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Reviewing The Effect of Antiplatelet Therapy on Lumbar Puncture Complications
Get PDFReviewing The Effect of Antiplatelet Therapy on Lumbar Puncture Complications aims to assess literature that discusses the possible risks of undergoing lumbar puncture while on antiplatelet therapy. Lumbar punctures offer vital information that can help guide making accurate diagnosis and creating appropriate treatment plans. However, a large portion of the population is on antiplatelet therapy for cardiovascular and cerebrovascular disease prevention. While there are many benefits to being on these medicines, patients are at increased risk for bleeding. Thus the clinical question as to whether or not proceed with lumbar puncture on patients taking antiplatelet therapy involves weighing risks and benefits. This study aims to assess the difference in traumatic lumbar punctures in patients taking antiplatelet therapy and those who are not and how this may contribute to negative outcome such as the development of spinal hematomas. Studies included were all articles published past 2000 involving human subjects that fit the PICO format and provided important background information. Results section analyzed studies comparing participants on antiplatelet therapy and those who were not and the difference in outcomes following lumbar puncture. Differences between groups were minimal and it was seen that antiplatelet therapy before lumbar punctures was not associated with traumatic taps. This review adds to the discussion on whether or not lumbar punctures should be delayed in emergent situations due to risk of bleeding and possible hematoma development. Studies assessed in this review suggest that it may be safe to proceed with lumbar puncture while on antiplatelet therapy
Efficacy of Platelet Rich Plasma on Thumb Basal Joint Osteoarthritis: A Narrative Review
Get PDFPlatelet-rich plasma (PRP) has emerged as a potential treatment for carpometacarpal (CMC) joint osteoarthritis, with studies suggesting it may offer more durable symptom relief compared to corticosteroids. A comprehensive review of four studies, including two randomized controlled trials (RCTs), a retrospective study, and a pilot study, revealed that both PRP and corticosteroid injections led to short-term improvements in pain and function. However, PRP demonstrated significantly better long-term outcomes, with VAS scores decreasing from 75 to 20 in the PRP group at 12 months, compared to a modest reduction from 70 to 65 in the corticosteroid group. Additionally, PRP showed a significantly lower DASH score at 12 months (20.4 vs. 43, P = 0.025). The pilot study indicated short-term improvements in pain and function, but some rebound in symptoms was observed at six months. Despite the promising results, variability in PRP protocols and study designs limits direct comparisons, and further large-scale, standardized trials are necessary to confirm these findings and establish optimal treatment protocols for CMC joint osteoarthritis
Patient Education and Health Literacy Effects on Statin Use and Adherence
Get PDFBackground: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.
Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from study participants included demographic information and cardiovascular history. Additional questions focused on patient education provided by a physician, and beliefs about cardiovascular disease. Information was submitted anonymously.
Results: Nineteen (19) responses were analyzed. Participants included 7 males and 12 females, and reported age of participants ranged from 30 to 79. Data demonstrated that 6 participants were currently using statin medications, 11 participants were never prescribed a statin, and 2 participants declined or discontinued statin use. Data demonstrated that males more so than females more strongly agreed with “If someone needs to use a statin they have failed go make good choices” (p=0.06).
Conclusion: Pilot study data collected did not capture enough participants who declined or stopped statin use to sufficiently examine how patient education might have influenced these choices. Data does suggest male participants have stronger beliefs regarding the effect of personal choice on health outcomes
The Impacts of Pre-matriculation Programs on Incoming First Year Medical Students: A Scoping Review
Get PDFMedical school provides many obstacles and stressors that can derail students\u27 journeys. Students need support to traverse these obstacles. Many schools provide support including tutoring, remediation protocols and pre-matriculation programs. Pre-matriculation programs are support programs that students encounter before matriculating into medical school. This scoping review focuses on the possible impacts of summer pre-matriculation programs on incoming first year medical students with the goal of better understanding how these programs positively, negatively or do not impact medical students. A scoping review was performed and three databases were searched (Pubmed, Scopus, Ovid Medline) resulting in a total of 295 articles with only 12 studies included in the final review. Overall, it was found that pre-matriculation programs, through both academic and social interventions, provide positive outcomes to incoming medical students. These outcomes include increased academic performance, better understanding of the expectations of medical school, development of their own academic skills, and a sense of community. Limitations of this review include the papers were often over a decade old and may be out of date when it pertains to current medical school curriculums. Studies also only focused on first year performance rather than following these students through their medical school career. Future directions include better understanding how these programs can be used to best identify students who need help so they may receive early intervention
Comparison of Patient Retention of PCL-5 vs. CAPS-5 in a Study on Tracking PTSD Symptoms After A Mobile App Intervention
Get PDFBackground: Due to mental health provider shortages, primary care providers are seeing more patients with mental health concerns.1 Due to the COVID-19 pandemic, mental health concerns increased requiring primary care to adapt new multidisciplinary interventions to assist patients.2 When assessing patients for PTSD, either the CAPS-5 or PCL-5 can be used, but they have different qualities that may affect retention.
Hypothesis: The PCL-5 will have a higher retention due to the ease of administration.
Methods: Providers identified eligible patients at the Rowan-Virtua family medicine office in Sewell. Upon consent, the CAPS-5 or PCL-5 was administered, and then the PTSD Coach app was used by participants for 30 days. A follow-up was requested from all participants, where the initial assessment was administered again.
Results: There was a decrease in average PCL-5 retention in relation to the CAPS-5 that is not statistically significant.
