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Pruskowski J, Childers J, Moore PA, Zemaitis MA, Bauer RE, Deverts DJ, Elnicki DM, Levine SC, Kaufman R, Dziabiak MP, Spallek H, Weiner DK, Horvath Z. Managing Acute Pain and Opioid Risks Following Wisdom Teeth Extraction: An Illustrative Case. MedEdPORTAL 2019; 15:10855. [PMID: 31934617 PMCID: PMC6953741 DOI: 10.15766/mep_2374-8265.10855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/24/2019] [Indexed: 05/09/2023]
Abstract
Introduction The opioid epidemic has awakened educators to the insufficiency of training in the areas of pain management and substance use disorders within the curricula of health sciences schools. The University of Pittsburgh Center of Excellence in Pain Education created an online educational module focusing on factors contributing to the opioid epidemic and the role of robust interprofessional communication in avoiding common practitioner errors. Methods The 1-hour module created by an interprofessional team comprised a pretest, video presentation featuring case vignettes, posttest, and learner satisfaction survey. The content of the module focused on four core concepts: (1) managing acute perioperative pain, (2) maximizing opioid safety, and (3) identifying and (4) managing suspected opioid abuse and diversion. Results Data were obtained from 250 dental, pharmacy, and nursing students from the University of Pittsburgh who completed the module as part of their respective profession-specific curricula. Results collapsed across the three school-specific implementations indicated an average increase in knowledge test scores from pre- to posttest (Z = -8.82, p < .001). In addition, the learner satisfaction data revealed an overall positive response to the module, with students commenting that they enjoyed the module and felt it provided them with a valuable learning experience. Discussion Learner outcomes and feedback suggest that our interprofessional team was successful in creating an effective learning module applicable to several health care professions, namely, pharmacy, dentistry, and nursing. Future studies might address the application of the knowledge gained to actual patient care.
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Affiliation(s)
- Jennifer Pruskowski
- Assistant Professor, Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy
| | - Julie Childers
- Translational Research Facilitator, University of Pittsburgh School of Dental Medicine
| | - Paul A. Moore
- Associate Professor, Division of General Internal Medicine, University of Pittsburgh School of Medicine
| | - Michael A. Zemaitis
- Professor, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine
| | - Richard E. Bauer
- Professor, Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy
| | - Denise J. Deverts
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Pittsburgh School of Dental Medicine
| | - D. Michael Elnicki
- Professor, Division of General Internal Medicine, University of Pittsburgh School of Medicine
- Director of International Medical Education Programs, Division of General Internal Medicine, University of Pittsburgh School of Medicine
| | - Steven C. Levine
- Professor, Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing
| | - Robert Kaufman
- Assistant Professor, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine
| | - Michael P. Dziabiak
- Instructional Technologist, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine
| | - Heiko Spallek
- Dean, Faculty of Medicine and Health, University of Sydney School of Dentistry
| | - Debra K. Weiner
- Professor, Psychiatry, Anesthesiology, and Clinical & Translational Science, University of Pittsburgh School of Medicine
- Acting Associate Director of Education and Evaluation, VA Pittsburgh Healthcare System
| | - Zsuzsa Horvath
- Assistant Professor, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine
- Director of Faculty Development, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine
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Vargo RJ, Potluri A, Bauer RE, Seethala RR, Bilodeau EA. Intraoral Pseudo-Onion Bulb Intraneural Proliferations in a Patient with Hemimandibular Hyperplasia: A Case Report and Review of the Literature. Head Neck Pathol 2016; 10:475-480. [PMID: 27140175 PMCID: PMC5082049 DOI: 10.1007/s12105-016-0725-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/27/2016] [Indexed: 11/24/2022]
Abstract
This report and review of the literature describes a case of benign intraoral lesions of perineurial origin in a patient with symptomatic hemimandibular hyperplasia causing partial denture soreness. Perineuriomas are a benign peripheral nerve sheath tumor composed of perineurial cells. Intraoral perineuriomas are an extremely rare entity. Two main types of perineuriomas have been described: intraneural and extraneural perineuriomas. A third, similar entity, called an intraneural pseudoperineuriomatous proliferation, has recently been proposed in the literature as a separate and distinctive diagnosis. This report describes the histologic and clinical presentation of intraneural pseudoperineuriomatous proliferations in a patient with hemimandibular hyperplasia.
