug Administration Adverse Event Reporting System, Simona A. Alomary, Nicole J. Baker, Temitayo Ogunleye, Susan C. Taylor

Student Papers, Posters & Projects

No abstract provided.

Dexmedetomidine (Precedex) Versus Propofol: In Patients Requiring Sedation While Mechanically Ventilated,, How Does The Use Of Dexmedetomidine (Precedex) Compared To Propofol, Affect Reintubation Within 48 Hours Post Extubation?, Kimberly Barbee, Markela Albright, Malak Amro, Evelyn Caty-Pletcher, Margaret Havey Phd, Aprn, Acnp-Bc, Chfn, Fhrs, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within …

The Role Of Magnesium Supplements In The Management And Prevention Of Headache Disorders, Tatum Schroeder

Libraries Undergraduate Research Award (LURA) Winners

Much of the global population suffers from headache disorders like migraine. Because there are so many triggers and unknown explanations for migraine, it can be hard to find effective treatments for it. There are some studies that point to inflammation as either a cause or result of headache disorders; therefore, it is natural that we should explore the possibility of inflammation reducing factors when considering treatment options. The factor being explored in this review is magnesium supplementation, which has been shown to reduce inflammation by decreasing the amount of calcitonin-gene-related-peptide (CGRP) in circulation. There is a clear link between migraine …

Evaluating Forearm Strength Variability In Collegiate Tennis Players Over The Course Of A Competitive Season, Jeffrey Williams, Payton Jensen, Kevin Laudner

Clinical Practice in Athletic Training

The muscles of the forearm undergo routine, forceful, and repetitive contractions while playing tennis and may experience adaptive changes that can precede injury. An understanding of forearm strength profiles of tennis players following a competitive season would assist clinicians’ evidence-based management of the forearm’s readiness for training, competition, and return-to-sport participation. Therefore, the purpose of this study was to explore the effects of a competitive tennis season on forearm strength among collegiate tennis athletes. A prospective, case-series design was used to examine a convenience sample of 15 asymptomatic NCAA Division I tennis players (males = 10, height = 182.88 [SD …

Acute Management Of A Hamate Fracture In A Collegiate Baseball Player: A Disablement Model Case Study, Kayleigh A. De Koker, Cory E. Barton, Lindsey E. Eberman

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to outline a collegiate baseball player with an isolated hamate fracture including the injury evaluation, diagnosis, and acute management. During a tournament game, the collegiate career of the patient ended abruptly following an injury sustained while at bat. The patient attempted to bat again but encountered significant difficulty due to the increasing pain in his hand. Consequently, the athletic trainer was called out for an on-field examination. The patient presented with no edema or ecchymosis but severe pain in the hypothenar eminence. This patient also presented with decreased grip strength with …

Quality Of Athletic Training Services For Lower Extremity Injuries, Katie Sniffen, Michael Rozier, Katherine Stamatakis, Paula Buchanan, Janet E. Simon, Leslie Hinyard

Clinical Practice in Athletic Training

The use of patient-reported outcomes in athletic training is inconsistent, limiting the ability to communicate service quality and value to key stakeholders. The objective of this study is to calculate meaningful quality outcome measures for athletic training services for lower extremity injuries in high school student-athletes. Data were collected from a subset of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program and a convenience sample of high school student-athletes with patient-reported outcome measures for lower extremity time-loss injuries. Failure-toprogress proportions (FTPPs) were calculated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee/thigh injuries and the Foot …

Recurrent Urinary Tract Infections In An Elite Level Diver: A Disablement Model Case Study, Matt O'Sullivan, Dominique M. Stevens, Lindsey E. Eberman

Clinical Practice in Athletic Training

This article presents a case of complicated and recurrent pyelonephritis, an infection of 1 or both kidneys, in an elitelevel diver. Urinary tract infections (UTIs) are among the most common outpatient infections in the United States; most are uncomplicated and resolve without significant mortality or morbidity. However, UTIs have the potential to present significant clinical challenges if the UTI becomes complicated or recurrent. Additionally, recurrent UTIs can carry a significant burden to both the individual patients and the larger healthcare system. The current paper reviews the epidemiological literature surrounding UTIs, the significant impact they have on a patient’s health-related quality …

Comfort Level Of Collegiate Student-Athletes In Opposite And Same-Gender Patient/Provider Relationships In Athletic Training, Samantha Dickie, Yashu Tang, Sydney Nelson, Emily Madrak

Clinical Practice in Athletic Training

Gender-based comfort in patient-provider relationships is a vital aspect of athletic training care. As the profession continues to evolve—particularly with a growing number of women athletic trainers (ATs) and progression of athletic training curriculum—it is essential to understand how gender dynamics influence the comfort of collegiate athletes when receiving care. This cross-sectional survey study examined how athlete comfort varies when treated by same- versus opposite-gender ATs in general patient care and in pathology-based scenarios. Ninety-six collegiate student-athletes (62.5% female) with the mean age of 20.26 (SD 1.7) years from NCAA and NAIA institutions completed the Gender Comfort with Athletic Trainer …

