2016 Oklahoma Research Day Full Program

This document contains all abstracts from the 2016 Oklahoma Research Day held at Northeastern State University

Continuing professional development - challenge for professional organization

Professions, as one of key sectors of social systems, bear a leading role in the existing social work organization. Free professions take up a special place and significance, all the way from Roman artes liberales to our times. Pharmaceutical profession, as one of the oldest, led by ethical principles, is regulated by postulates accepted by the profession members, and in modern times established through legislations. Typical determinants of the regulated professions, which also refer to pharmacists, as chamber members, are as follows: following ethical principles, specific skills and knowledge, professional development, autonomy at work, continuing improvement, competencies development, professional associations, licensing

Separator fluid volume requirements in multi-infusion settings

INTRODUCTION. Intravenous (IV) therapy is a widely used method for the administration of medication in hospitals worldwide. ICU and surgical patients in particular often require multiple IV catheters due to incompatibility of certain drugs and the high complexity of medical therapy. This increases discomfort by painful invasive procedures, the risk of infections and costs of medication and disposable considerably. When different drugs are administered through the same lumen, it is common ICU practice to flush with a neutral fluid between the administration of two incompatible drugs in order to optimally use infusion lumens. An important constraint for delivering multiple incompatible drugs is the volume of separator fluid that is sufficient to safely separate them. OBJECTIVES. In this pilot study we investigated whether the choice of separator fluid, solvent, or administration rate affects the separator volume required in a typical ICU infusion setting. METHODS. A standard ICU IV line (2m, 2ml, 1mm internal diameter) was filled with methylene blue (40 mg/l) solution and flushed using an infusion pump with separator fluid. Independent variables were solvent for methylene blue (NaCl 0.9% vs. glucose 5%), separator fluid (NaCl 0.9% vs. glucose 5%), and administration rate (50, 100, or 200 ml/h). Samples were collected using a fraction collector until <2% of the original drug concentration remained and were analyzed using spectrophotometry. RESULTS. We did not find a significant effect of administration rate on separator fluid volume. However, NaCl/G5% (solvent/separator fluid) required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). Also, G5%/G5% required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). The significant decrease in required flushing volume might be due to differences in the viscosity of the solutions. However, mean differences were small and were most likely caused by human interactions with the fluid collection setup. The average required flushing volume is 3.7 ml. CONCLUSIONS. The choice of separator fluid, solvent or administration rate had no impact on the required flushing volume in the experiment. Future research should take IV line length, diameter, volume and also drug solution volumes into account in order to provide a full account of variables affecting the required separator fluid volume

