Medicine and Health Sciences Commons^™

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Assessing Disparities In Sep-1 Bundle Compliance At Corewell Health, Zachary Awad, Mark Munir, Paul Bozyk, Ramin Homayouni

Posters

Sepsis, a life-threatening condition resulting from a dysregulated immune response to infection, carries significant mortality. To improve sepsis management, the Centers for Medicare & Medicaid Services (CMS) introduced the SEP-1 bundle, outlining critical interventions within specified timelines. This study aimed to investigate disparities in SEP-1 bundle compliance, examining variations among septic patients based on sociodemographic factors like age, race, and area deprivation index (ADI), as well as clinical factors like chronic health conditions.

Dido Times In Anterior Lvo Ischemic Stroke, Greg Palmateer, Anthony Gasparotto, Angelique Manasseh

Posters

• Acute ischemic stroke is a major cause of death and disability. Every 30 minute delay in time from onset to treatment lowers the likelihood of a good outcome.1

• Door-in-door-out (DIDO) is defined as the duration from time of arrival at a primary stroke center (PSC) to time of discharge to a comprehensive stroke center (CSC) for mechanical thrombectomy(MT). Shorter DIDO time relates to improved outcomes.

• There is no standardized DIDO for ischemic stroke, though the American Heart Association (AHA) offers an ideal DIDO time of < 90 minutes for 50% or more of patients.2

Comprehensive Analysis Of Racial Differences In Comorbidities And Prenatal Care Among Pregnant Women, Ryian Owusu, Kurt R. Wharton

Posters

• Research highlights that women of color face significantly higher risks of pregnancy-related morbidity and mortality.¹

• Factors contributing to these disparities include: 2,3

• Access to healthcare

• Health literacy

• Education level • Community support

• Prenatal care plays a pivotal role in mitigating these risks by educating women on healthy lifestyles and identifying those at high risk for complications. 4

• Determining patient satisfaction with their prenatal care could greatly contribute in defining a link between prenatal care services and maternal-fetal outcomes. 4

Identifying Barriers To Covid-19 Vaccination In Hispanic Populations, Saul O. Castillo, Kurt R. Wharton

Posters

Vaccination hesitancy has always been an issue within marginalized communities. This is why it came as no surprise when the COVID-19 vaccine was met with resistance upon its release1. However, it has been many years since the FDA approved the first COVID19 vaccine and on some level, COVID-19 has become a part of our daily lives. This means that people have had time to determine how they feel about the COVID19 vaccine and reflect on their decisions to receive or decline the vaccine.

There are many reasons as to why people choose to receive or decline the COVID-19 vaccine. This …

Clinician’S Perspective On Reproductive Healthcare & Reproductive Health Rights In Southeast Michigan, Skylar Sundquist, Kurt Wharton

Posters

Reproductive healthcare is essential care that includes family planning, assisted reproductive technologies, sexually transmitted infection (STI) screening and treatment, abortion access, and sexual health education. Unfortunately, reproductive healthcare and reproductive rights are often the subject of erosive litigation. This litigation limits individuals’ access to reproductive healthcare thereby inhibiting individuals’ ability to exert autonomy over their health. In June of 2022, the US Supreme Court ruled in favor of Dobbs in the case of Dobbs v Jackson Women’s Health Organization. This ruling effectively overturned the 1973 Roe v Wade decision and ended the protected right to access abortion care. After the …

Procalcitonin As A Biomarker Of Acute Kidney Injury In Patients With Suspected Bacterial Sepsis In The Acute Care Setting, Austin Kantola, Jose Navas Blanco, Jacob Keeley

Posters

Acute kidney injury (AKI) is a common, life-threatening complication in patients with sepsis and septic shock.→ Approximately one-half of patients with sepsis experience an AKI.4 → One-third of all acute kidney injuries are related to sepsis.4 → Sepsis-associated AKI raises in-hospital mortality eightfold and the risk of chronic kidney disease development threefold.1,2,3. Early identification of AKI could save time and resources, lower costs, improve patient outcomes. Therefore, a biomarker for earlier AKI detection in patients with sepsis would serve an outstanding role in health care.In the setting of bacterial infection, an upregulation of innate immune system gene transcription and translation …

