Medical Specialties Commons^™

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

Expanding Awareness Of Tbi Resources In The North Country, Nicholas W. Krant

Family Medicine Clerkship Student Projects

Disability, emotional dysregulation and financial stress are only some of the issues that many patients who suffer TBI encounter. While resources are available to alleviate some of these burdens on patients who suffer TBI in New York's North Country, patients often struggle to find these resources. This project endeavors to create a resource for patients, family members and practitioners to find available resources.

Supra-Additive Effect Of Chronic Inflammation And Atherogenic Dyslipidemia On Developing Type 2 Diabetes Among Young Adults: A Prospective Cohort Study, Yulong Lan, Dan Wu, Zhiwei Cai, Yuancheng Xu, Xiong Ding, Weiqiang Wu, Shaocong Lan, Lan Chen, Zheng Guo, Lois Balmer, Xingang Li, Manshu Song, Shouling Wu, Jingli Gao, Wei Wang, Youren Chen

Research outputs 2022 to 2026

Background: Both elevated inflammation and atherogenic dyslipidemia are prominent in young-onset diabetes and are increasingly identified as biologically intertwined processes that contribute to diabetogenesis. We aimed to investigate the age-specific risks of type 2 diabetes (T2D) upon concomitant chronic inflammation and atherogenic dyslipidemia. Methods: Age-stratified Cox regression analysis of the risk of incident diabetes upon co-exposure to time-averaged cumulative high-sensitivity C-reactive protein (CumCRP) and atherogenic index of plasma (CumAIP) among 42,925 nondiabetic participants from a real-world, prospective cohort (Kailuan Study). Results: During a median 6.41 years of follow-up, 3987 T2D developed. Isolated CumAIP and CumCRP were significantly associated with incident …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

The Mindfulness Minute For Caregiver Wellbeing, Veronica Silva, Trisha Saul

Articles, Abstracts, and Reports

Purpose {What): Research has shown a correlation between stress and job burnout. The Minute Project was developed as a simple tool for caregivers to reduce stress. Our intention is that when stress is reduced, burnout will also be reduced. This tool can be used anytime throughout the day to help our caregivers. Significance {Why): The wellbeing of caregivers in a hospital setting have been challenged over the past 2-3 years. Research has shown that mindfulness practices have an impact on stress levels by activating the parasympathetic nervous system. Given the limited education resources, we felt that addressing the stress levels …

Triple Inhaler Therapy In Adolescents And Adults With Moderate And Severe Persistent Asthma, Mark S. L'Eplattenier

Graduate Dissertations and Theses

Expert guidelines, metanalysis, and multiple randomized controlled trials have demonstrated the effectiveness of long-acting inhaled antimuscarinic agents (LAMA) as an additive medication in poorly controlled moderate and severe persistent asthma. LAMAs play an essential role in blocking acetylcholine binding to muscarinic receptors and reducing bronchoconstriction and mucous production. By adding this medication to other combination inhalers - long-acting beta-agonists (LABA) and inhaled corticosteroids (ICS), patients can utilize a triple inhaler to improve FEV_¹ values and decrease exacerbations. Current treatment guidelines allow clinicians to develop more personalized treatment plans for their asthmatic patients.

Comparative Retrospective Study Of Proton Arc Planning With Elsa Algorithm And Impt With Monte Carlo Algorithm With Raystation Treatment Planning System, Matthew L. Carpenter Ms, Msha, Bsrt(R)(T)

Culminating Experience Projects

Proton arc therapy (PAT) will become widely available soon. It is crucial to determine if this technique and the associated calculation algorithms provided by treatment planning system vendors compete favorably with established proton therapy techniques like intensity modulated proton therapy (IMPT) and the Monte Carlo dose calculation algorithm used to compute IMPT doses in today’s clinic. RaySearch Laboratories have produced a modified Monte Carlo algorithm called ELSA.

ELSA stands for early layer spot assignment and is RaySearch Laboratories proposed solution to reduce optimization time during treatment planning for PAT. This research study will look at proton plan robustness to determine …

Heart Failure Burden In Oman As A Mid-East Exemplar Versus Global Perspectives: An Integrative Review, Maryam Alharrasi, Chandrani Isac, Joy Kabasindi Kamanyire

Journal of the Saudi Heart Association

Heart failure (HF), a clinical syndrome caused by a structural and functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and pulmonary congestion. This study intends to investigate the state of heart failure (HF) in Oman and assess it in comparison of global trends. Ten published literatures from the past 20 years were included after a thorough search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar). These studies were reviewed considering the global literature. We have observed an increase in HF cases especially in older adults, over the past two decades in Oman. Acute coronary syndrome …

A Pre-Medical Student’S Reconciliation Of Feminist Narratives Regarding Women’S Health: A Consideration Of Perspectives On Childbirth In The U.S., Laura Clayton

sprinkle: an undergraduate journal of feminist and queer studies

Many feminists argue that one major negative aspect of reproductive healthcare in the U.S. is the common over-medicalization of women during childbirth, including potentially unnecessary procedures such as cesarean-section and episiotomy. As a solution, they advocate for increased involvement of midwives in childbirth practices, as midwives allow women to give birth at home with minimal medical intervention. This paper analyzes the benefits of midwifery as well as the current increased risk associated with homebirth in the U.S. Additionally, it questions the damaging stigma associated with assumptions of cesarean-section as a suboptimal outcome. A false dichotomy has developed in our culture …

