Rio Salado College Models of Care Discussion Response

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Respond to the following individual’s discussion posts. There need to be at least 2 paragraphs per question with a minimum of 7 sentences per paragraph.

Julie

Real-world implications for my capstone project (literature review for Xsensio Lab-on-Skin™ Sensing PlatformLinks to an external site.) are incredible. This device could allow for much earlier detection of acute myocardial infarction (AMI) that would not only allow for earlier treatment, but also alleviate considerable pressure on Emergency Departments (ED) because this device could be used at home. One study found that of ED visits for chest pain, about one-third required hospitalization, of which 10.7% of these were for AMI (Kohn et al., 2005). This means that two-thirds of unnecessary hospital visits for chest pain could be prevented and the 10% of people who need immediate help for their heart attack could receive much faster diagnosis and treatment.

However, this requires identification of biomarkers that could indicate AMI or other conditions. For example, troponin C is a protein found only in cardiac tissue and is used along with other tools (e.g. electrocardiography) to detect AMI. Alas, it can also be present in folks who’ve had recent heart surgery, for instance. Therefore, it is currently measured in hospital settings to detect changes in values within the individual over time; this can take hours. A further complication is that protein concentrations can vary significantly between individuals (i.e. men typically have higher concentration of these proteins than women). The unique thing about this device and hence the literature review to support a clinical trial, is that could measure changes in this protein as opposed to a static value. The possibilities of a device that measures changes in concentration over time in the home setting are tremendous. However, it will also depend on how well an individual uses the device.

If I had more time to research this, I would want to know more about advancements in microneedle sampling devices, which are very new. There is also a lot of variation in the literature that translates concentration of biomarkers in blood vs. in interstitial fluid. It’s interesting to note how advancements in technology, such as highly-sensitive tools developed in 2017 that allow for detection of proteins at the ng/mL level have evolved the literature. This increasing specificity has made some of the literature before 2017 irrelevant, whereas some of the literature such as the concentration of proteins in blood vs. ISF or variations in populations can be sourced from earlier materials. Additionally, this device could be used for so many conditions besides AMI, such as detection of sepsis within the body.

I would also love to see how the device manufacturers go about the incredibly complex process of knowing which biomarkers they are measuring and how the constraints of the device might affect measurement of the actual concentration of biomarkers. This is described in the article by Zhang et al. (2019). For instance, if there was a biomarker that was extremely easy to measure but suggested a less-severe condition, would it be reasonable enough to conduct trials? There are so many applications for a device like this; I’m thankful we’ve learned the regulatory process for bringing devices to market to support future trials.

References

Kohn, M. A., Kwan, E., Gupta, M., & Tabas, J. A. (2005). Prevalence of acute myocardial infarction and other serious diagnoses in patients presenting to an urban emergency department with chest pain. The Journal of Emergency Medicine, 29(4), 383–390. https://doi.org/10.1016/j.jemermed.2005.04.010Links to an external site.

Zhang, X., Chen, G., Bian, F., Cai, L., & Zhao, Y. (2019). Encoded Microneedle Arrays for Detection of Skin Interstitial Fluid Biomarkers. Advanced Materials, 31(37), 1902825. https://doi.org/10.1002/adma.201902825

Poonam

What might be real-world implications or consequences (influence on others’ behaviors or decision-making processes) of your capstone project findings?  

I am working on the “Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP): Study, Research and A Case Study.” In this project, I have completed a thorough literature review and surveyed women concerning awareness of the topic and disease characteristics. I also included a case study of a patient who experienced severe PUPPP during pregnancy. With all these details and promising survey results, I am hopeful my project will draw the research community’s attention so that this topic can get its due attention. There is a need to conduct large, international, multisite clinical trials for the disease and treatment options. I plan to project the necessity rigorously as much as possible. My survey results clearly show a need to spread awareness about the condition as it’s not very common. Various ways can spread awareness about the topic, such as advertisements, pamphlets, social media, seminars, etc.

My project findings also show that Gynecologists should keep a pamphlet or a chart in their office for patients to be aware of PUPPP during pregnancy. In this way, patients will have some idea about the condition. On the other hand, I may be able to show that the current treatment options are not able to help patients in need. Hence, there is a necessity to find effective treatments for PUPPP. These findings will enforce the requirement to explore further the area of PUPPP.

References:

U.S. Department of Health and Human Services. (n.d.). Pruritic urticarial papules plaques of pregnancy – about the disease. Genetic and Rare Diseases Information Center. Retrieved July 19, 2022, from https://rarediseases.info.nih.gov/diseases/9635/pr…

If you had more time, what additional research would you conduct related to this issue? Explain your answer.

In this short time span, conducting a large, international and controlled study is impossible. If I had more time, I could have planned to do certain activities for PUPPP. First, I would have talked to each participant via phone or zoom to explain the condition and perform the consent process in a detailed way instead of adding an informational paragraph to my survey. Second, I would have conducted a comparatively large observational study about PUPPP and treatment options along with the supplementary questions with a diverse population. I could not find a large, international study for this condition, so I would have explored this area.