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Atypical Neuroleptic Malignant Syndrome: A Case Presentation, Philip Mccarthy, Matthew Lacasse
Atypical Neuroleptic Malignant Syndrome: A Case Presentation, Philip Mccarthy, Matthew Lacasse
Research Day
Introduction: Neuroleptic malignant syndrome (NMS) is an emergent, often fatal, medical condition associated with the use of dopamine receptor antagonist medications. Fever, muscle rigidity, autonomic instability and altered mental status are known to be the hallmarks of the disease. In contrast with the typical presentation, Atypical NMS often presents with a different set of symptoms, making diagnosis difficult. It is important to use clinical acumen to make a timely and efficient diagnosis of NMS. We present a case of Atypical NMS in a 21 year old male. Clinical Case Pt is a 21 year old African American male with previous …
Mixed Goblet Cell Carcinoid-Adenocarcinoma: A Case Series, Jairo Espinosa M.D., Timothy Truong, Julia Miladore M.D., John T. Collins, Saad Shebrain M.D., Gitonga Munene M.D.
Mixed Goblet Cell Carcinoid-Adenocarcinoma: A Case Series, Jairo Espinosa M.D., Timothy Truong, Julia Miladore M.D., John T. Collins, Saad Shebrain M.D., Gitonga Munene M.D.
Research Day
INTRODUCTION: Mixed goblet cell carcinoid-adenocarcinoma (GCC) tumors are a group of rare heterogenous neoplasms of the appendix accounting for < 5% of all primary appendiceal tumors. They are characterized as an intermediate between classic carcinoid tumors and appendiceal adenocarcinomas, exhibiting both neuroendocrine and glandular/mucinous morphology that most commonly presents in Caucasian females in the fifth and sixth decades. We present three cases of mixed GCC presenting as acute appendicitis. CASE PRESENTATION: Case #1 A 65-year-old male presented with RLQ pain, nausea, emesis, and leukocytosis. CT of the abdomen revealed perforated appendicitis. The patient underwent a laparoscopic appendectomy. Pathology revealed a high-grade adenocarcinoma ex goblet cell carcinoid, signet ring type extending through the muscularis propria into the mesoappendix measuring >3cm. The patient subsequently underwent a colonoscopy that revealed diverticulosis, but was otherwise normal. Patient then underwent a right hemicolectomy and partial omentectomy. Pathology revealed normal ileal, omental, and colonic tissue without evidence of carcinoma. 0/12 nodes were positive. Case #2 A 49-year-old male presented with periumbilical pain, nausea, emesis, and leukocytosis. CT of the abdomen revealed appendicitis. The patient underwent a laparoscopic appendectomy. Pathology revealed a high-grade, poorly differentiated, adenocarcinoma ex goblet cell carcinoid invading through the muscularis propria into …
Delivery Of Health Education In Adolescents With Behavioral Health Challenges, Ashley Akkal, Ransome Eke Md, Phd, Sulin Wu, Amy Rechenberg, Michael Madrid, Jose Lopez-Vera, Duncan Vos
Delivery Of Health Education In Adolescents With Behavioral Health Challenges, Ashley Akkal, Ransome Eke Md, Phd, Sulin Wu, Amy Rechenberg, Michael Madrid, Jose Lopez-Vera, Duncan Vos
Research Day
BACKGROUND Adolescents with behavioral health issues tend to have inadequate access to health education, and are thus less aware of the importance of personal and dental hygiene, exercise, and healthy diet and lifestyle habits. Due to this disparity, this population has been known to harbor a higher prevalence of STI’s, drug and alcohol abuse, physical altercations, juvenile detention, and suicide attempts. PURPOSE The overall objective of this study was to examine the effect of integrating a health science curriculum in this population. METHODS Participants aged 5-17 years old were recruited and assigned to either control or science groups by Family …
Challenges In The Diagnosis And Management Of Pediatric Pulmonary Tuberculosis In Madagascar, Emily Cordes, Richard Roach
Challenges In The Diagnosis And Management Of Pediatric Pulmonary Tuberculosis In Madagascar, Emily Cordes, Richard Roach
Research Day
Introduction: Tuberculosis (TB) remains an important cause of morbidity and mortality in Madagascar. According to the World Health Organization (WHO), in 2015, the estimated incidence of TB was 57,000 and 11,000 of those cases were of patients less than 14 years old. Of the reported cases, 89% were bacteriologically confirmed. However, it is well established that bacteriologic confirmation of TB in children is especially difficult. Therefore, the incidence of TB in the pediatric population in Madagascar, and likely worldwide, is under estimated. We report a case of a 4 year old male that illustrates the challenges in diagnosis and management …
Antegrade Endosteal Fibular Strut Augmentation For Periprosthetic Femur Fracture Above Stemmed Total Knee Arthroplasty, Tyler Snoap, Jason Roberts, Matthew Jaykel
Antegrade Endosteal Fibular Strut Augmentation For Periprosthetic Femur Fracture Above Stemmed Total Knee Arthroplasty, Tyler Snoap, Jason Roberts, Matthew Jaykel
Research Day
