Medicine and Health Sciences Commons^™

Reduction In Healthcare Resource Utilization Associate With A Rapid Rule-Out Protocol For Suspected Acute Coronary Syndrome, Sophie Wittenberg, Nicole Xu

Medical Student Research Symposium

Background: Cardiovascular disease is the leading cause of mortality in the US. Cardiac biomarkers are the gold standard for detecting acute myocardial infarction (AMI) in the Emergency Department (ED). Current guidelines recommend using high sensitivity cardiac troponin (hs-cTn) to exclude AMI, which can potentially reduce hospital resource utilization and expedite diagnosis. In an attempt to improve the efficiency of diagnosis and triage for patients with possible ACS, we developed a protocol for rapid rule out (RACE-IT).

Methods: A secondary analysis of a stepped-wedge randomized trial of patients evaluated for AMI across 9 ED’s in the Henry Ford Health …

Time-To-Surgery And Short-Term Outcomes Of Trimalleolar Ankle Fracture During The Covid-19 Pandemic, Gabriel Burdick Bs, Rami Beydoun Bs, Alexander Pietroski Ms, Jonathan Warren Bs, Bushra Fathima Bs, Trevor Wolterink Bs, Michael Mcintosh Bs, Neethi Sriranga Bs, Stephanie Muh Md

Medical Student Research Symposium

PURPOSE: The purpose of this study was to evaluate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on time-to-surgery, complication rates, and functional outcomes of open reduction and internal fixation (ORIF) for trimalleolar ankle fracture.

METHODS: This retrospective cohort study compared patients who underwent ORIF for trimalleolar ankle fracture between April and July of 2020 of the COVID-19 pandemic (COVID group) to a pre-pandemic cohort treated in 2018 (2018 group). Demographic information, fracture characteristics, and surgical outcomes were collected from patients’ medical charts.

RESULTS: The COVID and 2018 groups consisted of 32 and 100 patients, respectively. The two groups …

Very Long Chain Acyl-Coa Dehydrogenase Deficiency Diagnosed By Michigan Newborn Screening And Their Cardiac Complications, Lindsay Jenkins, Kara Pappas Md, Shagun Kaur Md, Marissa Younan Ms, Cgc

Medical Student Research Symposium

With the expansion of newborn screening (NBS), there has been an increase in the number of patients diagnosed with genetic and metabolic conditions before the onset of symptoms. Very Long-Chain Acyl-CoA Dehydrogenase Deficiency (VLCADD) is a genetic disorder of fatty acid metabolism that can cause hypoglycemia, myopathy, rhabdomyolysis, cardiomyopathy and cardiac arrhythmias. VLCADD was included in the Michigan NBS in 2005 and since then, our center has diagnosed 28 patients with VLCADD. We have observed that many of these patients are asymptomatic or have a mild disease presentation. These patients may also have a lower incidence of cardiac complications than …

Social Determinants, Health Care Access And Utilization In Detroit, Michigan Latinx Community, Karla P. Escobar, Julia M. Yee, Miles Bowman, Myles Hardeman, Emile Tadros, Omar Mahmood, Kiernan S. Bloye

Medical Student Research Symposium

• Background - The Amigos Médicos Clinic is a Wayne State School of Medicine Latino Medical Student Association (LMSA) project started formally in June of 2021, that aims to bridge the healthcare gap faced by the uninsured/underinsured Latinx community of Detroit by providing free medical screenings and education to this community. According to a 2018 survey conducted by the University of Michigan’s Detroit Metro Area Community Study (DMACS), 22% of Latinx residents reported lacking insurance, and 14.2% of Latinx residents utilize hospital emergency rooms as their usual place of medical care when they are sick. Along with providing blood glucose and …

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Thromboelastography Profiles Of Hemophilia A Patients On Emicizumab, Daniel J. Vanzweden, Meera Chitlur, Charity J. Stadler

Medical Student Research Symposium

Emicizumab is a new monoclonal antibody developed to dtreat people with Hemophilia A, especially those with antibodies. However, breakthrough bleeding can still occur in patients taking Emicizumab. TEG is a global coagulation assay which measures coagulability through viscosity. This study describes the use of tissue factor activated TEG in measuring bleeding profiles in patients taking Emicizumab. The goal of this prospective study is to determine if TEG can be used, which variables of TEG might be useful, and how much more useful it is than the current standard, aPtt. Findings include a 25% increased R time and 24% increased K …

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Incidence Of Cannabinoid Hyperemesis Syndrome In An Urban Emergency Department Setting, Muhammad Ahmed, James Paxton

