Medicine and Health Sciences Commons^™

Assessing Ecg Abnormalities In Pediatric Athletes: A Retrospective Study On Incidence And Implications For Screening Protocols, Arkadeep Ghosh, Mark Gelatt, Lindsey Malloy-Walton, Ashley K. Sherman

Research Days

Background: Utilization of Electrocardiogram (ECG) screening in pediatric athletes remains controversial. The American Heart Association (AHA) hasn't supported the use of mandatory ECG screening for pediatric sports evaluations. The financial burden universal ECG screening in pediatric athletes poses on the healthcare system has supported that screening may not be justified given the low incidence of significant cardiac disease.

Objectives/Goal: This study aimed to examine the incidence, type of ECG abnormalities, and associated risk factors in healthy pediatric athletes.

Methods/Design: A single center retrospective cohort study was conducted on a local male youth competitive soccer program, ages 11-18. Exempt status was …

Temperature Monitoring In The Cardiac Operating Room, Abby Pint, Clint Humpherys, Dave Stubler, Nathaniel Lata

Research Days

Background: The goal of this project is to improve the accuracy of temperature readings in the cardiac operating room and, in turn, improve patient safety.

Methods: The project obtained nasopharyngeal, tympanic, and bladder/rectal temperature measurements from twenty CPB cases. Measurements were obtained at six critical points: time of incision, initiation of CPB, aortic cross clamping, removal of aortic cross clamping, CPB termination, sternal closure. Data was analyzed to determine discrepancies among methods of measuring temperature for each type of probe utilized. Plan: Tympanic probes are unreliable and provide lower temperature measurements when compared to other probes Do: Temperatures recorded from …

Academic Half Days Dedicated To Phone Triage Improves Resident Confidence To Independently Triage Calls, Sarah Gwazdacz, Kelsey Gavin, Cati Kral

Research Days

We aim to improve Children’s Mercy residents’ confidence and competence to independently triage admission phone calls, and to help residents develop a system to obtain information during a transport phone call through dedicated academic half days.

A needs assessment at the beginning of the 2024-25 academic year was completed to assess the need for triage education. Then, curriculum design, goals & objectives, educational strategies, and implementation of the half day were discussed with leaders in medical education, admission hub physicians, and hospital medicine. Pediatric residents of all training levels were divided into 5 cohorts of 10-15 participants, which rotated through …

Favorability Of Progesterone With Estrogen Among Physicians In Transgender Adolescents: A Survey, Samhita Bhattarai, Michelle Knoll

Research Days

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.

Low-Dose Bevacizumab Treatment For Retinopathy Of Prematurity, Makayla Ayres, Katherine Brown Md

Research Days

Background: Retinopathy of prematurity (ROP) is an eye disease that affects very premature infants and causes blindness. Treatment for ROP consists of anti-VEGF intravitreal injections (e.g., bevacizumab), laser therapy, and cryotherapy. The concern of anti-VEGF intravitreal injections is systemic toxicity and potential detrimental effects on these developing infants. In research trials, doses as low as 0.031 mg of bevacizumab have been shown to be effective in treating ROP. However, in clinical practice, the most common doses used are 0.125-0.25 mg.

Objectives/Goal: At CMKC, 0.075 mg doses of bevacizumab have been used to treat Type 1 ROP since 2022. We aim …

Navigating The Fallout: How Pediatric Spine Surgeons Cope, Recover, And Persevere After Major Surgical Complications, Sandeep Yanamala, Richard M. Schwend, Hannah Geoffroy, Gary Sutkin

Research Days

Hypothesis: We hypothesized that surgeons who continue practicing after a major complication are more likely to have strong institutional and peer support, a growth mindset, and access to coping mechanisms that mitigate distress and legal pressures. Study Design:
Qualitative study using Constructivist Grounded Theory (CGT) based on semi-structured interviews with pediatric spine surgeons who have experienced major surgical complications.
Introduction:
Complications in pediatric spine surgery have significant emotional, ethical, and legal
consequences. However, little is known about the factors that differentiate surgeons who continue performing spine surgery from those who transition away.
Methods:
33 pediatric spine surgeons were interviewed (28 …

The Relationship Between A Supportive Community And The Self-Efficacy Of Adolescents, Shalom Sulungaine

