Medicine and Health Sciences Commons^™

Access To Primary Care Among Emergency Department Patients, Megan Hanna, Nicholas Seitz, Steven Repas, Michael Harrington, David L. House, Tiffany Le, Derek Sorensen, Catherine Marco

Medical Student Research Symposium Abstracts and Posters

Primary care is an essential component of a robust healthcare system by promoting preventative medicine and health education. This study assessed the percentage of Emergency Department (ED) patients with access to primary care and barriers to primary care.

Identifying Factors Underlying The Decision For Genetic Carrier Screening Among Women In Montgomery County, Sowon Kim, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Genetic Carrier Screening (GCS) is a genetic test that allows patients to find out if they carry genes for certain genetic disorders. The results of the test enable patients to make changes to their family planning decisions and prenatal care when appropriate and allow them the opportunity to seek further medical and social support. Despite these health benefits and notable clinical utility of GCS, GCS has not been utilized in most nations due to moral and ethical controversy among the public. Previous studies have demonstrated patients’ ethnicity, socio-demographic (age, education) and economic factors were associated with the patient’s intention to …

First Profunda Artery Perforator Flap For Breast Reconstruction Performed At A Va Hospital, Kaitlynne Pak, Amanda Fang, Garrison Leach, Riley Dean, Sarah Crowley

Medical Student Research Symposium Abstracts and Posters

The profunda artery perforator (PAP) flap for breast reconstruction originated by Dr. Robert J. Allen in 2010 after multiple failed attempts at using muscle-sparing transverse rectus abdominal muscle (MS-TRAM) flap and implants. This flap method was initially approached due to the patient’s request for an autologous tissue graft that did not sacrifice muscle. The PAP flap has grown significantly in popularity and usage in breast reconstruction and makes up to about 16% of autologous breast reconstruction, coming second to DIEP flaps (76%). This well-tolerated, muscle-sparing approach is ideal for patients without sufficient abdominal fat (low BMI or previous abdominal liposuction) …

Adrenal Insufficiency Following Intraarticular Steroid Injections, Julia Hitchcock, Ankur Gupta

Medical Student Research Symposium Abstracts and Posters

A 59-year-old woman presented with fatigue and 50 pounds weight gain in the last two years.She has been receiving triamcinolone steroid injections in both knees every three months for the last two years.She has also been receiving triamcinolone injections in ankles sporadically during this time period. Laboratory evaluation showed undetectable serum cortisol and inappropriately normal serum adrenocorticotropic hormone (ACTH). The patient underwent cosyntropinstimulation test confirming secondary adrenal insufficiency (Table 1).Magnetic resonance imaging (MRI) showed a normal pituitary gland with no tumors.She was started on hydrocortisone 10mg twice daily with improvement in fatigue.The patient was recommended to minimize steroid injections. The …

Predictive Factors For Early Breastmilk Discontinuation In Premature Infants: A Retrospective Study, Smiti Gupta, Darah Yuhas, Janet Wasylyshen-Valesco, Adrienne Stolfi

Medical Student Research Symposium Abstracts and Posters

The AAP recommends exclusive breastfeeding for 6 months, followed by continuation of breastfeeding with introduction of complimentary foods for at least 1 year (1). There has been considerable success initiating breastfeeding in birth hospitals. This can largely be attributed to many beneficial programs, including the WHO/UNICEF Baby-Friendly Hospital Initiative and “10 Steps to Successful Breastfeeding” (2, 3). Despite the success with increasing breastfeeding rates in birth hospitals, only 58.3% of US infants received breast milk at 6 months of age and only 25.6% of US infants were exclusively breastfed at 6 months in 2019 (4).This discrepancy is even greater for …

A Case Of Ruptured Cornual Pregnancy With Delivery Of A Viable Pre-Term Infant, Elana Miller, Elena Fuell-Wysong, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Interstitial and cornual ectopic pregnancies are rare forms of ectopic with high mortality rate. As such, they pose significant challenges in diagnosis, treatment, and follow up.

