Medicine and Health Sciences Commons^™

Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868

for a patient with a recurrent diverticulitis complicated by abscess formation.

Buprenorphine For Pain Management Vs. Chronic Hydrocodone-Acetaminophen Therapy When Comorbidities Increase The Risk Of Opioid-Related Side Effects, Jessica Zhao, Doo Hee Kim

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Gordon A, Callaghan D, Spink D, et al. Buprenorphine transdermal system in adults with chronic low back pain: a randomized, double-blind, placebo-controlled crossover study, followed by an open-label extension phase. Clin Ther. 2010;32(5):844-860. https://doi.org/10.1016/j.clinthera.2010.04.018

for a patient on long-term opioid therapy with high risk factors for adverse effects.

Simplifying Treatment From Double-Inhaler To Single-Inhaler Triple Therapy In Patients With Chronic Obstructive Pulmonary Disease, Kelly Yang, Leah Warren

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Ferguson GT, Brown N, Compton C, et al. Once-daily single-inhaler versus twice-daily multiple-inhaler triple therapy in patients with COPD: lung function and health status results from two replicate randomized controlled trials. Respir Res. 2020;21(1):131. https://doi.org/10.1186/s12931-020-01360-w

for a patient requesting a simplified therapeutic regimen with equal efficacy for chronic obstructive pulmonary disease (COPD) management.

Effects Of Chaplain Care On Coping With Cancer, Sarah Battiston, Scott L. Baughan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical case decision report using:

Piderman KM, Radecki CR, Jenkins SM, et al. Hearing and heeding the voices of those with advanced illnesses. Journal of Palliative Care. 2020;35(4):248-255. https://doi.org/10.1177/0825859720928623

for a patient having difficulty coping with cancer

Efficacy Of Observational Care Versus Antibiotic Therapy For Treatment Of Acute Uncomplicated Diverticulitis, Morgan Mooty, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

van Dijk ST, Daniels L, Ünlü Ç, et al. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. Am J Gastroenterol. 2018;113(7):1045-1052. https://doi.org/10.1038/s41395-018-0030-y

for a patient with acute uncomplicated diverticulitis.

Radiofreqency Device As An Alternative Therapy For Refractory Nasal Valve Collapse, Sara Farooqui, Doo Hee Kim

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Silvers SL, Rosenthal JN, McDuffie CM, Yen DM, Han JK. Temperature-controlled radiofrequency device treatment of the nasal valve for nasal airway obstruction: A randomized controlled trial. Int Forum Allergy Rhinol. 2021 Dec;11(12):1676-1684. http://doi.org/10.1002/alr.22861

for a patient with nasal valve collapse.

Safety And Cost Effectiveness Of Immediate Sequential Bilateral Cataracts Surgery, Miles Bowman, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Rush SW, Gerald AE, Smith JC, Rush AJ, Rush RB. Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States. Journal of Cataract and Refractive Surgery. 2015;41(4):732-739. https://doi.org/10.1016/j.jcrs.2014.07.034

for a patient with bilateral cataracts.

The Effects Of Curcumin On Erα, P53, And P21 In The Mcf-7 Breast Cancer Cell Line, Samantha E. Pfiffner, Mia Morse, Erin Hallman, Kaylin Whittaker, Aisha Zanib, Sumi Dinda Ph.D.

Medical Student Research Symposium

Curcumin is a golden-yellow flavonoid compound derived from the turmeric plant root that has been used in Chinese and Indian medicine for centuries. Curcumin has been shown to have antioxidant and anti-inflammatory properties, and because of this, has been gaining traction in the field of cancer research. Breast cancer is the most commonly diagnosed cancer in women, and is the second leading cause of cancer death in women, next to lung cancer. Because of the prevalence and mortality of breast cancer, possible therapeutics must be investigated. Due to the beneficial properties of curcumin and pervasiveness of breast cancer, we have …

Integration Of A Social Needs Program Into An Urban Student Run Free Clinic, Iyanna Peppers

Medical Student Research Symposium

Background/Problem Statement

The Cass Clinic in Detroit, MI is a student-run free clinic (SRFC) that provides care for an underserved, underrepresented population. Our patients experience a high incidence of chronic health conditions accompanied by poverty, homelessness, and food insecurity which complicate care. Integrating social well-being into primary care creates a two-pronged approach to improving patient outcomes: medical care and disease prevention. A social needs program was implemented at Cass Clinic in order to address such social determinants of health.

