Medicine and Health Sciences Commons^™

Ebstein’S Anomaly In A Professional Soccer Player: A Case Report, Erik Zarandy, Eldad G. Saler, Saavan S. Boghara, Rithvik R. Sarasani, Vraj N. Patel

Research Day

INTRODUCTION:

Ebstein’s anomaly (EA) is a rare congenital defect involving malformation of the heart’s tricuspid valve. EA is associated with other congenital heart defects as well as increased risk of cardiac arrhythmia. This makes its identification especially important in athletes, as it could lead to sudden cardiac death. In this case, a young professional soccer player was found to have EA with WPW. Our goal is to highlight the appropriate work-up and subsequent treatment and follow-up of a competitive athlete with Ebstein’s Anomaly.

CASE REPORT:

A 20-year-old male professional soccer player received a preparticipation EKG and physical and was noted …

43-Year-Old Female Without Insurance With Progressive Back Pain For Two Years Due To Multiple Symptomatic Tarlov Cysts, Shereen M. Mohammed, Fatema Z. Momin, Joy I. Zarandy

Research Day

Introduction: Tarlov Cysts (TCs) are meningeal cysts that can affect spinal nerve roots, usually in the sacrum. Pathology is largely unclear. Women are twice as affected as men, with increased incidence around 40-50 years old. These cysts are generally asymptomatic and incidentally found on imaging. Estimated prevalence is 4.6%, with approximately 1% of TCs causing nonspecific symptoms like low back pain. Due to its vague symptomatology, TCs are commonly misdiagnosed. Because most TCs are asymptomatic, treatment guidelines for symptomatic cysts are ill-defined; however, surgical removal should be considered for TCs >1.5cm or causing symptoms to prevent possible progression to nerve …

Optimizing Pediatric Care: Bridging Gaps And Addressing Disparities For Children With Disabilities Or Medical Complexities Through Medication Therapy Management (Mtm), Phuongloan Hoang, Drew Mccanless, Seana-Pierre Williams, Rajat Sharma, Mariam-Sere Diaby, Lauren Callaway, Jihui Diaz

Research Day

INTRODUCTION

Children with disabilities and medical complexity require complex medication regimens that are challenging for caregivers when managing medication. We conducted a secondary meta-analysis using data from the National Health Interview Survey (NHIS) to explore medication adherence disparities based on caregivers’ socioeconomic status. Medication Therapy Management (MTM) and similar services have been shown to improve treatment adherence. We aim to investigate the utilization of MTM services among underprivileged communities by developing a structured survey for the target population and aim to examine whether caregivers’ socioeconomic status (SES) impacts medication adherence within our study cohort. Our ultimate goal is to improve …

Where Is The Baby?, Priya Merai, Shree Desai, Rohit Karnati, Sheba Mathew, Fatema Momin, Joy Zarandy, David Adelstein

Research Day

Introduction: People experiencing homelessness can struggle to have basic healthcare needs met due to a variety of factors, potentially resulting in the progression of untreated health issues and development of complications. Since the COVID19 pandemic, rates of homelessness have increased and women are the fastest growing subgroup. Women have a higher need for preventative care, especially when considering reproductive health and gynecologic issues. Health education and treatment, even for seemingly benign conditions, is imperative for improving health outcomes of women experiencing homelessness.

Case description: A 38-year-old woman experiencing homelessness becomes unresponsive, and an onlooker calls 9-1-1. No medical history is …

Quantitative Analysis Of Cadaveric Cervical Lymph Nodes And The Relationship With Cervical Carcinoma Treatments, Samuel Ighodaro, Mierra C. Robinson, Casey Thompson, Shelley Dicecco

Research Day

Introduction

Head and Neck Lymphedema develops most commonly as a secondary effect of cancer and its treatment (Banjdar). The head and neck, or cervical, region contains an intricate network of over 300 lymph nodes and serves as a critical component of the body’s immune system (Peach). Head and cervical lymph nodes are often combined in a total number, therefore this study focused primarily on quantifying the ranges of lymph nodes that are specifically in the cervical region. Knowledge of the anatomic relationships of the lymphatic nodal levels and the structures they drain is critical in the delivery of appropriate therapy …