This patient was a 42 y/o female G2P1001 at 25+3 weeks gestational age who presented from an outside hospital after an episode of sudden onset abdominal pain with syncope. She was noted to have hypotension, tachycardia, lactic acidosis, and peritoneal free fluid. Physical exam was significant for peritoneal signs with abdominal guarding and rebound. Her pregnancy was complicated by advanced maternal age, THC use, and late presentation for prenatal care in the second trimester. …

The Role Of Implantable Cardioverter Defibrillators For The Prevention Of Ventricular Arrhythmia In Left Ventricular Assist Device Recipients, Nikhil Reddy, Cristina Ortiz, Toshimasa Okabe, Muhammad Afzal, Mohamed H. Derbala, Asvin Ganapathi, Sakima Smith

Medical Student Research Symposium Abstracts and Posters

Advanced heart failure represents a significant strain on our health care system and is associated with increased morbidity and mortality. New device therapies, including left ventricular assist device (LVAD) implantation, have transformed management as both a destination therapy and as a bridge to transplantation. Although LVADs have improved patient outcomes, arrhythmias represent a significant and costly complication of this therapy. In recent years, implantable cardioverter-defibrillators (ICDs) have been developed to reduce the incidence of lethal arrhythmia. However, a gap in the literature exists for both guidelines in prevention of early ventricular arrhythmia (VA) in LVAD recipients and the effectiveness of …

A Review Of Identified Barriers To Sunscreen Adherence For Skin Cancer Protection, Kaitlynne Pak, Ericson Torralba, Clayton Connor, Julian J. Trevino

Medical Student Research Symposium Abstracts and Posters

Skin cancer is the most common cancer in the US and worldwide. A clear risk factor for all types of skin cancer (basal cell carcinoma, squamous cell carcinoma, and melanoma) is UV exposure, whether artificial or natural. It is well-understood that regular sunscreen use with an SPF of 30 or greater reduces the risk of skin cancers; and especially that of melanoma, which is responsible for a majority of skin cancer deaths. However, the annual incidence of skin cancer cases, including melanoma, continues to rapidly rise in recent years. This may have a strong association with low rates of daily …

Methamphetamine Associated Cardiomyopathy And Fatal Thrombus Formation, Kaitlynne Pak, Sanuri Gunawardena, Ericson Torralba, Juan Linares, Damian Valencia, Nathaniel Dittoe

Medical Student Research Symposium Abstracts and Posters

Stimulant abuse is a rapidly growing epidemic both in the United States, and around the world. Reports show that nearly 4.7 million Americans have tried methamphetamines at least once. It is known that methamphetamines and related compounds significantly increase cardiovascular morbidity and mortality. Substance-related chronic inflammation and tissue fibrosis can cause irreversible cardiac structural changes, leading to conditions like methamphetamine-associated dilated cardiomyopathy (MACM). Left ventricular dilation results in hemodynamic flow disturbances, which promote turbulent blood flow and stagnation. Furthermore, the sympathomimetic effects of methamphetamines also disrupt pathways in coagulation homeostasis, providing further incitement of thrombus formation. This unstable catecholamine driven …

Is Microscopic Colitis Associated With Increased Risk For Other Gastrointestinal Diseases?, Tanner Graves, Paul Koles

Medical Student Research Symposium Abstracts and Posters

Microscopic colitis is clinically suspected in patients with recurrent watery diarrhea and the absence of gross pathologic changes in the colon by endoscopic examination. The diagnosis is established only by microscopic evaluation of colonic biopsies. Microscopic colitis is currently classified into three subgroups: collagenous colitis (CC), lymphocytic colitis (LC), and combined CC and LC. The incidence rates are 4.14 per 100,000 person-years and 4.85 per 100,000 person-years for CC and LC, respectfully.

