Medicine and Health Sciences Commons^™

Lymphoscintigraphy Use And Surgical Planning In Patients With Recurrent Ipsilateral Breast Cancer, Noah Mejias, Katie Pyrz, Kathleen Jeffery

Research Day

Background/Objective:

In recent literature, there has been a question of how to surgically manage patients with recurrent ipsilateral breast cancer due to the possibility of aberrant lymphatic drainage pattern secondary to a previous axillary lymph node dissection. The use of preoperative lymphoscintigraphy to map possible aberrant drainage patterns prior to surgery remains investigational, necessitating the need for further management guidelines.

Methods:

We identified two patients in our database with recurrent ipsilateral breast cancer and previous nodal surgery as well as lymphoscintigraphy showing focal uptake of radioactive tracer on the contralateral side.

Results:

Two patients presented with recurrent ipsilateral breast cancer. …

Recurrence Of Symptoms Following Conservative And Surgical Treatment For Lumbar Radiculopathy: A Literature Review, Aribah Ali, Tina Alkhazali, Robert Ablove

Research Day

Introduction: Lumbar radiculopathy is a common clinical problem and remains a controversial diagnosis at fundamental levels, including its diagnostic criteria, pathophysiology, and optimal treatment. Patients with lumbar radiculopathy may improve with either conservative or surgical treatment; the specific treatment chosen is based on patient preferences, priorities of care, and comorbidities. However, there is limited evidence from clinical studies to support treatment choice in daily practice. The purpose of this literature review is to summarize evidence regarding the recurrence of symptoms following conservative treatments and surgical treatments for patients with lumbar radiculopathy.

Methods: The review was conducted using the OneSearch database …

A Systemic Review Of Efficacy, Ratings And Top Football Gear For Concussion Prevention In 2024, Mustafa I. Ansari, Mutasem F. Shopon, Erik Zarandy

Research Day

Introduction: Concussions in football pose significant health risks, requiring the implementation of effective protective gear to reduce the incidence of head injuries. Helmets and mouthguards are standard equipment, but their true effectiveness remains debated.

Objective: This study aimed to systematically evaluate the efficacy of modern football protective gear, specifically helmets and mouthguards, in the prevention of concussions.

Methods: Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Cochrane Library, Google Scholar, and Embase. A total of 3,894 studies were reviewed, and 35 studies met the inclusion criteria. Independent reviewers analyzed the studies to determine the impact of helmets and …

Breaking The Stereotype: Small Cell Lung Cancer In A Never-Smoking Patient, Alexandra She, Edward Hamilton, Francis Jenney

Research Day

In the United States, lung cancer is the second most common type of cancer whilst also accounting for 1 in 5 cancer deaths, making it also the deadliest. The vast majority of lung cancer is non-small cell lung cancer (NSCLC), contributing to 87% of all cases, while small cell lung cancer (SCLC) makes up about 13% of all lung cancers1. While SCLC is strongly related to smoking history, here we present a 65-year-old African-American male without a history of smoking tobacco presenting with a rapid progression of unilateral thoracic pain, dyspnea, and unintentional weight loss. The diagnostic work-up included concomitant …

Unique Presentation Of Pvcs In Young Athlete With Unremarkable Risk Factors, Om Bhardwaj, Nulchamp Sin, Meredith Wesley, Erik Zarandy

Research Day

This case study examines a 24-year-old male professional athlete who presented with heart palpitations, shortness of breath, and dizziness at the onset of exercise. The patient has no significant family history of cardiovascular disease and was otherwise healthy. His history was remarkable for a significant volume of premature ventricular contractions (PVCs) diagnosed by electrocardiogram (ECG) in 2017 and exercise-induced bronchospasms diagnosed in 2020 maintained via inhaled corticosteroids and albuterol use prior to exercise. He reported that these symptoms gradually improved through physical activity. These diagnoses never disqualified him from playing throughout his collegiate career.

Upon transitioning into his professional career, …

Effectiveness Of Osteopathic Manipulation Therapies Vs Pt/Rehabilitation Therapies On Multiple Sclerosis Symptoms, Daniel A. Dolinski, Sierra L. Hudson, Francis E. Jenney

Research Day

Introduction:

We review some of the epidemiologic and genetic aspects of Multiple Sclerosis (MS) while highlighting the benefits of an osteopathic approach to relieving symptoms and psychological distress in MS and similar disease states.

We focus on the efficacy of current PT/rehabilitation therapies versus Osteopathic Manipulative Therapies for selected symptoms in patients with MS, including changes in mood, motor functions, fatigue, vertigo, sleep, and chronic pain.

