Therapeutics Commons^™

Impact Of Behavioral Health Consultant Intervention On Health Outcomes In An Integrated Primary Care Setting, Arpita Suri, Attiyah Zaheer, Christine Leroy, Robert Steer, Bhavin Shah, Sahil Zaveri, Shideh Doroudi

Rowan-Virtua Research Day

Integrated Primary Care Models are fast gaining popularity, and often being advocated as an important step in enhancing patient care within a primary care setting. Several studies have shown a positive impact of Behavioral Health Consultant (BHC) intervention in terms of patient satisfaction, improvement in patient symptom scores and global mental functioning. However, additional studies are needed to assess if integrated behavioral health consultations can demonstrate measurable outcome improvements to quantify the benefits of this approach, related to some of the most commonly seen and treated medical diseases in a primary care setting. This study aims to measure three outcomes: …

Exploring The Viability Of A Microglia Attenuating Treatment Model For Fibromyalgia Patients, Rohan Yarlagadda

Rowan-Virtua Research Day

Fibromyalgia refers to a rheumatic condition experienced as pain all over the body without a specific cause. This is considered a diagnosis of exclusion. This classification seems to suggest that any treatment options for it are purely symptomatic and are not disease targeted. Its complex diagnosis and underlying pathology contribute to the challenge of medically addressing fibromyalgia. Without a strict cause, fibromyalgia is often treated symptomatically with CBT and SNRIs. However, recent research suggests that existing therapeutic approaches are not very effective, especially when considering long term benefits for this chronic condition. This beckons for novel treatment options for these …

Does Prehabilitation Prior To Ulnar Collateral Ligament Surgery Affect Return To Sport Rate Or Time In Baseball Players With Partial Ucl Tears?, Joshua Spada, Kourtney Snigar, Ryan W. Paul, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rowan-Virtua Research Day

Those who suffer a partial thickness ulnar collateral ligament (UCL) tear often undergo a period of nonoperative management including physical therapy rehabilitation. This treatment is aimed at optimizing range of motion (ROM) and strengthening the supporting structures around the elbow to help offload the UCL.

Unfortunately, some of these patients fail nonoperative management and require surgical intervention. This creates a unique set of patients who essentially underwent “prehabilitation” prior to their UCL surgery. Prehabilitation is considered a period of structured physical therapy rehabilitation aimed at strengthening structures surrounding an injured tendon or ligament, to allow for dissipation of stress away …

A Review Of The Effectiveness Of Osteopathic Manipulative Medicine At Alleviating Pregnancy-Related Pain, Alexandria Lomanno, Olivia Choi, Danielle Cooley

Rowan-Virtua Research Day

Globally, more than a quarter of pregnant patients experience low back pain (LBP) during pregnancy with additional complaints of pelvic girdle pain (PGP) and other somatic dysfunctions. Though the standard of care for LBP in pregnancy is often analgesics, concerns about potential side effects that may cause lasting harm to the fetus may preclude pregnant patients from taking pain medications. Osteopathic Manipulative Medicine (OMM) is a nonpharmacologic treatment option that is routinely used for LBP in non-pregnant patients. Given the low risk of adverse effects, OMM may prove to be beneficial for pregnant patients suffering from LBP or PGP.

What Motivates Patients To Enroll In A Naloxone Co-Prescribing Program?, Christina Kanagawa, David Aloisio, Eshani Choksi, Manasa Gowda, Tyler Klecha, Charles M. Defendorf

Rowan-Virtua Research Day

Patients were contacted via phone call to establish knowledge of and prescription status regarding naloxone. They were then invited to enroll in a research study consisting of two online surveys.

The patients who had been prescribed naloxone by the time the study had started ranked being persuaded by a medical professional as being the most important reason for accepting the naloxone prescription.

Insufficient data collected during the six-week time frame to draw statistically significant conclusions about what motivates patients to receive naloxone co-prescriptions.

Correlations seen in this study are interesting and warrant further investigation.

Cpap And Epistaxis: Is There A Connection In Osa Patients?, Aesha Patel

Rowan-Virtua Research Day

Nasal continuous positive airway pressure (CPAP) has become a standard form of therapy for patients with obstructive sleep apnea (OSA). There are reports of patients suffering from episodes of epistaxis within the initial few weeks of starting CPAP therapy, believed to be due to the high flow rate of air during use, nasal CPAP purportedly dries the nasal mucosa, leading to an increased risk of scabbing, ulceration, and ultimately epistaxis. This study seeks to analyze whether epistaxis is common in patients following CPAP initiation and then compare this rate of epistaxis amongst OSA patients that received upper airway stimulation (UAS) …