Abstract Title: ANTEGRADE ENDOSTEAL FIBULAR STRUT AUGMENTATION FOR PERIPROSTHETIC FEMUR FRACTURE ABOVE STEMMED TOTAL KNEE ARTHROPLASTY Abstract ID: 245 Abstract Category: Clinical Research Introduction: The management of peri-prosthetics fracture around total knee replacements is technically challenging. The options for operative fixation become more limited if the femoral component is stemmed, which often is the case after revision arthroplasty procedures. The goals of surgery for peri-prosthetic fractures above knee replacements are to provide a rigid construct to promote healing, allow immediate knee range of motion, and allow weight bearing during the healing process. Purpose: The purpose of this study is to …
Surviving As A Cancer Survivor: A Case Report Of Radiation-Induced Autonomic Dysfunction, Daphne Sy, Mark Schauer
Surviving As A Cancer Survivor: A Case Report Of Radiation-Induced Autonomic Dysfunction, Daphne Sy, Mark Schauer
Research Day
While radiation and chemotherapy have achieved high rates of cure for Hodgkin lymphoma, the medical community is only now starting to characterize the long-term effects of treatment on these young cancer survivors, many decades later. Mantle radiation has been implicated in significantly increased cardiovascular risks, pulmonary fibrosis, other cancers, and thyroid disease over the patient’s lifetime. However, new syndromes are still being discovered within this population as they age. The purpose of this case study was to consider the unique health issues of cancer survivors, and how their treatment history should prompt us to broaden our differentials. Our patient presented …
Food Insecurity In Kalamazoo, Nicholas Sweda, Cheryl A. Dickson, Jeffrey Friedman, Michelle L. Knapp, David Lee, Vina Tran
Food Insecurity In Kalamazoo, Nicholas Sweda, Cheryl A. Dickson, Jeffrey Friedman, Michelle L. Knapp, David Lee, Vina Tran
Research Day
Introduction: Food insecurity is both an inconvenience and problem. As of 2013, over 16 million children in the USA were food insecure. The consequences of food insecurity include health issues from nutritional deficits, developmental difficulties, and behavioral problems that manifest in educational, personal and professional challenges. Overall, food insecurity and its impact on individuals and families is under-recognized. Additionally, the extent to which physicians play a role in helping patients secure access to food assistance programs remains unclear. Objective: The objective of this study was to assess the efficacy and methodologies of current healthcare practices based in Kalamazoo County, MI, …
Improving Productivity Through Scheduling At The Wmed Family Medicine Residency Clinic, Alex Witte Md, Susan Jevert-Eichorn, Alison Radigan Md, Larry Mann Do, Jamie Mccartney Md, Aisha Shakoor Md
Improving Productivity Through Scheduling At The Wmed Family Medicine Residency Clinic, Alex Witte Md, Susan Jevert-Eichorn, Alison Radigan Md, Larry Mann Do, Jamie Mccartney Md, Aisha Shakoor Md
Research Day
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) requires every family medicine residency program to have a practice site that supports, “continuous, comprehensive, convenient, accessible, and coordinated patient care”. The WMed Family Medicine Resident Clinic (Team Oakland), located within the Family Health Center (FHC) – Paterson location, has long been plagued by scheduling difficulties, as evidenced by high no-show rates, empty appointment slots, and frequent cancellations threatening the ability of our residents to achieve the required number of outpatient visits mandated by the Family Medicine Residency Review Committee (RRC) and the requirement for continuity from the ACGME. We believe …
Social Determinants - Impacting Or Causing Disparities In Patient Care?, Shaena Faye Freeman Md, Kristi Vanderkolk Md
Social Determinants - Impacting Or Causing Disparities In Patient Care?, Shaena Faye Freeman Md, Kristi Vanderkolk Md
Research Day
Health disparities secondary to social factors including socioeconomic status, race, gender and ethnicity are well known to the health community and are a troubling issue in the United States. Social determinants are defined by the WHO as the structural “conditions people are born, live, grow, work and age in…determined by wealth distribution and available resources…that are mostly responsible for health inequalities.” We present here the case of TL, a 49 year old African American female who presented to the emergency department three times with atypical coronary disease symptoms in the setting of recent NSTEMI with subsequent 3 vessel CABG. At …
Traumatic Stab Wound To The Chest: A Rare Cause Of Pituitary Apoplexy, Jairo Espinosa M.D., Tim Wysozan, Chris Sloffer
Traumatic Stab Wound To The Chest: A Rare Cause Of Pituitary Apoplexy, Jairo Espinosa M.D., Tim Wysozan, Chris Sloffer
Research Day
INTRODUCTION: Pituitary apoplexy is an uncommon condition that results from infarction and hemorrhage of an established pituitary adenoma. Based on our review of the literature, this is the first description of pituitary apoplexy presenting after a knife stab wound to the deltopectoral region. CASE PRESENTATION: A 44 year-old male presented to the trauma bay as a tier 1 trauma activation status post stabbing to the left deltopectoral groove. The patient was found to be hypotensive, tachycardic and actively exsanguinating from the stab wound. He was taken to the operating room where the wound was explored and the left cephalic vein …