Living with MS is extremely expensive, ranging from an average per-person per-year cost of $65,612 for direct medical costs and an average of $18,542 for indirect costs/non-medical costs (Bebo et al., 2022). This study …

Clinical Significance Of Pelvic Arterial Variations In Uterine Artery Embolization For Obstetric Hemorrhage, Mustafa I. Ansari, Diana Peterson

Research Day

Introduction: The internal iliac artery (IIA) is a vital vascular structure that divides into an anterior and posterior division within the pelvic cavity. This branching is crucial for essential blood supply and innervation for pelvic structures and organs. Knowledge of the IIA is critical for diagnosing and managing injuries. This poster highlights a bilateral variation in the posterior branch of the IIA.

Methods: During a routine anatomy dissection of an elderly Caucasian male, a notable variation in the posterior branching pattern of the internal iliac artery was found. The variation was dissected and photographed with permission from the donor’s family …

Addressing Late Latent Syphilis In Pregnancy: A Case Study Emphasizing Interdisciplinary Communication And Public Health Collaboration, Mustafa I. Ansari, Audrey Arona

Research Day

Introduction: Congenital syphilis has re-emerged as a significant public health concern, despite being preventable through timely diagnosis and treatment during pregnancy. Late latent syphilis, particularly in high-risk populations, poses serious risks to both mother and fetus, with non-compliance to treatment exacerbating these dangers. Effective management requires coordinated efforts between healthcare providers and public health officials to ensure proper intervention and follow-up.

Objective: The objective of this study is to assess the impact of interdisciplinary communication and public health collaboration in the management of late latent syphilis during pregnancy, focusing on how coordinated care can address challenges such as patient non-compliance …

Successful Management Of Recurrent Pregnancy Loss And Heavy Menstrual Bleeding In A 34-Year-Old Female, Mustafa I. Ansari, Humza Omar, Audrey Arona

Research Day

Introduction: Endometrial polyps and uterine fibroids are common non-cancerous growths that can cause complications such as abnormal uterine bleeding and fertility issues in women of reproductive age. Polyps are growths of endometrial tissue, while fibroids consist of smooth muscle tissue within the uterus. This case focuses on a 34-year-old woman who experienced recurrent miscarriages and heavy menstrual bleeding due to these growths.

Objective: The objective of this case study was to explore the effectiveness of operative hysteroscopy in treating recurrent pregnancy loss and abnormal menstrual bleeding in a patient with uterine polyps and fibroids.

Methods: A 34-year-old female presented with …

Identifying The Potential Effect Of Zolmitriptan On The 1b Pathway Of Golgi Tendon Organs In Regulating Intermuscular Inhibition In The Extremities To Find A Link In The Mechanism Of Spasticity, Adam E. Davis, T. Richard Nichols

Research Day

The deep dorsal horn (DDH) of the spinal cord is a major integration center for receiving a variety of neural projections from the brainstem as well as a variety of afferent inputs from muscle spindles and Golgi tendon organs (GTOs) in the muscles. Following spinal cord injury (SCI) to the DDH, an overall loss of serotonergic input from the brainstem is observed, for which there is evidence to suggest that this may play a role in inhibiting the activity of bursting interneurons in the DDH, possibly leading to uncontrolled motoneuron activity, hyperreflexia. GTOs primarily supply the force feedback network (FBB), …

Management Of Ectopic Pregnancy In A 34-Year-Old Female, Mustafa Ansari, Rehana Lakhani, Audrey Arona

Research Day

Introduction: Ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity, most commonly in the fallopian tube. This condition can lead to life-threatening complications if not promptly diagnosed and managed. This case report presents a 34-year-old woman with symptomatic right ectopic pregnancy, who presented with abdominal pain, vaginal bleeding, and signs of internal bleeding.

Objective: The objective of this case study is to illustrate the surgical management of a right ectopic pregnancy using a tissue-sparing hydro-dissection technique and its impact on preserving future fertility.

Methods: The patient presented with right lower quadrant pain, cervical motion tenderness, and an …

Thickened Skull Found In Case Study With History Of Metastatic Brain Cancer, Zoe M. Rushetsky, Victoria Pfennig, Caleb M. Findley, Haley E. Wrobel, Diana C. Peterson

Research Day

Intro

A 21-year-old female was found to have thickened parietal bones and abnormal calvaria during a routine anatomy dissection. She was diagnosed with a malignant brain tumor, although the specific type of tumor was not identified. Skull thickening associated with brain tumors occurs due to pressure from the tumor, which stimulates bone growth. Other conditions that can lead to skull thickening include meningiomas, tuberous sclerosis, skeletal dysplasias, and acromegaly.