Science Symposium

Studies have proven that communities and relationships play a part in the development of adolescents. However, different communities and relationships impact adolescents differently, and not all influence their self-efficacy in the way that we may assume. It is known that teachers and parents play a role in building self-efficacy in adolescents and teaching them how to manage their own choices that influence their self-efficacy. A big factor that is not yet known is if and how community violence affects the self-efficacy of adolescents. In this study, I will be exploring the relationship between the self-efficacy of adolescents, and how this …

Autoimmune Diseases And Antibodies, Chloe A. Harvick

Science Symposium

This is a research presentation asking the question, "Is there a relationship between autoimmune diseases and the likelihood of higher antibody levels?" Using a dataset of participants with and without autoimmune diseases, it covers whether antibody levels (of Immunoglobulin M and Complement 4) average differently between a healthy control group and four autoimmune disease groups: Sjogren's Disease (SD or SS), Systemic Lupus Erythematosus (SLE), ANCA-associated vasculitis (SV), and Rheumatoid Arthritis (RA). Finding differences such as these will give a better understanding of the biomarkers of autoimmune diseases and help further the scientific research within the health field.

This is a …

Triple Antibiotic Paste Pulpotomy (Lstr: Lesion Sterilization And Tissue Repair Technique) To Treat Necrotic Primary Molars, Kayleigh Denner Dmd

St. Chris Research Day

No abstract provided.

Spectrum Of Hydrogen Peroxide Ingestions With Varying Management In The Pediatric Population, Narden Gorgy

St. Chris Research Day

No abstract provided.

Communication Matters! Exploring Experiences Of Non-English Language Preferred Families In The Neonatal And Pediatric Intensive Care Units, Sana Haq, Erin Cohen, Susan Schmidt, Rochanak Moassabeb, Folasade Kehinde

St. Chris Research Day

No abstract provided.

Mesoderm-Specific Transcript Has A Role In The Systemic Regulation Of Obesity, Maria J. Orellana Rosales

Thinking Matters Symposium

Mesoderm specific transcript (Mest) expression in white adipose tissue (WAT) is variable in genetically identical mice. Previous studies have shown a connection between Mest high expression and propensity for fat mass expansion. WAT and liver crosstalk has been well documented with hormone-like peptides signaling and regulating important metabolic pathways. The aim of this study is to investigate the correlation between these circulating factors and Mest expression in mice after exposure to a high fat diet (HFD). A group of 120 C57B6/J mice, males and females, were exposed to a HFD (Western Diet, 40 kcal% fat) for 4 weeks (8-12 weeks …

Podium Talk: Postpartum Hemorrhage In The Absence Of Traditional Risk Factors: A Clinical Perspective, Daniel R. York, Allison Tresner, Christian Edwards, Lisandra Chinea

Research Day

Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality that accounts for 27% of all maternal deaths worldwide. While most cases occur immediately postpartum, delayed onset hemorrhage can present critical management challenges and jeopardize maternal treatment outcomes. We report the case of a 20-year-old female who underwent an uncomplicated, augmented vaginal delivery with a Cook Cervical Ripening Balloon (CCRB). The estimated blood loss at delivery was approximately 200 cc. However, around six hours later, the patient became unresponsive, exhibiting signs of significant PPH, she was evaluated at bedside, and by then, she had expelled approximately 2 L …

Case Report: The Treatment Of Chronic Pelvic Pain Utilizing Topical Amitriptyline-Ketamine Compound Cream, Junius Rosario, Chiemeka Onyima

Research Day

Chronic pelvic pain (CPP) is a complex syndrome often associated with a variety of somatic, psychological, and functional impairments. This case report describes a 45-year-old woman with a history of CPP secondary to a traumatic delivery, who presented with persistent vaginal and perineal pain unresponsive to prior conservative therapies, including gabapentin and physical therapy. Following initiation of a multimodal treatment regimen incorporating a compounded topical cream containing 2% amitriptyline (AMI) and 0.5% ketamine (KET), the patient reported substantial improvement in pain, functionality, and quality of life. While the cream was well tolerated initially, prolonged use led to adverse effects, including …

The Underdiagnosis: Addressing The Underdiagnosis Of The Female Athlete Triad And Relative Energy Deficiency In Sport, Nicholas R. Bohannon, Kayla E. Hasty, Stacie Fairley, Robert Walker

Research Day

Introduction: Many elite athletes train their whole lives to reach elite status. For another set of athletes, their sports careers were cut short for one reason or another. The underdiagnosing of the Female Athlete Triad (Triad) or Relative Energy Deficiency in Sport (RED-S) might be the reason for some athletes. A few main barriers have prevented the medical community from accurately diagnosing athletes suffering from the Triad and RED-S.

