Medicine and Health Sciences Commons^™

The Influence Of Nutrition On The Gut Microbiota And Psychiatric Disorders: A Review, Megha Bhagavan, Francis Jenney

Research Day

The symbiotic harboring of gut microorganisms within the gastrointestinal tract has a profound influence on host physiology, well-being, and disease pathology. More specifically, the gut bacteria are able to interact with dietary components from foods chosen by the host and consequently relay their beneficial or precarious effects locally and systemically. The gut bacteria have the capacity to maintain a healthy gut microbiome or perpetuate intestinal imbalance, known as gut dysbiosis. Gut dysbiosis has both local effects in gastrointestinal pathologies, such as intestinal bowel syndrome (IBS) and intestinal bowel disorder (IBD), as well as systemic pathologies, such as type II diabetes, …

Bridging The Gap: The Lived Experience Of Women With Diastasis Recti Abdominis, Jennifer Wiley, Ruth Maher

Research Day

Research on Diastasis recti abdominis (DRA) has primarily focused on diagnostic tools, surgical and conservative treatments. Despite the association of significant physical symptoms and impact on quality of life, evidence is absent regarding knowledge or education provided to women about this condition.

Purpose: This study explored the lived experience of women who either self-identified or were medically diagnosed with DRA. A deeper insight into the experience of women with DRA may serve to enhance the patient-provider interaction during this critical time.

Methods: Qualitative methodology with a basic interpretive approach and purposive sampling was used. Participants shared their experiences through a …

Comparison Of Estimated Glomerular Filtration Rate Using Five Equations To Predict Acute Kidney Injury Following Total Joint Arthroplasty, Hunter Hayes, Kevin Mekkawy, Yash Chaudhry, Michael Raad, Raj Amin, Harpal Khanuja

Research Day

Introduction: Primary total joint arthroplasty (TJA) is one of the most common procedures in the United States, and as the incidence of this surgery increases, identifying methods for improving outcomes and reducing complications is essential. Acute kidney injury (AKI) following TJA is a potential source of morbidity and mortality. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. Several equations are commonly used to calculate eGFR. The purpose of this study was 1) to evaluate the agreement between five equations in calculating eGFR, and 2) to confirm which equation can best predict AKI in patients undergoing …

Pericardial Effusion "Worm-Like Strands" On Transthoracic Echocardiogram, Annamarie Pontier, Andrew Rose Md, Meredith Mcnelis Pa-C

Research Day

Background: Fibrinous Pericardial Effusion is the accumulation of excess fluid in the pericardial fibroelastic sac. It can be a symptom of any pathological process that affects the pericardium from acute pericarditis to systemic disorders. This broad differential poses a diagnostic challenge in the setting of acute fluid accumulation.

Case Presentation: A 50-year-old male with a past medical history of extensive intravenous drug use complicated by bacteremia and left ankle abscess formation presented to the Emergency Department complaining of mild-moderate chest pain for four days. Within the last month, he presented to the Emergency Department three times for similar symptoms; however, …

Lumbar Sympathetic Block As A Treatment Modality For Complex Regional Pain Syndrome, Kelci Beardsley, Ronald Lincow

Research Day

Setting: Outpatient Pain Management

Patient: A 28-year-old male with a history of cryptogenic stroke, bilateral lower extremity compartment syndrome, and severe left foot pain secondary to emergent fasciotomy.

Case Description: This patient presented to the office with a chief complaint of left foot pain. Past medical history was significant for cryptogenic stroke and bilateral lower extremity compartment syndrome, status post emergent fasciotomy. Severe left foot pain began after emergent fasciotomy, and he required a walker for ambulation. While hospitalized, several different treatment modalities were utilized in an attempt to alleviate the pain. Previous treatments included tricyclic antidepressants, gabapentin, and saphenous …

Soft Tissue Chondroma Of The Thumb, Harsha Upadhya, Darshdeep Singh

Research Day

A chondroma is a slow-growing, benign cartilaginous tumor. When a chondroma occurs in soft tissue without any involvement of the surrounding bone, it is known as a soft tissue chondroma which is an especially rare type of malignancy that has a predilection for the hands and feet. A soft tissue chondroma originates from either the synovial sheath of long tendons, para-articular tissues, or paratendinous soft tissues. This type of tumor can often be misdiagnosed as several different pathologies, including but not limited to, a ganglion cyst, osteochondroma, synovial chondromatosis, or even malignant examples such as a chondrosarcoma or synovial sarcoma. …

The Relationship Between Adhd-Specific Cognitive Distortions And Adult Adhd After Accounting For Clinical Syndromes And Personality Pathology, Carly Gerbi