Compression Garments For Genital Lymphedema: A Case Series, Shelley Dicecco

Research Day

Introduction: Individuals with genital lymphedema can experience gait deviations, urinary/bowel dysfunctions, pain, cellulitis, and reduced quality of life. An important aspect of treatment is the use of compression garments to help with the reduction and/or maintenance phases. It can be difficult to select a compression garment for the genital region due to the function, location, shape, and size of the genitals. The aim of this study was to investigate the ability of off-the-shelf compression shorts with a sex-specific pad insert to maintain the reduction of edema and the health of the tissues for two patients with controlled genital lymphedema. Methods: …

Enhancing Total Hip Arthroplasty Outcomes With Internet-Based Patient Engagement Platforms, Justin T. Butler, Ryan Decook, Joyce Harary, Thomas Bradbury, Charlie Decook, Brandon Naylor

Research Day

Introduction: As Internet-based patient engagement platforms (IPEPs) become increasingly utilized following THA (total hip arthroplasty), a clearer understanding of their role in influencing clinical outcomes is needed. This study aims to determine whether increased patient engagement with an IPEP has notable impacts on patient-reported outcome measures (PROMs) and post-acute care visits.

Methods: This retrospective study analyzed 5,557 patients who underwent Total Hip Arthroplasty (THA) and participated in an Internet-based Patient Engagement Platform (IPEP) from 2018 to 2022. Patients were categorized based on their engagement levels with the IPEP, measured as high or low based on the frequency of interactions. Key …

A Review Of Current Mrna-Based Cancer Vaccinations With Special Consideration For Future Breast Cancer Prevention Strategies, Alexandra She, Alexa Cornwell, Francis Jenney

Research Day

INTRODUCTION: According to the World Cancer Research Fund International (WCRFI), breast cancer (12.5%) has now topped lung cancer (12.2%) as the most prevalent form of cancer in the world (WCRFI, 2022). While therapeutic advances continue to be made, the current treatment of cancer is widely associated with severe side effects from classic therapies such as radiation and chemotherapy. Over the last two decades, studies have examined breast cancer vaccines in pre-clinical and clinical settings. Here, we present an in-depth review of current mRNA-based cancer vaccine literature to assess the prevalence of this technology in this field of medicine. This includes …

Case Study: Lead Contamination Propagation Into Plants Of A Metro Atlanta Home, Jaci Carithers, Samantha Gowen, Mbill Khan, Gokbet Owusu-Poku, Francis Jenney

Research Day

INTRODUCTION: Lead pollution in residential areas of Metro Atlanta has spurred action from the EPA to increase efforts to remediate the 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 its mimicry and blocking of important calcium-dependent pathways. Contributing to this issue are the historic practices of lead-based industries with poor disposal practices, causing local soil and water pollution. This issue is evident particularly along historical railroad routes used for transporting heavy metal-laden industrial goods. The soil along these routes frequently …

Exploring Medication Adherence In Children: A Survey-Based Approach To Addressing Disparities And Improving Treatment Outcomes., Rajat Sharma, Phuongloan Hoang, Drew Mccanless, Seana-Pierre Williams, Mariam-Sere Diaby, Lauren Callaway, Jihui Diaz, Xinyu Wang, Yujin Kim

Research Day

INTRODUCTION

Medication Therapy Management (MTM) aims to boost medication adherence, primarily focusing on seniors covered by Medicare and Medicaid. However, vulnerable populations like children with medical complexity or disabilities on medication (MCDM) lack access to this service. Previous research using the NHIS database identified disparities in medication adherence rates across socioeconomic levels, education, and ethnicity among caregivers. To investigate if these disparities persist in our community, we're developing a survey to assess medication adherence rates in children with MCDM. We conducted a literature review to create a questionnaire analyzing the impact of MTM services on children with MCDM.

