Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Development And Implementation Of A Pharmacist-Managed Outpatient Parenteral Antimicrobial Therapy Program, Eun Kyoung Chung, Cole B. Beeler, Eva W. Muloma, Danielle Osterholzer, Kendra M. Damer, Sharon M. Erdman

Scholarship and Professional Work – COPHS

Purpose The development and implementation of a pharmacist-managed outpatient parenteral antimicrobial therapy (OPAT) program in a county teaching hospital are described.

Summary A pharmacist-managed OPAT program was developed and implemented at a county teaching hospital to provide consistent evaluation, approval, and monitoring of patients requiring OPAT for the treatment of infection. The developmental and implementation stages of the OPAT program included (1) a needs assessment, (2) the identification of resources necessary for program operation, (3) delineation of general OPAT program operations and activities of individual OPAT clinicians, (4) the development of patient selection criteria, including a plan of care algorithm, …

What Is Causing This Man's Rectal Pain And Urinary Retention?, Mikaela L. Mckenney-Drake, Kali E. Veness, Christopher T. Roman

Scholarship and Professional Work – COPHS

Case: A 23-year-old man presented to an urgent care office with a 2-week history of rectal pain and scant rectal bleeding. In the few days leading up to his presentation, he also had a fever of 101° F (38.3° C), inguinal lymphadenopathy, and urinary retention.

Is Deep Brain Stimulation A Viable Treatment For Parkinson’S Disease?, Brocha Gold

The Science Journal of the Lander College of Arts and Sciences

Treatment options for those suffering from Parkinson’s Disease are as diverse as its symptoms. With the advent of modern technology there are new and innovative treatments that are becoming available, such as Deep Brain Stimulation (DBS). Prior to exploring treatment options one must understand the various causes of the disease. Treatment of the various motor and non-motor symptoms can include a combination of medication and surgical therapies. Among surgical interventions DBS is the treatment of choice. It has the fewest side effects and provides the greatest symptomatic relief.

Initial Development Of A Patient-Reported Instrument Assessing Harm, Efficacy, And Misuse Of Long-Term Opioid Therapy, William C. Becker, David A. Fiellin, Anne C. Black, Carol T. Kostovich, Robert D. Kerns, Liana Fraenkel

Nursing: School of Nursing Faculty Publications and Other Works

Guidelines on long-term opioid therapy recommend frequent reassessment of harm, efficacy, and misuse of these potentially harmful and sometimes ineffective medications. In primary care, there is a need for a brief, patient-reported instrument. This report details the initial steps in the development of such an instrument. An interdisciplinary team of clinician-scientists performed four discrete steps in this study: (1) conceptualization of the purpose and function of the instrument, (2) assembly of an item pool, (3) expert rating on which items were most important to include in the instrument, and (4) modification of expert-selected items based on a reading level check …

A Urinary Metabolic Signature For Multiple Sclerosis And Neuromyelitis Optica, Teklab Gebregiworgis, Helle H. Nielsen, Chandirasegara Massilamany, Arunakumar Gangaplara, Jay Reddy, Zsolt Illes, Robert Powers

Jay Reddy Publications

Urine is a metabolite-rich biofluid that reflects the body’s effort to maintain chemical and osmotic homeostasis. Clinical diagnosis routinely relies on urine samples because the collection process is easy and noninvasive. Despite these advantages, urine is an under-investigated source of biomarkers for multiple sclerosis (MS). Nuclear magnetic resonance spectroscopy (NMR) has become a common approach for analyzing urinary metabolites for disease diagnosis and biomarker discovery. For illustration of the potential of urinary metabolites for diagnosing and treating MS patients, and for differentiating between MS and other illnesses, 38 urine samples were collected from healthy controls, MS patients, and neuromyelitis optica-spectrum …

The Respiratory Protection Effectiveness Clinical Trial (Respect): A Cluster-Randomized Comparison Of Respirator And Medical Mask Effectiveness Against Respiratory Infections In Healthcare Personnel., Lewis J. Radonovich, Mary T. Bessesen, Derek A.T. Cummings, Aaron Eagan, Charlotte A. Gaydos, Cynthia Gibert, Geoffrey J. Gorse, +8 Additional Authors

Medicine Faculty Publications

BACKGROUND: Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.

METHODS: The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to …

Utilizing Electronic Health Records To Predict Acute Kidney Injury Risk And Outcomes: Workgroup Statements From The 15th Adqi Consensus Conference, Scott M. Sutherland, Lakhmir S. Chawla, Sandra Kane-Gill, Raymond K. Hsu, Andrew A. Kramer, Stuart A. Goldstein, John A Kellum, Claudio Ronco, Sean M. Bagshaw, On Behalf Of The 15 Adqi Consensus Group

Anesthesiology and Critical Care Medicine Faculty Publications

The data contained within the electronic health record (EHR) is “big” from the standpoint of volume, velocity, and variety. These circumstances and the pervasive trend towards EHR adoption have sparked interest in applying big data predictive analytic techniques to EHR data. Acute kidney injury (AKI) is a condition well suited to prediction and risk forecasting; not only does the consensus definition for AKI allow temporal anchoring of events, but no treatments exist once AKI develops, underscoring the importance of early identification and prevention. The Acute Dialysis Quality Initiative (ADQI) convened a group of key opinion leaders and stakeholders to consider …