Research Day

Introduction: Adults with attention-deficit/hyperactivity disorder (ADHD) experience many difficulties in daily functioning, which are related to the symptoms of the disorder. Psychostimulants, although considered the front-line of treatment for ADHD, are not always effective. On the other hand, psychosocial treatments, particularly cognitive behavioral therapy, is an evidence-based treatment, both in combination with medication as well as a stand-alone treatment for ADHD. It is theorized that some of the symptoms experienced by adults with ADHD result from cognitive distortions. Although, previous studies have identified a preliminary relationship between cognitive distortions and ADHD, which may be accounted for by comorbid disorders; these …

Stroke Centers Of Excellence In The United States: Certification, Access And Outcomes, Evan Kolesnick, Joshua Weinberg, Shyam Majmundar, Ahmad Sweid, Jane Khalife, Satish Gaddam, Zubin Hussain, Robin D'Ambrosio, Maureen Deprince, Pascal Jabbour, Stavropoula Tjoumakaris, M. Reid Gooch, Robert Rosenwasser, Nabeel Herial

Research Day

Introduction: Stroke is a leading cause of morbidity, mortality and healthcare costs in the United States. Evidence suggests that certified stroke centers have improved patient outcomes relative to non-certified hospitals. Our study explains the process, associated cost, quality and geographic proclivities of different certifying organizations.

Methods: Data was collected from published literature, information on certifying organizations’ websites and through direct communication with representatives of The Joint Commission (TJC), Det Norske Veritas and Germanischer Lloyd (DNV-GL), and Healthcare Facilities Accreditation Program (HFAP). Geographic mapping of thrombectomy capable centers and comprehensive stroke centers was performed with the ArcGIS online tool.

Results: Among …

Development Of Humanized Mouse Model For Organ Transplantation, Daniel D. Horuzsko, Ashwin Ajith, Laura Mulloy, A. Musa, Valia Bravo-Egana, Imran Gani, Anatolij Horuzsko

Research Day

Purpose of Study: Solid organ transplantation has been a life-saving procedure for thousands of patients worldwide. Recent advances on improving donor-screening diagnostics have aimed at identification of the most compatible donor for the transplant recipient to maximize allograft survival. Current standards of donor selection relies on HLA typing and in vitro mixed lymphocyte reaction (MLR) which do not take into account the in vivo environment and recipient’s adaptive immune response. Humanized mouse models are an appealing alternative that permits personalized investigation of the immunocompatibility of potential donor tissues for the recipient human immune system without putting patients at risk. By …

Strabismus Decompensation As A Possible Neurological Manifestation Of Covid-19: A Case Report, Tyler Stevens

Research Day

A 27-year-old female presents to the emergency room with acute onset horizontal binocular diplopia and a history of COVID-19 infection two weeks prior. She has a history of longstanding intermittent right esotropia. Before her COVID-19 infection she only had diplopia after extended reading and typically sees clearly. After the infection, she has constant double vision which started acutely and worsened over several hours. Her only other symptom at the time was increased fatigue. During examination of eye tracking, there was a left esotropia when looking left and a right esotropia when looking right. She was discharged with a Medrol Dosepak …

Virtually Building A Community Of Experts In The Medication-Assisted Treatment (Mat) Of Opioid Use Using The Project Echo Model, Matthew Momjian, Justin Canakis, Faraz Yousefian, Hayden Pond, Adrienne White, Gregory Mayer, Alison Essary

Research Day

Purpose: Project Extension for Community Healthcare Outcomes (ECHO) utilizes telemedicine to connect a multidisciplinary team of experts with a network of primary care physicians to enable rapid dissemination of evidence-based guidelines and practices at scale. In this study, the Project ECHO model disseminated the Arizona Pain and Addiction Curriculum to providers in rural Arizona with the goal to educate providers on MAT.

Methods: Participants engaged in biweekly, virtual teleECHO sessions and post-session surveys were used to collect data on provider satisfaction, self-efficacy, knowledge, barriers to change and changes in practice behavior. Results: Between February 2020 – November 2020, the MAT-ECHO …

Bleeding After Endoscopic Peg-Tube Removal On Patient Taking Clopidogrel, Sahil Patel, Michael Steinbook

Research Day

A 64-year-old man who is taking Clopidogrel was getting his PEG-tube removed endoscopically. Post-procedure, he started profusely coughing up blood clots. As a result, a repeat esophagogastroduodenoscopy had to be performed and revealed no blood in the esophagus or stomach. Upon further evaluation, the source of his blood clots was an ongoing episode of epistaxis which started following his COVID-19 test via nasopharyngeal swab three days prior. With the increasing need for COVID-19 testing, screening for epistaxis prior to performing out-patient procedures can help differentiate epistaxis from other procedurally-related complications

No Pain No Gain: Student Performance Over Time On The Revised Neurophysiology Of Pain Questionnaire, Ruth Maher, Jeanne P. Welch

Research Day

Purpose/Hypothesis: Core competencies in pain management for pre-licensure health professional education have been established. The purpose of this study was to assess the effect of 10-hours of pain neurophysiology education (PNE) on physical therapy students' understanding of pain and retention of key concepts.

