Medicine and Health Sciences Commons^™

Prevalence Of Traumatic Brain Injury Among The Guests At A Low-Barrier Homeless Shelter, Nicholas Ang, Jason Wasserman

Posters

Traumatic Brain Injury (TBI) is a significant public health concern, characterized by disruption of normal brain function due to head trauma, with common causes including automobile accidents, athletic injuries, and assault. TBI accounts for a substantial portion of injury-related deaths worldwide and is a leading cause of neurological disability. However, there's considerable variability in defining and measuring TBI, complicating prevalence comparisons. Studies indicate varying rates, with a particularly high prevalence among individuals experiencing homelessness, potentially due to increased vulnerability to trauma. The cognitive impairments associated with TBI, often manifesting years later, pose challenges, especially for marginalized populations like the homeless, …

Cancer Screening Guidelines In Midwest Adult Correctional Facilities, Stephen Greenwell, Jason Adam Wasserman

Posters

National cancer screening guidelines (CSGs) exist to promote early cancer detection, reducing mortality, morbidity, and cost. The incarcerated population is at increased risk for certain cancers, decreased cancer screening, and barriers to treatment. In this study we investigate how state and federal prison CSGs differ from the National Comprehensive Cancer Network’s (NCCN) CSGs.

Catholic Hospitals Should Permit Physicians To Provide Emergency Contraception To Rape Victims As An Act Of Conscientious Provision, Marlee Mason-Maready, Victoria Whiting, Abram Brummett

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Some Catholic hospitals provide emergency contraception (EC) to rape victims, but some prohibit it based on institutional conscience and that it may act as an abortifacient.

We argue that the reasonable internal disagreement on this issue can be the basis for Catholic hospitals to accommodate physicians who may feel compelled by conscience to provide EC.

U.S. legal asymmetries protect conscientious objection (CO) in health care, but not conscientious provision (CP). Catholic hospitals can sanction or even fire physicians who provide EC.1, 2.

Ramifications of barriers to EC access and potential objections to this perspective are also discussed.

Impact Of Housing First Supportive Housing Provision On Healthcare Accessibility And Health Status Of Individuals Who Previously Experienced Homelessness, Aubrey Haughn, Tiffany Loh, Jason Adam Wasserman

Posters

• The 2020 AHAR report to Congress revealed about 580,000 people experience homelessness on a single night.
• Approximately 3 out of every 200 people have experienced homelessness.
• Individuals experiencing homelessness face higher risks of infectious diseases, injuries, mental health issues, substance abuse, and suicide.
• Individuals experiencing homelessness are 6-10 times more likely to have unmet healthcare needs compared to the general population.
• In contrast to a treatment-first approach, the housing first (HF) approach of supportive housing focuses on provision of immediate stable housing for individuals experiencing homelessness without preconditions regarding substance use.
• Avalon House Hickory Way are newly implemented HF apartments …

Perspectives Of A Permanent Supportive Housing Population On Their Trust In Sources Of Health Information, Experiences With Health Care Providers, And Navigation Of Health Information Amidst The Covid-19 Pandemic, Tiffany Loh, Jason Wasserman

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Permanent supportive housing (PSH) has become the predominant housing intervention for addressing homelessness in the U.S.1 It provides o Unhoused adults with mental and substance use disorders long-term, affordable housing2 o Voluntary social support services.

Studies have found that the unhoused population experience mistreatment in health settings.3–6 o Some unhoused individuals expressed not being seen as human, feeling invisible to health providers, or treated as an experiment.

Limited research on sources of health information used by those who have experienced homelessness. o Allen et al. found that unhoused individuals refer to news media, word of mouth, the internet and social …

Critical Reflection And Place Based Medical Education In Bioethics, Humanism, And Professional Identity Formation: The Impact Of A Study Trip To Auschwitz, Maxwell Li, Ramona Stamatin, Hedy Wald, Jason Wasserman

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Between 1939 - 1945, unethical and often ghastly human experimentation was conducted in Nazi concentration camps. Physicians working in the camps also performed selections of prisoners for work detail or immediate death. Ultimately, there was a significant amount of physician complicity in Nazism and the Holocaust, ie. the genocide of European Jewry. At the end of WWII, war crime trials against the doctors and scientists involved helped give rise to the Nuremberg Code of Ethics.

