Student Publications and Research - MUCOM

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1. 6-MERCAPTOPURINE FOR SEVERE ATOPIC DERMATITIS INA LACTOSE-ALLERGIC CHILD

Title Tesim:
6-MERCAPTOPURINE FOR SEVERE ATOPIC DERMATITIS INA LACTOSE-ALLERGIC CHILD
Creator:
Zarkhin, Sonya
Related Url Tesim:
http://onlinelibrary.wiley.com/doi/10.1111/pde.13196/full
Description:
6-MERCAPTOPURINE FOR SEVERE ATOPIC DERMATITIS IN A LACTOSE-ALLERGIC CHILD Pediatric atopic dermatitis (AD) is encountered routinely in the gen- eral dermatology clinic, and most children with AD have readily- manageable mild to moderate disease. For severe AD that is resis- tant to topical corticosteroids and calcineurin inhibitors, the use of several steroid-sparing agents has been described in the literature, including cyclosporine, mycophenolate mofetil, methotrexate, and azathioprine. Herein we report what is to our knowledge the first use of 6-mercaptopurine (6MP) for pediatric AD. The patient was a 13-year-old boy with a long-standing history of severe atopic dermatitis. Previous treatments with topical corticos- teroids and heavy emollients were unsuccessful. The patient’s med- ical history was complicated by persistent asthma, food allergies, massively elevated IgE, and adrenal insufficiency related to chronic use of inhaled corticosteroids. Azathioprine and omalizumab were the main considerations for long term steroid-sparing agents, how- ever it was ultimately decided that the IgE levels were too high to safely proceed with omalizumab. Given his numerous food aller- gies, the composition of commercially available azathioprine was carefully reviewed and all were found to contain lactose. However, 6MP was determined not to contain lactose and was initiated. 6MP is the active metabolite of azathioprine. While originally approved for the induction and maintenance of acute lymphoblastic leukemia, 6MP has also been used for Crohns disease and ulcera- tive colitis. We followed the previously published dosing protocols for pediatric Crohns disease after checking baseline labwork, including thiopurine methyltransferase enzyme activity. The patient has tolerated the 6MP well and has maintained a significant reduc- tion of AD severity after an initial course of cyclosporine. This is therefore the first documented case of using 6MP as a lac- tose-free steroid sparing agent for the treatment of severe pediatric AD.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Type:
Poster
Keyword:
6-mercaptopurine (6MP) and Pediatric atopic dermatitis (AD)
Date Created:
6-16-2017

2. A unique variation of the jugular veins and its clinical significance

Title Tesim:
A unique variation of the jugular veins and its clinical significance
Creator:
Young, McKenzie, Zavitsky, Alexis, Niceley, Jillian, Battiston, Gabriella, and Sakthi-Velavan, Sumathilatha
Related Url Tesim:
Available from the publisher: https://journals.viamedica.pl/folia_morphologica/article/view/98618, Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/10160142074, and Available via PubMed: https://pubmed.ncbi.nlm.nih.gov/38390747/
Description:
The authors report a rare variation of the anterior jugular and internal jugular veins in a 78-year-old male donor. An enlarged and curved left anterior jugular vein (AJV) was formed as the continuation of the left common facial vein (CFV). The left AJV's diameter was wider than the internal jugular vein (IJV) and measured around 5 mm greater than the IJV's diameter and a channel connected the two veins. The right AJV and CFV continued from the two divisions of the right facial vein. The right AJV's diameter was smaller than the right IJV's diameter. The right external jugular vein was absent. No concurrent pathology supported the abnormal dimension of the left AJV and the findings were indicative of a variant anatomy. These variations have rarely been reported and have important clinical correlations. Failed IJV cannulation may result if the variant neck veins are missed. However, variant veins may serve as collateral channels and patch material in IJV reconstruction, carotid angioplasty, and ventricular-jugular shunts.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
Via Medica and Polish Anatomical Society
Identifier:
PMID: 38390747 and DOI: 10.5603/fm.98618
Type:
Article
Keyword:
anatomical variation, bilateral variation, catheterization, communicating vein, jugular veins, and venous anastomoses
Date Created:
2024

