Medical Physiology Commons^™

Point Of Care Ultrasound For Gastric Residual: An Objective Structured Clinical Examination, Brandon Quinn, Kaitlyn Gray

Doctoral Projects

Point of care ultrasound (POCUS) has become an invaluable tool in modern medical practice offering real-time diagnostic and procedural guidance for anesthesia providers. POCUS is a non-invasive assessment tool that gives anesthesia insight into a quantitative assessment of gastric residuals. Furthermore, POCUS assessments are useful in preventing anesthetic complications that can cause major morbidity and mortality such as aspiration pneumonia. Despite the growing relevance, formalized training on POCUS for assessing gastric residuals remains limited in many nurse anesthesia programs. The University of Southern Mississippi currently lacks a standardized curriculum for teaching student registered nurse anesthetists how to utilize gastric ultrasound …

Plasma Resuscitation Attenuates Hemorrhage-Induced Glomerular Barrier Damage And Dysfunction., William Byron Risinger

Electronic Theses and Dissertations

Introduction: Acute renal dysfunction following traumatic injury and hemorrhagic shock carries significant morbidity and mortality. Despite an extensive understanding of renal tubule damage after injury, less is known regarding early alterations to the glomerular filtration barrier following hemorrhagic shock and resuscitation. Previously, our lab and others have demonstrated improved hepatic and intestinal microcirculatory parameters when resuscitation strategies incorporate fresh frozen plasma. In addition to improving end-organ perfusion, plasma reconstitutes the endothelial glycocalyx, an essential regulator of vascular permeability and microcirculatory function. However, the impact of plasma resuscitation on the glomerular glycocalyx and barrier following hemorrhage remains unknown. We hypothesized …

Physiology And Genomics At The Bottom Of The World: Genome To Phenome, Amy Christine Klink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Mammals are exposed to a suite of physiological challenges based on the environment in which they inhabit. Animal individuals can overcome challenges associated with the dynamic nature of their habitat through variation in phenotypic traits. The plasticity of a phenotype relies on an individual’s genome and the transcription factors that act on regulatory elements. Species living in Antarctica display physiological specializations to withstand harsh conditions, such as severe cold temperatures, shifts in available ice habitat, and annual fluctuations in daylight. To explore the connections between an individual’s genome and its phenotype, we investigated two physiologies of the Antarctic Weddell seal …

Bilateral Popliteal Entrapment Syndrome: A Rare And Challenging Case Report, Jose Burgos, Gabriela Llerena, Spencer Rheingold, Jorge De La Portilla

HCA-NSU MD Research Day

Bilateral Popliteal Entrapment Syndrome: A Rare and Challenging Case Report Burgos, Jose Julian, MD, MDIV, HCA Florida Kendall Department of Vascular Surgery Miami, Florida. Llerena, Gabriela2, OMSIV, Nova Southeastern University Dr. Kiran Patel College of Osteopathic Medicine. Rheingold, Spencer, MSIV, Nova Southeastern University Dr. Kiran Patel College of Allopathic Medicine. De La Portilla, Jorge MD, assistant professor, HCA Florida Kendall Department of Vascular Surgery Miami, Florida1 Objective: This case describes an atypical presentation of PES in an older male patient who presented with a sudden onset of symptoms without a history of claudication. Background: Popliteal entrapment syndrome (PES) is a …

Nosebleed No More: Recognizing And Diagnosing Factor Viii Inhibitor, Salam Harb, Leidy Huie Martinez Md, Jose Alvarado Md, Ajit Koli Do, Hazem Nasef Ms4

HCA-NSU MD Research Day

Acquired hemophilia is a condition characterized by the unexpected onset of severe bleeding due to an issue with coagulation factors. Typically, this disorder results from the production of autoantibodies against the Factor VIII coagulation factor. Although acquired hemophilia is an extremely rare condition, with an annual incidence of just 1.5 cases per million, it is crucial to recognize and understand it. This is because diagnosing this disorder is intricate, and if left undiagnosed and untreated, it can lead to high levels of morbidity and mortality. This case stands out as the condition typically targets older adults, with around 80% of …