Treatment Rates In A Two-Step Clostridioides Difficile Diagnostic Testing Algorithm, Renee Ringler, Matthew Sims

Posters

Clostridioides difficile is a Gram-positive obligate anaerobe long associated with healthcare-acquired infections in the United States. 1 Clostridioides difficile infection (CDI) has thus become a key metric for assessing facility cleanliness and iatrogenic infection. C. difficile carriage is common, present in approximately 8% of hospitalized patients.2 Therefore, appropriate patient selection for testing and careful testing procedures is crucial to appropriately identify CDI while avoiding the detection of chronic colonization.

Considerable variability exists among institutions regarding standardized CDI laboratory diagnostic methods. Historically, the gold standard for CDI testing was the clinically inefficient toxigenic culture (TC). 3 This was followed by cytotoxic …

The Administration Of Antenatal Corticosteroids In The Late-Preterm Period, Sarah O’Mara, Sara Jaber, Kurt Wharton

Posters

The administration of corticosteroids in the late-preterm period (34 to 36+6 weeks' gestation) remains a topic of ongoing debate. The landmark Antenatal Late Preterm Steroids (ALPS) trial demonstrated a significant reduction in neonatal respiratory morbidity with the use of late-preterm corticosteroids, leading to updated recommendations by the Society of Maternal-Fetal Medicine in August 2016 supporting their administration for patients at risk of late-preterm delivery. Given that late-preterm births accounted for 7.4% of live births in the United States in 2020, optimizing neonatal outcomes in this population is a critical public health concern.

Antenatal corticosteroid administration between 24 and 33+6 weeks' …

Prostatic Urethral Length On Mri As A Predictor Of Late Genitourinary Toxicity After Prostate Cancer Radiation, Kyu Kim, Joseph Lee, Allison Hazy, Sayf Al-Katib, Hong Ye, Nathan Kolderman, Abhay Dhaliwal, Daniel Krauss, Thomas Quinn, Kimberly Marvin, Kiran R. Nandalur

Posters

Radiation therapy (RT) is a widely used treatment for prostate cancer.1 While effective, some patients develop late genitourinary (GU) toxicity, which can impact quality of life.2,4 Identifying pre-treatment factors that predict toxicity risk may help improve clinical decision-making. Recent studies suggest that prostatic urethral length (PUL) seen on MRI is associated with an increased risk of late GU toxicity.3 Understanding this relationship could enhance risk stratification before treatment.

Venlafaxine Exposure In Pregnancy And Its Association With Pre-Eclampsia Development, Jhanvi Patel

Posters

Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), is widely used to manage depression and anxiety, including in pregnant women. However, its known hypertensive side effects raise concerns about a potential link to pre-eclampsia, a serious pregnancy complication characterized by new-onset hypertension and proteinuria. Pregnant women with psychiatric disorders already have an increased risk of hypertensive disorders, and while untreated depression can lead to adverse outcomes such as preterm birth and fetal cortisol elevation, the safety of venlafaxine remains uncertain. Current research lacks wellcontrolled studies assessing its association with hypertensive complications in pregnancy. This systematic review aims to evaluate whether venlafaxine use …

Substance Use And Shame In Minority And Immigrant Communities, Zane Alroshood, Hassan Barade, Jeffrey Guina

Posters

Substance use disorder (SUD) has increased worldwide, especially in the United States, with millions struggling with drug and alcohol problems. Substance use (SU) can lead to significant adverse health outcomes along with stigmatization in healthcare settings. Shame plays a complex role in the development and mitigation of developing substance use problems, influenced by cultural contexts such as dignity, face, and honor. A systemic review attempted to identify the relationship between SU and shame, stating shame was reliably associated with SU, but revealing mixed results in which it served both adaptive and maladaptive functions in its development.

Impact Of Michigan Public Act 246 On Opioid Prescribing For Pediatric Surgical Patients, Madison Saunders, Pavan Brahmamdam

Posters

1. Opioid misuse is an epidemic in the U.S. affecting 3.1% of pediatric patients.2,3.

2. Most common way adolescence obtain access to opioids is by their own prescription or a family member. 3,4 3.

3. In December 2017, Michigan enacted Public Act 246 (P246) in an attempt to address rising opioid misuse.

4. P246 states that as of June 1, 2018, a prescriber of a controlled substance must discuss the risks of opioid usage minor and the minor’s parent or guardian and sign a consent form.