Micrornas Are Involved In The Development Of Morphine-Induced Analgesic Tolerance And Regulate Functionally Relevant Changes In Serpini1., Jenica D. Tapocik, Kristin Ceniccola, Cheryl L. Mayo, Melanie L. Schwandt, Matthew Solomon, Bi-Dar Wang, Truong V. Luu, Jacqueline Olender, Thomas Harrigan, Thomas M. Maynard, Greg I. Elmer, Norman H. Lee

Pharmacology and Physiology Faculty Publications

Long-term opioid treatment results in reduced therapeutic efficacy and in turn leads to an increase in the dose required to produce equivalent pain relief and alleviate break-through or insurmountable pain. Altered gene expression is a likely means for inducing long-term neuroadaptations responsible for tolerance. Studies conducted by our laboratory (Tapocik et al., 2009) revealed a network of gene expression changes occurring in canonical pathways involved in neuroplasticity, and uncovered miRNA processing as a potential mechanism. In particular, the mRNA coding the protein responsible for processing miRNAs, Dicer1, was positively correlated with the development of analgesic tolerance. The …

Using Platelet-Rich Plasma To Reverse The Effects Of Tendinopathy And Prevent Tendon Re-Rupture After Surgery In Athletes: The Search For A Standardized Protocol, Shiv Patel

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

30-50% of all lesions amateur and professional sports players will experience during activity are related to the tendon. Moreover, the incidence of tendinopathy, a precursor to tendon rupture, is much higher in both of these groups due to excessive loading of tendons during physical activity, insufficient rest afterwards and certain antibiotic use. The tendon anatomically has both a low blood supply and a low cell turnover rate, which contribute to the relative ease by which an athlete can develop tendinopathy. Chronic tendinopathy has very few high-success treatments but in recent years, platelet-rich plasma (PRP), a treatment in which platelets are …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

Connexin-43 And Traumatic Brain Injury: A Potential Target For Therapeutic Intervention, Lauren R. Moore

UReCA: The NCHC Journal of Undergraduate Research and Creative Activity

Traumatic Brain Injury (TBI) is a widespread, degenerative affliction with no current therapeutic interventions. The long-term degradation caused by TBI results from secondary injury cascades that are initiated by primary injury. An early and important step in the damage process is reactive astrogliosis in astrocytes. Astrocytes communicate through gap junctions, which are composed of two connexon hemichannels from the two communicating cells and these connexons themselves are composed of six connexin protein subunits. Connexin 43 (Cx43) is a particularly important connexin to gap junctional communication and could act either to preserve the astrocytes from oxidative stress, or to propagate the …

The Effect Of Varying Bisphosphonate Treatment On Changes In Bone Microdamage In Osteoporotic Women, Stefanie L. Pagano

Theses and Dissertations--Biomedical Engineering

Bisphosphonates (BPs) are used for the treatment of osteoporosis. This study evaluated changes in bone microdamage with BP treatment duration. Fifty-one iliac crest biopsies were obtained from Caucasian women, ages 41 to 87 years, who were previously diagnosed and treated for osteoporosis with oral BPs for 1-16 years duration. Patients diagnosed with any disease, drug, or substance abuse that may affect bone metabolism were excluded.

Bone samples were sectioned, stained, and histologically examined using light and fluorescence microscopy. Bone area, number and length of microcracks were quantified. Following adjustment for age, BMD, BV/TV, trabecular thickness, and turnover, regression analysis revealed …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Alexandra Smola, Lauren Hurley

Williams Honors College, Honors Research Projects

Therapeutic horseback riding (THR) has positive health related outcomes in children with developmental disabilities. The purpose of this study was to determine the effect of a 10-week THR intervention on balance and task-specific self-efficacy in children with developmental disabilities. Bandura’s social cognitive theory and the physical stress theory guided the quasi-experimental study. A pre-test post-test design (N=20) was implemented with a 10-week THR class at a riding center in Midwest United States. The first research question was: In children with developmental disabilities ages 5 to 18, does one 10-week session of THR affect balance? With time 1 balance mean at …

Whole Body Cryotherapy Vs. Cold Water Immersion, Brett M. Johnson

Physician Assistant Scholarly Project Posters

In this country a significant percentage of the population present to clinics with generalized musculoskeletal disorders related to pain. More than one-quarter of Americans (26%) age 20 years and over, or an estimated 76.5 million Americans report a problem with general musculoskeletal disorders related to pain that persisted for more than 24 hours in duration. The treatment for various musculoskeletal disorders related to pain are anti-inflammatory agents or opioid analgesics. Another form of anti-inflammatory /analgesia for such ailments is cold therapy.

