| Authors: |
Jeremy Jones OMS-II, Alabama College of Osteopathic Medicine. Dothan, AL; John Pacanovsky, M.S. Founder, Crosslink JL dba Triangle Polymer Nano Technologies, Cary, NC |
| Objective: | To compare the weight-to-weight absorbency and evaluate qualitative factors of the novel nanofiber dressing to an existing data set. |
| Methods: | In this experiment, early samples of the TEOS (tetraethyl orthosilicate) nanofiber were weighed, immersed in normal saline until saturated, allowed to drip for 30 seconds, then weighed again, per Wound Dressing Absorption: A Comparative Study (Fulton et al, 2011). The method used here was qualified by conducting the same method with known simple gauze sponge absorbance already in the data set (Table 1). |
| Results: | The TEOS nanofiber was capable of absorbing between 18 and 20 times its weight in normal saline (Table 2). This places the weight-to-weight absorbance between alginates and collagen dressings. A variety of qualitative observations were made, including an increased risk of friability in the dressing, an uneven distribution of absorption with hydrophobic spots in the dressing, and most importantly, that the TEOS nanofiber dressing stropped dripping after less than 10 seconds, whereas the gauze would continue to drip for at least the prescribed 30 seconds. |
| Conclusions: | The Triangle Polymer Nano Technologies TEOS nanofiber novel dressing should continue to be evaluated in its iterations; its potential strengths are: 1) absorption without dripping, 2) nonbiologic low potential for immune response, 3) heat insulation and resistance, 4) friability, 5) shelf life, and 6) light weight. Accordingly, the TEOS nanofiber mitigates a great many risks that must be evaluated by any patient care team: 1) care team time, as well as potential for infection with dripping bandages, 2) potential sensitivity to biologic dressings, 3) hypothermia in burns or shock, 4) disrupting the platelet plug when changing dressings, 5) expired dressings, and 6) limited capacity in a combat medic’s aid bag. These qualities imply use as a battlefield dressing as well as for heavily exudative or infectious wounds. Further research should be conducted on the presumably limited immune potential of TEOS versus biologic dressings. |
| Authors: | Timothy Ross Thompson, OMS - II, William Dipprey, OMS - II, Phillip Cochran, OMS-III, Jurian Edelenbos, OMS-III, MaryAnn May, PhD, Kristen Helms, PharmD, R. Wayne Parker III, PharmD |
| Background: | Opioid overdoses account for more than 2/3rds of Alabama’s overdose related deaths. In recent years, synthetic opioids have entered the market requiring multiple naloxone administration and potentially deadly consequences. The Alabama Drug Use Central Data Repository collects overdose death figures but lacks information on opioid reversals or naloxone use. |
| Purpose: | Our aim was to develop a tool which could collect information on the demographics of individuals receiving naloxone, the environment of use, the care received, and the outcome in overdose cases. By gaining direct insight from the individuals using naloxone to save a life, the coalition can better track the results of their efforts and provide distribution where it is needed. |
| Description: | In partnership with ACOM’s naloxone coalition, we developed a short survey and created a QR code sticker attached to the bottom of naloxone distributed in Alabama and other southeastern communities. |
| Conclusion: | We were able to develop an unobtrusive method of collecting data from naloxone use. The naloxone coalition has recently begun distributing cases with QR code labels. |
| Authors: | Devesh Dahale, MS, MBA, CPHQ, CPXP |
| Background: | Surgical site infection (SSI) is the second most frequent nosocomial infection, which accounts for 40% of all the healthcare-related infections in patients undergoing surgery. Particularly patients who undergo surgery for colorectal diseases are more likely to develop SSI. |
| Purpose: | For the purpose of this project, we focused our efforts on the organ / space (deep to fascia) infections only. The goal of the project was to reduce Colon SSI by 50%. |
| Description: | We created a multi-disciplinary team to work on this project. We followed the DMAIC (Define – Measure – Analyze – Improve – Control) method of Quality improvement methodology. Initial work involved gathering baseline data and incorporating the appropriate criteria to get complete and accurate information. We then performed data analysis using patient details of those who incurred an SSI in the past two years. We identified the subpopulation of patients who were at highest risk of developing SSI. Since a particular portion of the anatomy (sigmoid colon) and type of surgical approach (laparoscopic) strongly influenced the risk negatively, we proposed a solution to surgeons to use an alternative approach instead for these patients. The surgeons bought in and executed the intervention. |
| Conclusion: |
The team accomplished improvement in SSI colon rates through effective teamwork, collective buy in and by leveraging data analytics to influence decision-making. Colon surgery bundle compliance improved from 35% to 92%. Colon SSI SIR rate reduced from an SIR of 1.5 in FY 2023 to 0.3 in FY 2024 (80% relative reduction). |
| Authors: | Jessica Hecker OMS-II, Kayla Leiber OMS-II, Dr. Wayne Parker PharmD |
| Background: | The prevalence of opioid overdoses has reached alarming levels, largely driven by over-prescribing, illicit use, and insufficient education or intervention. Evidence from various states indicates that targeted interventions can effectively reduce overdoses, specifically with the use of Narcan. This initiative aims to increase Narcan education and awareness while also demonstrating a successful model for other programs to replicate. |
| Purpose: | Our program focuses on distributing Narcan to organizations, schools, and healthcare professionals. Our initiative emphasizes training on Narcan administration and promotes broader community engagement in overdose prevention. By spreading awareness and facilitating safer practices, we aim to decrease the incidence of opioid overdoses in our region. |