There are increasing calls for inclusion of education on medicine during the Holocaust in medical school curricula. A study trip to Poland with pre-trip study …

Exploring Illness Beyond Disease: Development Of A Sense Of Identity In Patients With Inflammatory Bowel Disease (Ibd), Nicholas Totah, Jason Adam Wasserman

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• Inflammatory bowel disease (IBD) poses significant challenges to an individual’s physical and emotional well-being, often reshaping their sense of self and life trajectories.
• Patient narrative can illuminate the illness experience in ways that are often unaddressed in the literature.

Space Loss After Removal Of A Band And Loop Space Maintainer: A Case Report And Review Of The Literature., Kaitlin Carlson, Robin Onikul, Amy Burleson, Jenna Sparks, Neena Patel, Brenda S. Bohaty

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Premature loss of a first primary molar can occur due to a multitude of reasons, including caries and infection. 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 first primary molar is minimal and space maintainers in that area may not be needed. This case report details an 8-year-old female who had significant space loss between the mandibular …

Differential Diagnosis Of A 12-Year-Old Presenting With A Nodular-Sessile Lesion On The Hard Palate: Review Of Literature And Report Of A Case., Meredith Clark, Robin Onikul, Amy Burleson, Brenda S. Bohaty, Jenna Sparks, Neena Patel, A Naidu

Posters

Soft-tissue lesions in children present with a wide range of etiologies, including those related to normal development, underlying systemic illness and/or those associated with benign or malignant tumors1 . In children and adolescents, the most common soft tissue lesions include, aphthae, fibromas, papillomas, pyogenic granulomas and traumatic lesions all of which may present on the hard palate.2 This case report details a 12-year-old female presenting to Children’s Mercy Dental Clinic with a chief complaint of a flesh-colored nodular sessile lesion visualized on the anterior hard palate, directly posterior to teeth #8 and #9. The patient’s medical history is non-contributory, and …

Assessing Impact Of Image-Based Immunization Education On Pediatric Vaccine Uptake Within Families Of Low English Literacy, Ahmed Ali, Mariam Bassalious, Sharfaa Chowdhury, Coral Hufnagel, Salwa Bajjey, Amaal Haimout, Nelia Afonso, Raouf Seifeldin

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• Vaccinations have been hailed as the most effective public health strategy in mitigating infectious diseases. Since the advent of vaccines at the end of the 18th century, the incidence, prevalence, and mortality of vaccine-preventable diseases have markedly decreased.
• Vaccine hesitancy has been increasing within the last decade due to various reasons including misinformation and a lack of understanding. 2 This is especially true amongst patients with limited literacy skills as traditional vaccine education material is not optimal for their understanding.
• Several studies across various healthcare disciplines have shown that the use of picture-based health education for patients with limited literacy …

Comparing The Outcomes Of Titanium And Stainless Steel Flexible Nails In Repairing Pediatric Long Bone Fractures, Novelpreet Boparai, Suzan Kamel-Elsayed, Ehab Saleh

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• Traditionally, pediatric femoral fracture treatment favored conservative methods.
• Surgical intervention was deferred until age 6, as non-operative approaches often resulted in complications.
• Titanium elastic nailing (TENS) emerged as an effective treatment for diaphyseal femoral fractures in ages 6 to 16. However, the choice between TENS and stainless steel elastic nailing (SSENS) remains debated due to inconsistent findings.

Public Perception Of Robotic Assisted Total Hip Replacement Surgery, Marvee Espiritu, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Moore, Mark Karadsheh

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• Robotic or technology assisted THA has received significant attention recently due to its precision in acetabular cup placement within the Lewinnek safe zone.1
• Few studies have assessed the public’s perception of robotic-assisted THA.3,4 Insight into patients’ perception of robotic-assisted THA may yield valuable information that may impact further integration of the technology within hospitals and surgeon training.