Atypical presentation of a rare cardiac anomaly in an infant of diabetic mother

Introduction: Screening for heart defects in babies is widely required. Here we present a case of neonatal asphyxia and pneumothorax. Early cardiac ECHO on the first day of life can reveal a rare congenital heart defect. Presentation: This reports an infant of a diabetic mother with oligohydramnios presented with, symmetrical IUGR at 37 weeks of gestation. She presented due to foetal distress, went for instrumental delivery, and the baby was born to find with one cord coil around the neck. Upon delivery, the baby was limp and required active resuscitation and intubation. The APGAR score was 6 and 7 at one and five minutes respectively, and the cord blood gas showed a pH of 7.27 and a BE of -7.2. Ventilator settings were on minimal sittings where the baby had stable vital signs and normalized ABG, warranting extubation to high nasal flow cannula, the baby covered by first-line antibiotics awaiting the results of septic workup. The baby tolerated HFNC for a short time before experiencing respiratory distress. CXR showed right-sided pneumothorax with normal cardiac shadow, baby was reintubated. Clinical examination did not reveal any murmurs, but bedside ECHO screening was unable to pick the tributaries of the MPA. Urgent formal ECHO showed absent right pulmonary artery. CT thorax with contrast showed an oligemic right lung compared to the left lung. With ASD, RPA anomalies, Patent left PDA from aortic isthmus to the main pulmonary. Cardiac catheterization confirmed closing PDA, a blind pouch of RPA from brachiocephalic, abnormal RPA connections, disconnected RPA, and supply of PDA. Conclusion: Even in the absence of signs of CHD on physical examination and CXR, the early cardiac screen in neonates is important. Either by cardiac screen via oxygen saturation and perfusion index or real-time ECHO can accomplish early detection, intervention, and improved prognosis. Keywords: (5 words) Cardiac screening, Neonates, Congenital Heart Disease, ECHO, Infant of Diabetic Mother. Introduction: Screening for heart defects in babies is widely required. Here we present a case of neonatal asphyxia and pneumothorax. Early cardiac ECHO on the first day of life can reveal a rare congenital heart defect. Presentation: This reports an infant of a diabetic mother with oligohydramnios presented with, symmetrical IUGR at 37 weeks of gestation. She presented due to foetal distress, went for instrumental delivery, and the baby was born to find with one cord coil around the neck. Upon delivery, the baby was limp and required active resuscitation and intubation. The APGAR score was 6 and 7 at one and five minutes respectively, and the cord blood gas showed a pH of 7.27 and a BE of -7.2. Ventilator settings were on minimal sittings where the baby had stable vital signs and normalized ABG, warranting extubation to high nasal flow cannula, the baby covered by first-line antibiotics awaiting the results of septic workup. The baby tolerated HFNC for a short time before experiencing respiratory distress. CXR showed right-sided pneumothorax with normal cardiac shadow, baby was reintubated. Clinical examination did not reveal any murmurs, but bedside ECHO screening was unable to pick the tributaries of the MPA. Urgent formal ECHO showed absent right pulmonary artery. CT thorax with contrast showed an oligemic right lung compared to the left lung. With ASD, RPA anomalies, Patent left PDA from aortic isthmus to the main pulmonary. Cardiac catheterization confirmed closing PDA, a blind pouch of RPA from brachiocephalic, abnormal RPA connections, disconnected RPA, and supply of PDA. Conclusion: Even in the absence of signs of CHD on physical examination and CXR, the early cardiac screen in neonates is important. Either by cardiac screen via oxygen saturation and perfusion index or real-time ECHO can accomplish early detection, intervention, and improved prognosis. Keywords: (5 words) Cardiac screening, Neonates, Congenital Heart Disease, ECHO, Infant of Diabetic Mother. References 1-Maryam M, Furqan M, Muhammad A, et al. HEART BIRTH DEFECTS IN INFANTS OF DIABETIC MOTHER. Zenedo. Org, December 31, 2019 2-Roy V, Jai G, Jeeva N, et al. Anomalous origin of right pulmonary artery from innominate artery: Repair using pulmonary artery pedicled flap plasty. Ann Pediatr Cardiol. 2017 Sep-Dec; 10(3): 278–280. PMCID: PMC5594939, PMID: 28928614 3-Carolyn A, David R. Identifying newborns with critical congenital heart disease. UpToDate. Literature review current through: Oct 2020. 4-Abouk R, Grosse SD, Ailes EC, et al. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths. JAMA. 2017; 318(21): 2111-2118. 5-Lisa A. Wandler and Gerard R. Critical Congenital Heart Disease Screening Using Pulse Oximetry: Achieving a National Approach to Screening, Education and Implementation in the United States Martin Children’s National Heart Institute, International Journal of Neonatal Screening. 19 October 2017 CT pulmonary angio showing absent right pulmonary artery

The History and Practice of College Health

This volume is the first definitive reference and textbook in the one-hundred-fifty year history of college health. Written for professionals and for those working in student services and higher education administration, it covers the history of college health, administrative matters including financing and accreditation, and clinical issues such as women’s health, HIV/AIDS, and mental health. The book also focuses on prevention, including immunization and tuberculin testing. The contributors are well respected in the field and are actively working in the specific areas on which they write. H. Spencer Turner, MD, is director of the University Health Service and clinical professor of preventative medicine and environmental health at the University of Kentucky. Janet L. Hurley, Ph.D., is the Associate Director and Administrator of the University of Kentucky\u27s Health Service.https://uknowledge.uky.edu/upk_history_of_science_technology_and_medicine/1003/thumbnail.jp

From Sin to Science: The Cancer Revolution of the Nineteenth Century

This dissertation analyzes the critical importance of the late nineteenth century to the development of a novel, radical approach to cancer that continues into the twenty-first century. From the 1870s to the 1890s, physicians and the public came to understand cancer in an entirely new light, founded upon the application of scientific principles, methods, and instruments to cancer medicine as well as upon a major change in the social perception of the disease. Cancer as it was conceptualized, diagnosed, and treated prior to this revolutionary transformation will be explored. The birth of cellular pathology will set the stage for the transition of cancer from a macroscopic, eponymous malady to a microscopic, cellular disease. The founding of an institution devoted solely to the care of cancer patients and the investigation of the disease will illustrate how societal beliefs, combined with personal tragedy, philanthropy, and medical expertise, legitimized the disease and fostered cancer research. The histories of the cancers of two Presidents of the United States, Ulysses S. Grant and Grover Cleveland, who were diagnosed with the disease only nine years apart during these critical years, will be compared and contrasted for the insights they provide on this great transformation. The scientific underpinnings of these changes will be examined from their roots in physics, chemistry, and biology to their applications in microscopy, anesthesia, and antisepsis. Modern cancer will be shown to be based firmly on the medical microscope and the advent of scientific surgery that occurred in the late nineteenth century