The Col27a1 And Col11a1 Gene Variants Are Not Associated With The Susceptibility To Anterior Cruciate Ligament Rupture In Polish Athletes, Zhuo Sun, Aleksandra Bojarczuk, Pawel Cieszczyk

Baltic Journal of Health and Physical Activity

Introduction: Sports injuries are the most common cause of anterior cruciate ligament (ACL) ruptures. Previous research has demonstrated links between some of the COL27A1 and COL11A1 genetic variants and musculoskeletal soft tissue injuries. However, no previous research has investigated the COL27A1 rs1570460 and the COL11A1 rs3753841 in the context of ACL rupture in any population. Thus, our study aimed to assess the association between specific single nucleotide polymorphisms (SNPs), i.e., COL27A1 rs946053 and COL11A1 rs3753841, and the occurrence of ACL injury (ACL-I) in a cohort of Polish athletes. Methods: The study enrolled 233 athletes with ACL-I (161 males and …

The Prevention And Cardiac Rehabilitation Group Of The Saudi Heart Association Recommendations Regarding Establishing A Cardiac Rehabilitation Service, Abdulhalim Jamal Kinsara, Raghdah Aljehani, Jadwiga Wolszakiewicz, Adam Staron, Muteb A. Alsulaimy

Journal of the Saudi Heart Association

Cardiac rehabilitation (CR) is a cornerstone in the secondary prevention of cardiovascular disease (CVD). Comprehensive cardiac rehabilitation has obtained the highest class of recommendation and the level of evidence for the treatment of patients with ST-segment elevation myocardial infarction, after myocardial revascularization, with chronic coronary syndromes, and in patients with heart failure (HF). Comprehensive cardiac rehabilitation should be implemented as soon as possible, be multi-phasic, and adjusted to the individual needs of the patient. CR is still suboptimally used, and many cardiac centers do not have such services (2). The provision of CR services should be based on standards and …

Biliary Dyskinesia In Stiff Person Syndrome: An Association Between Reduced Gaba Production And Gastroenteric Dysmotility, Scarlet Louis-Jean, Nirav Agrawal, Shire Chaudhry, Adrien Mazer

Journal of Community Hospital Internal Medicine Perspectives

Stiff person syndrome (SPS) and biliary dyskinesia are two rare but potentially debilitating conditions that can significantly impact quality of life. SPS is a rare neurological disorder characterized by muscle stiffness, rigidity, and muscle spasms that primarily affect the trunk and limbs and is associated with extra-axial manifestations involving the gastrointestinal tract. Biliary dyskinesia is a gastrointestinal disorder characterized by abnormal gallbladder emptying, leading to symptoms of intense abdominal pain, nausea, and vomiting. Despite their distinct clinical presentations, studies have suggested a possible connection between the two disorders. This link may be due to involvement of similar neurotransmitters and autoantibodies …

Rhino-Cerebral Aspergillosis In An Immunocompetent Patient, Jisun Won, Carolina Severiche Mena, Joseph Glowacki, Dimple Patel

Journal of Community Hospital Internal Medicine Perspectives

Rhino-cerebral aspergillosis is a rare phenomenon describing a contiguous spread of Aspergillus species from the paranasal sinuses to the intracranial space. In this case report, we describe a case of invasive rhino-cerebral aspergillosis arising in the setting of prolonged intranasal steroid use in an 81-year-old patient with chronic sinusitis. This case report emphasizes the importance of recognizing steroid use as a risk factor for invasive aspergillosis in otherwise immunocompetent individuals.

Prevalence Of Depression In Patients With Hematologic Diseases In Marrakesh, Morocco: A Single Center Experience, Fatima Zahra Lahlimi, Oumaima Maghnouj, Khawla Khalil, Safaa Chaabane, Illias Tazi

Journal of Community Hospital Internal Medicine Perspectives

Depression in patients with cancer influences negatively their physical symptoms, treatment success, coping, and their quality of life, and it is associated with increased mortality. Reported prevalence of emotional distress in patients followed in hematology varies widely across studies. The present study aimed to investigate the prevalence of depression, and to explore the possible associated factors in patients followed in a hematological department Method: in this descriptive cross-sectional study among patients admitted to the hematology department in the University Hospital Mohammed VI of Marrakech, between August 2020 and December 2020, depression symptoms were assessed using Mini International Neuropsychiatric Interview test …

Treatment Of Knee Synovitis From Psoriatic Arthritis With Platelet Rich Plasma Injection, Nicolle Mazzei, Arielle Hall, Cody Clinton