Objective: This study investigates the critical barriers to early and accurate detection of the Triad and RED-S. Key obstacles include insufficient research, limited physician education, and inadequate awareness among athletes and …

Bilateral Anatomical Variation Of The Extensor Hallucis Longus: Dual Attachments To The Hallux, Setareh T. Khani, Austin S. Dobson, Julianne R. Fay, Grace A. Jones, Armando De La Nuez, Dennis Rossi, Shiv Dhiman

Research Day

Introduction:

The extensor hallucis longus (EHL) is a crucial muscle in the lower limb, responsible for the extension of the hallux and dorsiflexion of the ankle. While anatomical variation of the EHL has been documented, the extensor hallucis longus muscle typically has a single attachment on the dorsal aspect of the base of the distal phalanx of the hallux. Variations in its attachment sites can provide clinical significance for reconstructive procedures.

Methods:

Medical students at Philadelphia College of Osteopathic Medicine (PCOM) in South Georgia conducted a cadaveric dissection on a 69-year-old male. During a routine cadaver dissection, a bilateral observation …

Histopathological Changes At Thoracic Duct Bifurcations: Implications For Lymphatic Obstruction, Fibrosis, And Chylothorax Risk, Lily Dwyer, Melea Neely, Valerie Yepez, Tyler Stanton, D’Andre Edwards, Emranul Huq

Research Day

Introduction:

The thoracic duct (TD) is the primary lymphatic vessel responsible for transporting lymph into the venous system. Anatomical variants, including duplication, right-sided termination, and bifurcation, have been documented, though their clinical significance is not fully understood. Notably, studies indicate that the thoracic duct exhibits variant anatomy in approximately 40% of individuals, with multiple channels or partial duplications occurring in about 20% of cases. Bifurcation sites may experience unique structural and histopathological changes that contribute to dysfunction. However, little is known about how these sites may predispose individuals to lymphatic obstruction, fibrosis, and chylothorax.

Objective:

This study examines the variation …

The Impact Of General Anesthesia On Postoperative Respiratory Complications In Patients With Chronic Obstructive Pulmonary Disease (Copd): A Literature Review, Oscar Acosta, Lisandra Chinea, Amaan Ismail, Zain Ismail, Matthew Shelnutt

Research Day

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disease characterized by airway narrowing and alveoli breakdown that eventually causes air trapping leading to increased Total Lung Capacity (TLC) and compromised expiration. COPD includes chronic bronchitis and emphysema, which are common among smokers. Patients with COPD are at increased risk of perioperative complications, including but not limited to: Increased post-operative pulmonary complications (PPCs), increased risk of respiratory infections, respiratory failure, prolonged ventilator dependence, and subsequent increased length of hospital stay. Understanding the relationship between COPD severity and postoperative outcomes is critical for optimizing perioperative management and reducing morbidity and mortality …

Unusual Branching Of The Axillary Artery: A Case Report On Subscapular Artery Variation, Brandon Worth, Doan Nguyen, Abigail Reynolds, Daniel Lee, Jay Rogers, Jodeci Mitchell, Shiv Dhiman

Research Day

The axillary artery is a significant vascular structure in human anatomy that supplies oxygenated blood to the upper limb. Classically, the artery gives rise to six major branches that are typically divided into three parts based on their relationship to the pectoralis minor muscle. Even though variations in its branching pattern are well-documented, certain deviations are underrepresented in anatomical research but hold clinical significance. Awareness of these anomalies is essential for physicians in order to avoid vascular complications during procedures. During a cadaveric dissection of a 96-year-old female, we witnessed an uncommon variation in the axillary artery’s branching pattern. The …

Case Report: Ocular Syphilis With Rapid Loss Of Visual Acuity, Pathya Kunthy, John M. Roach

Research Day

Introduction: Syphilis is caused by the spirochete, Treponema pallidum. In 2023, over 200,000 cases of syphilis including congenital syphilis were reported in the US, which was a 61 percent increase since 2019. Ocular syphilis is rare but is a growing concern given the rising incidence of syphilis. Delay in diagnosis and treatment can lead to vision loss. The aim of this report is to present a unique case of ocular syphilis and its associated findings.

