Medicine and Health Sciences Commons^™

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

Inhibitors Of Histone Deacetylase And Mcl-1 Synergistically Reduce Proliferation In Malignant Melanoma, Mehrnoosh Ghafouri, Chester Gauss, Yue Xi Phd, William Azkoul Ii Md, Abby Knudsen, Jordan Zuckerman, Sharon K. Michelhaugh Phd, Sandeep Mittal Md, Andrew M. Fribley Phd

Medical Student Research Symposium

Melanoma is a skin cancer that arises in melanocytes; it is the fifth most common cancer in the United States with approximately 100,000 new cases per year. Current treatments for malignant melanoma are surgical excision, radiation therapy and systemic therapy; however, the five-year survival rate for patients with stage IV is 29.8%. There is an urgent unmet clinical need to investigate novel treatments for these patients. Panobinostat is an orally available histone deacetylase inhibitor used in several hematologic malignancies, but it was ineffective as a single agent against melanoma in Phase 1. To address the insufficiency of options for melanoma …

Residential Racial Segregation And Neighborhood Adversity: Associations With Hemoglobin A1c In Adolescents With Type 1 Diabetes, Zechariah Jean, April Carcone, Deborah Ellis

Medical Student Research Symposium

Black adolescents with Type 1 Diabetes (T1D) are at increased risk for disparities in health outcomes. More research is necessary on the effects of neighborhood characteristics such as residential racial segregation (RRS) and neighborhood adversity on health.

149 Black youth with T1D were recruited from seven pediatric diabetes clinics in Detroit and Chicago to participate in a clinical trial to improve diabetes management. RRS was calculated at the census block group level based on US census data using Location Quotients. LQs represented the ratio of patients to total population in the block group compared to the same ratio in the …

Assessing Accessibility And Equity Of Autism Spectrum Disorder Screening Tools, Kiernan S. Bloye, Joseph Aderemi Md, Roman Grossi, Tessa Hampton, Melissa Maye Phd

Medical Student Research Symposium

Introduction: Disparities to accessing autism spectrum disorder (ASD) screening tools have been demonstrated across race, ethnicity, socioeconomic status, and language. Additionally, there are concerns that existing screening tools are not as accurate for minoritized individuals. Thus, it is likely that level 1 screening tools must be adapted and developed for, and with, marginalized populations in the United States to promote increased levels of universal screening access and accuracy among minoritized populations.

Methods: Using the PRISMA scoping review checklist, an initial search produced 1880 unique records. Following title and abstract review, 35 articles met criteria for full manuscript review. Finally, 7 …

Complications Of Pediatric Cochlear Implant Surgery, Andrew Stefan, Sabrina Bernardo, William Azkoul Ii, Bianca Siegel

Medical Student Research Symposium

Background:

Cochlear implantation (CI) surgery is the standard of care treatment for pediatric patients diagnosed with severe to profound sensorineural hearing loss. While considered a relatively safe operation, any invasive procedure involving the cranium has risks. However, there are few recent studies in the United States that have analyzed complication rates among children who have received CI. Furthermore, existing studies fail to discuss specific risk factors that led to post-operative complications, nor offer solutions to reduce their incidence. This study aims to 1) determine the incidence of specific complications in pediatric CI patients and 2) identify evidence-based risk factors for …

Endoscopic Cricoid Split As A Treatment For Subglottic Stenosis: A Systematic Review, Silvia Aluia, Katherine Akers, Michael Chung Md

Medical Student Research Symposium

Introduction: Subglottic stenosis, a fibrotic narrowing of the airway below the vocal cords extending to the lower border of the cricoid cartilage, can be classified as congenital, idiopathic, or acquired in neonates from prolonged intubation. Treatment has more recently expanded from open surgical intervention to include endoscopic procedures. This systematic review aims to evaluate existing literature on anterior and posterior endoscopic cricoid split procedures as a treatment for congenital and acquired subglottic stenosis in order to explore the efficacy of these techniques.

