Medicine and Health Sciences Commons^™

Antinociceptive Effects Of G-Protein Biased Mu Opioid Receptor Agonists In Male And Female Rats With Chemotherapy-Induced Neuropathy, Tilak Patel Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Aim: Mu-opioid receptor (MOR) agonists are often prescribed for the treatment of chemotherapy-induced neuropathy (CIN). Recent drug development strategies have focused on opioids with signaling profiles that “bias” activation of specific intracellular pathways (e.g., G-protein signaling) over others with the aim of increasing therapeutic selectivity. However, it is unknown if the variances in these signaling profiles at the MOR differentially modulate the antinociceptive effects of MOR agonists against neuropathic pain. In the present study, we tested a series of MOR agonists of varying G-protein signaling bias in a rat model of CIN. Methods: CIN was induced in male and female …

Are You In Or Obs? A Qi Project To Improve Resident Accuracy Of Admission Status Of Hospitalized Patients, Brooke Farquhar

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Telemedicine Hcv Treatment In Department Of Corrections Results In High Svr In Era Of Direct-Acting Antivirals (Daa), Taseen A. Syed, Reena Cherian, Lewis Shawn, Richard K. Sterling

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Efficacy Of Combined Spinal Epidural With Adductor Canal Block For Total Knee Arthroplasty, Simrat Kaur, Nicholas Bastug, Michael Buxhoeveden, Sabrina Dhillon

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction: Combined Spinal Epidural (CSE) is often used as the primary anesthetic for Total Knee Arthroplasties (TKA) (4). Intrathecal morphine (ITM) is associated with pruritus, post-operative nausea and vomiting (PONV), and respiratory depression(3). Our institutional preference for TKA includes an opioid free CSE with Adductor Canal (AC) block. The objective of this study is to ascertain if CSE with AC block is beneficial as compared to CSE with ITM for TKA. We hypothesized improved side-effect profile and non-inferior pain control.

Methods: We reviewed 20 patients that received a CSE and AC block for TKA in 2018 and compared them to …

More Than Meets The Ipex: Finding The Right Source In An Immunosuppressed Patient, Ban Wang, Brant Ward

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Patients with immune dysregulation polyendocrinopathy enteropathy X-linked (IPEX) syndrome usually present with autoimmunity, but are also prone to significant infections. In this case report, we introduce a 21-year-old gentleman with IPEX syndrome who presented to our ED with witnessed episodes of tonic-clonic seizures that likely represented aseptic meningitis secondary to Ehrlichia infection.

We determined that our patient’s clear exposure history to animals likely carrying zoonotic diseases fits the clinical picture of aseptic meningitis that was triggered by systemic tick-borne infection. We were able to make our conclusions based on our patient’s multiple negative viral and bacterial in both blood and …

Erector Spinae Plane (Esp) Blocks In Patients Receiving Subcutaneous Icd Placement: A Noninferiority Trial, Andrew Cutshall, Sabrina Dhillon, Michael Buxhoeveden, Juhee Sharma

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

How To Improve Resident Firearm Safety Education, Hannah Hollon, Elizabeth Wolf, Darina Dinov

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Abstract: How to Improve Resident Firearm Safety Education

Hannah Hollon, MD, Darina Dinov, DO, Elizabeth Wolf, MD, MPH

Background: Gun violence is the second leading cause of death in children, and one third of children in the United States live with a gun in the home.¹ Despite this public health challenge, there is a lack of firearm safety education in residency programs. One study from 1997 surveyed pediatric residencies across the country and found that 34% of programs reported having formal firearm safety education as part of their curricula. The programs cited lack of trained personnel, educational …

Mohs Micrographic Surgery In A Pediatric Patient With Squamous Cell Carcinoma, Cameron Nichols, Shields W. Callahan Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

An 11-year old boy presented with biopsy proven squamous cell carcinoma (SCC) of the left cheek. Pathology demonstrated moderate to well-differentiated SCC with positive deep and peripheral margins and no signs of definitive perineural invasion. Past medical history was significant for radiation therapy, chemotherapy, and stem cell transplant seven years prior for the treatment of a spinal embryonal tumor with multilayered rosettes with no signs of recurrence. He never had any direct radiation therapy to the site of his SCC. Mohs micrographic surgery (MMS) was ultimately selected as the treatment of choice for his SCC.

