Chemicals and Drugs Commons^™

Review Of Adjunctive Midodrine To Facilitate Weaning Intravenous Vasopressors In Critically Ill Patients, Claudia Martin Diaz, Heidi Clarke, Payal Patel, Radhan Gopalani, Stephanie Palma

All Publications

Background/Purpose: Intravenous (IV) vasopressor agents are mainstay therapy for the management of refractory hypotension in critically ill patients in the intensive care unit (ICU). Patients remain in the ICU for vasopressor administration and monitoring which results in increased length of stay (LOS). Midodrine is an oral alpha-1 adrenergic agonist that causes vasoconstriction and increased blood pressure. It is commonly utilized off-label as an adjunctive therapy to help wean off vasopressors and decrease ICU LOS. Although midodrine offers many benefits, a study by Rizvi, et al stated that inappropriate continuation at hospital discharge resulted in a 1.6-fold higher risk of 1-year …

Pharmacological Prevention Of Atrial Fibrillation After Cardiac Surgery With And Without The Use Of Nonsteroidal Anti-Inflammatory Drugs, Laura Neubauer, Radhan Gopalani, Faaria Quadri, Mario Pascual, Heidi Clarke, Andrea Marr-Peralto

All Publications

Purpose: Atrial fibrillation after cardiac surgery (AFACS) is the most common complication following open heart procedures, with significantly increased morbidity and mortality associated with its occurrence¹. A previous study done at Baptist Hospital of Miami (BHM) showed a decrease in the incidence of AFACS from 36% to 22% after implementation of a prevention protocol that includes guideline-directed therapy with a beta-blocker and amiodarone. The protocol also includes nonsteroidal anti-inflammatory drugs (NSAIDs) modeled after a study published in 2004 that showed that NSAIDs lowered the incidence of postoperative atrial fibrillation by 65% when they were used in the postoperative …

Friend Or Foe? Recent Strategies To Target Myeloid Cells In Cancer, Mehdi Chaib, Subhash C. Chauhan, Liza Makowski

School of Medicine Publications

The tumor microenvironment (TME) is a complex network of epithelial and stromal cells, wherein stromal components provide support to tumor cells during all stages of tumorigenesis. Among these stromal cell populations are myeloid cells, which are comprised mainly of tumor-associated macrophages (TAM), dendritic cells (DC), myeloid-derived suppressor cells (MDSC), and tumor-associated neutrophils (TAN). Myeloid cells play a major role in tumor growth through nurturing cancer stem cells by providing growth factors and metabolites, increasing angiogenesis, as well as promoting immune evasion through the creation of an immune-suppressive microenvironment. Immunosuppression in the TME is achieved by preventing critical anti-tumor immune responses …

Evaluation Of Clinical Outcomes Of 4-Factor Prothrombin Complex Concentrate Versus Andexanet Alfa In The Treatment Of Intracerebral Hemorrhage, Eduardo Guizan Corrales, Radhan Gopalani, Heidi Clarke, Jonatha Kline, Felipe De Los Rios La Rosa, Thomas Wolfel

All Publications

Purpose: Oral anticoagulants account for up to 20% of intracerebral hemorrhages (ICH) with one-year mortality estimated as high as 54%. Several studies have examined the use of 4-Factor prothrombin complex concentrate (4F-PCC) and andexanet alfa in the treatment of factor Xa associated ICH. High cost burden, lack of clinical outcomes, and risk of thromboembolic events continues to be a major dilemma behind product selection at many healthcare systems. The purpose of this project is to compare clinical outcomes between 4F-PCC and andexanet alfa in the management of patients with ICH secondary to apixaban and rivaroxaban at Baptist Hospital of Miami …

Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel

All Publications

Purpose/Background: The Surviving Sepsis Campaign recommends norepinephrine as the first-line vasopressor in patients with septic shock to maintain a mean arterial pressure (MAP) of at least 65 mmHg. The guideline also makes a weak recommendation (2B) to use vasopressin as an adjuvant therapy to raise MAP to goal or to reduce the norepinephrine rate required to maintain the goal MAP. The recommendation is based on conflicting results of the VASST trial that showed no significant difference in 28-day all-cause mortality between patients managed with norepinephrine alone compared to norepinephrine and vasopressin. However, in subgroup analysis, the VASST trial showed mortality …

Ctrp3 And Alcoholic Liver Disease In Female Mice, Callie Root

Undergraduate Honors Theses

C1q TNF Related Protein 3 (CTRP3), is a cytokine that is primarily secreted from adipose tissue, which classifies it as an adipokine. Our previous research has shown that CTRP3 prevents alcoholic fatty liver disease (ALD) in male mice. However, even when accounting for confounding factors such as absolute and relative alcohol intake, females are more sensitive to the effects of consumption compared to male mice. Therefore, the goal of this project was to determine whether CTRP3 prevented ALD in female mice. Methods: Female wild type (WT) and female CTRP3 transgenic over expressing (Tg) mice were fed an ethanol containing liquid …

Effects Of Nicotinamide Riboside And Beta-Hydroxybutyrate On C. Elegans Lifespan, Jeffery Peters

Undergraduate Honors Theses

The nicotinamide riboside (NR) form of vitamin B₃and the ketone body ß-hydroxybutyrate (BHB) are two of the most promising natural compounds yet identified for the treatment of aging and aging-related diseases. Forms of vitamin B₃are precursors for the synthesis of the coenzymes nicotinamide adenine dinucleotide (NAD(H)) and nicotinamide adenine dinucleotide phosphate (NADP(H)). In aged cells levels of NAD⁺decline, decreasing metabolism and decreasing activity of protective sirtuin protein deacetylases. In aged cells NR, but not more common forms of vitamin B3, boost NAD⁺levels. BHB is naturally produced by the body when individuals fast …

The Role Of Dopamine In Decision Making Processes In Drosophila Melanogaster, Michelle C. Bowers

Undergraduate Honors Theses

Understanding the neural processes that mediate decision making is a relatively new field of investigation in the scientific community. With the ultimate goal of understanding how humans decide between one path and another, simpler models such as Drosophila Melanogaster, the common fruit fly, are often utilized as a way of determining the neural circuits involved in these decision-making processes. One of the most important decisions flies make is the decision of where to lay their eggs (oviposit). Choosing the proper substrate upon which to lay eggs is a crucial decision that can ultimately impact their fecundity. This paper investigates the …

Surface-Enhanced Raman Spectroscopy For Cocaine Detection, Kiersten Jo Mead

Chemistry

The detection of drugs of abuse using Raman spectroscopy is of particular interest to forensic researchers at the moment. Raman spectroscopy is highly specific, fast, non-destructive, and can be adapted for in-situ measurements, making it the ideal forensic technique. Researchers working under the guidance of Doctor Igor Lednev have been able to use UV resonance Raman spectroscopy to detect cocaine in oral fluid without the need for sample pretreatment. They were however unable to detect the cocaine at forensically relevant levels. To overcome this limitation, surface-enhanced Raman spectroscopy (SERS) was used in this proof of concept study for the detection …

Impact Of Epa And Dha Supplementation And 15-Lox-1 Expression On Colitis And Colitis-Associated Colorectal Cancer, Jonathan Jaoude

Dissertations and Theses (Open Access)

Inflammatory bowel disease (IBD) patients not only suffer from colitis but also from increased morbidity and mortality of colitis-associated colorectal cancer (CAC). The enzyme 15-lipoxygenase-1 (15-LOX-1) is crucial to converting omega-3 fatty acid derivatives eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to resolvins, potent anti-inflammatory products. 15-LOX-1 effects on the conversion of EPA and DHA to resolvins that subsequently exert anti-inflammatory and anti-tumorigenic effects have received little attention. To address this knowledge gap, we hypothesize that 15-LOX-1 expression in colonic epithelial cells is essential for resolvin biosynthesis from EPA and DHA to modulate immunophenotype, limit inflammation, promote resolution, and help …