Number of Subjects: Thirty-three second-year physical therapy students.

Materials and Methods: Ten hours of PNE was embedded in a clinical neuroscience course which included a 2-hour lab assignment called “The Matrix”. The content was guided by key principles recommended by the International Association for the study of Pain (IASP). The lab assignment included case studies that required …

Assessment Of Patient And Employee Mental Health During Covid-19, Lanerica Rogers, Tammy Phillips, Aerial Petty, Gabriana Freire, Carline Denis-Barnes

Research Day

Background: Many individuals in the United States have anecdotally reported a decline in their mental health due to worry and stress over the COVID-19 pandemic. Although much research has been dedicated to populations across the country, patients and employees at community health centers have been overlooked in terms of the effect of pandemic conditions on their mental health. The present study seeks to understand how the mental health of these populations has been impacted and offer recommendations for what can be done to address any unmet mental health needs.

Methods: Survey responses were compiled from patients and employees of the …

Psychological Impact Of Covid-19 On Individuals With Prior Trauma, Marzena Podkalicka, Susan Panichelli Mindel

Research Day

The new coronavirus disease (COVID-19) was first recognized in December 2019 in Wuhan, Hubei Province, China. The World Health Organization Emergency Committee declared the COVID-19 outbreak to be a global health emergency and a pandemic in early 2020. Due to the lack of unequivocally effective methods of treatment for the coronavirus disease, governments enforced nonpharmacological interventions to decrease the transmission of the coronavirus including social distancing, isolation, and shelter in place to stop the spread of COVID-19. The scale of the pandemic, the speed of the spread, and high mortality rate created a sense of panic, stress, and helplessness among …

The Association Between Trauma History And Body Image, Depression, Posttraumatic Stress, And Relationship Satisfaction In Postpartum Women, Kristen Hawk-Purcell, Michelle R. Lent

Research Day

The postpartum period can be a time of significant change and transition. Little is known regarding how a history of trauma may impact functioning during this critical time. The literature is consistent regarding the relationship between trauma and body image-related issues, but this has not been investigated with this population. While posttraumatic stress symptoms are considered a significant public health concern, the association between depression and interpersonal concerns has not been thoroughly explored. The purpose of this observational, cross-sectional study is to explore the relationship between trauma and body image, mood, and relationship satisfaction in postpartum women.

Proposed Methods: English …

Benefits Of Preclinical Osteopathic Medical Students' Joining Interprofessional Research Teams, Alexander Rembalsky, Stephanie H. Felgoise

Research Day

Challenge/ Issues: There are few options for interprofessional research experiences that offer medical students the ability to collaborate with clinical psychology doctoral (PsyD) students. While a core principle of osteopathic medicine is holistic care, exposure to psychosocial aspects of medical conditions is limited or unrepresented in the preclinical education years. As an example, the psychosocial aspects and quality of life issues related to kidney dialysis are not discussed in the classroom.

Objectives: The objectives for integrating medical students into a research study on quality of life and psychosocial aspects in persons undergoing kidney dialysis are to: a) have psychology and …

Problem-Solving Teletherapy For Adults With Visual Impairment: A Feasibility Study To Improve Access And Treatment, Marissa Ferrito, Bradley Michael Rosenfield, Stephanie Ferretti, Michael B. Roberts

Research Day

Introduction: Adults with visual impairment are at increased risk of developing depression and experiencing a decreased quality of life, as compared to vision intact adults. However, there are many barriers to accessing health problems for this population.