Methods

A social needs screening modality was created and integrated into a medical encounter triage form. Two AAFP social needs screening …

Utility Of The Severity-Of-Illness Score For Toxic Epidermal Necrolysis (Scorten) In Pediatric Stevens-Johnson Syndrome Patients, Nina Kb Gust, Rebecca M. Adams, Ashley Frei, Michelle Coughlin Md, Justin Klein Md, Elika Ridelman Ph.D, Christina Shanti Md

Medical Student Research Symposium

Introduction

The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) is a scoring system that seeks to predict in-hospital mortality for disorders affecting skin integrity. The scoring system has been validated and widely utilized in adults, but not pediatrics. This study aims to determine the accuracy of the SCORTEN in pediatrics.

Methods

A retrospective review of pediatric patients admitted at a verified pediatric burn center with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) from 2008 to 2022 was performed.

Results

Twenty-seven eligible SJS/TEN patients were identified. Three patients were excluded due to incomplete data, allowing twenty-four patients to be analyzed. Ten patients had …

Rapid (Reducing The Anxiety Of Patients In Interventional And Diagnostic) Radiologic Procedures: A Review Of The Literature, Unie Háng, Nathan Sim, Harika K. Bollineni, Arif Musa Md, Foaz Kayali Md, Roger Kakos Md, Monte Harvill Md, Ali Harb Md

Medical Student Research Symposium

Abstract Title: RAPID (Reducing the Anxiety of Patients in Interventional and Diagnostic) Radiologic Procedures: A Review of the Literature

Background: Pre-procedural anxiety is a prevalent concern that can be associated with negative effects for patients including perceived pain. Most interventional radiologic procedures are performed under local anesthesia with minimal sedation if any, which may not be sufficient in relaxing the patient. Effective patient education with appropriate pain management and anxiety control can improve comfort and can yield optimal post-procedural outcomes.

Methods: A search was done with the PubMed database for studies concerning patient anxiety in radiologic procedures. Search terms included, …

The Utility Of Non-Specific Ecg Findings In The Setting Of Low High-Sensitivity Cardiac Troponin Levels, Arqam Husain, Nathan Klausner, Emily Schwab, Joseph Miller, Kaab Husain

Medical Student Research Symposium

Objective: Our objective was to assess the relationship between non-specific ischemic electrocardiogram (nsi-ECG) findings and the occurrence of major adverse cardiac events (MACE) within a 30-day timeframe among patients in the Emergency Department (ED) with low high-sensitivity cardiac troponin (hs-cTnI) levels.

Methods: We conducted a secondary analysis of the RACE-IT trial, a randomized trial performed across 9 EDs from July 2020 through March 2021 that looked at the effectiveness of hs-cTnI in evaluating the risk for acute myocardial infarction (AMI). Our study assessed the association between nsi-ECG findings (left bundle branch block, ST-segment changes, or T-wave inversions) and 30-day MACE …

Impact Of Covid-19 Pandemic On Student-Run Free Clinic Services For An Underserved Urban Patient Population, Mina Sitto, Adlai Nelson, Sara L. Ma, Sara Kazyak, Nili Modi, Kathy Lu, Alexander Wind, Jennifer Schmidt, Robert Sherwin

Medical Student Research Symposium

Background:

The COVID-19 pandemic significantly impacted healthcare delivery in high density urban communities. This clinic provides free medical care to patients in an urban Midwestern community including limited prescriptions, vaccines, and over-the-counter medications. This study aims to understand how the patient demographics and medical services offered at the clinic have been impacted by the COVID-19 pandemic.

Methods:

Walk-in student-run clinics were held weekly on Saturday mornings in an urban Midwestern city, with patients consisting of underinsured and uninsured residents experiencing housing instability. Number of returning and new patients, physicals, flu shots, blood glucose readings, HbA1c, lipid panels, and …

M4-Intern Mentorship Project, Christian Freitag, Sahar Elmenini, Kyla Kosidowski

Medical Student Research Symposium

Wayne State University School of Medicine (WSUSOM) in 2018 formed Learning Communities (LCs), that facilitate student engagement, comradery, and mentoring. These programs include medical student-premed, near-peer, and faculty/attending mentorships. There has been an identified gap in mentorship between near-peer and faculty/attending mentorship, and that is near-peer mentors at WSUSOM have yet to complete the residency process to guide other students through it. Moreover, faculty/attending mentors are more removed from residency and may not have relevant advice for students. As resident physicians are recent graduates, they are more likely to provide relevant insight about residency applications, academic challenges, and efficiency than …

Are Chatgpt Responses To Urologic Health Inquiries Readable And Supported By American Urological Association Guidelines?, Chase Morrison, Jack Vercnocke Md, Isaiah Dennis, Michael Cher Md, Steven Lucas Md, John Cochrane Md, Aron Liaw Md, Kevin Ginsburg Md

Medical Student Research Symposium

Introduction and Objective:

ChatGPT is widely accessible to patients, but it is unknown if the responses provided by the chatbot are supported by corresponding American Urological Association’s (AUA) guidelines. Our primary objective was to assess if cGPT’s responses to a hypothetical patient’s question regarding their urologic conditions were supported by the AUA guidelines.