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Affiliation(s)
- Richard J. Vargo
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, G-132 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261 USA
| | - Anitha Potluri
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Richard E. Bauer
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Raja R. Seethala
- Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261 USA
| | - Elizabeth A. Bilodeau
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261 USA
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Abstract
Maxillary surgery to correct dentofacial deformity has been practiced for almost 100 years. Significant advances have made maxillary surgery a safe and efficient means of correcting midface deformities. Anesthetic techniques, specifically hypotensive anesthesia, have allowed for safer working conditions. Landmark studies have proven manipulation and segmentalization of the maxilla is safe and allowed this surgery to become a mainstay in corrective jaw surgery. This article provides an overview of surgical techniques and considerations as they pertain to maxillary surgery for orthognathic surgery. Segmental surgery, openbite closure, vertical excess, grafting, and a technology update are discussed.
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Affiliation(s)
- Richard E Bauer
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, 203 Lothrop Street, Suite 214, Pittsburgh, PA 15213, USA.
| | - Mark W Ochs
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, 203 Lothrop Street, Suite 214, Pittsburgh, PA 15213, USA
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Bauer RE. Bone Regeneration Using Nano-Structured Calcium-Phosphate Carriers. J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.joms.2008.05.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gratzer S, Lithgow T, Bauer RE, Lamping E, Paltauf F, Kohlwein SD, Haucke V, Junne T, Schatz G, Horst M. Mas37p, a novel receptor subunit for protein import into mitochondria. J Cell Biol 1995; 129:25-34. [PMID: 7698990 PMCID: PMC2120374 DOI: 10.1083/jcb.129.1.25] [Citation(s) in RCA: 150] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
By screening a collection of Saccharomyces cerevisiae mutants temperature sensitive for growth on a nonfermentable carbon source, we have isolated a gene (termed MAS37) which encodes a novel receptor for protein import into mitochondria. Mas37p is a 37-kD outer membrane protein with two putative membrane-spanning regions. Inactivation of the MAS37 gene renders cells temperature-sensitive for respiration-driven growth, inhibits import of precursors into isolated mitochondria, and is synthetically lethal with a deletion of one of the genes encoding the import receptors Mas70p or Mas20p. Inactivation of Mas37p with specific antibodies inhibits import of different precursors to different extents; the precursor specificity of Mas37p resembles that of the previously described import receptor Mas70p. Mas70p and Mas37p form a 1:1 complex in detergent extracts of mitochondria and overexpression of one protein enhances that of the other. We suggest that the Mas37p/Mas70p heterodimer functions as a receptor for protein import into yeast mitochondria and that the mitochondrial receptor system consists of hetero-oligomeric subcomplexes with distinct binding activities, but overlapping precursor specificities.
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Affiliation(s)
- S Gratzer
- Biozentrum, University of Basel, Switzerland
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Walsh-Sukys MC, Bauer RE, Cornell DJ, Friedman HG, Stork EK, Hack M. Severe respiratory failure in neonates: mortality and morbidity rates and neurodevelopmental outcomes. J Pediatr 1994; 125:104-10. [PMID: 7517446 DOI: 10.1016/s0022-3476(94)70134-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To compare the survival, neurodevelopmental, and health outcomes of children with severe respiratory illness treated with and without extracorporeal membrane oxygenation (ECMO). DESIGN Prospective collection of clinical and demographic data of all neonates reaching illness severity criteria, with follow-up at 8 and 20 months of age. Patients were assigned to treatment by the attending physician. PATIENTS Consecutive sample of 74 neonates during a 24-month period with an alveolar-to-arterial gradient exceeding 620 for 8 or more hours. RESULTS Eighteen (69%) of 26 neonates treated with conventional therapy survived to 20 months, in comparison with 43 (90%) of 48 neonates treated with ECMO. The conventionally treated group had significantly more chronic lung disease, longer duration of oxygen therapy, more chronic reactive airway disease, and more rehospitalizations than those treated with ECMO. Hospital charges were similar in the two groups. Macrocephaly was noted in 24% of those treated with ECMO and in none of the conventional group. Of those completing evaluation, 4 (24%) of 17 conventionally treated survivors and 20 (26%) of 38 ECMO-treated survivors had neurodevelopmental impairment. CONCLUSION Survivors of severe neonatal respiratory illness have significant pulmonary and neurodevelopmental impairment, regardless of the treatment used. Neonates treated with ECMO had neurodevelopmental outcomes similar to those of patients treated conventionally, but better pulmonary outcomes.