METHODS

From …

The Effects Of Plant Milks On Bone Growth And Bone Density In Children And Adolescents, Julienne Ryland, Jeannel Miclat, Diana Peterson

Research Day

Introduction:

Improper nutrition is a controllable factor contributing to bone development during the peak growth years of 9-16 years old. In the past few decades, cow milk and dairy products have been the primary sources of vitamin D and calcium; however, the increased prevalence of plant-based dairy products on the market resulted in nutritional differences. Plant-based products have decreased amounts of vitamin D and calcium, disrupting endochondral ossification. Furthermore, plant milk generally has lower protein and fat content than cow milk. We hypothesize that consuming plant-based products may decrease metabolic fat stores, vitamin D, and calcium availability, thus lowering bone …

Diagnostic Ambiguity Of Distal Dvt (Ddvt) Misdiagnosed As Nonpurulent Lower Extremity Cellulitis (Nlec): A Case Study, Jessica M. Ruiz-Myara, Hunter Alberto Vásquez, Joy Zarandy

Research Day

Introduction

Given the lack of a definitive diagnostic test for cellulitis, about 39% of cases are misdiagnosed. The repercussions of misdiagnosing nonpurulent lower extremity cellulitis (NLEC) for deep vein thrombosis (DVT) can be grave, considering the potential risk of pulmonary embolism (PE). While distal DVT (dDVT) is associated with <5% of PE formation, about 25% of untreated dDVT can ascend to the proximal leg veins; whereas 50% of proximal DVTs (pDVT) progress to PE development within a 3-month timeframe.

Case Report

A 50-year-old female presents to her PCP with a right medial ankle rash for 2 days. She denies inciting events, fever, chest pain, dyspnea, weeping lesions, or swelling. Past medical history includes obesity and controlled diabetes mellitus. Vitals are normal. Examination reveals a 10 x 6 cm blanchable, erythematous …

Chest Binding Alters Thoracic Anatomy In Transmasculine Youth, Julienne Ryland, Jeannel Miclat, Diana Peterson

Research Day

Introduction:

With the recent legislation restricting gender-affirming care for minors, more mechanical means of gender-confirming methods are being used as a substitute. For adolescent transmasculine people, this includes chest binding, designed to flatten breast tissue and give a more streamlined masculine appearance. Chest binding is a relatively inexpensive and widely available technique to affirm gender identity without the need for healthcare professional involvement. Although chest binders are recommended to be worn for less than 8 hours daily, transmasculine youth have been documented wearing their chest binders for upwards of 18-21 hours a day. This consistent pressure on their chest essentially …

Pregnancy And Lymphedema: Is There A Link?, Kathryn E. Downing, Shelley Dicecco

Research Day

Introduction: The current literature regarding pregnancy is lacking data on a significant population: individuals with lymphedema. This void of information ultimately creates barriers to understanding the pathology surrounding lymphedema during pregnancy and the potential for poorer outcomes due to clinical practice that is not evidence-based. This literature review aims to provide a brief overview of anatomical and physiological changes that occur with lymphedema and pregnancy, summarize the current literature on the effects of pregnancy on the lymphatic system and lymphedema, and analyze the data to develop a clinical reference for evidence-based practice.

Methods: A One search, google scholar, and Pubmed …

The Effect Of State And Trait Anxiety On Pain-Pressure Threshold, Scott Lowe, Christian T. Hughey, Kathryn E. Downing, Breana L. Fair

Research Day

Background:

The global burden of persistent pain is substantial, affecting up to 30% of the world's population. Despite growing awareness, challenges persist with accurate pain measurement, limiting research and clinical efforts. One method to assess pain perception is the Pain-Pressure Threshold (PPT), indicating the pressure at which pain is reported. Anxiety, comprising state and trait anxiety, has been suggested as a potential influencer of PPT, yet its precise impact remains uncertain. State anxiety is defined as a "transient state of arousal subjectively experienced as anxiety" Trait anxiety is “an individual's tendency to appraise situations as threatening, avoid anxiety-provoking situations, and …