Diagnosis is typically made without measuring the exact thickness of the subepithelial collagen band or by counting the number of lymphocytes in the epithelium. There is little research …

Normocomplementemic Urticarial Vasculitis In A Pediatric Patient: Case Report And Literature Review, Kristin Petit, Thomas Selby, Julian J. Trevino

Medical Student Research Symposium Abstracts and Posters

Urticarial vasculitis (UV) is a rare type of leukocytoclastic vasculitis characterized by urticarial skin lesions lasting greater than 24 hours and is often associated with angioedema, post-inflammatory hyperpigmentation, and cutaneous dysesthesia. Initially, painful or pruritic wheals are arranged on the trunk, proximal extremities, or face and progress to purpura or ecchymosis. UV is most commonly reported in women in the fourth and fifth decades of life; cases of UV in children are rare. In children, UV is often preceded by upper respiratory tract infections however drug-induced UV has also been reported with the use of penicillins and non-steroidal anti inflammatory …

Triamcinolone With Vitamin D Synergistic Efficacy In Psoriasis, Steven Repas, Jeffrey B. Travers

Medical Student Research Symposium Abstracts and Posters

Psoriasis is one of the most common skin conditions in the United States affecting more than 8 million people. High amounts of vitamin D has been shown to be effective in treatment of psoriasis. It also has a well-documented safety profile at the doses and duration that will be used during this study. Triamcinolone and other topical corticosteroids are considered a first line treatment for mild to moderate psoriasis with a well-documented safety profile. Individually both of these medications have shown effectiveness in the management and treatment of mild to moderate psoriasis. This study is designed to test whether a …

Global And Local Service Connection: Global Health Experiences And Local Community Engagement In Wright State University Boonshoft School Of Medicine Alumni, Katie Lomeo, Katharine A. Conway, Kelly Muterspaw, Kaitlyn Danner, Virginia Keim

Medical Student Research Symposium Abstracts and Posters

The Global Health Scholars Program (GHSP) at Wright State University Boonshoft School of Medicine (BSOM) has been in place for 18 years. The GHSP gives medical students an opportunity to serve in various medical settings around the world. There are many reasons why healthcare professionals seek global health experiences. One main reason for global health participation is altruism and the desire to improve community health abroad. However, global health participants are widely criticized for neglecting their home countries’ problems to solve those around the world. The goal of this study is to assess the relationship between global health experiences and …

Reconstructionof Congenital Arhinia With Stereolithography, Kelly Spiller, Kaitlynne Pak, Lucas M. Harrison, Spencer Anderson, Steven Schmidt, Salim Mancho

Medical Student Research Symposium Abstracts and Posters

Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and nasopharyngeal airway. In this study, we report our novel multi-staged reconstructive approach of congenital arhinia in addition to literature review. Reconstruction was achieved via several spaced operations. A nasal methyl methacrylate prosthesis was first created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 osteotomy with cannulization was then utilized for midface advancement and nasopharyngeal airway formation. External nasal framework was constructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts. The patient was overall pleased …

Placental Hypoxia-Inducible Factor 1 Alpha In Early-Onset Preeclampsia As A Predictor Of Future Risk In Maternal And Fetal Health, Julie Slyby, Bryce Linkous, Sarah Scott, Chandni Chandiramani, Amy Hwang, Danielle Spanbauer, Melissa R. Kaufman, Traci Rackett, Kailey Nolan, Emily Stone, Rose A. Maxwell, David N. Dhanraj, Thomas L. Brown

Medical Student Research Symposium Abstracts and Posters

Preeclampsia is a life-threatening, pregnancy-associated disorder characterized by the rapid development of hypertension with renal dysfunction. While preeclampsia generally occurs later in pregnancy, early-onset preeclampsia (EOPE) can occur much earlier and is usually more devastating. Early-onset preeclampsia is also associated with an increased risk of maternal cardiovascular and metabolic disease in mothers later in life and neurocognitive dysfunction in their offspring. EOPE is strongly associated with abnormal placental development and fetal growth restriction during pregnancy.