Industrial Explosion Survival After Presenting To A Rural Hospital: A Case Report, Carol L. Wright Becker, Roger Tillotson, William Krantz, Brad End, Stephanie Rellick, Emily Nutter

Marshall Journal of Medicine

Explosions can lead to numerous injuries.¹ Studies show that trauma mortality increases by 14% when patients are treated at rural hospitals compared to non-rural facilities.² A 43-year-old male arrived at a rural hospital with injuries from an explosion, where only a single board-certified emergency physician was on duty. The patient's polytrauma was severe, resulting in bilateral orbital compartment syndrome and Cushing's triad. Remarkably, he survived these extensive injuries. Despite the limitations of rural healthcare, such as restricted equipment, medications, and longer transfer times, rural emergency physicians should remain optimistic and help guide future management. This high-acuity, low-frequency trauma …

Genetically Conditioned Interaction Among Microrna-155, Alpha-Klotho, And Intra-Renal Ras In Male Rats: Link To Ckd Progression, Lisa M. Harrison-Bernard, L. Raij, R. X. Tian, E. A. Jaimes

School of Graduate Studies Faculty Publications

Incident chronic kidney disease (CKD) varies in populations with hypertension of similar severity. Proteinuria promotes CKD progression in part due to activation of plasminogen to plasmin in the podocytes, resulting in oxidative stress-mediated injury. Additional mechanisms include deficiency of renal alpha-klotho, that inhibits Wnt/beta-catenin, an up regulator of intra-renal renin angiotensin system (RAS) genes. Alpha-klotho deficiency therefore results in upregulation of the intra-renal RAS via Wnt/beta-catenin. In hypertensive, Dahl salt sensitive (DS) and spontaneously hypertensive rats (SHR), we investigated renal and vascular injury, miR-155, AT1R, alpha-klotho, and TNF-α. Hypertensive high salt DS (DS-HS), but not SHR developed proteinuria, plasminuria, and …

Aging Skeletal Muscle: Influence Of Obesity And Role Of The Exercise Responsive Nuclear Receptor Nor-1, Hector G. Paez

Alternative Theses and Dissertations (AETDs)

Skeletal muscle mass and function are critical components of overall health and quality of life. Advanced age is associated with skeletal muscle disease characterized by a loss of muscle mass, function, and quality. Indeed, low muscle mass and function is associated with poor disease outcomes and greater mortality, greater incidence of falls, and a high fiscal and societal cost. Aging contributes to a decline in skeletal muscle health through several intrinsic and extrinsic mechanisms including impaired nutrient sensing, mitochondrial dysfunction, inflammation, physical inactivity, and proteostatic imbalance. Obesity, an increasingly prominent public health concern, is becoming more common in the elderly …

Unveiling The Impact Of Phosphate On Skeletal Muscle Dysfunction In Chronic Kidney Disease, Hiram Garcia, Sowmya Duddu, Erik Hinojosa, Model Zerfu, Nathaniel L. Alvarez, Mohammad Razzaque, Alex Zuo

Research Colloquium

Background: Chronic Kidney Disease (CKD) is characterized by progressive decline in renal function that ultimately culminates in the inability of the kidneys to effectively maintain homeostasis. The kidneys are a key regulator of phosphate, with other organs assisting in regulation including the skeletal system. In CKD, reduced kidney function leads to hyperphosphatemia. While its impact on the skeletal system is moderately studied, its effects on skeletal muscle are less reviewed. In our literature review, we aim to describe the effects of phosphate in the context of patients who have CKD while providing clinical context for this deserving population. We describe …

Hydroxyurea In The Sickle Cell Disease Modern Era, Chazmyn Riley, Walter K. Kraft, Robin Miller

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

INTRODUCTION: Sickle cell disease is an inherited disorder characterized by hemoglobin S polymerization leading to vaso-occlusion and hemolytic anemia. These result in a variety of pathological events, causing both acute and chronic complications. Millions around the world are affected by sickle cell disease with predominance in sub-Saharan Africa. Hydroxyurea was the first drug approved for use in sickle cell disease to reduce the occurrence of painful crises and blood transfusions in patients with frequent, moderate to severe painful crises.