Methods

In the gross anatomy lab, thickening of the skull was observed during routine dissection. Permissions were secured from the body donation program and the donor's family to document and publish …

Enlarged Asymptomatic Basilar Artery, Zoë M. Rushetsky, Caleb M. Findley, Victoria Pfennig, Diana C. Peterson

Research Day

Intro: During anatomical dissection in a gross anatomy laboratory, an enlarged basilar artery was observed in a 76-year-old cadaver. The basilar artery supplies blood to the brainstem and cerebellum. Enlargement of this artery can lead to a variety of symptoms (e.g., ataxias, vertigo, auditory problems, analgesia, and headaches). Patients can also be asymptomatic. The absence of symptoms, in the patient’s medical history, raises concerns about under-reporting of this pathology.

Methods: In the gross anatomy lab, basilar artery distension was observed during routine dissection. Permissions were secured from the body donation program and the donor's family to document and publish the …

Chronic Intranasal Xylazine Use Resulting In Nasal, Palatal, And Orbital Floor Necrosis With Inferior Rectus Entrapment, William C. Jones, Lauren Melley

Research Day

Xylazine, a non-opioid veterinary tranquilizer not approved for human use, has infiltrated the illicit drug supply causing public health officials to release statements warning of an emerging epidemic. Referred to as “Tranq” or “Tranq-Dope” when combined with heroin or fentanyl, recreational xylazine in the United States was first detected in Philadelphia in 2006, and has been associated with increasing fatal overdoses and chronic necrotic wounds. Xylazine functions as a strong synthetic alpha-2-adrenergic agonist but is thought to have partial alpha-1-adrenergic agonist activity, inducing peripheral vasoconstriction, poor perfusion, and necrosis. Numerous case reports and media photos have emerged of “characteristic necrotic …

Case Study Of Bone-Anchored Hearing Aid, Victoria Pfennig, Zoë M. Rushetsky, Caleb M. Findley, Diana C. Peterson

Research Day

Introduction: A 74-year-old female cadaver from a medical school gross anatomy lab was found to have a Bone-Anchored Hearing Aid (BAHA). A BAHA is utilized in patients who suffer from conductive hearing loss in order to bypass dysfunctions of the outer and middle ear and directly transmit the sound waves to the cochlea. The most common etiologies of conductive hearing loss include cerumen impaction, middle ear effusion, congenital malformation, and ossicular chain fixation.

Methods: An assisted hearing device was observed during a routine medical gross anatomy course dissection. Permissions were obtained from the body donation program and the donor's family …

Readability Analysis Of Faq Responses From The American College Of Mohs Surgery, Chatgpt, And Google Gemini, Caleb M. Findley, Neha R. Momin, Seth E. Bernacki

Research Day

INTRODUCTION: The readability of patient education materials (PEMs) greatly affects patients’ understanding and adherence to medical treatments. To ensure effective healthcare communication to a broad audience, the American Medical Association (AMA) recommends that PEMs be written at a sixth-grade reading level or lower. This study aims to compare the readability of responses to Mohs surgery-related frequently asked questions (FAQs) on the American College of Mohs Surgery (ACMS) website to PEMs generated by popular AI platforms, ChatGPT and Google Gemini.

METHODS: Seven FAQs about Mohs surgery from the ACMS website were obtained. ChatGPT and Google Gemini were asked to (1) …

Optogenetic Deactivation Of Amygdalo-Auditory Cortex Circuit, Mustafa Ansari, Jessica Swaby, Diana Peterson

Research Day

Introduction: While the functions of many amygdalar circuits have been widely studied, the role of the direct amygdalo-auditory cortex (AM-AC) circuit is unknown.

Objective: Understand the function of the direct projection from the amygdala to the auditory cortex.

Methods: Two experiments were performed. In Experiment 1:Electrophysiology was utilized to record single and multi-unit responses from the auditory cortex. Optogenetic activation or deactivation of the amygdalo-auditory cortex circuit was then utilized to examine changes to auditory neuron firing rate during normal and deactivation scenarios. In Experiment 2, the protocols for experiment 1 were tested in animals with a sound-induced tinnitus to …

From Irb Approval To Implementation: Evaluating Medication Therapy Management (Mtm) Services On Medication Adherence In Children With Special Healthcare Needs (Cshn), Jalen Love, Justice Sconiers, Joy Nish, Yujin Kim, Xinyu Wang