Methods:

Thirty prompts, each addressing one or more AUA Guideline, were written from the perspective of a patient. Responses were assessed by 8 evaluators consisting of practicing Urologists and current Urology Residents. Each response was evaluated using a Support Score (SS) and Quality Score (QS) (Table 1). …

Anatomy And Physiology Of Intraosseous Infusion, Andrew Mizerowski, James Paxton

Medical Student Research Symposium

The introduction of fluids and medications via intraosseous (IO) infusion is highly dependent upon many unique aspects of bone anatomy and physiology. Key considerations include differences in the medullary cross-sectional area between insertion sites, age- and location-dependent variation in the distribution of red and yellow bone marrow, volume and pressure capacity within the venous system, and the influence of hormones and other chemical messengers on vasomotor tone. In addition to an exploration of these concepts, this chapter will also discuss the physiologic basis for pharmacokinetic relationships reported in the prevailing literature and propose methods to optimize the use of IO …

Alcohol And Cannabis Use Among Women With Infertility: Associations With Psychological Distress, Attempts To Conceive, And Engagement In Fertility Treatment, Genevieve E. M. Joseph-Mofford Ms, Leah M. Hecht Phd, Rory Iacobelli Bs, Amy M. Loree Phd, Lisa R. Miller-Matero Phd

Medical Student Research Symposium

Objective: An infertility diagnosis can lead to distress. Although substance use is common and can also lead to distress, little is known about use among those with an infertility diagnosis. This is important since substance use can have implications for fertility. The purpose of this study was to estimate the rate of alcohol and cannabis use among women with infertility and examine whether substance use had associations with psychiatric symptoms, attempts to conceive, and engagement in fertility treatments.

Materials and Methods: Patients from one healthcare system were eligible if they received a female infertility diagnosis within the past 2 years. …

Vulnerable Neighborhoods Had Smaller Gains In Health Insurance Coverage During Early Covid-19, Ismail Mustafa Aijazuddin, Ammar Sukari

Medical Student Research Symposium

Background:

The Covid-19 pandemic has illuminated the inequities that jeopardize health, prompting rapid interventions to promote care access. However, such efforts have had mixed success in eradicating disparities. One focus is the equity of improvements in insured rates.

Methods:

Self-reported health insurance coverage rates among adults aged 18-64 were obtained from the CDC’s PLACES datasets for collection years 2018 and 2021, at the Census Tract level. These data were merged with the CDC’s 2018 Social Vulnerability Index (SVI), which ranks Tracts on 15 measures of social determinants of health. Across Tracts nationally and by state, univariate correlations between Overall SVI …

Improvement Of Total Body Weight Loss In A Comprehensive Weight Loss Program At A Community Gastroenterology Practice With Consistent Support Group Attendance, Nishant S. Kumar Bs, Sejal Gunaratnam Ms, Sangini Tolia Md, Mallory Evans Rd, Naresh Gunaratnam Md Agaf

Medical Student Research Symposium

Introduction

Obesity-related gastrointestinal disorders, including non-alcoholic fatty liver disease (NAFLD), account for over 30% of visits to GI practices. Total body weight loss (TBWL) of 10% or more is associated with reversal of NAFLD-associated fibrosis and steatosis. Support groups have proven to help individuals recover from other lifestyle diseases. This study assesses the impact of support group attendance on a patient achieving 10% TBWL while enrolled in a community-based weight loss program.

Methods

Patients participated in a 6-month support group with weekly meetings. TBWL was calculated by taking the difference between the patient’s starting weight and their 6-month weight divided …

Reduced Venous Blood Oxygen Saturation May Associate With Cognitive Decline In Patients With Multiple Sclerosis, Hasan Sawan, Chenyang Li, Sagar Buch, Fahad Malik, Ying Wang, Evanthia Bernitsas, E Mark Haacke, Yulin Ge, Yongsheng Chen

Medical Student Research Symposium

Introduction: Reduced brain oxygen metabolism may be associated with neuronal activity in individuals with Multiple sclerosis (MS). Quantitative susceptibility mapping (QSM), an advanced MRI technique, can measure venous blood oxygen saturation via deoxyhemoglobin levels. It remains unknown whether QSM-derived venous blood susceptibility can be used as an imaging biomarker of neuronal activity in MS. The objective of this study was to investigate the susceptibility of internal cerebral veins (ICVs) in patients with relapsing-remitting MS (RRMS), and their correlations with clinical measures.