Case Presentation: This is a case of a 58-year-old male in a large metropolitan city presented to an ophthalmologist complaining of floaters and blurry vision …

Definitive Surgical Management Of Uterus Didelphys: A Case Report, Emma High, Britany Dyer, Allison Tresner, Christine Lurie

Research Day

Uterus didelphys is a rare congenital Mullerian anomaly characterized by the presence of two uteri due to incomplete fusion of the paramesonephric ducts during development. While often asymptomatic, it can be associated with significant gynecologic and obstetric complications, including dysmenorrhea and dyspareunia with an increased risk of premature births, c-sections, and miscarriages. We present the case of a 36-year-old female with a history of uterus didelphys having experienced recurrent miscarriages and severe dysmenorrhea. Management options, including reproductive counseling and potential surgical interventions, were explored. Given the severity of symptoms and reproductive challenges, definitive surgical management was pursued. This case highlights …

Descriptive Analysis Of Modified Baux Scores And Mortality In Burn Patients At Jms Burn Center: A Five-Year Institutional Analysis, Mark Shearer, Rajiv Sood

Research Day

Background: The modified Baux score is a widely used, easily calculated tool that combines patient age, total body surface area burned, and the presence of inhalation injury to predict mortality in burn patients. Despite its clinical utility, institutional data correlating modified Baux scores with observed mortality remain limited.

Objective: This study aims to retrospectively analyze modified Baux scores greater than 100 in a cohort of 119 patients of all ages, with 61 patients being over 50 years old, treated over the past 5 years at JMS Burn Center. The goal is to describe mortality rates across defined 10-point score intervals …

Genetic Associations With Heart Failure Across Ancestries: An Analysis Of The All-Of-Us Nih Database., Marisela Benitez, Thomas J. Last

Research Day

Introduction

Heart failure (HF) is a complex clinical syndrome characterized by the heart’s inability to pump blood efficiently. This can be significantly influenced by genetic factors. Genetic predisposition varies across ancestries, which can impact disease susceptibility. This study identifies ancestry-specific and shared genetic variants associated with HF.

Methods

We analyzed the “All by All” genome-wide association study (GWAS) result tables within the All-of-Us NIH Database using phenotype code CV_424 for HF. Heart failure (HF) patients were stratified into American (AMR), African (AFR), and European (EUR) ancestry groups. The analysis of GWAS identified significant ancestry-specific variants, followed by a meta-analysis to …

Anatomical Variations Of The Anterior Cruciate Ligament: A Cadaveric Study On Sex And Age Differences, Amaan S. Ismail, Zain M. Ismail, Oscar E. Acosta, Shiv Dhiman

Research Day

Introduction

The anterior cruciate ligament (ACL) plays a critical role in knee stability, particularly in controlling anterior translation and rotational movement of the tibia relative to the femur. Numerous studies have reported morphological differences in the ACL based on sex and age, which have implications for injury susceptibility, surgical reconstruction, and rehabilitation protocols. This study aims to investigate the anatomical variations of the ACL across different sexes and age groups, particularly within specific regions like South Georgia, contributing to a better understanding of its structural adaptations and clinical significance.

Objective

The primary objective of this study is to document and …

A Case Of Cryptosporidiosis In An Iga Deficient Child, Macy Rowan, Preston Hawkins, Madison Morgan, Anthony Adetomiwa

Research Day

Cryptosporidium parvum is an important infectious cause of watery diarrhea in the general, pediatric, and immune-compromised populations, especially in underdeveloped countries and regions (CDC). Transmission primarily occurs through the ingestion of fecally contaminated water. After ingestion, the parasites invade the epithelial cells of the gastrointestinal tract and begin to multiply through asexual reproduction (CDC). Thus, mucosal immunity, especially by way of IgA, is likely critical in defending the host from infection (Borad). This illness is typically self-limiting in the general population. However, in the immune-compromised, it can lead to chronic diarrhea, malnutrition, and life-threatening wasting (CDC). This prognosis is especially …