Methods: Literature searches were conducted in PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, and Google scholar, which produced …

Luspatercept Diminishes The Need For Red Blood Cell Replacement In Transfusion-Dependent Β-Thalassemia Patients, Joudeh B. Freij

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Cappellini MD, Viprakasit V, Taher AT, et al. A phase 3 trial of luspatercept in patients with transfusion-dependent β-thalassemia. N Engl J Med. 2020;382(13):1219-1231. https://doi.org/10.1056/NEJMoa1910182

for a patient with transfusion-dependent beta-thalassemia.

Cyclosporine Shows Benefit As Compared To Methotrexate For Treatment Of Pediatric Atopic Dermatitis Refractory To Topical Medications When Rapidity Of Clinical Response Is Of Key Importance To The Patient, Connor R. Buechler, Steven Daveluy Md

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

Little Is Known About Cannabidiol For Improving Severe Behavioral Symptoms Of Autistic Spectrum Disorder, Keerteshwrya Mishra

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Barchel D, Stolar O, De-Haan T, et al. Oral cannabidiol use in children with autism spectrum disorder to treat related symptoms and co-morbidities. Frontiers in Pharmacology. 2019;9. https://doi.org/10.3389/fphar.2018.01521

Management Of Childhood Migraine By Headache Specialist Versus Non-Headache Specialists, Kelly Valentini, Radhika Gutta, Gunjanpreet Kaur, Ahmad Farooqi, Lalitha Sivaswamy

Medical Student Research Symposium

This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of pediatric migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians. A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018. Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed …

Atrx Loss In Pediatric Glioma Results In Epigenetic Dysregulation Of G2/M Checkpoint Maintenance And Sensitivity To Atm Inhibition, Brendan Mullan, Tingting Qin, Ruby Siada, Carla Danussi, Jacqueline Brosnan-Cashman, Drew Pratt, Taylor Garcia, Viveka Nand Yadav, Xinyi Zhao, Meredith Morgan, Sriram Venneti, Alan Meeker, Alnawaz Rehemtulla, Pedro Lowenstein, Maria Castro, Carl Koschmann

Medical Student Research Symposium

ATRX is a histone chaperone protein recurrently mutated in pediatric glioma. The mechanism which mediates the proliferative advantage of ATRX loss in pediatric glioma remains unexplained. Recent data revealed a distinct pattern of DNA binding sites of the ATRX protein using ChIP-seq in mouse neuronal precursor cells (mNPCs). Using the ATRX peaks identified in p53^-/- mNPCs, we confirmed that ATRX binding sites were significantly enriched in gene promoters (p < 0.0001) and CpG islands (p < 0.0001) compared with random regions. Gene set enrichment (GSE) analysis identified that cell cycle and regulation of cell cycle were among the most significantly enriched gene sets (p=2.52e-16 and 1.61e-9, respectively). We found that ATRX loss resulted in dysfunction of G2/M checkpoint maintenance: (1) ATRX-deficient pediatric glioblastoma (GBM) cells exhibited a seven-fold increase in mitotic index at 16 hours after sub-lethal radiation, and (2) murine GBM cells with ATRX knockdown demonstrated impaired pChk1 signaling on western blot at multiple time points after radiation compared to controls (p=0.0187). Notably, the ATM signaling (pChk2) remained intact in those cells, suggesting a potential therapeutic target. ATRX-deficient mouse cells were uniquely sensitive to ATM inhibitors at 1 uM alongside 8 Gy radiation compared to controls with intact ATRX (AZD0156: p=0.0027 and AZD01390: p=0.0436). Mice intra-cranially implanted with ATRX-deficient GBM cells showed improved survival (n=10, p=0.0018) when treated with AZD0156 combined with radiation. Our findings suggest that ATRX loss in glioma results in unique sensitivity to ATM inhibition via epigenetic dysregulation of G2/M checkpoint maintenance.