Prescribed Aerobic Exercise And Sport-Related Concussion Recovery: A Validation Case Series, Lacy L. Chapel, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Active rehabilitation, including prescribed sub-symptom threshold aerobic exercise implemented during the acute phase of recovery after sport-related concussion, has been shown to facilitate recovery and reduce the risk of persisting postconcussion symptoms. The purpose of this validation case series was to evaluate currently available external evidence regarding the effects of prescribed aerobic exercise interventions on recovery after sport-related concussion. For this study, the patient population included college athletes diagnosed with a sport-related concussion who participated in at least 5 days per week of supervised, prescribed aerobic exercise, based on graded aerobic exercise testing and heart rate threshold. Our study findings …

Suture Augmentation With Ucl Repairs In Baseball Pitchers As An Alternate To Reconstructions: An Evidence-To-Practice Review, Kayleigh A. De Koker, Kenneth E. Games

Clinical Practice in Athletic Training

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the …

Comparison Of Vibrating And Non-Vibrating Foam Roller On Hamstring Range Of Motion, Rakhoon Sung, Portia B. Resnick, Karen G. Roos, Mimi Nakajima

Clinical Practice in Athletic Training

Tightness in the distal hamstring is a common complaint among active individuals. While a foam roller is used to release muscle tension, there are limited studies about the effect using a vibrating foam roller (VFR) on hamstring flexibility and knee range of motion (ROM). For this reason, the purpose of the research was to compare the effect of a VFR and nonvibrating foam roller (NVFR) on hamstring flexibility and knee ROM in active college students. It was hypothesized that there would be more improvement in hamstring flexibility and knee ROM with a VFR than an NVFR. A randomized controlled trial …

A Review Of Mentorship And Recruitment Strategies For Minority Athletic Training Students, Dariana M. Brown

Clinical Practice in Athletic Training

The underrepresentation of minority athletic trainers remains a critical issue, affecting both the profession and the quality of patient care. While patient demographics continue to diversify, the athletic training workforce has not kept pace, leading to potential communication barriers, mistrust, and inadequate culturally competent care. This review examines whether culturally tailored mentorship programs and targeted recruitment initiatives improve retention, career satisfaction, and diversity in athletic training compared to standard methods. By analyzing studies on underrepresented minority students in athletic training, the review highlights key institutional barriers and systemic factors impacting recruitment and retention. Findings suggest that tailored mentorship and supportive …

Breaking Into Hiv-1'S Epigenetic Vault: Cure Strategies To Eliminate The Viral Reservoir, Joanna Jones, Chelsea Gunderson, Brian Wigdahl, Michael Nonnemacher

Kimmel Cancer Center Faculty Papers

Human immunodeficiency virus type 1 (HIV-1) is a retrovirus that integrates into the host cell's DNA as a provirus. Transcription from the provirus is regulated in large part by cellular proteins and epigenetic factors. These may be repressive or permissive to productive infection. The host factors that regulate this balance are therefore attractive targets for HIV-1 therapeutics. Indeed, proviral chromatin is the focus of two of the current HIV-1 cure strategies. "Shock and Kill" uses latency reversal agents to open the provirus's chromatin, promoting high levels of gene expression that induce the killing of infected cells. "Block and Lock" uses …

Sacroiliac Dysfunction In A Middle-Aged Female Runner: A Case Study, Blair Bradshaw

Clinical Practice in Athletic Training

Introduction: Research has indicated an increased prevalence of low back pain (LBP) due to SIJ dysfunction, with some reports suggesting it is the main source of pain in 15- 30% of cases. Women are more prone to incidence of SIJ pain due to a wider, more uneven, less curved, and posteriorly rotated sacrum. Additionally, women have increased mobility at the SIJ which increases stress and shear loading. Repetitive loading such as running can further contribute to SIJ dysfunction. Research suggests that female runners with SIJ pain had common biomechanical patterns putting them at more risk for injury including decreased knee …

Awareness Of Native American Living Conditions Among Athletic Trainers, Laurel Trail, Brandon Warner, Rebecca Peebles, Robert French, Lynzi Warner, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Native Americans and First Nations People have dealt with healthcare disparities that have been documented in previous studies. One factor that appears to have played a role in these disparities was the Indian Removal Act of 1851 which established the first Native American reservations. The foundation of these reservations led to many Native Americans being displaced from areas where the United States was establishing new population centers. This has led many individuals not understanding the conditions that Native Americans live in. Lack of knowledge of the conditions patients live in may negatively affect clinicians’ ability to provide optimal healthcare. …

Ulnar Collateral Ligament Reconstruction Compared To Common Flexor Tendon Repair With Ulnar Collateral Ligament Reconstruction: A Case Series, Amanda Dubois, Melissa Long

Clinical Practice in Athletic Training

Introduction: The ulnar collateral ligament (UCL) is found in the medial aspect of the elbow joint capsule and is commonly injured in baseball pitchers. The common flexor tendon (CFT) is also found in the medial elbow and is less commonly injured. Both structures are key in overhead throwing, repaired via surgery, and injured due to valgus stress placed on the elbow. There is research on UCL injuries but very little on CFT injuries. There is not substantial research on the return to play protocol or rehabilitation process for either of these two structures after surgery. Patient Information: The patients for …