Medical Student Research Symposium

Introduction:

Cannabis is a psychoactive drug that is widely used for both medicinal and recreational purposes. Despite its traditional use as an antiemetic, emerging evidence suggests a possible association between excessive cannabis usage and the incidence of Cannabinoid Hyperemesis Syndrome (CHS), a condition characterized by otherwise unexplained cyclic abdominal pain and vomiting. Although previous studies have been done in mixed-race or primarily Caucasian populations, our study focuses on an urban, predominantly African-American population. We aim to measure the incidence of CHS among patients presenting to two urban Detroit emergency departments, including a descriptive analysis on apparent demographic and behavioral risk …

Cardio-Net: A Matlab-Based Software For The Display And Diagnostic Utilization Of Vectorcardiograms, Ali H. Mannaa, Domenico Gatti

Medical Student Research Symposium

Background: The 12-lead technique is the standard in ECG, however alternate cardiography modalities such as vectorcardiography (VCG) exist . While the VCG modality offers unique clinical metrics and certain advantages over ECG, it is hardly utilized due to it being more difficult to obtain than ECG. Here we introduce Cardio-Net, a MATLAB-based software that uses standard 12-lead ECG data to generate and visualize VCGs. Furthermore, we demonstrate the diagnostic potential of VCG by utilizing a recurrent neural network (RNN) to accurately classify vectorcardiograms.

Methods: MATLAB version 2019b and the following toolboxes were used for data processing: Deep learning, …

Learning Communities: Do They Improve Imposter Syndrome And Loneliness Among Medical Students?, Nicole C. White, Sahar Elmenini

Medical Student Research Symposium

Current literature links imposter syndrome (IS), isolation, and locus of control (LOC). Learning communities (LCs) serve to directly and effectively combat loneliness, feelings of isolation, and better promote students’ wellbeing and success. We hypothesized that those who attend more LC events will score lower on the IS scale and lower on the social loneliness scale. Furthermore, those who scored higher on IS and social loneliness are more likely to have an external LOC. To test this, a survey was sent to the Classes of 2021, 2022, 2023, and 2024 at Wayne State University School of Medicine, resulting in 144 participants. …

Validation Of The Termination Of Resuscitation Rules In Detroit, Arqam Husain, Adam D. Chalek, Robert Dunne

Medical Student Research Symposium

Introduction: 326,000 patients suffer from an out of hospital cardiac arrest (OHCA) each year. The Termination of Resuscitation (TOR) criteria guides physicians in determining the futility of continuing CPR and transporting patients to the hospital. We examined compliance with current BLS TOR rules and assessed an alternate set of rules to derive improved TOR guidelines for OHCAs in Detroit.

Methods: A retrospective study was conducted utilizing non-traumatic OHCA cases in Detroit from January 1, 2017 to December 31, 2019, which includes time before and after BLS TOR guidelines were implemented. Patients younger than 18 and arrests of traumatic origin or …

Medical Student Mock Interview And Diabetes Education During The Covid-19 Pandemic, Ajith Thomas, Kendahl Oberdorfer, Suma Alzouhayli

Medical Student Research Symposium

Background: The Diabetes Education and Wellness (DEW) clinic is an interprofessional, student-run free clinic that promotes education and autonomy in diabetes management for underserved communities. When pandemic restrictions prevented in-person clinic visits, DEW opted instead to meet their patients virtually. DEW coordinators from the school of medicine designed a primer course to teach skills and medical knowledge that directly impacts diabetes management to ensure continued care of our patients.

Methods: The two components of the intervention were mock interviews and diabetes education. Medical students who previously volunteered at DEW were recruited to provide mock interviews. First year medical students were …

Intrabody-Mediated Postsynaptic Recruitment Of Camkiiα Improves Memory, Anthony Chifor, Jeongyoon Choi Dr., Joongkyu Park Dr.

Medical Student Research Symposium

Long-term potentiation (LTP), the selective strengthening of specific synapses based on recent activity, has widely been accepted as the biological mechanism responsible for learning and memory. N-methyl-D-aspartate receptors (NMDARs) play a critical role in LTP, which when activated, result in a surge of postsynaptic intracellular calcium levels. The calcium rise during LTP results in the activation of Ca²⁺/calmodulin-dependent kinase II alpha (CaMKIIa), which consequently enacts multiple cellular effects that ultimately result in the strengthening of synaptic connections. Previous work has examined the effects of CaMKIIa overexpression in rat hippocampi on spatial memory, however, significant but limited improvement in …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Ultrasound Education Curriculum Increases First Year Student Visualization Ability Three-Fold, Joseph Files, Majd Faraj, Jared Hudson, Anna Kang, David Melville, Charles S. Day

Medical Student Research Symposium

Introduction: Ultrasound usage in identifying a subsheath within the first dorsal extensor compartment may be useful in determining cortisone shot effectiveness in alleviating pain for DeQuervain’s Tenosynovitis(1,2). However, no ultrasound educational curriculum has been established for non-radiologists(3-5). We hypothesize that an ultrasound training protocol will show marked improvement of anatomical knowledge and technical knowledge of how to utilize an ultrasound probe to visualize the first extensor compartment and any possible septation.