Evaluation Of Chronic Pyoderma Gangrenosum, Acne, And Suppurative Hidradenitis (Pash) Syndrome And Its Effect On Kidney Function: A Cadaveric Study., Sydnee N. Jackson, Marisela Benitez, Kayla E. Hasty, Patrice Sarrazin, Gerardo J. Tabares, Cailin Ingram, Shiv Dhiman

Research Day

INTRODUCTION

Pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) syndrome is a rare, hereditary autoinflammatory disorder characterized by the presence of all three dermatological conditions. While PASH syndrome has only recently been identified, there is growing evidence linking pyoderma gangrenosum to kidney dysfunction. However, the relationship between kidney impairment and PASH syndrome remains largely unexplored. Understanding the potential impact of PASH syndrome on renal function is critical not only for advancing our knowledge of this rare condition, but also for improving patient management and treatment strategies. This case study aims to investigate the effect of PASH syndrome on kidney function through …

Meningococcal Sepsis In Pregnancy: A Case Of Neisseria Meningitidis Bacteremia In The First Trimester, Tiffany Pittman, Madison Morgan, Monica Drummond, Allison Tresner

Research Day

Introduction:

Meningococcal sepsis caused by Neisseria meningitidis is a rare but life-threatening infection, especially in pregnant women, where the risk of rapid deterioration can occur. The diagnosis of sepsis due to N. meningitidis in early pregnancy is particularly challenging due to limited treatment options that are safe for both mother and fetus. This case highlights the clinical course, diagnosis, and management of Neisseria meningitidis bacteremia in an 8-week pregnant woman, providing valuable insights for clinicians treating systemic infections in pregnancy.

Case Presentation:

A 29-year-old female, gravida 4 para 2012, at 8 weeks and 6 days gestation with no other contributory …

Arachnidism Leading To A Complicated Infection In A Middle Aged Female, Monica S. Drummond, Carol A. Medina, Madison A. Morgan, Alex J. Studebaker

Research Day

Arachnids are known to seek out dark, undisturbed areas, where they can be secluded. Although generally not known for their aggression towards humans, they are known to bite when prompted. Most bites occur unknowingly while cleaning a storage area, putting on clothing/shoes, doing yard-work, or even rolling over in bed. Often, the bite is painless. The severity of a patient’s reaction to the bite originates from the genus of arachnida, the amount of venom injected, and the individual’s sensitivity to it. Several types of arachnid venoms are known to be cytotoxic and hemolytic. While many initial bites are commonly painless, …

Adhd Treatment In Adults: Evaluating The Efficacy Of Stimulant Medication Combined With Cognitive Behavioral Therapy, Lisandra Chinea, Monica Drummond

Research Day

Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder that presents with features of hyperactivity, inattention, and impulsivity which impair concentration and normal neurocognitive function. Stimulant medications, namely Methylphenidate, are the first line treatment for ADHD, however, it carries potential side effects including but not limited to: headaches, anxiety, mood changes, hypertension, and tachycardia (Weibel et al., 2021). In addition to stimulants, Cognitive Behavioral Therapy (CBT) has shown promising results when treating adults with ADHD. The article “A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with ADHD” revealed that CBT with or …

Investigation Of Generalized Lymphadenopathy And Lung Cancer: A Cadaveric Case Study, Maxwell F. Deen, Sydney E. Williams, Morgan L. Brown, Shacamryn A. Malone, Josianne M. Fils, Natalie R. Marrero, Shiv Dhiman

Research Day

Introduction:

Generalized lymphadenopathy is characterized by the abnormal enlargement of lymph nodes throughout the body. This finding is clinically significant and can be indicative of potential systemic diseases, including but not limited to infections, autoimmune disorders, and malignancies. Lung cancer, one of the leading causes of cancer-related mortality worldwide, often metastasizes to the lymph nodes. This case report aims to investigate and analyze the relationship between generalized lymphadenopathy and lung cancer through cadaveric dissection and laboratory testing. In this study, we observe a case where widespread lymph node enlargement is present in conjunction with diagnosed lung cancer, offering an opportunity …