Fluorescence-Guided Surgical Debridement Of Chronic Osteomyelitis Utilizing Doxycycline Bone Labeling: A Technical Trick Revived, Garrhett G. Via, David A. Brueggeman, Grant M. Slack, James M. Danias, Jennifer L. Jerele

Medical Student Research Symposium Abstracts and Posters

The present manuscript discusses the concept of fluorescence-guided surgical debridement of chronic osteomyelitis in the orthopaedic patient based upon a two-fold mechanism, natural fluorescence of healthy bone combined with bone labeling by tetracyclines. The senior author prefers preoperative administration of oral doxycycline 100 mg twice daily for at least 1 month. The excitation source of choice is an ordinary blacklight, as this is both cost-effective and readily attainable. Intraoperatively, viable bone is noted to fluoresce a greenish hue which is then used to guide the debridement. Previous studies have demonstrated that bleeding bone is not a reliable indicator of a …

Local Wound Infiltration With Liposomal Bupivacaine Decreases Post-Cesarean Pain Scores, Avni Gupta, Justin Williams, Rose A. Maxwell, Marilyn Kindig

Medical Student Research Symposium Abstracts and Posters

Surgical patients are routinely prescribed opioid analgesics that are strongly associated with drug overdose deaths. Liposomal bupivacaine is a long-acting local anesthetic that received FDA approval in 2011 for local surgical site infiltration to promote post-operative analgesia. This anesthetic has demonstrated an improvement in post-operative pain control in various surgical realms, indicating a decreased need for opiates and subsequently decreased risks. However, few studies have investigated its use at the time of cesarean delivery.

Oncofertility Awareness And Attitudes Among Health Care Providers And Breast Cancer Patients In A Chinese Academic Setting1, John P. Zucal, Ewelina Biskup, Xin Zhaochen, Yun Sun, Yao Lu, Leslie C. Appiah, Hongwei Zhang, Steven R. Lindheim

Medical Student Research Symposium Abstracts and Posters

As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.

Domestic Currency As A Foreign Body, Nikhil Reddy, Long Vu, Sangeeta Agrawal

Medical Student Research Symposium Abstracts and Posters

Foreign body ingestion is most commonly described in children, however this event can occur in adults as well. In Western countries, the most common cause of esophageal foreign bodies in adults is meat, while coins represent the most common object found in children. Symptoms of foreign body ingestion include sensation of a foreign body, chest pain, dysphagia, and vomiting. In 80% of cases, the foreign body is passed naturally. However, complications of retained esophageal foreign bodies can be life-threatening; therefore, emergent esophagogastroduodenoscopy (EGD) within 2-6 hours is recommended for ingestions of sharp objects, batteries, or those causing complete esophageal obstruction. …

Neonatal Health Outcomes Following Water Immersion During Labor And Delivery, Ariel L. Lanier, Samantha L. Wiegand, David Mckenna

Medical Student Research Symposium Abstracts and Posters

Water birth is child delivery that occurs in a tub of water. Water birth delivery has been offered by Miami Valley Hospital in the Family Beginnings Birth Center since 1994. The first water birth delivery that was documented in a medical journal occurred in France in 1805, which reported that the delivery resulted in a healthy baby. Water birth deliveries have been growing in popularity in the United States as mothers are interested in the possible alleged benefits of water birth including shorter labor, less pain, improved maternal experience of childbirth, and more. Although there are many potential benefits, The …

Evaluating The Effectiveness Of Early Exposure: Obstetrics And Gynecology Two-Week Virtual Elective, Elisabeth N. Adkins, Marilyn Kindig, Rose A. Maxwell

Medical Student Research Symposium Abstracts and Posters

Clinical clerkships are an integral part of undergraduate medical education. Until now, clerkships have either been offered through simulation labs, didactics or in the healthcare setting dependent upon the pedagogical approach of each institutions’ curricula. Subsequent to coronavirus-2019, medical students had decreased accessibility to the aforementioned educational settings. This has provided an innovative opportunity for clerkship directors to provide the same clinical experience to students in a novel way –virtually.

Recently, the Larner College of Medicine at the University of Vermont created a two-week virtual simulated clerkship electiveencompassing the curricula taught throughout the OB/GYN clerkship. Until now, this virtual elective …

Disparities In Health Care Utilization And The Effect Of Family Resilience And Neighborhood Support, Temitope Omoladun, Nora L. Vish

Medical Student Research Symposium Abstracts and Posters

Resilience, the ability to recover from adversity and turn obstacles into strengths and successes, can mitigate negative health outcomes associated with external drivers of health. Poverty, low educational attainment, insurance status and marginalized communities along with adverse childhood events are all known to be associated with poor health outcomes. Resilience is increasingly understood as a potent mitigating factor of negative health outcomes associated with toxic stress and social determinants of health. Individual resilience itself is impacted by external drivers such as family resilience and community cohesion.