The Development And Evaluation Of Alginate Nanofibers As A Neuroprotective Nano-Scaffold For Amyotrophic Lateral Sclerosis (Als), Julia Bielanin

Chemistry & Biochemistry Undergraduate Honors Theses

Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disorder characterized in pathology by a significant loss of upper and lower motor neurons, leading to muscle wasting and loss of voluntary movement. There are about 6,000-8,000 new cases of ALS diagnosed per year in the U.S., with a fatal outcome within 2 to 4 years (on average) after diagnosis. There are only two FDA approved drugs for treating ALS. Both are very expensive and only have modest benefits for patients. The population is in dire need of more affordable and effective medicine for the treatment of ALS.

Therefore, the goal …

Peptoid And Antibody-Based Gfp Sensors, Solomon Isu

Graduate Theses and Dissertations

In this work, we have made and characterized a pair of immunobiosensors for detecting the green fluorescent protein (GFP) in an aqueous matrix. An anti-GFP antibody-based biosensor was assembled to detect GFP, while a novel peptoid (N-substituted oligomers of glycine designated as IOS-1) biosensor was also assembled for GFP detection. A quartz crystal microbalance (QCM) gold sensor was used as the supporting substrate for self-assembly of the immunobiosensors. Gravimetric measurements of the QCM gold sensor during immunobiosensor construction and operation were available in real-time using a QCM instrument. X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, and Fluorescence microscopy were used …

Transition From Fixed-Dosing To Symptom-Triggered Management Of Alcohol Withdrawal Syndrome In The Intensive Care Unit Of A Community Hospital, Marianela Robainas, Heidi Clarke, Claudia Chang, Frances Ordieres Gonzalez, Lorenzo Porras Jr.

All Publications

Background/Purpose: In the United States, 2 to 7% of heavy alcohol users admitted to the hospital for general medical care will develop severe alcohol withdrawal (AW) requiring treatment. The most dangerous complications of AW are delirium tremens and seizures. Benzodiazepines (BZD) are considered first-line therapy, with varying modality options available to providers. Fixed-dosing has historically been used to manage AW. However, studies suggest that symptom-triggered therapy (STT) can decrease length of stay and BZD duration of therapy. The purpose of this study was to evaluate the current fixed-dose protocol and outline the transition to STT in the intensive care unit …

Characterization Of Novel Cb2 Agonist Smm-295 And Its Effects In Ischemia/Reperfusion Injury, Jeffrey D. Pressly

Theses and Dissertations (ETD)

Acute kidney injury (AKI) is a major problem clinically affecting up to two-thirds of intensive care unit patients, and results in increased hospitalization time, the risk of developing chronic kidney disease, and mortality. Hallmarks of AKI include tubular cell death and a decrease in renal perfusion which leads to decreases in renal function following injury. For 20 years the pathophysiology of AKI has been well established. However, therapies for AKI have shown minimal to no success clinically. The work here describes our efforts to further categorize the effects of CB2 activation, a possible novel therapeutic target in AKI.

There is …

Calcitonin Prescribing Criteria For The Management Of Hypercalcemia In A Community Hospital, Jessica Hernandez, Radhan Gopalani, Heidi Clarke, Joyce Lee, Alyssa Donadio

All Publications

Purpose/Background: Hypercalcemia is a clinical condition in which serum calcium levels exceed the upper limit of normal (>10.5 mg/dL). The most common causes of hypercalcemia are primary hyperparathyroidism and malignancy, however, it can also be caused by vitamin D intoxication, endocrine disorders, and immobilization due to an increase in bone resorption. First-line treatment of hypercalcemia includes hydration with intravenous (IV) normal saline and IV bisphosphonates. Calcitonin (Miacalcin®) is a synthetic hormone with a rapid onset of action and used intramuscularly (IM) or subcutaneously (SQ) as a second-line treatment in the management of hypercalcemia, specifically in severe and in symptomatic …