Conclusions: CAPS-5 might better serve to increase retention rates of participants, despite its longer administration time. Limitations included a small sample size and differing protocols
Case Report: Dissecting Retroperitoneal Abscess with Gas Formation
Get PDFPresenting as a case to the emergency department was a 53-year-old male with a complaint of diffuse abdominal pain and focal right flank pain at site of recent percutaneous abscess drain site performed exactly one month prior. This followed hospitalization in the preceding year for complicated multifocal intra-abdominal infections requiring surgical interventions including exploratory laparotomy and surgical debridement for intra-abdominal abscess and scrotal abscess formation. Despite prior aggressive management and extensive coverage with broad-spectrum antibiotics, this patient was found to have fulminant recurrance of infection in the right retroperitoneal space with an expanding abscess dissecting through the retroperitoneal structures into the abdominal wall musculature. The patient was hospitalized for sepsis secondary to this infection, with escalating antibiotic therapy and replacement of a percutaneous drain at the retroperitoneal focus of abscess formation. While the management was complex, this patient ultimately made a recovery and was discharged after the fourth day of hospitalization. However, this case does highlight the importance of early recognition and treatment of an aggressive and rapidly developing infection, and the unusual evolution of a gas-forming abscess with dissecting features
Bone Marrow Aspirate Concentrate Adjunct for Acetabular Labral Tear Repair: A Systematic Review and Meta-Analysis
Get PDFBACKGROUND: The objective of this study was to determine the effect of bone marrow aspirate concentrate (BMAC) on long-term patient outcomes when used as an adjuvant to acetabular repair of the labrum.
METHODS: A systematic review and meta-analysis were completed following PRISMA 2020 guidelines. Included in the analysis were controlled studies which assessed functional outcomes via the International Hip Outcome Tool-33 (iHOT-33) 12 or 24 months after acetabular repair with BMAC adjunct. Four studies totaling 315 participants were analysed.
RESULTS: Pooled effect sizes for iHOT-33 scores were not significantly different between control and treatment groups at 12 (p = 0.14, Cohen\u27s D ≏ 0.79) or 24 months (p = 0.30, Cohen\u27s D ≏ 0.56).
CONCLUSIONS: Non-significant trends in favor of BMAC augmentation were found in this study. However, the trends reported are promising and warrant further investigation with further randomised controlled trials
Library workshop on how to build effective prompts in AI generators
Get PDFThe STEM librarian and IT communications director at an public university created a hands-on workshop on prompt engineering. Covering ethical concerns and limitations, data privacy issues and prompt frameworks and techniques, the session concludes in a collaborative exercise where participants refine a basic prompt and compare Microsoft Copilot’s responses. This interactive approach helps attendees learn from peers while observing how small refinements impact AI-generated outputs.
Presentation: Generative AI in Libraries (GAIL) conference (https://shsulibraryguides.org/genailibraries/schedule
ENHANCING GPR RELIABILITY FOR CONCRETE INFRASTRUCTURE: INTEGRATING SIGNAL PROCESSING AND DEEP LEARNING FOR DEFECT AND CORROSION ASSESSMENT
Get PDFThis research addresses the critical issue of deteriorating civil infrastructure by utilizing GPR integrated with advanced signal processing and machine learning. Employing the Conquest 100 system, four concrete slab configurations were tested: multi-layer rebar with defects, single- and double-layer rebar setups, varied rebar spacing, and pre-corroded rebars (0–30% mass loss). GPR B-scans collected over 3–60 days demonstrated that detection accuracy varied significantly with curing time, structural complexity, and moisture levels. A custom-developed Python script surpassed EKKO_Project software in rebar localization, achieving lower position errors (0.4–0.7 inches compared to 0.5–1.25 inches). Notably, the amplitude of GPR signals unexpectedly increased with corrosion progression (from 9.667 mV at 20% mass loss on Day 3 to 16.000 mV on Day 28), challenging conventional understanding by suggesting rust-induced scattering enhances reflections. A semi-supervised deep learning technique—Bootstrap Your Whole Latent (BYWL)—trained on 1,543 synthetic images and fine-tuned on 179 real GPR scans, demonstrated superior rebar localization accuracy (RMSE: 19.05 pixels; errors down to 2%), outperforming baseline models. This methodology minimizes manual interpretation and enhances inspection reliability under challenging conditions and holds significant promise for infrastructure assessment and non-destructive evaluation
THE EFFECTS OF LOW DOSE METHYLPHENIDATE ADMINISTRATION ON RISK/REWARD DECISION MAKING AND CATECHOLAMINE TRANSPORTER EXPRESSION FOLLOWING REPETITIVE MILD TRAUMATIC BRAIN INJURY IN RODENTS
No full textRepetitive mild traumatic brain injury (rmTBIs) impairs catecholamine (CA) regulation within the prefrontal cortex (PFC)-mediated leading to aberrant higher-order decision making processes. The psychostimulant, methylphenidate (MPH), elevates CA levels by blocking their reuptake transporters. However, to establish a treatment regimen, it is necessary to characterize how chronic therapeutic doses of MPH affect rmTBI-induced disruptions of decision making. Here, we assessed risk/reward decision making for 4 weeks in male and female rodents trained on the probabilistic discounting task (PDT) following rmTBI induced by the closed head-controlled cortical impact model. Rats received daily administration of saline or low-dose MPH beginning 48 hours from final injury through behavioral testing. The combination of rmTBI and MPH treatment significantly increased risky choice preference in males for 2 weeks post-surgery. In contrast, MPH alone disrupted choice behavior in uninjured females within the first week post-surgery. CA transporter protein levels were altered within subregions of the PFC only within the first week following injury, MPH treatment and the combination. These results indicate MPH treatment transiently exacerbates risky behavior and CA transporter protein in males, but not females, following rmTBI. These sex-specific responses advise caution for males exposed to making decisions that involve uncertain risk/reward outcomes when considering MPH to treat post-rmTBI cognitive symptoms