Safety Profile Of Spinal Cord Stimulator Paddle Lead Revision And Replacement, Saini Kethireddy, Michael Staudt

Posters

• Spinal cord stimulation (SCS) is a neuromodulatory treatment for patients experiencing chronic pain resistant to conservative therapies. It is often used for postlaminectomy syndrome, complex regional pain syndrome, and neuropathic pain.
• SCS leads can be categorized into percutaneous leads and paddle leads, the latter requiring a laminectomy for implantation.
• The advantages of paddle leads include lower migration rates and more efficient energy delivery.
• Revision surgery may be required in instances of lead failure, migration or misplacement. Paddle lead replacement can be challenging due to extensive scar tissue formation, often requiring additional dissection.
• Reoperation for paddle leads has raised concerns about …

Epic Best Practice Alerts Increases Sep1 Orderset Usage, Mark Munir, Zachary Awad, Paul Bozyk, Ramin Homayouni

Posters

Sepsis is a massive, system-wide inflammatory response to an infection that can lead to multisystem organ failure.1 Sepsis has a very high mortality rate of 20-50% in patients with severe sepsis and is the 10th leading cause of death in the United States.2 One of the most significant ways of reducing mortality from sepsis is timely detection and initiation of treatment in septic patients.3

Electronic medical records such as Epic have implemented sepsis warning algorithms and alerts to facilitate quicker detection of sepsis and thus earlier initiation of treatment. The goal of this study is to determine if an Epic …

Aquablation Compared With Simple Prostatectomy For Prostate Volumes >80 Grams, Joshua Kuperus, Minhaj Jabeer, Aidan Kennedy, Paul Horning, Greg Palmateer, Bernadette M.M. Zwaans, Jason Hafron, Kenneth M. Peters

Posters

• Benign prostatic hyperplasia (BPH) is the most common benign urological disease in men. 1

• Moderate-to-severe lower urinary tract symptoms (LUTS) from BPH affect 30% of men over 502 and medical treatment often fails for men with moderate-to-severe symptoms, leading them to seek surgical options. 3

• Transurethral resection of the prostate (TURP) remains the gold standard for prostates less than 80 mL; simple prostatectomy (SP) remains the standard for larger prostates.

• Aquablation (Aqua) is a novel BPH procedure that may be used for both small and large prostates from 50 to 150 mL. 4

• Although TURP …

Bisphosphonate Treatment In Pediatric Patients With Rare Ovarian Malignancy And Hypercalcemia: A Case Series, Seth Lamb, Samhita Bhattarai, Jennifer Boyd

Posters

Objective: To describe the presentation, management, and outcomes of severe hypercalcemia in two adolescent females secondary to ovarian malignancy. Methods: The case series includes two adolescent female patients, aged 11 and 16, diagnosed with rare ovarian malignancies and associated hypercalcemia. The 11-year-old female was diagnosed with small cell carcinoma of ovary while the 16-year-old was diagnosed with dysgerminoma. Both patients presented with abdominal pain, nausea and constipation. The 11-year-old received zoledronic acid while the 16-year-old received pamidronate. Serum calcium level, symptoms and adverse effects were monitored before and after both medications. Results: Both patients presented with severe hypercalcemia. The 11-year …

Physician Use Of Progesterone In Transgender Adolescents: A Survey, Samhita Bhattarai, Michelle Knoll

Posters

Objectives To evaluate the current perspective and clinical practices of physicians regarding the use of synthetic progestins as an adjunct to estrogen therapy in transfeminine adolescents. The survey focuses on perceived benefits, risks and overall efficacy in gender affirming hormone therapy. Methods A cross sectional survey was conducted among physicians who care for transfeminine patients. The survey included questions regarding their specialty, practice setting, age range of patients. Data was also collected regarding their indication for use, perceived benefits (e.g. breast development) and rationale if not using progestins for this purpose. Results Of 110 physicians who participated in the survey, …

Influence Of Medicaid And Medicare On Total Joint Arthroplasty Outcomes: 10-Year Report Of Michigan Hospitals, Madeleine Declercq, Jacob Keeley, Robert Runner, Kevin Weisz, Leonardo Cavinatto, Drew Moore

Posters

Access to healthcare significantly varies by medical insurance type, particularly for individuals for low socioeconomic status.