Research Day

Institutional Review Board (IRB) reviews and approves research studies involving human subjects to ensure compliance with ethical standards set by the US government. Our research team is preparing to investigate whether Medication Therapy Management (MTM) services improve medication adherence in children with special healthcare needs (CSHN) aged 5-17, many of whom require complex medication regimens. Prior studies show that a caregiver’s socioeconomic status significantly impacts a child’s medication adherence due to financial constraints and limited healthcare literacy. MTM services could address these barriers and enhance adherence through caregiver education on medication administration and by reducing prescription burden. Before conducting our …

Social Determinants Of Health In Patients With Diabetes Mellitus Ii, Iman N. Ashraf, Donald Penney

Research Day

Introduction: More than 37 million people in the United States have diabetes, the majority 90-95% with type 2 diabetes. The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. The SDH have an important influence on health inequities - the unfair and avoidable differences in health status seen within and …

Skin Graft Treatment For Necrotizing Fasciitis, London Samone Wheeler, Isabella Baeumler, Alramahi Bashar

Research Day

A 40-year-old male presented to the emergency room with perianal pain and left leg pain. During a comprehensive physical exam, a bullous lesion on the left thigh was noted. Further investigation revealed an extensive necrotizing fasciitis infection, confirmed by a pelvic CT scan. This case emphasizes the importance of considering alternative diagnoses in patients with preexisting conditions and highlights the necessity of a thorough diagnostic workup. Additionally, it showcases the effectiveness of skin grafts following extensive surgical debridement in managing such severe infections.

Recently Reported Adverse Effects Of Miscellaneous Antibiotics, Essie Samuel, Jeffrey D. Mccanless, Zuhal M. Saadut, Victoria Vo, Andrew Wilson, Komal Bhut

Research Day

Purpose

Antibiotics are utilized for the treatment of various infections though they are not used entirely without any safety concerns. Antibiotics are known to be associated with various adverse effects and literature review can be utilized in not only learning about these adverse effects but also how to manage them. Our research focuses on the adverse effects published in the literature during 2023 on multiple antibiotic drug classes. The purpose of this review is to provide an updated collection of information to healthcare professionals from all disciplines on both pre-existing and new or uncommon side effects of antibiotics.

Methods

A …

Benign, Estrogen-Producing Testicular Leydig Cell Tumor: A Case Report Of An Incidental Finding Explaining A Patient’S Infertility, Jaci Carithers, Kaitlyn Brown, L. Michael Waters Jr

Research Day

Introduction: Classified as a sex-cord stromal tumor, testicular Leydig cell tumors (LCTs) are rare, accounting for only 1-2% of all testicular neoplasms. They are most common in men aged 30 to 60 and can produce androgens or less commonly estrogen. For patients with an estrogen-producing LCT, symptoms can include gynecomastia, loss of libido, erectile dysfunction, and infertility.

Case Presentation: A 33-year-old white male presented to his primary care physician with concerns of an inguinal hernia and was referred to a general surgeon, who incidentally discovered a mass involving the right testicle. The timeline for the mass is inconclusive but was …

Neuromodulation Treatment For The Superior Cluneal Nerve By Peripheral Nerve Stimulation: A Case Report, Jovante Dockery, Suyin Lee

Research Day

Introduction: Superior cluneal neuralgia is an often misdiagnosed condition that is mistaken for sciatica, SI joint dysfunction, or lumbar facet syndrome. Patients suffer pain in their lower back, which can sometimes radiate down their legs due to the overlapping nerve routes between these conditions. peripheral nerve stimulation is a technique that uses neuromodulation to disrupt the pain pathways and lead to pain relief. We present a case that highlights a patient who suffered from chronic low back pain for 20 years, which was eventually identified to be caused by the superior cluneal nerve and was relieved with peripheral nerve stimulation. …

Stretch-Induced Hip Injury Causing Septic Arthritis: A Case Report, Jovante Dockery, Felix Bui, Ciara Burgess, Noorjahan Ali

Research Day

Introduction: Septic arthritis is a serious bacterial condition commonly affecting kids through hematogenous spread. It is frequently caused by organisms such as Staphylococcus Aureus and Kingella Kingae. The joint space of bones, such as the hips and knees of children, is a common location for septic arthritis to form. Monitoring the ESR and CRP are important in diagnosing and treating the infection. We present a rare case that highlights septic arthritis in a child that was caused by a stretching incident that was not evident due to normal lab values and was considered to be a muscle strain.