Cooper Rowan Medical Journal

Psoriatic arthritis has been known to cause many inflammatory clinical features, including synovitis. In the past, synovitis has been primarily treated with NSAIDs, corticosteroid injections, and synovectomy when needed. This case report outlines a 49-year-old female with synovitis caused by psoriatic arthritis who did not respond to conventional treatment options and was apprehensive to surgery. She was offered a platelet rich plasma (PRP) injection as alternative therapy to a synovectomy. This case explores the use of PRP injections as a potential treatment modality for patients with synovitis caused by psoriatic arthritis. This patient was able to show improvement in her …

Equity And Inclusion In Pediatric Gastroenterology Telehealth: A Study Of Demographic, Socioeconomic, And Digital Disparities., Edward B. Mougey, Wesley C. Judy, Rajitha D. Venkatesh, Elizabeth Berg, Jennifer A. Lee, John Rosen, B U K Li, Alex Koster, Kristin Maiden, Zhongcui Gao, James P. Franciosi

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of our study is to compare in-person and telehealth pediatric care ambulatory visits for gastroenterology (GI) at the Nemours Children's Health System in the Delaware Valley (NCH-DV) based on geospatial, demographic, socioeconomic, and digital disparities.

METHODS: Characteristics of 26,565 patient encounters from January 2019 to December 2020 were analyzed. U.S. Census Bureau geographic identifiers were assigned to each participant and aligned with the American Community Survey (2015-2019) socioeconomic and digital outcomes. Reported odds ratios (OR) are telehealth encounter/in-person encounter.

RESULTS: GI telehealth usage increased 145-fold in 2020 compared to 2019 for NCH-DV. Comparing telehealth to in-person usage …

A Recommended Preclinical Extracorporeal Cardiopulmonary Resuscitation Model For Neurological Outcomes: A Scoping Review, Jin Kook Kang, Andrew Kalra, Syed A. Ahmad, Arjun K. Menta, Hannah J. Rando, Ifeanyi Chinedozi, Marcus Spann, Steven P. Keller, Glenn J.R. Whitman, Sung-Min Cho

Rothman Institute Faculty Papers

Background: Despite the high prevalence of neurological complications and mortality associated with extracorporeal cardiopulmonary resuscitation (ECPR), neurologically-focused animal models are scarce. Our objective is to review current ECPR models investigating neurological outcomes and identify key elements for a recommended model.

Methods: We searched PubMed and four other engines for animal ECPR studies examining neurological outcomes. Inclusion criteria were: animals experiencing cardiac arrest, ECPR/ECMO interventions, comparisons of short versus long cardiac arrest times, and neurological outcomes.

Results: Among 20 identified ECPR animal studies (n = 442), 13 pigs, 4 dogs, and 3 rats were used. Only 10% (2/20) included both sexes. …

Kneiffiella Palmae: A Non-Aspergillus Fungal Infection Isolated From A Pulmonary Nodule In A Child With Chronic Granulomatous Disease, Bianca E. Ituarte, Connie Canete-Gibas, Nathan P. Wiederhold, Liset Olarte

Manuscripts, Articles, Book Chapters and Other Papers

We report the first known human case of Kneiffiella palmae in the medical literature. K. palmae was isolated from a pulmonary nodule in a 7-year-old male with chronic granulomatous disease. The mold was identified as K. palmae at a national reference laboratory, where 17 other human respiratory samples tested positive for K. palmae from 2013 to 2021. Optimal antimicrobial treatment is unknown, but azoles and amphotericin B demonstrated in vitro activity against each tested isolate.

Contraceptive Counseling For Adolescents In The Emergency Department: A Novel Curriculum For Nurse Practitioners And Physician Assistants., Laurel S. Gabler, Michelle Shankar, Tara Ketterer, Jennifer Molnar, Amber Adams, Jungwon Min, Elizabeth Miller, Romina Barral, Aletha Akers, Melissa K. Miller, Cynthia Mollen

Manuscripts, Articles, Book Chapters and Other Papers

Many adolescents use the emergency department (ED) as their primary source of health care. As a result, the ED serves as a unique opportunity to reach adolescents. Although many adolescent visits to the ED are related to reproductive health, ED providers report barriers to providing this care, including lack of training. Nurse practitioners (NPs) and physician assistants (PAs) serve a vital role in the provision of consistent care to adolescents in the ED. The purpose of this study was to create a curriculum to train NPs and PAs at two pediatric institutions to provide patient-centered contraceptive counseling to adolescents in …

Hla-Ii Alleles Influence Physical And Behavioral Responses To A Whey Allergen In A Transgenic Mouse Model Of Cow's Milk Allergy, Danielle L. Germundson, Suba Nookala, Nicholas A. Smith, Yassmine Warda, Kumi Nagamoto-Combs

Biomedical Sciences Faculty Publications

The symptoms of food allergies vary significantly between individuals, likely due to genetic determinants. In humans, allergy development is initiated by antigen-presenting cells via class II human leukocyte antigen (HLA-II). The HLA-II gene is highly polymorphic, and its allelic variance is thought to influence the susceptibility of individuals to a particular allergen. However, whether antigen presentation by different HLA-II variants contributes to symptom variation is not clear. We hypothesized that HLA-II allelic variance affects symptom phenotypes, including immediate physical reactions and delayed behavioral changes, in individuals with food hypersensitivity. To test our hypothesis, male and female mice of three transgenic …