Medical homes seek to promote patient well-being by establishing a partnership of trust and …

Dosing Recommendations For Vancomycin In Children And Adolescents With Varying Levels Of Obesity And Renal Dysfunction: A Population Pharmacokinetic Study In 1892 Children Aged 1–18 Years, Cornelis Smit, Sebastiaan C. Goulooze, Roger J. M. Brüggemann, Catherine M. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Vancomycin is an effective but potentially nephrotoxic antibiotic commonly used for severe infections. Dosing guidelines for vancomycin in obese children and adolescents with or without renal impairment are currently lacking. This study describes the pharmacokinetics of vancomycin in a large pediatric cohort with varying degrees of obesity and renal function to design practical dosing guidelines for this population. A multi-center retrospective population pharmacokinetic study was conducted using data from patients aged 1−18 years who received >1 dose of vancomycin and had ≥1 vancomycin concentration measured between January 2006 and December 2012. Besides pharmacokinetic data, age, gender, body weight, creatinine clearance …

Keratinocyte-Derived Microvesicle Particles Mediate Ultraviolet B Radiation-Induced Systemic Immunosuppression, Langni Liu, Azeezat A. Awoyemi, Katherine E. Fahy, Pariksha Thapa, Christina E. Borchers, Benita Y. Wu, Cameron L. Mcglone, Benjamin Schmeusser, Zafer Sattouf, Craig A. Rohan, Amy R. Williams, Elizabeth E. Cates, Christina Kinsely, Lisa E. Kelly, Ji C. Bihl, David R. Cool, Ravi P. Sahu, Jinju Wang, Yanfang Chen, Christine M. Rapp, Michael G. Kemp, Ron Michael Johnson, Jeffrey B. Travers

Dermatology Faculty Publications

A complete carcinogen, ultraviolet B (UVB) radiation (290–320 nm), is the major cause of skin cancer. UVB-induced systemic immunosuppression that contributes to photocarcinogenesis is due to the glycerophosphocholine-derived lipid mediator platelet-activating factor (PAF). A major question in photobiology is how UVB radiation, which only absorbs appreciably in the epidermal layers of skin, can generate systemic effects. UVB exposure and PAF receptor (PAFR) activation in keratinocytes induce the release of large numbers of microvesicle particles (MVPs; extracellular vesicles ranging from 100 to 1000 nm in size). MVPs released from skin keratinocytes in vitro in response to UVB (UVB-MVPs) are dependent on …

Clinical And Diagnostic Imaging Manifestations Of Erdheim-Chester Disease, Avrey Thau, Roland Gazaille, Alejandro Calvo, Christina E. Borchers, Ronald E. Warwar, William Boyce, Joseph Blake

Dermatology Faculty Publications

Introduction: Erdheim-Chester disease (ECD) is a rare form of non-Langerhans-cell histiocytosis which typically presents with bilateral masses due to retro-orbital deposition, xanthelasma of the eyelids, cardiopulmonary manifestations, along with sclerosis and cortical thickening of the long bones, particularly in the lower extremities.

Case Report: We present the case of a 58-year-old male who presented to a local emergency department with a one day history of severe dizziness, diaphoresis, dyspnea, and intermittent diplopia. Imaging demonstrated bilateral symmetric retrobulbar masses. Subsequent imaging as well as orbital and bone marrow biopsies lead to the diagnosis of ECD.