Neonatal Encephalopathic Cerebral Injury In South India Assessed By Perinatal Magnetic Resonance Biomarkers And Early Childhood Neurodevelopmental Outcome, Peter J. Lally, David L. Price, Shreela S. Pauliah, Alan Bainbridge, Justin Kurien, Neeraja Sivasamy, Frances M. Cowan, Guhan Balraj, Manjula Ayer, Kariyapilly Satheesan, Sreejith Ceebi, Angie Wade, Ravi Swamy, Shaji Padinjattel, Betty Hutchon, Madhava Vijayakumar, Mohandas Nair, Krishnakumar Padinharath, Hui Zhang, Ernest B. Cady, Seetha Shankaran, Sudhin Thayyil

Department of Pediatrics

Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR) biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India.

Augmented Annotation And Orthologue Analysis For Oryctolagus Cuniculus: Better Bunny, Douglas B. Craig, Sujatha Kannan, Alan A. Dombkowski

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

The rabbit is an important model organism used in a wide range of biomedical research. However, the rabbit genome is still sparsely annotated, thus prohibiting extensive functional analysis of gene sets derived from whole-genome experiments. We developed a web-based application that provides augmented annotation and orthologue analysis for rabbit genes. Importantly, the application allows comprehensive functional analysis through the use of orthologous relationships.

Results

Using data extracted from several public bioinformatics repositories we created Better Bunny, a database and query tool that extensively augments the available functional annotation for rabbit genes. Using the complete set of target genes …

Evaluation Of Age-Related Changes In Translocator Protein (Tspo) In Human Brain Using 11C-[R]-Pk11195 Pet, Ajay Kumar, Otto Muzik, Varun Shandal, Diane Chugani, Pulak Chakraborty, Harry T. Chugani

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We studied the distribution and expression of translocator protein in the human brain using ¹¹C-[R]-PK-11195 positron emission tomography (PK11195 PET) and evaluated age-related changes.

Methods

A dynamic PK11195 PET scan was performed in 15 normal healthy adults (mean age: 29 ±8.5 years (range: 20 to 49); 7 males) and 10 children (mean age: 8.8 ±5.2 years (range: 1.2 to 17); 5 males), who were studied for potential neuroinflammation but showed no focally increased PK11195 binding. The PET images were evaluated by calculating standard uptake values and regional binding potential, based on a simplified reference region model, as …

Hepatic Failure, Neonatal Hemochromatosis And Porto-Pulmonary Hypertension In A Newborn With Trisomy 21 - A Case Report, Erin Neil, Josef Cortez, Aparna Joshi, Erawati V. Bawle, Janet Poulik, Mark Zilberman, Mohammad F. El-Baba, Beena G. Sood

Wayne State University Associated BioMed Central Scholarship

Abstract

Liver failure in neonates is a rare but often fatal disease. Trisomy 21 is not usually associated with significant infantile liver disease. If present, hepatic dysfunction in an infant with Trisomy 21 is likely to be attributed to transient myeloproliferative disorder with hepatic infiltration by hematopoietic elements and may be associated with secondary hemosiderosis. A less commonly recognized cause of liver failure in neonates with Trisomy 21 is neonatal hemochromatosis (NH); this association has been reported in nine cases of Trisomy 21 in literature. NH is a rare, severe liver disease of intra-uterine onset that is characterized by neonatal …

A Three-Year-Old Boy With X-Linked Adrenoleukodystrophy And Congenital Pulmonary Adenomatoid Malformation: A Case Report, Ibrahim Abdulhamid, Sermin Saadeh, Nedim Cakan

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

X-linked adrenoleukodystrophy leads to demyelination of the nervous system, adrenal insufficiency, and accumulation of long-chain fatty acids. Most young patients with X-linked adrenoleukodystrophy develop seizures and progressive neurologic deficits, and die within the first two decades of life. Congenital or acquired disorders of the respiratory system have not been previously described in patients with X-linked adrenoleukodystrophy.