A Brief Literature Review On Heparin: To Bolus Or Not To Bolus, That Is The Question, Alex Gechlik, James Espinosa, Alan Lucerna, Kishan Patel

Rowan-Virtua Research Day

Heparin is an anticoagulant medication, used to inhibit the formation of thrombi that pose arteriolar and vein-occlusive risk. The choice between starting a heparin infusion with or without an initial bolus is case dependent based on whether a patient is already anticoagulated and if so, foregoing an initial bolus. In contrast, both anticoagulated and non-anticoagulated patients share the same goal when receiving Heparin for various thromboembolic syndromes, and that is to be within aPTT target range of 1.5-2.5 or 45 to 75 seconds. Falling below goal range leads to a 20-25% recurrence of VTE, and aPTT above goal range has …

Interaction Of Fluorescent Probes With Sirtuin Proteins, James Fusco, Brian P Weiser

Rowan-Virtua Research Day

Sirtuins are a class of proteins belonging to the Sir2 (Silencing information regulator 2) family of NAD+ dependent protein lysine deacylases. Different Isoforms (SIRT1-SIRT7) differ in their specific deacylase activity and cellular location. They have roles in DNA repair, glucose metabolism, and cellular proliferation which make them highly desirable targets for carcinoma therapeutics. We previously used 1-aminoanthracene’s (AMA) fluorescent properties when bound with SIRT2 (Kd of 37 μM) to develop a high-throughput screen to identify novel ligands that inhibit SIRT2’s enzymatic activities. We hope to reveal other potential probes for future high-throughput screening with all the sirtuin isotopes. 1-AMA’s fluorescence …

Efficacy Of Δ-9-Tetrahydrocannabinol For Hiv-Related Neuropathic Pain, Kaia Horne

Honors Theses

Despite the availability and success of antiretroviral therapeutics, ~30% of patients living with HIV experience neuropathic pain that is often intractable. The mechanisms are not known, but there is evidence to support a role for the HIV virotoxins, Tat and/or gp120, which can damage or degenerate neurons and peripheral nerves. One mechanism by which Tat and gp120 promote nerve damage involves the stimulation of proinflammatory cytokine production from immune cells which can damage or kill bystander cells. Notably, compounds found in Cannabis exert anti-inflammatory effects and many studies report HIV patients to consume more marijuana than seronegative individuals. When people …

Cases From A Community Hospital… Jchimp Series #1: 55-Year-Old Male With Acute Pe Who Developed Persistent Epistaxis., Jerrica N. Mueller, Bobby Mathew, Douglas D. Reh, Joseph Fuscaldo

Journal of Community Hospital Internal Medicine Perspectives

This is the first in a new series of case reports that will present real scenarios from our community hospital. The cases are chosen to highlight clinical dilemmas and offer review and perspective on what is currently known about the topic. We present the case of a 55-year-old Caucasian male who presented to the emergency department of our community hospital for worsening dyspnea. Evaluation in the Emergency department revealed a diagnosis of extensive pulmonary emboli in the pulmonary vasculature. The patient was admitted to the ICU. A clinical decision was made to initiate treatment with low-dose tissue plasminogen activator (tpa) …

When Problems Become Solutions: Harnessing The Osteogenic Capacity Of Disease-Causing Stem Cells To Repair Bone Fractures, Mehreen Pasha

University Scholar Projects

While we often perceive disease as negative, there is potential to engineer seemingly negative biological phenomena into therapeutics to treat a variety of human illnesses. Fibrodysplasia ossificans progressiva (FOP) is a genetic disorder involving uncontrolled, widespread, extraskeletal bone growth, or heterotopic ossification (HO). In FOP patients, stem cells called fibro/adipogenic progenitors (FAPs) follow an abnormal, osteogenic pathway. In the present study, we investigate whether we can adapt these Acvr1 mutant FAPs, which are exceptional at producing bone, to repair bone fractures in otherwise normal patients. The primary aims of this study are (1) to devise and optimize a novel method …

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

Foundations Of Plasmas For Medical Applications, T. Von Woedtke, Mounir Laroussi, M. Gherardi

Electrical & Computer Engineering Faculty Publications

Plasma medicine refers to the application of nonequilibrium plasmas at approximately body temperature, for therapeutic purposes. Nonequilibrium plasmas are weakly ionized gases which contain charged and neutral species and electric fields, and emit radiation, particularly in the visible and ultraviolet range. Medically-relevant cold atmospheric pressure plasma (CAP) sources and devices are usually dielectric barrier discharges and nonequilibrium atmospheric pressure plasma jets. Plasma diagnostic methods and modelling approaches are used to characterize the densities and fluxes of active plasma species and their interaction with surrounding matter. In addition to the direct application of plasma onto living tissue, the treatment of liquids …

Targeting Metabolic Adaptations To Anti-Angiogenic Therapy In Ovarian Cancer, Deanna M. Glassman, Deanna Glassman

Dissertations and Theses (Open Access)

ABSTRACT

Background: Ovarian cancer is the most lethal gynecologic malignancy. Despite modest clinical improvements with anti-VEGF antibody (AVA) therapy, adaptive resistance is nearly ubiquitous and additional therapeutic options are limited. A dependence on glutamine metabolism, via the enzyme glutaminase (GLS), is a known mechanism of adaptive resistance.