Case Report: …

A Prehabilitation Protocol For The Asymptomatic, Newly Diagnosed, Stage Iv Colon Cancer Patient., Scott Salters, Kaitlyn Wright, Sumana Moole

Research Day

Introduction

Prehabilitation is defined as the process of optimizing a patient’s health prior to a medical or surgical intervention. Although this is an emerging concept and is not yet standard of care, literature has shown prehabilitation to be a potentially useful tool in medicine. In the field of gastroenterology, it has been primarily used for patients undergoing surgery to remove cancers. We want to utilize prehabilitation and apply it towards patients that are awaiting oncological treatment for asymptomatic, advanced gastrointestinal malignancies. This case report highlights the need for a specific prehabilitation protocol in these scenarios and discusses evidence-based recommendations based …

A Rare Presentation Of Thalamic Stroke Due To Infarction Of The Artery Of Percheron Post Cataract Surgery, Aribah Ali, Christie Taylor, Emily Willis, Sonu Gupta

Research Day

Introduction

The Artery of Percheron (AOP) is a rare anatomical variant in which a single arterial branch from the posterior cerebral artery supplies the rostral midbrain and ventromedial thalami bilaterally. Infarction of the AOP presents a diagnostic challenge due to its subtle imaging findings and diverse clinical manifestations, which may include cognitive impairment, ocular movement disorders, motor deficits, and altered consciousness.

Objectives

This case report aims to highlight the clinical presentation, diagnostic challenges, and management of AOP infarction. By presenting a case of AOP-related stroke following cataract surgery, we emphasize the importance of early recognition and appropriate imaging to improve …

Cutaneous Sarcoidosis Imitating Necrobiosis Lipoidica: A Case Report And Review, Felix Bui, Noor Hasan, Jeannel Miclat, Joseph Dyer

Research Day

Introduction

Sarcoidosis is a granulomatous skin condition of unknown etiology, which is diagnostically challenging because it can mimic various skin conditions. In this review, we report the case of a 59-year-old male presenting with previously undiagnosed cutaneous sarcoidosis in the form of alopecia and atrophic plaques on his scalp that clinically resembled necrobiosis lipoidica (NL).

Objectives

The primary objective of this study is to compare the treatment outcomes of our case report along with other existing cases of NL-like sarcoidosis.

Case Report

A 59-year-old male patient exhibited a shiny pink-yellow atrophic plaque with crusting, telangiectasias, and secondary alopecia. With a …

Spine-Tingling 3d Prints: Bringing Spinal Tracts To Life!, Alexandra She, Nathan She, Robert Mcafee, Donald Penney

Research Day

The concept of “neurophobia” has been a known global issue in the attitudes of medical trainees. Accordingly, studies have suggested that medical students considered neurology the most challenging specialty and one in which they had the least knowledge and confidence. Studies noted that the primary culprit was the comparatively increased complexity of neuroanatomy and insufficient teaching. Herein, we propose a novel way of teaching a common neuroanatomy and neuropathology concept - the spinal tracts. We have designed and built a 3D-printed model of the spinal cord and brain stem cross sections and brain coronal sections to enhance the learning and …

Perforated Duodenal Ulcer In A Patient With Multiple Endocrine Neoplasia Type 1: A Case Report, Ahad Y. Khatri, Andrew A. Kramer

Research Day

Introduction: Multiple Endocrine Neoplasia Type 1 (MEN1) is a hereditary syndrome characterized by tumors of the parathyroid, pancreas, and pituitary gland. Among its gastrointestinal manifestations, gastrinomas are particularly concerning due to their association with Zollinger-Ellison syndrome (ZES), which leads to excessive gastric acid secretion and peptic ulcer disease (PUD). These symptom overlaps can lead to misdiagnosis of MEN1 as peptic ulcer disease and gastroenteritis. Additionally, while ulcers are a well-recognized consequence of gastrinomas and MEN1, perforation remains a rare but life-threatening complication.

Case Presentation: A 36-year-old female initially presented with diffuse abdominal pain, nausea, vomiting, and diarrhea. She had a …

Lead Contamination Propagation Into Plants Of A Metro Atlanta Home, Jaci Carithers, Samantha Gowen, Francis Jenney

Research Day

INTRODUCTION: Lead pollution in residential areas of Metro Atlanta has spurred the EPA to increase efforts to remediate contaminated soil, resulting in the designation of the Westside Lead Atlanta, GA Superfund site. Lead poses significant risks to human health, interfering with vital biological functions, such as blocking important calcium-dependent pathways. Historic practices of lead-based industries with poor disposal procedures have caused local soil and water pollution. This is evident particularly along historical railroad routes used for transporting metal-laden industrial goods. The soil along these routes frequently exhibits heightened levels of heavy metals due to regular train activity, exacerbated by waste …