Materials & Methods: First-year medical students were polled for participation from a single medical school at a tertiary care academic medical center in the Midwest. Evaluations were developed and …

Management Of Patients Diagnosed With Pregnancy Of Unknown Location, Mayra A. Shafique

Medical Student Research Symposium

Ectopic pregnancies account for 75% of maternal deaths in the first trimester and 9%-13% of all pregnancy-related deaths.¹ It is critical that patients at risk for ectopic pregnancy be treated promptly. Pregnancy of unknown location (PUL) classifies a patient at risk for ectopic pregnancy when a pregnancy cannot be located on ultrasound but bhCG level is positive.² The incidence of PUL is 15% in patients undergoing a transvaginal ultrasound early in the first trimester.^2,3 In order to determine a management strategy to improve management of patient’s with PUL, a retrospective chart review of patients who presented to …

Corticosteroid Injection Exhibits Symptomatic Improvement In Cts Patients With Negative Emgs, Brooke G. Garnica, Aaron R. Prater, Elizabeth A. Washnock-Schmid, Alaa Hazime, Dr. Charles S. Day

Medical Student Research Symposium

Introduction

While corticosteroid injections for carpal tunnel syndrome (CTS) are effective in patients with mild EMGs, no literature has examined the effectiveness of injections in patients with negative EMGs. We hypothesized that patients with negative EMGs will have minimal symptomatic and functional improvement.

Methods

The Boston Carpal Tunnel Questionnaire (BCTQ) was administered to patients clinically diagnosed with CTS and a negative or mild EMG prior to corticosteroid injection. The BCTQ comprises functional (FSS) and symptom status (SSS) questions. The patient was re-evaluated at 2-weeks, 1-, 3-, and 6-months post-injection. Data were analyzed via one-way ANOVA tests. A post-hoc Benjamini-Hochberg FDR …

Sex Differences In Locomotor Activity And Behavioral Sensitization In Rats Administered Fentanyl, Jessica J. Lee, Nareen Sadik, Cameron Davidson Phd, Majd Yahya, Josie Zdun, Shane Perrine Phd

Medical Student Research Symposium

Opioid overdoses have continued to increase, and women have experienced a greater rate of increase than males. Preclinical studies demonstrate marked sex differences in addiction-related behaviors, with females being more vulnerable due to a potential role of estradiol. We sought to understand how the estrous cycle, as a proxy measure of estradiol, influences sex differences in the sensitizing effects of fentanyl. In this ongoing study, we used male and female rats to investigate potential sex effects of fentanyl (20µg/kg subcutaneously) administration for 14 days and a forced abstinence period of 13 days on behavioral sensitization via locomotor activity (LMA) following …

Do Orthopedic Surgeons Follow Through On Verbal Commitments To Participate In Deficit Recovery Efforts?, Maxwell T. Yoshida, Wendy Jin, Joseph S. Files, Austin M. Meadows, Charles S. Day M.D. Mba

Medical Student Research Symposium

No abstract provided.

Social Determinants Of Health Influence Outcomes In Patients Undergoing Total Hip Arthroplasty: A Systematic Review, Varag Abed Bs, Daisy Ference Ba, Alex Duvall Ba, Ajith Dupati Bs, Joshua Castle Md, Eric Makhni Md/Mba

Medical Student Research Symposium

Purpose: To examine the effects of social determinants of health (SDOH) on patient outcomes following total hip arthroplasty (THA)

Methods: A systematic search was conducted using the MEDLINE, Epub Ahead of Print, Web of Science, PubMed and Embase databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies involving at least 1 SDOH and its effects on patient reported outcomes and surgical outcomes following THA. 2,840 studies were initially identified and we are still in the process of determining which studies will eventually meet the criteria regarding SDOH influencing postoperative THA outcomes.