The main concern with MMS …

"I Play One On Television." A Case For Palliative Telemedicine, Sarah E. West, Danielle Noreika, Egidio Delfabbro

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Prevalence Of The Hypervirulent Nap1/Bi/027 Strain Of C. Difficile In Southwestern Virginia And Risk Factors Associated With Infection, Andrew O. Hanna, Anthony Baffoe-Bonnie, Shikha Vasudeva

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

C. difficile infection (CDI) incidence has increased over the last several decades. The BI/NAP1/027 ribotype was discovered in 2005 and has since been responsible for multiple outbreaks in the US and Canada. This subtype of C. Difficile is known to be more virulent in vivo and produce more severe disease. Limited regional data of the prevalence of this ribotype is available, which could help guide treatment. Using infection control data from a large regional hospital and a VA medical center, this study documented the prevalence of the 027 ribotype in Southwest Virginia. Patients were included if they were tested at …

Getting On The Same Page: A Quality Improvement Project To Reduce Overnight Nursing-To-Resident Physician Pages In An Inpatient Rehabilitation Unit, Renae Fisher Md, Rajbir Chaggar Md, Anthony Zenger Md, Susan Hamilton Rn, Bsn, William Carter Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction
Many Physical Medicine and Rehabilitation (PM&R) residency programs utilize “home call” systems for nighttime coverage of inpatient services. In this system, trainees are expected to work at full capacity the following day after taking nocturnal call. While “on call,” trainees receive both urgent and non-urgent pages throughout the night, which disrupt sleep. To mitigate fatigue, improve hand-offs and improve timing of patient care, this study targeted reducing non-urgent overnight pages from nurses to home call PM&R residents between 11pm to 6am.

Methods

We implemented a prospective quality improvement study with interventions including holding “Getting on the Same Page” meetings …

Hypoxic Ischemic Encephalopathy Severity, Seizure Medication Strategies And Early Neurodevelopmental Outcome, Desiree Garcia-Alvarez

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.

Implementation Of A School-Wide, Epa-Based Acting Internship Curriculum, Adam Garber

Health Sciences Education Symposium

Objectives. The core entrustable professional activities for entering residency (Core EPAs) were established by the AAMC as a framework to assess competency. The Acting Internship (AI) rotation is an excellent space to assess core EPAs, however many institutions have no structured AI curriculum. Our goal is to develop a standardized, school-wide AI curriculum that includes evaluation and assessment of designated core EPAs. Method. At our institution, two non-departmental AI directors were directed to oversee all AI rotations across the school and implement goals, objectives, and curriculum focused around specific core EPAs. A clinical skills-focused curriculum combining a mix of didactic …

Emergency Medicine Elective Impact On Third-Year Medical Student Specialty Choice, Nathan Lewis

Health Sciences Education Symposium

Emergency Medicine (EM) is a competitive, sought-after specialty among medical students (1). National standardized curricula have been developed for both third-year (M3) and fourth-year (M4) rotations (2-3), however, there is variability in course implementation (4). Additionally, it is unclear to what extent earlier rotations help students choose a specialty. We developed a two-week elective course to allow M3 students exposure to EM earlier than previously allowed at our medical school. Students were asked to complete an entry survey describing their specialty interests and sources of influence. During the course, students were encouraged to observe the environment and speak to providers, …

Epigenetic Silencing Of Socs3 Expression Contributes To Fibrosis In Crohn’S Disease, Emily T. Marshall, Chao Li, John K. Kuemmerle

MD Student Summer Research Fellowship Program Posters

Identified risk polymorphisms affecting the Jak-STAT3 pathway in patients with Crohn’s disease could affect TGF-β1 and collagen I expression and in the pathway’s negative regulator, SOCS3. Genetic factors, however, account for only ~25% of disease. Epigenetic events also shape gene expression. Recent experiments showed that autocrine IL-6 production in mesenchymal cells, subepithelial myofibroblasts (SEMF) and muscle cells, of patients with fibrostenotic Crohn’s disease causes sustained Jak-STAT3 activity, excess TGF-β1 and Collagen I production and fibrosis. SOCS3 paradoxically decreased in these cells. We now identify epigenetic mechanisms that silence SOCS3 expression in SEMF of patients with fibrostenotic Crohn’s disease. In a …