3. Accessibility of ethics education and the formation of Catholic healthcare providers

Title Tesim:
Accessibility of ethics education and the formation of Catholic healthcare providers
Creator:
Purzycka, Anna
Related Url Tesim:
Poster abstracts also found at the following URL: https://www.tandfonline.com/doi/pdf/10.1080/00243639.2016.1159900?needAccess=true&
Description:
Specifically in the medical field, Catholic providers rarely receive extensive education regarding the applications of moral theology to their work. Those knowledgeable on the topic have often gone to great lengths to acquire such formation. Both crises have a direct impact on the medical field as tensions rise between demands within the profession and providers’ beliefs.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Identifier:
https://doi.org/10.1080/00243639.2016.1159900
Type:
Article
Keyword:
Undergraduate Medical Education, Medical School, and Ethics
Date Created:
1/1/2016

4. Addressing Motivations and Barriers to Research Involvement during Medical School among Osteopathic Medical Students in the United States

Title Tesim:
Addressing Motivations and Barriers to Research Involvement during Medical School among Osteopathic Medical Students in the United States
Creator:
Zahl, Sarah, Hum, Julia M., Jackson, Krista L., Griffin, Nicole, Lowery, Jonathan W., Nick, Benjamin, Herber, Jake, Hamby, T., Baumann, Michael, and Ogunbekun, Oladipupo
Related Url Tesim:
Available from the publlisher: https://www.mdpi.com/2227-7102/12/6/407 and Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/9532526413
Description:
Involvement in research is regarded as a high-impact educational practice, which, for medical professionals, is associated with sharpened critical thinking and life-long learning skills, greater appreciation for evidence-based medicine, and better clinical competence scores. However, there are limited data regarding the research experience and/or interest among osteopathic medical students in the United States despite a rapidly increasing enrollment and expansion of the number of osteopathic medical schools. Thus, we administered an electronic survey examining prior research experience, interests, and perceptions about research participation during medical school to four successive classes of incoming first-year osteopathic medical students. We also performed focus groups with rising third-year osteopathic medical students around the topic of perceived barriers to and potential enablers of promoting research participation. This yielded a survey addendum where first-year osteopathic medical students provided feedback on the likelihood of specific incentives/enablers to encourage participation in research during medical school. Overall, osteopathic medical students are interested in research, view research experience as valuable, and perceive research experience as beneficial to future career development. Students perceive that the primary barrier to involvement in research is a potential negative impact upon performance in coursework. Feedback on the likelihood of specific enablers/incentives was also garnered. Our findings from a single institution may have important implications in defining the prior experiences and perceptions held by first-year osteopathic medical students. Specifically, our study indicates that research experiences intentionally designed with (1) a strong likelihood of gaining a publication, (2) financial compensation, and (3) the opportunity for short-term involvement, a flexible time commitment, and/or a dedicated time period are most likely to encourage research participation by osteopathic medical students.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
MDPI
Identifier:
DOI: https://doi.org/10.3390/educsci12060407
Type:
Article
Keyword:
incentive, barrier, osteopathic medical school, undergraduate medical education, and focus groups
Date Created:
2022

5. Anatomical review of internal jugular vein cannulation

Title Tesim:
Anatomical review of internal jugular vein cannulation
Creator:
Kosnik, Natalie, Kowalski, Taylor, Lorenz, Lorraine, Valacer, Mercedes, and Sakthi-Velavan, Sumathilatha
Related Url Tesim:
Available from PubMed: https://pubmed.ncbi.nlm.nih.gov/36794685/, Available from the publisher: https://journals.viamedica.pl/folia_morphologica/article/view/93047, and Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/9772374662
Description:
The internal jugular veins (IJV) are the primary venous outflow channels of the head and neck. The IJV is of clinical interest since it is often used for central venous access. This literature aims at presenting an overview of the anatomical variations, morphometrics based on various imaging modalities, cadaveric and surgical findings, and the clinical anatomy of IJV cannulation. Additionally, the anatomical basis of complications, techniques to avoid complications, and cannulation in special instances are also included in the review. The review was performed by a detailed literature search and review of relevant articles. A total of 141 articles were included and organized into anatomical variations, morphometrics, and clinical anatomy of IJV cannulation. The IJV is next to important structures such as the arteries, nerve plexus, and pleura, which puts them at risk of injury during cannulation. Anatomical variations such as duplications, fenestrations, agenesis, tributaries, and valves, may lead to an increased failure rate and complications during the procedure, if unnoticed. The morphometrics of IJV, such as the cross-sectional area (CSA), diameter, and distance from the skin-to-cavo-atrial junction may assist in choosing the appropriate cannulation techniques and hence reduce the incidence of complications. Age, gender, and side-related differences explained variations in the IJV-common carotid artery relationship, CSA, and diameter. Accurate knowledge of anatomical variations in special considerations such as pediatrics and obesity may help prevent complications and facilitate successful cannulation.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
VM Media Group
Identifier:
PMID: 36794685 and DOI: 10.5603/FM.a2023.0008
Type:
Article
Keyword:
anatomical variations, cannulation, imaging, internal jugular vein, landmarks, and morphometrics
Date Created:
2023

