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, …

Utilization, Utility, And Variability In Usage Of Adjunctive Hyperbaric Oxygen Therapy In Spinal Management: A Review Of The Literature, Kurt Knepley, Jennifer Mao, Patrick Laird, Nicholas Imperato, Asham Khan, Justice Agyei, Tim O'Conner, John Pollina, Jeffrey Mullin

Research Day

The objective of this review was to understand the clinical utilization, utility, and variability in the usage of adjunctive hyperbaric oxygen therapy (HBOT). Surgical site infection is associated with high morbidity and mortality, increased health care expenditure, and decreased quality of life. With the increasing prevalence of adult spinal deformity and spinal fusion surgery, it is imperative to understand the potential benefits of adjunctive treatments. HBOT is a safe and common procedure indicated to treat various medical conditions. We conducted a literature search across 3 databases for English articles published between December 1, 2019 and December 1, 2000. Thirteen studies …

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 …

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 …

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 …

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 …

Direct Oral Anticoagulants And Prosthetic Heart Valves: A Systematic Review Of Case Reports, Tyler Richie, Steven Carter, Jiehyun Lee

Research Day

Background: Direct oral anticoagulants (DOACs) are indicated to treat and prevent venous thromboembolism and to prevent stroke or systemic embolism in patients with non-valvular atrial fibrillation. The introduction of DOACs has provided an alternative to warfarin for patients in need of oral anticoagulation. It is, however, unclear whether DOACs are safe and effective in patients with heart valve replacement. The RE-ALIGN trial published in 2013 did not support the use of dabigatran in patients with mechanical valve replacements; however, there are ongoing studies, such as the PROACT Xa trial and the ATLANTIS trial, investigating the use of other DOACs in …

A Review Of Applicable Materials For 3d Printing A Biomechanically Accurate Cervical Spine Model For Surgical Education & Case Preparation, Nathaniel Neavling, Mashaal Syed, Adedayo Adetunji, Brandon L. Mariotti, Slah Khan, Jennifer J. Mao, Jeffrey Mullin

Research Day

Objectives: The authors review the literature to compare biomechanical properties of the human cervical spine as determined by cadaveric and finite elemental model (FEM) studies, with commercially available three-dimensional (3D) printing materials to aid in the development of 3D-printed cervical spines that can be used as biomechanically accurate educational tools. Specifically, 3D printing materials for fused deposition modeling (FDM) printers were explored.

Methods: A literature review of biomechanical specifications such as Young’s Modulus and Poisson’s ratio of certain anatomical aspects of the cervical spine was performed by searching the databases PubMed, MEDLINE via Ovid, Wolters Kluwer, ClinicalKey, and EMBASE via …

Designing For Disability: Making Activities Of Daily Living More Manageable Through 3d Printing, Mashaal Syed, Anne Egan, Denah Appelt

Research Day

Introduction: While there have been many innovations developed for those with physical disabilities in recent years, a multitude of unmet needs still remain. With the advent of new and affordable technologies such as 3D printing, it is now more possible than ever before to bring one’s ideas to life; from creating customized prosthetics to wheelchair attachments for water bottles and umbrellas, we are able to quickly realize potentials otherwise unlikely - and in turn, we have the capacity to make the activities of daily living more manageable for those with physical disabilities.

Objectives: By personally hearing from individuals with physical …

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, …

Pediatric Bladder Teratoma Case Report, Michael Caro, Médina Ndoye, Lissoune Cissé, Shana Santarelli, Clayton Bunting, Mohamed Jalloh, Mouhamadou Mbodji, Serigne Gueye

Research Day

Background: Limited cases of bladder teratomas in the pediatric population have been published. Often, these tumors will present as hematuria, which is regarded as benign. Because of this presentation, pediatric patients often are not diagnosed until years after their initial presentation. We present a 4 year-old female patient who presented initially at 6 months with progressive hematuria that ultimately ended up being diagnosed with a bladder teratoma. In conclusion, bladder teratomas should be included in the initial work-up when presenting with hematuria.