The purpose of this literature review is to compare Whole Body Cryotherapy (WBCt) to Cold Water Immersion (CWI) in …

An Empirical Investigation Of Privacy And Security Concerns On Doctors’ And Nurses’ Behavioral Intentions To Use Rfid In Hospitals, Thomas George Winston

CCAC Theses and Dissertations

Radio frequency identification (RFID) technology is a useful technology that has myriad applications in technology, retail, manufacturing, and healthcare settings. Not dependent upon line-of-sight, RFID can scan devices in their proximity and report the information to connected (wired or other wireless) information systems. Once touted as the panacea for home healthcare, RFID devices can add benefit to patients in remote settings. RFID devices have been used to optimize systems in areas such as manufacturing and healthcare to expose inefficiencies in a system or process. Unlike manufacturing, however, RFID in healthcare settings presents security and privacy concerns to the people being …

Dietary Intake Of Vitamin D Is Related To Blood Levels Of Advanced Glycation End Products During A Weight Loss Program In Obese Women, Shin Sukino, Kazuhiko Kotani, Shinsuke Nirengi, Alejandro Gugliucci, Russell Caccavello, Kokoro Tsuzaki, Naoki Sakane

Faculty Publications & Research of the TUC College of Osteopathic Medicine

BACKGROUND/OBJECTIVES: Advanced glycation end products (AGEs) contribute to the pathophysiology of lifestyle-related diseases. To identify nutrients associated with AGEs, this study explored the factors by investigating the relationship between nutrients changes and changes of blood AGEs during a weight loss program in obese women.

SUBJECTS/METHODS: Twenty-five obese women (age: 50 ± 8 years, body mass index: 28.7 ± 3.4 kg/m2 ) underwent a weight loss program with energy-restricted meal replacement for 2 months. Three-day weighted dietary records and blood tests including blood AGEs were performed at the baseline and after the 2-month intervention. Their correlation was examined during …

Relief Of Cervicogenic Headaches After Single-Level And Multilevel Anterior Cervical Diskectomy: A 5-Year Post Hoc Analysis, Jonathan J. Liu, Gilbert Cadena, Ripul R. Panchal, Rudolph J. Schrot, Kee D. Kim

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Study Design Prospective study.

Objective Because single-level disk arthroplasty or arthrodesis in the lower subaxial spine improves headaches after surgery, we studied whether this effect may be better appreciated after two-level arthroplasty.

Methods We performed an independent post hoc analysis of two concurrent prospective randomized investigational device exemption trials for cervical spondylosis, one for single-level treatment and the other for two adjacent-level treatments.

Results For the one-level study, baseline mean headache scores significantly improved at 60 months for both the cervical disk arthroplasty (CDA) and anterior cervical diskectomy and fusion (ACDF) groups (p < 0.0001). However, mean improvement in headache scores was not statistically different between the investigational and control groups from 6 months through 60 months. For the two-level study, baseline mean headache scores significantly improved at 60 months for both the CDA and ACDF groups (p < 0.0001). The CDA group demonstrated greater improvement from baseline at all points; this difference was statistically significant at 6, 12, 24, 36, and 48 months but not at 18 and 60 months.

Conclusion Both CDA and ACDF at either …

The Health Exception, Monica E. Eppinger

All Faculty Scholarship

The abortion doctrine laid out in Roe v. Wade permits a procedure necessary to preserve the life or the health of the pregnant woman, setting out what has come to be called the “life exception” and the “health exception.” This Article investigates the background and antecedents of the health exception, identifying three periods of formation and change up to the drafting of the Model Penal Code in 1959. It argues that theories of health lie at the heart of legal doctrine, shaping common-law treatment of abortion and persisting in nineteenth- and twentieth-century statutes. This account reveals origins of a health …

Marijuana Compounds: A Nonconventional Approach To Parkinson’S Disease Therapy, Mariana Babayeva, Haregewein Assefa, Paramita Basu, Sanjeda Chumki, Zvi G. Loewy

Touro College of Pharmacy (New York) Publications and Research

Parkinson’s disease (PD), a neurodegenerative disorder, is the second most common neurological illness in United States. Neurologically, it is characterized by the selective degeneration of a unique population of cells, the nigrostriatal dopamine neurons. The current treatment is symptomatic and mainly involves replacement of dopamine deficiency.This therapy improves only motor symptoms of Parkinson’s disease and is associated with a number of adverse effects including dyskinesia. Therefore, there is unmet need for more comprehensive approach in the management of PD. Cannabis and related compounds have created significant research interest as a promising therapy in neurodegenerative and movement disorders. In this review …

Inadequate Sedation During Therapeutic Paralysis: Use Of Bispectral Index In Critically Ill Patients, Chelsea L. Tasaka, Jeremiah J. Duby, Komal Pandya, Machelle D. Wilson, Kimberly A. Hardin

Faculty Publications & Research of the TUC College of Pharmacy

Background: Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BISTM) provides an objective measure of sedation; however, the role of BISTM is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA).

Objective: The aim of this study was to delineate the relationship between BISTM and level of sedation for critically ill patients during therapeutic paralysis.

Methods: This was a retrospective observational study conducted in ICU patients receiving continuous infusion NMBA and BISTM monitoring. The primary endpoint was the correlation of BISTM\60 during therapeutic paralysis with …