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Affiliation(s)
- M C Walsh-Sukys
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
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Cosgrove JL, Alexander MA, Kitts EL, Swan BE, Klein MJ, Bauer RE. Late effects of poliomyelitis. Arch Phys Med Rehabil 1987; 68:4-7. [PMID: 3800623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Muscular atrophy and decreased functional abilities are recognized as late complications of poliomyelitis. This study sought to more clearly define late-onset, postpolio muscular weakness--age of onset, symptoms, and severity--and to determine whether people might benefit from environmental modification, respiratory aids, and orthoses. A total of 183 postpolio patients were examined by a physician and completed a questionnaire on their ambulatory status and related musculoskeletal and respiratory symptoms. Of those participating in the study, 154 claimed to be experiencing late deterioration in strength. The syndrome included decreased endurance, more limited ambulation, and increased weakness in the previously affected limb/s. For those describing late-onset weakness, average ages were determined for the onset of polio (8.3 years), the onset of postpolio muscular weakness (42.3 years), and the latent period of stable functioning (34.8 years). Patients claimed to have experienced a new, lower level of strength for an average of 4.7 years. All 33 patients who had undergone muscle transfer surgery were experiencing late-onset weakness in that extremity. Fasciculations (51%) and long-bone fractures secondary to falls (21%) were common sleep disturbances occurred frequently (31%) even in those without prior bulbar involvement. Upper motor neuron signs were present in only one case. Bracing was rare (16%) and the braces used were usually old. The subjects did not report a steadily or rapidly progressive decline, but rather described a steplike decrement with long plateaus. The population described losses in strength that had significant bearing on functional status and general health.(ABSTRACT TRUNCATED AT 250 WORDS)
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Bergman I, Bauer RE, Barmada MA, Latchaw RE, Taylor HG, David R, Painter MJ. Intracerebral hemorrhage in the full-term neonatal infant. Pediatrics 1985; 75:488-96. [PMID: 3975118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Supratentorial intracerebral hemorrhage was diagnosed in 18 full-term neonates, including six with primarily intraparenchymal hemorrhage and 12 with primarily intraventricular hemorrhage. Precipitating or associated factors were hypoxic-ischemic injury in five patients, polycythemia in two, and cranial birth trauma in two. Nine other infants had no identifiable medical risk events. The pathogenesis of intraparenchymal hemorrhage was probably related to hemorrhagic infarction, but the pathogenesis of intraventricular hemorrhage was often unknown. All 17 survivors returned for neurologic and developmental examinations between 1 and 7 years of age. Follow-up assessments were normal in nine children and abnormal in eight. Two had perceptual difficulties, three had moderate-to-severe cognitive deficiencies (two of the three had hemiplegia), and three had severe mental and neurologic handicaps. Eight of nine children with known or suspected hypoxic-ischemic or traumatic insults suffered moderate-to-severe disabilities whereas eight of nine children with no known precipitating cause for their hemorrhage developed normally.
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Taylor HG, Michaels RH, Mazur PM, Bauer RE, Liden CB. Intellectual, neuropsychological, and achievement outcomes in children six to eight years after recovery from Haemophilus influenzae meningitis. Pediatrics 1984; 74:198-205. [PMID: 6611537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Twenty-four grade school children who had sustained an earlier episode of Haemophilus influenzae type b meningitis were tested, along with a group of 24 school-aged siblings. Evaluations consisted of tests of IQ, academic achievement, and neuropsychological skills. Parents completed forms rating each child's behavioral adjustment and temperament. Available school-administered standardized achievement tests were also obtained. Information relating to the episode of meningitis was extracted from the medical charts of each child who had had meningitis in order to investigate the relationship of these parameters to developmental outcome. Results showed that, compared with nearest-age siblings, children who had had meningitis scored lower on performance IQ and full-scale IQ. The group that had had meningitis also performed more poorly on several neuropsychological tasks. However, the groups did not differ in verbal IQ, and they performed comparably on all academic measures. Significant behavioral adjustment problems were absent from both groups, and there were no notable differences in temperament. Although findings support the existence of postmeningitis sequelae, the selective nature of the deficiencies observed indicate that prognosis for children in the age range examined may be better than that suggested by earlier studies.
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