Purpose: To assess the efficacy of a glutaminase inhibitor as a means of exploiting the metabolic vulnerability of glutamine dependence that develops as a result of adaptive resistance to AVA therapy.

Experimental Design: We used a glutaminase inhibitor (GLSi) synthesized at MD Anderson Cancer Center for all in vitro and in vivo experiments. …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

“Translation Of Hdac6 Pet Imaging Using [18f]Ekz-001 – Cgmp Production And Measurement Of Hdac6 Target Occupancy In Nhps” – A Review, Dania Rahal

Chemistry & Biochemistry Undergraduate Honors Theses

The inhibition of histone deacetylase 6 (HDAC6) has been reported to alleviate the effects of neurodegenerative diseases such as Alzheimer’s disease. The brain-penetrant PET radioligand [¹⁸F]EKZ-001 has high affinity and selectivity towards HDAC6 and therefore suggests great promise in therapeutic treatment studies and development for neurodegenerative diseases. “Translation of HDAC6 PET imaging using [¹⁸F]EKZ-001 – cGMP production and measurement of HDAC6 target occupancy in NHPs” has achieved an effective, fully automated method of producing [¹⁸F]EKZ-001 in compliance with current good manufacturing practices (cGMP) to support the translation of [¹⁸F]EKZ-001 PET for …

Synthesis, Structural Characterization, And In Vitro Biological Assessment Of Trans- Platinum (Ii) Thionate Complexes As Potent Anticancer Agents, Mia Alshami

Chemistry & Biochemistry Undergraduate Honors Theses

The content of this thesis has been originally reported in our published paper, “trans-Platinum (II) Thionate Complexes: Synthesis, Structural Characterization, and in vitro Biological Assessment as Potent Anticancer Agents” ChemPlusChem 2019 84, 1525-1535, DOI: 10.1002/cplu.201900394, in which I served as coauthor. Cancer caused 9.6 million deaths in 2018 worldwide, with 18.1 million new diagnoses during that same year.The most widely used metal in anticancer drugs is platinum (Pt), and these drugs are used to treat almost 50% of cancer patients. To optimize drug effectiveness, trans-configured Pt(II) complexes have been introduced as a strategy to potentially overcome the …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Comparing The Effectiveness Of Perioperative Ketorolac To Opioids: A Scoping Review, Kruze T. Vanderford Bsn, Ccrn, Srna, Abbie E. Walter Bsn, Ccrn, Srna, Anastasiya V. Woodard Bsn, Ccrn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Abstract Purpose/Background Opioids are commonly administered in the perioperative period to manage surgical pain. However, the ongoing opioid epidemic in the United States makes it necessary to evaluate other modalities of pain management that do not cause respiratory depression, nausea, vomiting and addiction. Ketorolac is a nonsteroidal anti-inflammatory drug that can manage pain safely and effectively. This scoping review examines the available literature on the effectiveness and feasibility of using ketorolac to minimize perioperative opioid use.

Methods A comprehensive literature review was performed between October 2020 and September 2021 utilizing five scholarly databases: GoogleScholar ™, PubMed, Ovid, Cochrane Library, and …

Effectiveness Of Perioperative Ketamine Vs. Opioid Analgesia On Extubation Time And Total Perioperative Opioid Requirement, Robert H. Gray Srna, Sarah S. Hardesty Srna, Heidi E. Higginbotham Srna, Charles A. Hoyt Ii, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Opioid analgesics are a primary source of pain control in the perioperative patient. However, all opioids decrease ventilatory drive secondary to mu2 receptor agonism in the brainstem. Ventilatory depression delays extubation after mechanical ventilation in post-operative patients, thus increasing the risk of complications such as ventilator-associated pneumonia and barotrauma. Non-opioid analgesics such as ketamine have been considered for use in order to reduce this risk. Ketamine is a noncompetitive N-methyl-D-aspartate receptor-antagonizing sedative that bears analgesic properties while preserving respiratory drive. Research suggests that ketamine provides effective perioperative pain control and decreases postoperative extubation time when given alone or with …