6. Automated Suturing For Pacemaker Lead Placement Via Video Guided Minimally Invasive Surgical Access

Title Tesim:
Automated Suturing For Pacemaker Lead Placement Via Video Guided Minimally Invasive Surgical Access
Creator:
Sauer, JS, Siordia, JA, Turek, JW, Cavanaugh, Nicholas B., and Knight, PA
Description:
The placement of permanent and temporary cardiac epicardial pacemaker leads through minimally invasive cardiac surgery (MICS) access remains a challenge. A reliable ergonomic approach for remote lead placement requires improved technology. We present a novel means to enable the remote placement of epicardial leads using automated suturing devices and videoscopy.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Type:
Poster
Keyword:
Automated Suturing and Video Guided Minimally Invasive Surgical Access
Date Created:
1/1/2017

7. Bacterial Contamination of a Marking Pen in Anterior Cruciate Ligament Reconstruction

Title Tesim:
Bacterial Contamination of a Marking Pen in Anterior Cruciate Ligament Reconstruction
Creator:
Rud, Christopher T. OMS-3, Ridley, T. J., Macalena, J. A., and Krych, A. J.
Related Url Tesim:
Full text available at the following URL: https://pubmed.ncbi.nlm.nih.gov/29796399/
Description:
Background: A sterile surgical marking pen is commonly used during anterior cruciate ligament reconstruction (ACLR) to outline the proposed skin incision and then to mark the graft during preparation. Once in contact with the skin, the pen is a potential source of bacterial transmission and subsequent infections after ACLR. Purpose/Hypothesis: The purpose of this study was to assess whether the skin marking pen is a fomite for contamination during arthroscopic ACLR. We hypothesized that there would be a difference in the rate of culture-positive pens between control pens and the study pens used to delineate the proposed skin incision. Study Design: Controlled laboratory study. Methods: Twenty surgical marking pens were collected prospectively from patients undergoing ACLR over a 12-month period. All patients underwent standard preoperative sterile preparation and draping procedures. Proposed incisions were marked with a new sterile pen, and the pen tip was immediately sent for a 5-day inoculation in broth and agar. Negative controls (unopened new pen) and positive controls (used to mark the skin incisions preoperatively) were also cultured. Additionally, blank culture dishes were observed during the growth process. All pens were removed from the surgical field before incision, and new marking pens were used when needed during the procedure. Results: Three of the 20 study pens (15%) demonstrated positive growth. All 3 pens grew species of <em>Staphylococcus</em>. None of the negative controls demonstrated growth, 6 of the 12 positive controls showed growth, and none of the blank dishes exhibited growth. Conclusion: This study found a 15% rate of surgical marking pen contamination by <em>Staphylococcus</em> during ACLR. It is recommended that the skin marking pen not be used for any further steps of the surgical case and be discarded once used. Clinical Relevance: Infections after ACLR are rare but may result in significant morbidity, and all measures to reduce them should be pursued. Surgeons performing ACLR should dispose of the surgical marking pen after skin marking and before intraoperative use such as graft markup.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Identifier:
10.1177/2325967118772043
Type:
Article
Keyword:
infection and ACL reconstruction
Date Created:
5/16/2018

8. Bitter melon extract suppresses metastatic breast cancer cells (MCF-7 cells) growth possibly by hindering glucose uptake

Title Tesim:
Bitter melon extract suppresses metastatic breast cancer cells (MCF-7 cells) growth possibly by hindering glucose uptake
Creator:
Kakuturu, Abhinav , Choi, Heeyun , Noe, Leah G., Scherer, Brianna N., Sharma, B., Khambu, B., and Bhetwal, Bhupal P.
Related Url Tesim:
Available via PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509689/ and Available via the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/10015060304
Description:
Breast cancer is one of the most commonly diagnosed cancers among women, however the complete cure for metastatic breast cancer is lacking due to poor prognosis. There has been an increasing trend of dietary modifications including consumption of natural food for the prevention of cancer. One of the popular natural foods is bitter melon. Bitter melon grows in tropical and subtropical areas. Some of the beneficial effects of bitter melon towards disease including cancer have been reported at the whole body/organismal level. However, specific cellular mechanisms by which bitter melon exerts beneficial effects in breast cancer are lacking. In this study, we used a human metastatic breast cancer cell line, MCF-7 cell, to study if bitter melon alters glucose clearance from the culture medium. We co-cultured MCF-7 cells with bitter melon extract in the presence and absence of supplemented insulin and subsequently measured MCF-7 cells viability. In this study, we report a noble finding that bitter melon extract exerts cytotoxic effects on MCF-7 cells possibly via inhibition of glucose uptake. Our findings show that insulin rescues MCF-7 cells from the effects of bitter melon extract.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
California Institute of Technology
Identifier:
DOi: 10.17912/micropub.biology.000961, PMCID: PMC10509689, and PMID: 37736248
Type:
Article
Keyword:
bitter melon, metastatic breast cancer, MCF-7 cell, glucose clearance, supplemented insulin, and cytotoxic effects
Date Created:
2023