Conclusion: Erdheim-Chester disease is a rare …

Outcome After Surgical Stabilization Of Rib Fractures Versus Nonoperative Treatment In Patients With Multiple Rib Fractures And Moderate To Severe Traumatic Brain Injury (Cwis-Tbi), Jonne T.H. Prins, Esther M. M. Van Lieshout, Francis Ali-Osman, Zachary M. Bauman, Eva-Corina Caragounis, Jeff Choi, D. Benjamin Christie Iii, Peter A. Cole, William B. Devoe, Andrew R. Doben, Evert A. Eriksson, Joseph D. Forrester, Douglas R. Fraser, Brendan Gontarz, Claire Hardman, Daniel G. Hyatt, Adam J. Kaye, Huan-Jang Ko, Kiara N. Leasia, Stuart Leon, Silvana F. Marasco, Allison G. Mcnickle, Timothy Nowack, Terri D. Ogunleye, Prakash Priya, Aaron P. Richman, Victoria Sschlanser, Gregory Semon, Ying-Hao Su, Michael H. J. Verhofstad, Julie Whitis, Fredric M. Pieracci, Mathieu M. E. Wijffels

Department of Surgery Faculty Publications

BACKGROUND

Outcomes after surgical stabilization of rib fractures (SSRF) have not been studied in patients with multiple rib fractures and traumatic brain injury (TBI). We hypothesized that SSRF, as compared with nonoperative management, is associated with favorable outcomes in patients with TBI.

METHODS

A multicenter, retrospective cohort study was performed in patients with rib fractures and TBI between January 2012 and July 2019. Patients who underwent SSRF were compared to those managed nonoperatively. The primary outcome was mechanical ventilation-free days. Secondary outcomes were intensive care unit length of stay and hospital length of stay, tracheostomy, occurrence of complications, neurologic outcome, …

Population Pharmacokinetics Of Olanzapine In Children, Anil R. Maharaj, Huali Wu, Kanecia O. Zimmerman, Julie Autmizguine, Rohit Kalra, Amira Al‐Uzri, Catherine M.T. Sherwin, Stuart L. Goldstein, Kevin Watt, Jinson Erinjeri, Elizabeth H. Payne, Michael Cohen‐Wolkowiez, Christoph P. Hornik

Pediatrics Faculty Publications

Aims The aim of this study was to evaluate the population pharmacokinetics (PopPK) of olanzapine in children and devise a model-informed paediatric dosing scheme. Methods The PopPK of olanzapine was characterized using opportunistically collected plasma samples from children receiving olanzapine per standard of care for any indication. A nonlinear mixed effect modelling approach was employed for model development using the software NONMEM (v7.4). Simulations from the developed PopPK model were used to devise a paediatric dosing scheme that targeted comparable plasma exposures to adolescents and adults. Results Forty-five participants contributed 83 plasma samples towards the analysis. The median (range) postnatal …

Vital Signs, Winter 2021, Boonshoft School Of Medicine

Vital Signs

A newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Consent For Emergency Treatment: Demographic Variables And Relationship To Patient Comprehension, Ashwatha Thenappan

Scholarship in Medicine - All Papers

Objective: One of the most important pillars of patient autonomy is informed consent for medical treatment. This study was undertaken to measure patient recall and understanding of consent for treatment among ED patients. Methods: This prospective survey study was conducted at Miami Valley Hospital, an Urban Level 1 Trauma Center. Trained research assistants obtained verbal consent in private patient treatment rooms. Data were collected from the electronic medical record and from a survey questionnaire. Results: A total of 293 patients consented to participate (95% participation rate). The majority of participants stated that they had signed a consent document (N …

Uvb-Induced Microvesicle Particle Release In Human Skin In Vivo Is Diminished Following Oral Vitamin C And E Antioxidant Administration, Cameron Mcglone

Scholarship in Medicine - All Papers

An important question in photobiology asks how Ultraviolet B (UVB, 290 – 320 nm) radiation, which mostly absorbs in the outer epidermis of skin, can generate a systemic response such as immunosuppression. Previous in vitro and ex vivo studies demonstrate UVB-dependent release of bioactive molecule-containing microvesicle particles (MVPs) from keratinocytes. Furthermore, MVP release is diminished upon antioxidant administration. The purpose of this study is to examine UVB-induced MVP release and antioxidant response in vivo. In this IRB-approved study, 8 male participants with Fitzpatrick type I or II skin were treated with 1000 J/m2 UVB irradiation to a 5 by 5 …