AREAS COVERED: With the development of new therapeutics, the role of hydroxyurea is evolving. This narrative review aims to provide clinical …

Preventive Effects Of Quercetin On The Leaky Gut By Suppression Of Il-1beta-Induced Transcription Factors Involved In An Inflammatory Pathway In Colonic Epithelial Cells, Wannaporn Chayalak, Sumpun Thammacharoen, Chatsri Deachapunya, Sutthasinee Poonyachoti

The Thai Journal of Veterinary Medicine

Flavonol quercetin (Q), found in vegetables and fruits, demonstrates the most potent anti-inflammatory effect. The preventive effect and cellular mechanisms of Q (Q1, Q10, and Q100 µM) on IL-1β induced leaky gut via the signaling molecules of inflammatory pathway, NF-κB p65-iκB/or p38/ERK1/2/MLCK/phospho(p)-MLC were investigated in Caco-2 cells. The cytotoxic effect of Q was initially determined by MTT assay. Transepithelial electrical resistance (TER) and apical-to-basolateral fluorescein isothiocyanate-labeled dextran (FD-4) flux were used to determine paracellular permeability. The protein expression of signaling molecules was examined by Western blot analysis, and their target MLCK mRNA expression was determined using real-time PCR. All Q …

Epigenetic Mechanisms Differentially Regulate Blood Pressure And Renal Dysfunction In Male And Female Npr1 Haplotype Mice, Prerna Kumar, Kandasamy Neelamegam, Chandramohan Ramasamy, Ramachandran Samivel, Huijing Xia, Daniel R. Kapusta, Kailash N. Pandey

School of Graduate Studies Faculty Publications

We determined the epigenetic mechanisms regulating mean arterial pressure (MAP) and renal dysfunction in guanylyl cyclase/natriuretic peptide receptor-A (GC-A/NPRA) gene-targeted mice. The Npr1 (encoding NPRA) gene-targeted mice were treated with class 1 specific histone deacetylase inhibitor (HDACi) mocetinostat (MGCD) to determine the epigenetic changes in a sex-specific manner. Adult male and female Npr1 haplotype (1-copy; Npr1+/−), wild-type (2-copy; Npr1+/+), and gene-duplicated heterozygous (3-copy; Npr1++/+) mice were intraperitoneally injected with MGCD (2 mg/kg) for 14 days. BP, renal function, histopathology, and epigenetic changes were measured. One-copy male mice showed significantly increased MAP, renal dysfunction, and fibrosis than 2-copy and 3-copy mice. …

Caffeine Trends And Optimal Intake Systematic Review, Mark Byaliy

Theses and Graduate Projects

Background: Caffeine is the world’s most consumed psychoactive stimulant, with many different sources. Many individuals drink caffeine for the wakefulness effect, but there are many secondary effects that might be unknown to most consumers.

Purpose: This review explores the trends in caffeine consumption, how our bodies process caffeine, the potential benefits and adverse effects of caffeine, and the health benefits associated with natural sources. It also examines the ingredients found in energy drinks, such as vitamin B complexes and taurine.

Methods: A literature review was conducted using Augsburg Lindell Library, NIH National Library of Medicine, and Google Scholar. Using the …

Novel Mechanisms For The Neural Control Of Breathing In Acute Lung Injury, Kajal Kamra

Theses & Dissertations

Acute lung injury (ALI) triggers inflammation that disrupts the normal alveolar-capillary endothelial barrier, impairing gas exchange and causing hypoxemia, which reflexively increases respiration. An elevated respiratory rate (fR) usually develops within hours to days following ALI. This acute respiratory failure disorder affects approximately 200,000 new cases annually in the US and accounts for 10% of ICU admissions, with high morbidity and mortality. The neural mechanisms underlying respiratory dysfunction post-ALI are not fully understood. My doctoral dissertation aimed to investigate the mediators of abnormal ventilation during ALI. Systemic hypoxia stimulates the carotid body (CB) chemoreflex, a crucial protective reflex that maintains …