Results: …

Utilizing Primary Care To Engage Patients On Opioids In A Psychological Intervention For Chronic Pain, Sikander Chohan, Lyuba Gavrilova Bs, Leah Hect, Kristi Autio, Erin Tobin, Brian K. Ahmedani, Lisa R. Miller-Matero

Medical Student Research Symposium

Introduction: Chronic pain is commonly encountered in primary care. It is often treated with opioids, which can cause overdose and death. Psychological interventions are an effective alternative, yet difficulty engaging patients with opioid prescriptions has led to their underutilization. Offering these interventions in primary care settings may alleviate this barrier.

Objective: Determine whether opioid prescriptions are related to patients engaging in a brief psychological intervention for chronic pain management in primary care.

Study Design: Secondary analysis of a pilot randomized clinical trial (RCT) of a 5-session psychological intervention for chronic pain. Patients with chronic pain (N= 220) were approached to …

The Effect Of Socioeconomic Status On Patient Outcomes Following Rotator Cuff Repair At Two Hospital Campuses, Bushra Fathima, Emily Lau, Joshua P. Castle, Cassandra Keinath, Chaoyang Chen, Gabriel Burdick, Stephanie J. Muh

Medical Student Research Symposium

INTRODUCTION: To examine the relationship between demographics, socioeconomic status (SES), and patient outcomes after rotator cuff repair (RCR).

METHODS: A retrospective review identified 7564 patients who underwent RCR between 2017 and 2021. Patients were stratified into two groups, urban(U) or suburban(S), based on which campus they underwent surgery. Demographic information, medical comorbidities, SES and other preoperative risk factors were compared. Pre- and postoperative functional outcomes at each location were analyzed. Categorical variables were reported as counts and percentages while continuous variables were reported as means and standard deviations. Chi-square tests were used to compare categorical variables while independent …

Blood Pressure Response In Children With Heart Disease, Daisuke Kobayashi, Mara A. Darian

Medical Student Research Symposium

Abstract:

Background: Cardiopulmonary exercise testing (CPET) has been utilized for the management of children with congenital heart disease. Blood pressure (BP) response is one of the important markers that may carry a prognostic implication and has not been well studied in children who underwent Fontan operation.

Objective: The aims are to evaluate the incidence of abnormal BP response and the association between BP response and mortality/transplant at follow up in children undergoing Fontan operation.

Methods: This was the retrospective study of 114 children status post Fontan operation, who underwent treadmill CPET at Children’s Hospital of Michigan. The study duration was …

Evaluation Of The Utility Of Lymph-Vascular Invasion As An Independent Prognostic Predictor Of Overall Survival For Patients With Renal Cell Carcinoma That Undergo Nephrectomy, Ivan Rakic, Nikola Rakic Md, Nicholas Corsi, Austin Piontkowski, Sami Majdalani Md, Akshay Sood Md, Deepansh Dalela Md, Sohrab Arora Md, Marcus Jamil Md, Craig Rogers Md, Firas Abdollah Md

Medical Student Research Symposium

Lymph-vascular invasion(LVI) is recognized as an adverse pathological feature in patients with renal cell carcinoma RCC) patients. Its impact on overall survival (OS) is not clear, and scarcely addressed in literature. Our aim was to assess the prognostic ability of LVI as a predictor of OS in RCC patients using a large, North American cohort.

We included 45,036 cM0 RCC patients from 2010-2015 who underwent partial or radial nephrectomy within the NCDB. Kaplan-Meier curves and log-rank test compared survival curves. Cox regression analysis tested the relationship between LVI and OS.

Median age was 60. Most patients had pT1 stage(70.0%), and …

A Pilot Study On Hand Palmar And Digital Nerve Ultrasound In Peripheral Nerve Diseases, Luke Geierman, Ryan Castoro, Christopher Andriano, Arthur Yan, Amira Badr

Medical Student Research Symposium

INTRODUCTION:

Palmar and digital nerves of the hand can be imaged with high resolution using ultrasonography because of their superficial anatomic locations. However, no studies have systematically evaluated these nerves in polyneuropathies.

OBJECTIVE:

Measure the cross-sectional area (CSA) and echogenicity (represented as % black) of the palmar and digital nerves of the hand in chronic polyneuropathies.