Methods: We recruited 18 patients with RRMS and 10 age-matched healthy controls (HC). Participants were scanned on a 3T …

Perception Of Trust, Virtual Care, And Access Among The Uninsured Population: A Multi-Site Study At Student Run Free Clinics, Hanna Simmons, Ahmad Chouman, Juliann Binienda Phd

Medical Student Research Symposium

Introduction/Problem:

Since the onset of the COVID-19 pandemic, utilization of virtual visits has significantly increased. Advantages of virtual visits include lower healthcare costs and improved access to healthcare. Although one of the main goals of implementing virtual visits is to increase access to the underserved population, there have been few studies with a focus on the opinions of African Americans or the uninsured. Moreover, distrust in physicians and healthcare, although universal, is more prevalent among the African American and uninsured populations. It is also known that trust leads to better self-reported health outcomes, patient satisfaction, health behaviors, quality of life, …

Characteristics Of Patients With Low Hepatitis C Treatment Rates In Urban Medical Center Clinics, Rana Khamis, Crisshy Auguste, Paul H. Naylor Phd, Milton G. Mutchnik Md

Medical Student Research Symposium

The objective of this study was to determine whether there were different characteristics between HCV patients who were treated and those not treated after their first visit to a Gastroenterology (GI) or Infectious Disease (ID) clinic. This information might identify potential targets for remedial actions that could be performed to increase the number of treated patients.

Data was collected from 2019 HCV patient EMR charts including patient demographics, treatment history, and laboratory studies. We defined success as receiving treatment by July 2020 (6-18 months after the first visit).

We found that of 587 patients with HCV who were seen at …

Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md

Medical Student Research Symposium

Introduction: Pessaries are a non-invasive treatment option for patients with pelvic organ prolapse (POP) or stress urinary incontinence (SUI). There is currently limited data regarding pessary usage among urology patients. The aim of this study is to determine the patient characteristics that predict long term pessary usage versus surgical intervention.

Methods: A 10-year retrospective review of pessary usage in women with either SUI or POP was performed. Patients were stratified into pessary longevity of less than or greater than one year. Quality of life measures before and after pessary use included pads per day, incontinence symptom index (ISI) scores, and …

Predicting Risk Of Atrial Fibrillation In Hematopoietic Stem Cell Transplant, Min Yi Wu, Madhulata Reddy, Shatha Farhan

Medical Student Research Symposium

Background

Atrial fibrillation (AF) in hematopoietic stem cell transplant (HSCT) recipients is associated with significant morbidity. We have previously reported that obstructive sleep apnea (OSA), older age and presence of dilated left atrium (LA) are significant predictors of AF early post HSCT. In the current study, we sought to evaluate if TSH pre HSCT and serum electrolytes and eGFR at engraftment in patients undergoing HSCT are associated with increased risk of AF.

Methods

This is a single center retrospective study, involving 748 consecutive patients undergoing autologous and allogenic HSCT from 2012 to 2022. Patients’ charts were reviewed to acquire clinical …

Activating Neuroprotective Effects Of Glial Cells In Vps13d-Associated Ataxia, Abrielle Fretz

Medical Student Research Symposium

Ataxia is a common symptom among many neurological conditions. Due to its high prevalence and quality of life impact, there is significant interest in understanding the underlying cause, as well as potential therapeutic approaches to mitigate its severity. Our lab uses a model of Vps13D-associated ataxia in the fruit fly, Drosophila Melanogaster, which recapitulates aspects of the human disease including age-dependent motor deficits.

The anti-oxidant compounds gastrodin and 4-HBA were found to have neuroprotective effects in Drosophila and mouse models of Parkinson’s disease. Previous work has demonstrated that these compounds can activate the Nrf2-pathway, a master regulator of anti-oxidant defenses. …

Anterior Cruciate Ligament Hybrid Remnant Preservation Reconstruction Demonstrates Similar Outcomes As Traditional Reconstruction After 6 Months: A Randomized Control Trial, Joshua P. Castle, Eleftherios L. Halkias, Brittaney Pratt, Ashley Frei, Matthew A. Gasparro, Vasilios Moutzouros

Medical Student Research Symposium

Background

The anterior cruciate ligament (ACL) is often debrided during reconstruction (ACLR) to improve visualization. However, remnant ACL tissue contains nerve fibers and including remnant tissue in ACLR could provide benefit. Therefore, a technique was developed that preserves the tibial remnant and incorporates it into ACLR: Hybrid Remnant Preservation Reconstruction (HRPR) ACLR. This study compares HRPR-ACLR to traditional reconstruction by comparing patient reported outcomes and complications.