Morbidity Of Tendon Harvest Site For Acl Autograft; A Systematic Review, Jessi Fore, Betina Hinckel, Elijah Auch

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Primary anterior cruciate ligament (ACL) ruptures are highly common and lead to a significant number of primary ACL reconstruction surgeries in the U.S.1. When choosing a graft, surgeons can pick between auto- and allografts2. An autograft can include a bone-patellar tendon-bone (BPTB) graft, a hamstrings tendon (HT) graft, or a quadriceps tendon (QT) graft2. Currently, there is a wide range of research on graft types, but no paper compares all threes graft types directly. This review will compare literature to determine the morbidity associated with each graft type and determine which autograft is best for primary reconstruction.

Metastatic Osteosarcoma Involving The Skin: A Systematic Review Of Patient Demographics, Clinical Characteristics, And Treatment Outcomes, Sarah Fried, Ameen Suhrawardy, Rafey Rehman, Malik Al-Jamal, Drew Moore, Darius Mehregan

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Skeletal osteosarcomas - most common primary malignant bone tumor1 and commonly metastasize to:

• Lungs (95%)2 •

Other bones (50%)2 •

Kidneys (12%)2 •

Rarely to the skin3

Extraskeletal osteosarcomas (ESOS) – soft tissue tumors that may also metastasize to the skin4,5,6

Value in gathering data on this rare phenomenon:

• Informs biology and dermatologic care of patients suffering from this cancer.

This systematic review characterizes metastatic osteosarcomas involving the skin.

Assessing Patient Preferences For Technology-Assisted Versus Traditional Total Knee Arthroplasty Using A Validated Online Survey Marketplace: Before And After Patient Education, Tanner J. Hafen, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Runner

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• Computer (CA) and robotic (RA) assisted TKA has becoming increasingly prevalent in orthopaedic surgery1,2.
• There is limited insight into the public perception of CA and RA3.

Outcomes Of Primary Acl Repair For Proximal Tears: A Systematic Review And Meta Analysis, Collin Braithwaite, Tanner Hafen, Robert Dean, Joseph Guettler, James Bicos

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The purpose of this study was to determine which primary ACL repair technique resulted in the lowest failure rates postoperatively.

Pediatric Upper Cervical Spine Trauma: A 10-Year Single Center Retrospective Study, Sazid Hasan, Muhammad Waheed, Shahrukh Naseer, Jad G. Khalil, Ehab S. Saleh

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This study seeks to answer whether or not there is a significant association between mechanism of injury and patient age, and to elucidate any notable differences in overall outcomes based on various treatment modalities.

Accuracy Of Ora And Newer Generation Formulas For Iol Power Calculation After Prior Refractive Surgery, Raheel Khan, Mark Rolain

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• Patients with cataracts have cloudiness of the lens that impairs vision.
• It must be replaced with a prosthetic lens however the lens’ refractive power has to be calculated using formulas to predict the kind of lens that will be implanted for best visual outcomes.
• Patients that have had prior refractive surgery of the cornea do not have as good refractive outcomes after cataract surgery.1
• The concern is that there is not a goldstandard formula that can be used for this population to predict the refractive power of the lens that should be implanted.
• Optiwave refractive analysis (ORA) is a new …

Coats And Coats-Like Retinopathy In Female Patients, Zara Saleem, Drew Scoles, Antonio Capone Jr

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To report the presentation, stage, clinical characteristics, and course of female patients with Coats and Coats-like retinopathy.

Fractionated Radiosurgery Associated With High Rates Of Local Control For Large Volume Intact Brain Metastases, Ryan Ko, Hong Ye, Peter Chen, Zachary Seymour, Kuei Lee, Inga Grills

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Radiosurgery is a well-established treatment modality for patients with intact brain metastases, and there is a known impact of tumor size and volume on tumor control. Utilizing our single-institution database, we investigated outcomes for patients with intact brain metastases treated with FSR using LINAC or GK modalities.