| Description: | Narcan education and distribution was accomplished by reaching out to organizations in communities across the state. Our program educated medical students on how and when to use Narcan and provided guidelines on safer prescribing practices. We also trained school teachers, nursing students, college students, police, and various organizations. Our presentations provided background on the opioid epidemic and provided guidelines on the use of Narcan. Narcan kits were given to participants following our trainings. |
| Conclusions: |
Our program has largely increased Narcan education and distribution in the region and became one of the state’s top distributors of Narcan. We have provided greater odds of successful intervention in the event of an opioid overdose in our target communities and have greatly increased public awareness. In educating medical and nursing students on the opioid epidemic, we have also increased awareness amongst the next generation of healthcare workers. |
| Authors: | Unika Mirza, OMS-II Dr. Eric Johnson PhD |
|
Background: |
This project sought to find associated phenotypic abnormalities correlating to mutations within the Glucokinase Regulatory Protein (GKRP). GKRP will modulate the body’s reaction to different levels of glucose in the blood which has clinical implications of hyperglycemia or hypertriglyceridemia depending on the genotype of the GKRP. This project aimed to characterize different genetic variants of GKRP through analysis of its enzymatic activity and how it compared to the native GKRP. |
|
Design: |
This project utilized an in vitro assay which was designed and validated. Each mutation was tested utilizing E. coli produced and purified recombinant protein. The resulting protein Vmax was compared in order to analyze the activity of the mutational enzyme against the native GKRP. Comparing the Vmax helped to decipher what kind of activity the mutation has compared to the native GKRP. |
|
Results: |
A known pathogenic variant P446L was compared to the native protein and its activity was compared with the findings from other peer reviewed articles which came to the similar conclusion that it was pathogenic. An additional variant, Q443R was also tested for pathogenicity. Results concluded that their activity levels were decreased with this mutation. |
|
Conclusion: |
Results showed that the activity of the P446L and Q443R mutations decreased the activity of the glucokinase regulatory protein enzyme leading to clinical implications of hyperglycemia. Some limitations with this research are that it did not investigate other factors which may affect the way a protein mutation affects the human body. |
| Authors: | Alexander Bennett, OMS-III, Meaghan Barros OMS-III, Niloo Tehrani, OMS-I, Taras Kochno, MD, and Thomas J. Fotopoulos, DO; Alabama College of Osteopathic Medicine |
|
Background: |
Patients frequently present with low back pain, it is currently the 5th leading cause of primary care visits. This project targets the sacroiliac joint (SI), one of the many causes of low back pain that patients present with, demonstrating the effectiveness of this technique to treat this somatic dysfunction. |
|
Design: |
This project was a quasi-experimental pre-and-post experimental design with 20 students, 10 male and 10 female. A goniometer assessed passive range of motion (ROM) of the hip. The hip was assessed for internal and external rotation. The participant then extended their knee with their leg flat on the table. The researcher performed a leg tug with the hip in neutral positioning followed by external rotation and then internal rotation. The participant was then reassessed after the technique was performed. |
|
Results: |
This technique improved the somatic dysfunction present at the SI joint. Participants improved their hip range of motion and also reported decreased low back pain following the technique. |
|
Conclusion: |
The SI technique alleviates somatic dysfunction that often presents in many patients. The technique not only corrected the dysfunction but had an added benefit of decreasing pain, as well as internal and external hip range of motion. This technique should be further incorporated into clinical practice so that other physicians can continue to help their patients that present with these symptoms. |
| Authors: | Meaghan Barros OMS-III*, Alexander Bennett, OMS-III*, Zach Burr, OMS-II*, Taras Kochno, MD, and Thomas J. Fotopoulos, DO; Alabama College of Osteopathic Medicine: |
|
Background: |
Patients can present with asymptomatic and symptomatic somatic dysfunction in their tibia-fibular region. This can result in decreased internal and external rotation of the ankle and feet, as well as leg pain. Decreased range of motion (ROM) reduces function and increases negative effects. This technique will be used to address this ROM limitation, improving patient function. |
|
Design: |
This project was conducted as a quasi-experimental pre-and-post experimental design with 20 students, 10 female and 10 male. A goniometer was used to assess passive ROM. While stabilizing the proximal tibia-fibular joint at the knee, the participant’s leg was extended and assessed for external and internal rotational motion at the ankle. The researcher then performed a leg tug while the participant’s leg remained in neutral positioning. The participant was then reassessed after the technique was performed. |
|
Results: |
Following the technique, the participant’s passive ROM improved in both internal and external motion at the ankle/foot. The participants also noticed an improvement in their hip flexion motion following the technique. |
|
Conclusion: |
While observing ROM, hip flexion motion also improved following the technique. This remains as a further research endeavor to assess how this technique can also improve hip ROM. Additionally, assessing the ROM by stabilizing the distal tibia-fibular joint may serve as a more accurate measurement of the dysfunction. Additionally, following the technique, some participants had less motion. We believe this is due to previous underlying lower extremity somatic dysfunction that was not addressed in the technique. Overall, the ankle/foot and hip ROM was increased utilizing this technique. |