METHODS:

We studied 52 individuals: 26 with electrodiagnostically confirmed chronic peripheral nerve diseases (16 demyelinating/10 axonal) compared with 26 age and gender matched controls. Ultrasonography was performed in the median and ulnar nerves at: digit 2/5 lateral common palmar nerves at the distal palmar …

Radiation Exposure, Emergency Department Usage, And The Impact Of Parental Health Literacy On A Cohort Of Pediatric Hydrocephalus Patients In Detroit, Jacob Gluski, Bushra Fathima, Jeffery Sondhiemer, Carolyn A. Harris

Medical Student Research Symposium

Hydrocephalus is a significantly morbid long-term disease. While working with patients for another study we became aware of significant radiation exposure and emergency department usage in this patient population. For this study we quantified this usage; additionally, in an IRB approved study we collected health literacy data from the patients’ parents to see if it was correlated with either of these measures. A survey was sent to the 129 families for whom contact information was available. Complete data from a cohort of 110 patients was used. A survey response rate of 8% was obtained. Patients averaged 12.96 (±16.02 SD) emergency …

The Short-Term Effects Of Fine Airborne Particulate Matter And Climate On Covid-19 Disease Dynamics, El Hussain Shamsa, Kezhong Zhang

Medical Student Research Symposium

Background: Despite more than 60% of the United States population being fully vaccinated, COVID-19 cases continue to spike in a temporal pattern. These patterns in COVID-19 incidence and mortality may be linked to short-term changes in environmental factors.

Methods: Nationwide, county-wise measurements for COVID-19 cases and deaths, fine-airborne particulate matter (PM_2.5), and maximum temperature were obtained from March 20, 2020 to March 20, 2021. Multivariate Linear Regression was used to analyze the association between environmental factors and COVID-19 incidence and mortality rates in each season. Negative Binomial Regression was used to analyze daily fluctuations of COVID-19 cases …

Racial Disparities In Risk For Covid-19 In Pregnancy: Results From The Michigan Statewide Collaborative, Inara Ismailova, Robert Sokol Md, Yasmin Hasbini Md, Dereje Gudicha Phd

Medical Student Research Symposium

Objective:

Though previous studies have looked at both COVID-19 outcomes in pregnancy and racial disparities among patients with COVID-19, few have specifically studied racial disparities among pregnant patients with COVID-19. Our goal in this study is to analyze the relationship, if any, between race and disparate COVID-19 risk in pregnancy.

Study Design:

A retrospective cohort analysis was performed on data collected as part of the COVID-19 in Pregnancy and The Newborn: State of Michigan Collaborative, an established database of pregnant patients admitted to 14 institutions in South Michigan. Cases were defined as patients with a positive SARS-CoV-2 test result. Controls, …

How Do Anesthesiologists Prefer To Reduce Preoperative Anxiety In Pediatric Patients?, Arif Musa, Jahan Tajran, Rana Movahedi, Jeffrey C. Wang, David Safani, Christopher Cooke, Guillaume Farah, Syed F. Hussain, Brendan Lynch, Gligor Gucev

Medical Student Research Symposium

250 or less

Evaluating Quality Of Life And Functional Outcomes In Salvage Surgery For Head And Neck Cancer, Arielle Best, Nitika Tripathi, John Riley, Amy Williams Phd, Steven Chang Md, Samantha Tam Md

Medical Student Research Symposium

INTRODUCTION

Unique challenges surround treatment for residual or recurrent head and neck squamous cell carcinoma (HNSCC). Of the limited treatment options for residual or recurrent HNSCC, salvage surgery is often the best option. However, salvage surgery can result in significant morbidity, affecting both quality of life (QoL) and functional outcomes. Few studies have examined QoL outcomes following salvage surgery in the setting of HNSCC. Our goal is to analyze the head and neck related quality of life, and functional outcomes in patients with head and neck cancer who underwent salvage surgery.

METHODS

In this study, FACT-HN Version 4 was administered …

Ets-Related Gene (Erg) Is Differentially Expressed In Dermatofibroma (Fibrous Histiocytoma) As Compared With Dermatofibromasarcoma Protuberans And Hypertrophic Scars: A Pilot Immunohistochemical Study, Meredith Hengy, Jesse Veenstra, Kyle Perry, David M. Ozog, Ben Friedman

Medical Student Research Symposium

Immunohistochemical staining can be of great utility in differentiating various cutaneous spindle cell neoplasms, particularly when the histomorphological appearance of the lesions is inconclusive. Nuclear staining for ETS-related gene (ERG), a highly sensitive endothelial cell marker, has seldom been studied in the context of cutaneous spindle cell neoplasms. Little is known about its specificity for vascular differentiation. In this pilot study, immunohistochemical analysis for ERG was performed on fifteen dermatofibromas (DF), ten keloids, and nine dermatofibrosarcoma protuberans tumors (DFSP). Consistent nuclear expression of ERG was found in DF [100% (15/15) of the lesions demonstrated >50% labeling of tumor cells with …