Analysis Of Ed Visitors For Dermatological Disorders Prior To And During The Covid Pandemic, Faris Alkhouri, Jacob Keeley, Ramin Homayouni

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Dermatology-related Emergency Department (ED) visits make up more than 3% of total ED visits1; however, only around 2% of these visits can be considered true emergencies.2 To our knowledge, there are no studies that examined demographic influences on ED visits in regards to skin disorders in the adult population.

The sudden onset of the COVID-19 pandemic had significant effects on healthcare systems and policies, which resulted in a nationwide decline of 20-43% in ED visits.3 However, no studies have examined the impact of the pandemic on the presentation of skin disorders in the ED.

Methenamine Prophylaxis Reduces Recurrent Urinary Tract Infections, Salwan Al Hani, Matthew Sims

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• Recurrent urinary tract infections (UTIs) are the most common outpatient infection in the US and are often managed with antibiotics in clinical practice.
• A recurrent UTI is defined as 2 or UTIs each 6 months or 3 or more UTIs each year.
• Methenamine is an antiseptic compound approved by the FDA to prevent rUTIs but is seldom used in clinical practice.
• Under acidic conditions, methenamine is converted to 6 molecules of formaldehyde, a compound which prevents bacterial growth.
• This study seeks to determine the effectiveness of methenamine for prevention of recurrent UTIs.

The Hiv Care Continuum - A Quality Improvement Project To Reconnect With Hiv-Positive Patients Lost To Follow-Up Care, Kate Romero, Janet Lombardi, Carmen Demarco, Paul C. Johnson

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• Human Immunodeficiency Virus (HIV): incurable illness transmitted through sex, blood, and trans placentally • Consistent management of HIV prevents progression to AIDS.
• 2013 study à HIV-positive patients who failed to attend their follow-up visit within 4-6 months of the prior visit were more likely to have virologic failure.
• Not much published on barriers to care, but one prior study found barriers shown in Figure 2 below – What are barriers to care faced by HIV-positive patients in Southeast Michigan?

Hiv Diagnosis And Linkage To Care In The Emergency Department, Gabrielle Rowlison, Christopher F. Carpenter

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• It is estimated that 1.2 million people are living with human immunodeficiency virus (HIV) in the United States, and that 14% of this population are unaware of their status.
• Approximately 40% of community transmissions happen between people who do not know they have HIV.
• Current CDC recommendations are that anyone seeking treatment for a sexually transmitted infection (STI) be routinely screened for HIV.
• The Emergency Department (ED) is an ideal place to test for HIV, especially in areas with underinsured populations and high rates of ED visits.
• The HIV testing rate in Corewell Health (CH) East’s ED was previously found …

Relationships Between The Number Of Chaplain Visits And Patient Characteristics At A Large, Midwestern Suburban Teaching Hospital, Sarah E. Toates, Kevin D. Hickey

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Hospital-based chaplaincy increases patient satisfaction and overall quality of life1 and has been shown to positively influence physical and mental health outcomes.2 Given that most inpatient chaplaincy departments operate with limited staff and resources, and that the vast majority (83%) of patients wish to discuss religion and spirituality with their health care team,3 understanding the activities of inpatient chaplains is essential to optimize the care chaplains provide to hospitalized patients. In general, the current medical literature lacks data to guide inpatient chaplains’ activities based on patient characteristics,4 thus, there is a need for an empirical evaluation of spiritual care departments’ …

Near-Surface Dose Correlates With Moist Desquamation And Unplanned Reconstructive Surgery In Patients With Implant-Based Reconstruction Receiving Postmastectomy Radiation Therapy, Patrick Thrasher, Ronald Levitin, Bryan S. Squires, Allison J. Hazy, Michael J. Maywood, Anthony P. Delise, Muayad F. Almahariq, Nayana Dekhne, Lauren Oliver, Peter Y. Chen, Kailee J. Walters, Diane Dudley, Joshua T. Dilworth