When Treating Sick Joints Harms Lungs, Ixekizumab Induced Pleural Effusion, Rami Batarseh, Kyle Smith, Mohammed Al-Ourani, Amro K. Al-Astal

Marshall Journal of Medicine

Immunological therapies have provided a multitude of new and effective treatment strategies for various disease states. While monoclonal antibody therapy benefits many patients, side effects are widely variable. here we present a case of pleural effusion complicating psoriatic arthritis treatment.

A Study Of The Antioxidant Versus Pro-Oxidant Nature Of The Amyloid Beta Peptide And An Analysis Of The Natural Products, Isorhamnetin And Narignenin, As Antioxidants, Kaylee Holmes

Honors Theses

Alzheimer’s disease is a neurodegenerative disorder with no cure. Due to the widespread effects of this disease, abundant research efforts have gone towards finding a cure. The amyloid beta (Ab) peptide has been shown to be a potential cause of the disease due to destructive effects on tissues that it can have both by itself and through reactive oxygen species (ROS) generation. This study was performed in order to assess the structural properties of Ab₄₂monomers, fibrils and oligomers, to assess the antioxidant versus pro-oxidant behavior of the Ab peptide, and to assess the antioxidant nature of the natural …

Screening A Library Of Chalcone Derivatives For Antibacterial Properties Via Kirby Bauer Disk Diffusion, Breena Z. Frazier

Undergraduate Theses

As antibiotic resistance emerges stronger than ever, novel antimicrobial compounds are necessary to continue the infectious fight against disease and prevent millions of deaths by multidrug-resistant bacteria. One compound thought to be a natural source of antimicrobial activity is the chalcone. Abundant in fruits and vegetables, chalcones are versatile compounds that are easily synthesized via Claisen-Schmidt condensation and have demonstrated a wide-range of biological activity. Previous studies have found that the addition of a free hydroxyl group to either the A or B ring of the chalcone skeleton may contribute to mild to moderate antimicrobial activity. Halogen substituents, such as …

A Systematic Search And Review On The Efficacy, Safety, And Cost-Effectiveness Of Utilizing Lactobacillus Probiotics In Concurrence With Prescribing Antibiotics To Reduce Clostridium Difficile Infection Rates In Hospitalized Patients, Laura Sheehan

Nursing Masters Papers

Incidence of Clostridium difficile infection, (CDI) in patients receiving antibiotics is significant. In 2017, there were approximately 223,900 cases of CDI in hospitalized patients alone (Center for Disease Control [CDC], 2017). Despite enhanced infection control measures, CDI rates remain prevalent and are associated with increased costs to healthcare. An integrative literature review and synthesis was performed. Studies were analyzed to delineate if Lactobacillus containing probiotics, when administered concurrently with high risk antibiotics, decrease CDI rates for patients in the inpatient hospital setting. Additional analysis of probiotic safety and a cost versus benefit analysis was researched. The purpose of the review …

The Urban/Rural Divide In Access To Medication-Assisted Treatment For Opioid Use Disorder In Utah, Debasree Dasgupta, Erin Fanning Madden, Sandra H. Sulzer, Timothy Light, Michelle Chapoose, Suzanne Prevedel

All Current Publications

Death by drug poisoning is the leading cause of death due to injury in the state of Utah (UDOH, 2014). From 2013-2015, Utah ranked seventh in the nation for drug overdose deaths, the majority of which were opioid-related (CDC, 2018a). In 2017, the age-adjusted mortality rate from drug overdose in Utah was 15.5 per 100,000, putting the state above the national average of 14.9 per 100,000 (CDC, 2018b). Opioid overdose death rates in most of rural Utah far exceeds rates across the urban counties of the state. The higher rates of deaths in rural Utah is indeed concerning. Evidence indicates …