Case presentation

A 3-year-old Arabic boy from Yemen presented with discoloration of the mucous membranes and nail beds, which were considered cyanoses due to methemoglobinemia. He also had shortness of breath, fatigue, emesis and dehydration episodes for which he was admitted to …

Pediatricians' Attitudes, Experience And Referral Patterns Regarding Complementary/Alternative Medicine: A National Survey, Anju Sawni, Ronald Thomas

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

To assess pediatricians' attitudes toward & practice of Complementary/Alternative Medicine (CAM) including their knowledge, experience, & referral patterns for CAM therapies.

Methods

An anonymous, self-report, 27-item questionnaire was mailed nationally to fellows of the American Academy of Pediatrics in July 2004.

648 of 3500 pediatricians' surveyed responded (18%).

Results

The median age ranged from 46–59 yrs; 52% female, 81% Caucasian, 71% generalists, & 85% trained in the US. Over 96% of pediatricians' responding believed their patients were using CAM. Discussions of CAM use were initiated by the family (70%) & only 37% of pediatricians asked about CAM use …

Developmental Variations In Plasma Leptin, Leptin Soluble Receptor And Their Molar Ratio In Healthy Infants, Winston Wk Koo, Mouhanad Hammami, Elaine M. Hockman

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Leptin and its soluble receptor (sOB-R) are important to regulation of body composition but there are no data on the developmental variations in these plasma variables and their relationship with body composition measurements,

Methods

Weight, length, and body composition (bone, fat and lean mass) by dual energy absorptiometry, and plasma variables were measured in healthy infants at 2, 4, 8 and 12 months.

Results

15 whites and 29 African Americans (21 males and 23 females) with mean birth weight 3357 +/- 45 (SEM) g and gestation of 39.3 +/- 0.17 weeks were studied. The overall Z score for …

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

Ethnicity And Gender Related Differences In Extended Intraesophageal Ph Monitoring Parameters In Infants: A Retrospective Study, Dena Nazer, Ronald Thomas, Vasundhara Tolia

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gastroesophageal reflux disease (GERD) is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy.

Methods

Extended pH monitoring data (EPM) from infants <1 year of age were reviewed. Results were classified in two groups, as control and Gastroesophageal reflux disease (GERD) group based on the reflux index (RI). The GERD group had RI of equal to or more than 5% of total monitoring period. The parameters of RI, total number of episodes of pH < 4, and the number of episodes with pH < 4 lasting more than 5 minutes were compared by genders and by ethnic groups, Caucasians and African American (AA).

Results

There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA). No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants …

Childhood Cancer Among Arab Americans In Southeast Michigan, Hadi Sawaf, Adonis Lorenzana, George Dombi, Merlin Hamre, Kendra Schwartz

FMPHS Faculty Publications

Cancer is relatively rare among children, yet it remains an important public concern. Childhood cancer ranks second as a cause of death after accidents. Population-based data such as Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute create an opportunity to study the effect of ethnic background on the incidence and mortality of cancer. Studies on migrants have been widely used to infer the relative importance of environmental factors versus inherited factors and have proved valuable in developing population-specific interventions. Unfortunately, information on cancer occurrence among Arab Americans is lacking because of incomplete reporting of nationality and …

Cancer Among Arab Americans In The Metropolitan Detroit Area, Kendra L. Schwartz, Anahid Kulwicki, Linda K. Weiss, Haifa Fakhouri, Wael Sakr, Gregory Kau, Richard K. Severson

FMPHS Faculty Publications

Detroit is home to one of the largest populations of Arab Americans outside of the Middle East, yet little is known about the cancer distribution in this ethnic group. The authors of this study created an Arab/Chaldean surname list and matched it with the Detroit SEER Registry to identify cancer cases of probable Arabic descent. We then determined proportional incidence ratios (PIR) for specific cancer sites among metropolitan Detroit Arab Americans as compared to non-Arab Whites, and contrasted the results with Middle Eastern data. Arab/Chaldean men had greater proportions of leukemia (29%), multiple myeloma (46%), liver (64%), kidney (33%), and …