Purpose: The purpose of the study is to explore the impact of a virtual group-based intervention utilizing strategies from motivational interviewing and cognitive-behavioral problem-solving therapy to improve attendance and treatment outcome for adults with visual impairment. Specifically, the study will focus on improving previously demonstrated low rates of attendance, as well as improving depression, quality of life, problem-solving skills; and reducing cognitive distortions. …

Surgical Techniques For Lymphedema Management, Matthew Kayal, Shelley Dicecco

Research Day

Introduction: Lymphedema is known as a debilitating disease where the management plan can require a combination of surgical and conservative treatments. Worldwide, greater than 300 million people suffer from lymphedema. The lymphatic system is responsible for the drainage of fluid from the interstitial tissues and organ systems and is the body’s primary way of managing edema. The aim of this review was to investigate the efficacy of the procedures and the multiple surgical options that exist for the treatment of lymphedema, including the Charles procedure, liposuction or suction-assisted protein lipectomy (SAPL), lymphovenous anastomosis (LVA), and vascularized lymph node transfer (VLNT). …

Pretreatment With Naltrindole Exhibits Robust Cardioprotection In An Isolated Rat Heart Model Of Ischemia-Reperfusion Injury, Alexis Verwoert, Arjun Nair, Michael Bamimore, Tameka Dean, Sunit Singh, Melinda Beale, Kayla Harrell, Cameron Stinson, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Previously, a novel three-amino acid peptide (tripeptide) that is structurally similar to other amino acid-based delta and kappa-opioid receptor agonists (the predominant opioid receptor subtypes in heart tissue) demonstrated a significant reduction in infarct size and improved cardiac function when administered during preconditioning in isolated rat hearts using the Langendorf model. The cardioprotective effects of tripeptide were blocked by naloxone (NX, broad-spectrum opioid antagonist) and nor-binaltorphine (BNI, kappa-opioid receptor antagonist), whereas naltrindole (NTI, delta-opioid receptor antagonist) seemed to augment the effects of tripeptide. To determine whether the cardioprotective effects of the combination were due to tripeptide or NTI, the effects …

Anatomical Investigation Following Incidental Horseshoe Kidney Finding, Alexandra Cain, Brannan De Voto Noonan, Sara Eliseo, Anthony Sciuva, Leslie Pryor Mcintosh

Research Day

Horseshoe kidneys are congenital anomalies that result from the fusion of the right and left kidneys across the midline of the abdomen after both kidneys failed to ascend during fetal development. During a standard educational dissection of 12 donor bodies from the Body Donor Program at PCOM Georgia, a horseshoe kidney was discovered in an 88-year-old female with a reported fatality related to left lung carcinoma, encephalopathy, and hypercalcemia. The circumstances of this discovery presents an opportunity to explore the anatomical arrangement of the congenital malformation in detail. Anatomical dissection and analysis of the neurovascular and renal organization was documented …

Rapid Return To Normal Activities At A Residential Summer Camp During Covid-19 Pandemic, Anna Klunk, Rachel Holloway, Arash Babaoff, Eric Jelin

Research Day

Aim: Infection prevention and control (IPC) within residential settings is a central focus of the coronavirus disease 2019 (COVID-19) pandemic. Youth residential summer camps are an excellent model for such environments and have thus far had mixed results. The aim of this report is to describe the successful implementation of a seven-week overnight summer camp with rapid return to normal activities from June to August 2020

Subjects and Methods: This retrospective study includes 427 individuals who traveled from 24 US States. All staff and campers were tested by serial nasopharyngeal PCR tests in the context of strict infection prevention and …

A 37-Year-Old Female With Low Back Pain And Acute Lower Extremity Weakness, Kelci Beardsley, Ronald Lincow

Research Day

Setting: Outpatient Pain Management

Patient: A 37-year-old female with no significant past medical history presents with low back pain and unilateral lower extremity weakness two weeks after a motor vehicle accident.

Case Description: This patient presented to the office with a chief complaint of new right sided low back pain and right lower extremity weakness. History revealed that the patient was involved in a motor vehicle accident (MVA) several weeks prior to presentation. She was the restrained driver and was hit from behind by another motorist. The patient noted that she immediately felt stiffness in her low back, but did …

Special Considerations In Facial Transplantation: A Systematic Review, Melanie Shpigel, Sammy Othman, Jason Cohn, Christopher Hill, Paige Bundrick, Gabriel F. Santiago, Chad Gordon

Research Day

Background: Vascularized composite allotransplantation (VCA) of the face is an exceedingly complex procedure, requiring extensive planning and surgical precision in order to successfully manage patients with facial disfigurements. This review aims to present an overview of the salient anatomic considerations in facial transplantation, as well as give attention to unique patient populations and special considerations.