Methods

Patients presenting to one surgeon's clinic with an ACL injury are screened. Exclusion criteria are patient age<14 years, multi-ligament injury, chronic tears, and revision ACLR. Patients are consented and randomized to HRPR or traditional ACLR. Demographics, patient-reported outcomes, range of motion (ROM) and complications were collected.

Results

Thirty-three patients were included, 20 HRPR and 13 controls. No demographic differences were noted. PROMIS-PF, …

Home Visits: A Way To Build Genuine Connection And Learn From A Vulnerable Refugee Population, Shirley M. Elfishawy

Medical Student Research Symposium

Among non-immigrant populations, maternal psychosocial stress was associated with impaired maternal bonding. Parents’ stress and depressive symptoms were associated with lower levels of supportive coparenting and impaired child development. To date, no studies have evaluated whether coparenting is related to maternal bonding in immigrant families. The goal of this study was to examine the relationship between maternal psychosocial stress (acculturative stress, posttraumatic stress, maternal depression), coparenting, and maternal bonding with the child among a sample of Arab-American immigrant and refugee mothers. As a first-generation Egyptian-American medical student, I was part of the team who went to the homes of immigrant …

Exploring Arab Americans’ Preferences Towards Telemedicine As A Mental Health Treatment, George G. Kidess, Liam Browning, Nicole Oska, Liza Hinchey, Arwa Saleem, Sadie Knill, Malaak Elhage, Arash Javanbakht

Medical Student Research Symposium

Introduction

Arab Americans—a large minority group in the United States—experience higher rates of mental illness and relatively lower rates of treatment compared to the general population. While some factors leading to this disparity have been proposed, data in the literature remains lacking. This study aims to explore Arab-American mental health perspectives with regards to their preferences towards telemental health as a treatment option.

Methods

Responses were collected through an anonymous bilingual Qualtrics survey from both Arab and non-Arab participants (n=294, ages 18+). Participants’ perceptions towards telemental health and mental illness stigma were assessed, performing comparisons between Arabs and non-Arabs, as …

A Retrospective Study Characterizing Myocardial Strain Patterns In Patients With Mitral Annular Disjunction With And Without Mitral Valve Prolapse, John A. Gallagher, Ahmad El-Moussa Md, John Dawdy Md, Luis Afonso Md

Medical Student Research Symposium

Background: Mitral annular disjunction (MAD) is an atrial displacement of the mitral valve hinge point. MAD may occur with or without mitral valve prolapse (MVP) and has been linked to ventricular arrhythmias (VA) and sudden cardiac death (SCD). Although cardiac magnetic resonance imaging (cMRI) is the gold standard for MAD detection, it is not practical for screening. We used 2D transthoracic echocardiography (TTE) with speckle tracking echocardiography (STE) to characterize segmental and global longitudinal myocardial strain (SLMS, GLMS) patterns in patients with MAD, +/-MVP.

Methods: 43 subjects were identified by searching “MAD” in our institution’s database. GLMS and …

Neural Correlates Of Fear Extinction: Investing The Impact Of Puberty And Sex In Children And Adolescents Through Neuroimaging, Sneha Bhargava, Clara Zundel, Samantha Ely, Carmen Carpenter, Reem Tamimi, Leah Gowatch, Mackenna Shampine, Emilie-Clare O'Mara, Jovan Jande, Shravya Chanamolu, Ahmad Almaat, Hilary Marusak

Medical Student Research Symposium

Fear-based disorders, including anxiety and posttraumatic stress disorder, are more prevalent in females than males. Steroid hormones (e.g., estradiol) are involved in fear extinction learning and later recall—a process implicated in the pathophysiology of fear-based disorders. Fear-based disorders commonly emerge during the transition from childhood to adolescence, a period marked by the onset of puberty and a natural increase of steroid hormones. Here, we examined the effects of puberty, sex, and their interaction on extinction recall and underlying neural circuitry in youth. Eighty-five youth (6-17 years, 46% female) completed a two-day Pavlovian fear extinction paradigm while undergoing functional magnetic resonance …