9. Bovine Aortic Arch Shortens Available Clamping Distance for Extended End-to-End Repair of Infant Coarctation of the Aorta

Title Tesim:
Bovine Aortic Arch Shortens Available Clamping Distance for Extended End-to-End Repair of Infant Coarctation of the Aorta
Creator:
Turek, Joseph, Froud, Julia, Meyer, Alex, Larcia, Archana, Ashworth, Ravi, Endelman, Levi, and Cavanaugh, Nicholas B.
Description:
Bovine aortic arch is an anatomical variant in which the innominate and left common carotid arteries share a common origin. It is generally considered to be benign. The current literature estimates its prevalence may be as high as 30%. Coarctation of the aorta is a congenital heart defect characterized by narrowing of the aortic arch, usually near the insertion of the ductus arteriosus. Untreated coarctation of the aorta can lead to hypertension, poor perfusion of the lower extremities, and left ventricular hypertrophy and failure. Resection with extended end-toend anastomosis from a left thoracotomy remains the standard of care in the absence of arch hypoplasia. Extended end-to-end anastomosis requires the placement of a proximal clamp just distal to the innominate artery and a distal clamp on the descending aorta. The distance between the proximal clamp and the coarctation represents the amount of vessel the surgeon has available for reconstructing the aorta with this technique. The goal of this study is to determine if bovine aortic arch anatomy affects the clamping distance.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Type:
Poster
Keyword:
Infant Coarctation of the Aorta and Bovine Aortic Arch
Date Created:
1/1/2016

10. Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis.

Title Tesim:
Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis.
Creator:
Conway, Brian D, Aldoss, Osamah, Rossi, Nicholas P, El-Hattab, Ahmed, Turek, Joseph W, Cavanaugh, Nicholas B, Meyer, Alex M, and Reinking, Benjamin E
Related Url Tesim:
Full Text available at the following URL: https://www.sciencedirect.com/science/article/pii/S0022522317323772
Description:
Note: supplemental powerpoint slides available below. and OBJECTIVES: Arch branching has never been shown to influence recoarctation after extended end-to-end anastomosis via thoracotomy, yet in each study bovine arch identification is grossly underreported. This study aims to (1) assess chart review reliability in bovine arch identification; (2) determine recoarctation risk with a bovine arch; and (3) explore an anatomic explanation for recurrent arch obstruction based on arch anatomy. PATIENTS: A total of 49 consecutive patients underwent thoracotomy with extended end-to-end aortic coarctation repair at a single institution (2007-2012). METHODS: Echocardiograms from these patients were reviewed for arch anatomy and compared with the echocardiographic reports. Recurrent arch obstruction was defined as an echocardiographic gradient across the repair of 20 mm Hg or greater. For cases with angiographic images (n = 17), a scaled clamping distance between the left subclavian artery and the maximal proximal clamp location on orthogonal projections was then calculated across arch anatomies. RESULTS: Chart review identified 6.1% (3/49) of patients with a bovine arch compared with 28.6% (14/49) on targeted image review. A total of 28.6% (4/14) of patients with a bovine arch had a follow-up gradient of 20 mm Hg or greater. Only 5.7% (2/35) of patients with normal arch branching had a follow-up gradient of 20 mm Hg or greater. The mean clamping index was significantly diminished in patients with bovine arch anatomy. CONCLUSIONS: Arch anatomy often goes undocumented on preoperative imaging, yet children undergoing extended end-to-end repair with bovine arch anatomy are at a significantly increased risk of recoarctation. This may be due to a reduced clampable distance to facilitate repair. These results should be considered in the preoperative assessment, parental counseling, and surgical approach for children with discrete aortic coarctation.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Identifier:
10.1016/j.jtcvs.2017.10.055
Type:
Article
Keyword:
anastomosis
Date Created:
3/1/2018