Methods: A literature review was performed in search of articles pertaining to considerations in facial transplantation using the databases PubMed, Web of Science, and Cochrane. Articles selected for further review included full-text articles with an emphasis on specific anatomic defects and how they were addressed …

A Case Study Of The Anomalous Extensor Digitorum Brevis Manus, Herve Peacemaker Ineza, Darshan Patel, Jeanine Garcia, Macy Rowan, Leslie Pryor Mcintosh

Research Day

During routine forearm dissection of 12 cadavers, which originated from the PCOM Georgia Body Donor Program, at PCOM South Georgia, an aberrant muscle was discovered on the dorsal surface of the hand of a 72-year-old Caucasian male. The muscle, known as the Extensor Digitorum Brevis Manus (EDBM), was located bilaterally and deep to the tendons of the Extensor Digitorum. On assessment, the left hand of the donor had two EDBM tendons that intersected and attached to the proximal phalanx of the third digit. The right-hand tendons ran parallel and inserted onto the third digit of the proximal phalanx. An investigation …

A Rare Anatomical Variation Of The Origin And Insertion Of The Extensor Pollicis Et Indicis Communis Muscle, Derek George, Travis Tuck, Samuel P. Prhalow, Cody Hyatt, Leslie Pryor Mcintosh

Research Day

The extensor compartment of the forearm is a site with frequent anatomic variation that are encountered during examination with radiologic imaging, surgery, and general cadaver dissections. One such variation is the extensor pollicis et indicis communis (EPIC) which has a prevalence of 0.5 to 4% in the global population. Our group at PCOM South Georgia discovered this anatomical variation on a female cadaver of 58 years during a routine dissection of 12 cadavers obtained through the Body Donor Program at PCOM Georgia. The EPIC muscle was encountered unilaterally on the posterior aspect of the right forearm between the extensor pollicis …

De Novo Sox6 Variants Cause A Neurodevelopmental Syndrome Associated With Adhd, Craniosynostosis, And Osteochondromas, Dara Tolchin, Jessica P. Yeager, Abdul Haseeb, Marco Angelozzi, Véronique Lefebvre, Cédric Le Caignec

Research Day

Introduction: The SOX gene family consists of twenty transcription factors that play a pivotal role in cell fate and differentiation during the development of many organ systems. Within these SRY-related (SOX) genes is a highly conserved high mobility group (HMG) domain that has been shown to be critical for DNA binding and bending, nuclear trafficking, and protein-protein interactions. Mutations within this transcription factor family have been associated with rare congenital disorders, known as SOXopathies. These mutations are commonly de novo, heterozygous and inactivating, and exhibit gene haploinsufficiency. Of these twenty transcription factors, SOX6 is known to be involved in chondrocyte …

Adapting To Challenges Presented In Training New Students In Laboratory Techniques During Covid-19, E-Jine Tsai, Rushil Brahmbhatt, Jessica Kim, Troy Hillanbrand, Grzegorz Gorski, Arturo Bravo Nuevo

Research Day

Introduction: In early 2020, COVID-19 entered the United States, and by the end of March 2020, the city had mandated schools shut down to slow the spread and flatten the curve. Beginning in the fall, PCOM started slowly opening up research labs again to students with restrictions in capacity and returning onto campus. The new standards affected the normal timeline of introducing new students into the lab. The Bravo research laboratory takes an average of 20 students in each year, with a limited number of students allowed to be trained at the time, the lab management personnel had to adapt …

Effects Of Lycopene And The Mediterranean Diet On Prostate Cancer: A Critical Analysis Of The Data, Natalie Silk, Dianzheng Zhang

Research Day

Background: Prostate cancer (PCa) is one of the most widespread cancers diagnosed in men in the United States and is the second leading cause of cancer-related deaths worldwide. PCa will be a major cancer-related burden both socially and economically in the near future. It has been shown that dietary intake of natural anti-inflammatory agents are capable of inhibiting cancer progression, but due to the nature of dietary studies it is difficult to accurately conclude that diet is capable of impacting chronic diseases and mortality.This systematic review aims to collect and evaluate literature focused on prostate cancer progression and the natural …

Etiology Of Svc Syndrome And Its Role In Determining Best Treatment Approach - A Case Report, Molly Casey, Sagar Desai, Vinnit Khanna, Rakesh Ahuja

Research Day

Introduction: Obstruction of the Super Vena Cava (SVC) can result in symptoms, such as facial plethora and swelling, and be due to a variety of underlying causes besides lung malignancies, the rates of which have changed over time; the underlying etiology is used to determine the best management strategy.

Objectives: This case report aims to discuss the role of etiology in determining the best initial treatment for SVC syndrome (SVCS) and outlines the unique management for a patient that represents the changing demographics of SVCS causes.

Case Presentation: A 73-year-old male with end-stage renal disease (ESRD) and metastatic carcinoma of …