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Postmastectomy radiation therapy (PMRT) utilized as part of a breast cancer treatment regimen reduces the risk of disease recurrence in appropriately selected patients.1,2,3,4,5 However, PMRT increases risk of radiationrelated toxicities that can interfere with breast reconstruction post-mastectomy.6 Following mastectomy, implant-based reconstruction can increase patient satisfaction and quality of life7,8; complications induced by PMRT such as infection and tissue contracture, though, increase risk for implant loss and may ultimately require further surgeries for the patient.

PMRT is delivered based on treatment plans that are optimized to provide appropriate radiation dosages to tissues along the chest wall while simultaneously limiting exposure of …

The Impact Of Patch Placement Using Fluoroscopy Guidance On Outcome Of Electrical Cardioversion Of Atrial Fibrillation, Joshua France, Luai Madanat, Nolan Shoukri, Daniel Walsh, Ilana Kutinsky, Sujana Gundlapalli, Abhay Bilolikar, Anil Kumar Anil, Brian Williamson, Elvis Cami, Michael Gallagher, Richard Bloomingdale, David E. Haines, Nishaki Mehta

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and is Conclusions increasing in prevalence, especially as the population ages.1 Proper management of AF is imperative to prevent long-term complications including hemodynamic impairment and thromboembolic events which result in significant morbidity, mortality, and health care cost.2 Electrical cardioversion (EC) is frequently used to restore sinus rhythm in patients with AF.3, 4 However, it can be unsuccessful in up to 10-12% of patients.5 Despite the increased utilization of EC for the treatment of AF, guidelines provide little procedural guidance on methods to maximize EC success rates. Current European and American …

The Effects Of Untreated Reflux On The Incidence Of Feeding Difficulties In Neonates, Anne Grossbauer, Anya Costeloe, Prasad J. Thottam

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• Gastroesophageal reflux (GERD) is the involuntary regurgitation of gastric contents into the esophagus and commonly occurs in infants.
• It is associated with various consequences related to feeding difficulty, such as feeding resistance, oral aversion, dysphagia, laryngomalacia, and failure to thrive.2
• There is a paucity in the literature regarding the incidence rate of feeding difficulties in latepreterm and full-term neonates in the neonatal intensive care unit (NICU).
• Many NICUs employ the use of anti-reflux medications, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2As), to treat GERD.3
• The use of these medications is debated and variable due to perceived …

Pulmonary Embolism In Pregnancy And Early Postpartum – Identifying Significant Variables To Improve Risk Stratification, Nida Haider, Bhavinkumar Dalal

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• Pulmonary embolism (PE) resulting from deep vein thrombosis (DVT) is one of the leading causes of maternal deaths in developed countries1
• The causative Virchow triad (venous stasis, endothelial injury, and hypercoagulable state) is enhanced in pregnancy making pregnancy an independent risk factor1
• Due to significant overlap between normal physiological changes in pregnancy and clinical symptoms of PE, the threshold for CTPA, confirmatory imaging for PE with potentially harmful effects due to ionizing radiation, is low with increasing incidence of false positives2

Quantitative And Comparative Analysis Of Dream Content In Parkinson’S Disease Patients Pre- And Postdeep Brain Stimulation, Sarvar Oreizi-Esfahani, Michael Staud

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Parkinson’s Disease (PD) is a neurodegenerative disorder stemming from the loss of dopaminergic neurons in the substantia nigra, resulting in impaired neuronal activation which primarily affects the body’s motor function1. Common symptoms include tremor, rigidity, akinesia and loss of balance.

PD also exerts significant effects on sleep patterns. The Default Mode Network (DMN), a series of hubs in the brain with increased metabolic rate during rest, are implicated in the process of dreaming2. Differential activation of these regions may alter the content and quality of one’s dreams2. PD has been shown to impact the function of the DMN and as …