• Medicaid often covers these individuals (a government-funded program for low-income adults and children).

• Only 45% of primary care providers accept new Medicaid patients, versus 94% for private insurance.1

• Large non-profit medical centers accept Medicaid but still present considerable access challenges for patients.

• Lower reimbursement rates, complex medical needs, and extensive administrative requirements are key barriers for providers accepting Medicaid.

• Studies, such as those by Deans et al., highlight greater travel burdens for Medicaid patients needing revision hip or knee …

Does The Possibility Of No Surgery In Watch And Wait For Rectal Cancer Affect Patient Decision-Making?, Joanna F. Wasvary, Ga-Ram Han, Jacob A. Applegarth, Matthew A. Ziegler

Posters

INTRODUCTION & OBJECTIVE

Prior studies have established that the watch and wait protocol for rectal cancer is a reasonable approach in patients with excellent response to total neoadjuvant therapy (TNT). Current guidelines stipulate that patients eligible for this protocol have no residual tumor on re-staging imaging and endoscopy. Patients who have evidence of residual disease are referred for surgery. This study assessed all patients in our institution who underwent TNT for rectal cancer and the subsequent recommendations for treatment. Primary aim: assess patient compliance with surgeon recommendations for residual disease after TNT.

Secondary aim: assessment of oncologic outcomes and the …

Implementation Of An Opioid Free Pediatric Hernia Repair Protocol, Corey Shafer, Antonela Muca, Randy Hilleary, Kristin Lemarbe, Diane Studzinsk, Kaveh Aslani, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Posters

Surgery most often provides children with their first exposure to opioids which may lead to misuse and overuse. Protocolizing pain management perioperatively can reduce opioid exposure in children while still providing adequate pain management.

Enhancing Reproductive Anatomy Education: A Comprehensive Approach Integrating Near-Peer And Reciprocal Peer Tutoring, Hope Hefferan, Emelie-Jo Scheffler, Erin Mueller, Varna Taranikanti

Posters

• Near-peer tutoring (NPT): Tutors are more advanced than tutees, typically offering support in understanding complex concepts.1

• Reciprocal peer tutoring (RPT): Students with similar levels of training alternate between tutor and tutee roles, facilitating collaborative learning.1

• Peer tutoring fosters professional development and improves long-term retention of complex medical concepts.3,4,5

• Reproductive anatomy is a challenging area for many medical students; Innovative peer tutoring methods may help improve understanding and retention of anatomical structures.

• We hypothesize that integrating NPT and RPT within the laboratory setting in the reproductive organ system course will enhance student motivation, self-efficacy, and long-term …

Examining Health Disparities: An Observational Study On Peripheral Vascular Access Outcomes Among Hospitalized Patients, Charlotte O’Sullivan, Nicholas Mielke, Yuying Xing, Amit Bahl

Posters

Peripheral intravenous catheter (PIVC) placement is the most common invasive procedure performed in healthcare, with an estimated 90% of hospitalized patients requiring PIVC access during their stay. This equates to around two billion PIVCs used annually.1–3 Studies report 36% to 63% of catheters fail due to a variety of complications, including infiltration, occlusion, phlebitis, dislodgment, and infection. 2–6 These failures not only cause immediate patient discomfort and increased clinical workload but also have wider implications such as prolonged hospital stays and delays in critical treatments.2 The factors contributing to PIVC failure are multifaceted, involving clinical presentation, patient anatomy, provider skill …

Pr Novel Hematoma Prevention Device, Nolan Shoukri, Steven Pearl, Nishaki Mehta

Posters

• Hematomas are a common complication in cardiac internal electronic device (CIED) placement procedures, they occur in up to 20-25% of CIED implants.

• Previous RCT tested a novel hematoma compression device (PR) and showed good tolerability, decreased hematoma formation from 15% to 6%, and wound improvement.