Podocyte Cell-Specific Npr1 Is Required For Blood Pressure And Renal Homeostasis In Male And Female Mice: Role Of Sex-Specific Differences, Chandramohan Ramasamy, Kandasamy Neelamegam, Samivel Ramachandran, Huijing Xia, Daniel R. Kapusta, Farhad R. Danesh, Kailash N. Pandey

School of Graduate Studies Faculty Publications

Atrial and brain natriuretic peptides (ANP and BNP) bind to guanylyl cyclase A/natriuretic peptide receptor A (GC-A/NPRA), stimulating natriuresis and diuresis and reducing blood pressure (BP), but the role of ANP/NPRA signaling in podocytes (highly specialized epithelial cells covering the outer surfaces of renal glomerular capillaries) remains unclear. This study aimed to determine the effect of conditional deletion of podocyte-specific Npr1 (encoding NPRA) gene knockout (KO) in male and female mice. Tamoxifen-treated wild-type control (PD Npr1 f/f; WT), heterozygous (PD-Cre-Npr1 f/+; HT), and KO (PD-Cre-Npr1 f/-) mice were fed a normal-, low-, or high-salt diet for 4 wk. Podocytes isolated …

Standardized Patient Evaluation Tool: A Valid Measure Of The Core Competencies, Lindsey E. Eberman, Jessica Edler Nye

Clinical Practice in Athletic Training

No abstract provided.

The Value Of Using Validated Competency-Based Assessments Across The Career Span Of An Athletic Trainer, Matthew Drescher, Lindsey Eberman

Clinical Practice in Athletic Training

No abstract provided.

The Development, Implementation, And Value Of The Athletic Training Milestones For Assessing Progressive Clinical Behaviors, Hollie Walusz, Eric Sauers, Mark Laursen, Forrest Pecha

Clinical Practice in Athletic Training

No abstract provided.

Perceptions And Use Of The Athletic Training Milestones In Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie L. Van Lunen, Lindsey E. Eberman

Clinical Practice in Athletic Training

The Athletic Training Milestones (AT Milestones) were developed as an evaluation tool to capture the breadth and depth of athletic training knowledge, skills, and behavior. However, it is unclear whether athletic training programs are implementing this tool or how they are implementing it to gauge the clinical progression of students or residents in athletic training. We aimed to explore the perceptions and use of the AT Milestones among educators in athletic training programs. We used a cross-sectional, web- based survey with open-ended questions to collect data from athletic training programs on if and how they implement the AT Milestones at …

Adjunctive Therapy With An Oral H2s Donor Provides Additional Therapeutic Benefit Beyond Sglt2 Inhibition In Cardiometabolic Heart Failure With Preserved Ejection Fraction, Jake E. Doiron, Huijing Xia, Xiaoman Yu, Alexandra R. Nevins, Kyle B. Lapenna, Thomas E. Sharp, Traci T. Goodchild, Timothy D. Allerton, Mona Elgazzaz, Eric Lazartigues, Sanjiv J. Shah, Zhen Li, David J. Lefer

School of Graduate Studies Faculty Publications

Background and Purpose: Sodium glucose cotransporter 2 inhibitors (SGLT2i) have emerged as a potent therapy for heart failure with preserved ejection fraction (HFpEF). Hydrogen sulphide (H2S), a well-studied cardioprotective agent, could be beneficial in HFpEF. SGLT2i monotherapy and combination therapy involving an SGLT2i and H2S donor in two preclinical models of cardiometabolic HFpEF was investigated. Experimental Approach: Nine-week-old C57BL/6N mice received L-NAME and a 60% high fat diet for five weeks. Mice were then randomized to either control, SGLT2i monotherapy or SGLT2i and H2S donor, SG1002, for five additional weeks. Ten-week-old ZSF1 obese rats were randomized to control, SGLT2i or …