Introduction: Bladder tumors are uncommon in children with an incidence of 0.1%-0.4% during the first two decades of …

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 …

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 …

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 …

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 …

Predictors Of Post-Deployment Distress In Female Veterans., Shalonda Griffin, Robert A. Ditomasso, Bradley Michael Rosenfield, Odelia Mcfadden

Research Day

Introduction: The female veteran population is expected to increase over the next few decades, representing approximately 16.3% of the living population by the year 2042. As women are discharged from the military, they are frequently challenged with the tasks of reintegrating into society and adjusting to life. While some women successfully readjust, many continue to struggle with combat-related challenges and reintegration stressors such as mental health, military sexual assault, substance abuse, interpersonal relationship issues, and everyday necessities. The purpose of the present study was twofold: (a) to identify factors associated with and predictive of postdeployment distress and (b) to identify …

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 …

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 …

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. …

Social Media Use, Connectedness, And Depression In Graduate Students, Marisa Gretz, Stephen R. Poteau, Robert A. Ditomasso, Michael B. Roberts

Research Day

This study will examine the relationship between social media use, sense of connectedness, and depression among graduate students. Graduate students are often disconnected from their social supports due to their program's demands; additionally, the risk of depression in this population has been established in the literature. The impact of social media on depression has been investigated, and the results are discrepant. The relationship between a sense of connection, the use of social media, and depression in a graduate student population has not yet been explored. Graduate students at The Philadelphia College of Osteopathic Medicine (PCOM) and other universities studying psychology, …

Inventory Of Cognitive Distortions-Youth Version: The Development And Validation Of A Psychometric Test For The Measurement Of Cognitive Distortions, Kelsey Jones, Robert A. Ditomasso, Susan Panichelli Mindel, Michael B. Roberts

Research Day

Cognitive distortions are systematic biases in an individual’s thinking that maintain a person’s belief in their negative views of themselves or others, even in the presence of contradictory evidence. The Inventory of Cognitive Distortions (ICD), created by Yurica and DiTomasso, provided a template to measure distorted thinking in adults. Currently, there is not a youth measure of cognitive distortions that adequately encapsulates the range of distorted thinking that may be present in youth. Therefore, the purpose of this study is to create and validate a newly designed instrument of cognitive distortions, The Inventory of Cognitive Distortions-Youth Version (ICD-YV), with youth …

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 …

A Computer-Based Intervention May Be Effective For Treating Bereavement As Measured By Scores Of Prolonged Grief, Anxiety, Depression, And Cognitive Distortions., Michael Kastelnik, Bradley Michael Rosenfield, Michael B. Roberts

Research Day

Many people suffer from complications due to grieving the death of a loved one, an experience known as bereavement. In addition to the emotional suffering, complications can lead to functional impairment, negatively impacting relationships, work, and health of those who grieve. Although there are evidence-based interventions for bereavements, there are barriers to treatment, including costs and accessibility. Computer-based interventions are empirically demonstrated to overcome these barriers. The present study aims to test the effectiveness of a computer-based single-session treatment for bereavement. It is hypothesized that individuals who complete a computer-based CBT intervention for bereavement will experience a significant decrease in …

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

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 …

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 …

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 …

Meta-Analysis Of Antiganglioside Antibodies In Peripheral Neuropathies: A Potenital Diagnostic Indicator In Cidp, Gbs, And Mmn, Morgan Ilgenfritz, Shafik Habal

Research Day

Introduction: Autoimmune diseases that attack the peripheral nervous system are rare and difficult to precisely diagnose. Current diagnostic techniques rely heavily on patient symptomatology which prove problematic considering the varying presentations and the interchangeability of symptomatology among many peripheral neuropathies. Little is understood about the precise mechanism of pathogenesis which makes obtaining a biomarker challenging, but the presence of autoantibodies which target myelin proteins suggest a humoral component. In previous studies antiganglioside IgG and IgM antibodies that attack myelin have been reported in up to 60% of cases of Guillain-Barre syndrome (GBS) and 50% of cases of multifocal motor neuropathy …

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). …