• Based on feedback collected from the nurses, physicians, allied health professionals during the randomized control trial, iteration of the PR was done (Gen 2 PR).

• This study evaluated 1) bench testing of the Gen 2 PR device and 2) healthy volunteer testing of Gen 2 PR device.

Primary Molar Loss And Resulting Space Outcomes: A Systematic Review, Kaitlin Carlson, Meredith Clark, Richard Nguyen, Brenda S Bohaty, Amy Burleson, Robin Onikul, Neena Patel, Jenna Sparks

Posters

Premature loss of a primary molar can occur due to a multitude of reasons, including caries, infection, and trauma. When this occurs and restoration of the affected primary tooth is not possible, the AAPD recognizes space maintenance as a “Best Practice” to prevent loss of arch length, width, and perimeter after extraction. However, reports suggest that with proper intercuspation of first permanent molars, space loss from premature loss of a primary molar is minimal and a space maintainer in that area may not be needed. The clinical management for such cases has been controversial across pediatric dental providers, with factors …

Increasing Incentive Spirometry Use In Patients With Sickle Cell Disease Admitted To Cmh, Juan Nario Ramirez, Alexandra Prosser-Dombrowski, Thomas R. Cochran, Joel Thompson

Posters

Acute chest syndrome is one of the leading causes of morbidity and mortality in patients with sickle cell disease. The National Heart, Lung, and Blood Institute (NHLBI) recommends that patients with sickle cell disease perform ten breaths of incentive spirometry (IS) every two hours while awake to prevent development of acute chest syndrome. By not meeting these guidelines, patients are more likely to develop this potentially life-threatening acute complication. To increase the use of IS in patients with sickle cell disease admitted to the hospital for vaso-occlusive pain. Patients were identified and IS occurrences were measured via review of electronic …

Oral Surgical Needs In A Pediatric Hospital Dental Clinic, Meredith Clark, Richard Nguyen, Kaitlin Carlson, Brenda S Bohaty, Amy Burleson, Robin Onikul, Neena Patel, Jenna Sparks

Posters

Purpose: The aim of this study is to evaluate and assess the oral surgery needs in a pediatric hospital dental clinic at Children’s Mercy Hospital in Kansas City. Methods: Following IRB approval, appointments over a 6-month time-period were reviewed and recorded when a referral was placed to an oral surgeon. The reason for referral, patient age and medical history were recorded and analyzed. Results: Half of the patients needing oral and maxillofacial procedures were between the ages of 8-10 years old. There was an equal number of patients needing extractions due to carious/non-restorable teeth with and without special health care …

Differential Diagnosis Of Oral Ulcerations: A Case Report, Richard Nguyen, Kaitlin Carlson, Meredith Clark, Amy Burleson, Brenda S Bohaty, Robin Onikul, Neena Patel, Jenna Sparks

Posters

The diagnosis of oral lesions in children can be challenging as it can be an unspecified symptom of several diseases. Differential diagnoses can range from infectious diseases of childhood, inflammations, nutritional deficiencies, and chronic diseases. Because of this, children with oral ulcers may be treated by different specialists such as pediatric dentists and pediatricians. The purpose of this poster is to report the case of a twenty-one-month-old female patient who presented to Children’s Mercy Hospital Kansas City Emergency Department with chief concern for acute onset of intraoral oral ulcers, extraoral blisters near the lower lip, and fetid oral odor. Patient …

Medication Assisted Treatment - The End In Mind, Nandita C. Kapur, Annas Aljassem

Posters

• Opioid Use Disorder (OUD) is defined as a problematic pattern of substance use causing significant impairment or distress, and it is a leading cause injury deaths1 in the U.S.
• Medication-Assisted Treatment (MAT), using methadone (full agonist) and buprenorphine (partial agonist/antagonist), is the gold standard for OUD2 , stabilizing patients by alleviating withdrawal symptoms and cravings.
• • Stigma and skepticism about MAT's effectiveness hinder its adoption in acute care settings3.
• More research is needed to overcome misconceptions and enhance the efficacy of MAT in hospitals since it is the first point of contact for patients.
• This project aims to educate patients …