The Importance Of Early Recognition And Management Of Battery Ingestion In A 15-Month-Old: A Case Study, Yuna Seo, Anna Yoon, Joy Zarandy

Research Day

INTRODUCTION

With the proliferation of home battery-powered gadgets, emergency visits for accidental pediatric battery ingestions have doubled from 2010 to 2019. Battery ingestion is associated with a risk of serious injury and potential death, particularly lithium button batteries. Tissue damage begins within15 minutes of impaction, with major corrosive injury as soon as two hours; thus, emergent management is crucial to optimize patient outcome.

CASE DESCRIPTION

A healthy, asymptomatic 15-month-old male presents with his father, a physician, for suspected ingestion of a button battery. Vital signs and physical exam are normal. Stat nose-to-rectum plain films confirm the presence of an opaque …

Estrogen Mediated Mitochondrial Dysfunction, Menopause, And The Progression Of Alzheimer’S Disease, Kristina D. Grant, Richard E. White

Research Day

Alzheimer’s Disease is a fatal and progressive neurodegenerative disease that results in losses in memory and cognitive function. Menopause is known as a woman’s transition from reproductive to post-reproductive life. During menopause, the levels of ovarian hormones, such as estrogen, decrease eventually to an undetectable level. Estrogen plays essential roles throughout the body, and the loss of estrogen during menopause has been shown to cause various symptoms, including vasomotor symptoms, changes in mood, and changes in cognition. Given that Alzheimer’s Disease is more common in postmenopausal women than men, this review aims to examine the connection between the loss of …

Collaborating With Faith-Based Organizations And Municipalities To Increase Hypertension Awareness, Antonio A. Henry, Charisma Bell, Joe Williams, Renee A. Taylor, Charlz Bisong, Adwoa Aduonum, Valerie Cadet

Research Day

Background

Conversations involving health status of underrepresented minority demographics in the U.S. often ascribe the burden of poor health to individuals rather than systemic conditions. Research has shown that ignoring the role of these conditions on health and socioeconomic status undermines community-based morbidity and mortality reduction efforts. But, while systemic approaches are paramount, the importance of healthcare institutions and professionals making meaningful relationships with community members remains essential.

This study describes medical student efforts in creating relationships with individuals and community stakeholders in the Gwinnett County area to address hypertension awareness. Awareness of hypertension, a leading cause of morbidity and …

Delayed Diagnosis Of Pelvic Fracture In A 27-Year-Old With Cerebral Palsy: A Case Report, Sheba A. Mathew, Felina Thomas, Joy Zarandy

Research Day

INTRODUCTION:

Cerebral palsy (CP) is the most common cause of neurological and motor disability in the pediatric population, and manifests with varying degrees of severity. Due to complications involving motor, functional, and cognitive impairment, patients with severe CP generally experience a shorter life expectancy. Over the past 30 years however, mortality rates have declined and most children with CP survive into adulthood. The recent trend of increased life span in this population presents an interesting phenomenon in which patients in their 20’s must transfer from the familiarity and comfort of pediatric care into adult care. PCPs inheriting these patients may …

Non-St Elevation Myocardial Infarction Presentation In Severe Aortic Stenotic Patient, Margi Desai, Daniel Maysonet, Maysonet Patel

Research Day

This case report demonstrates a patient who presents with typical findings for a diagnosis of NSTEMI. Upon further evaluation, this diagnosis was able to be ruled out. Presentations and labs consistent with NSTEMI masked the true diagnosis of aortic stenosis due to an oxygen supply/demand mismatch.

Meta-Analysis Of Complications Associated With Sutured Vs. Sutureless Primary Gastroschisis Closing, Michael T. Bien, Sharnikha Saravanan, Shrey M. Patel, Madeline A. Felice, Ashton S. Amos, Gary E. Freed

Research Day

Introduction: Traditionally, surgical management of gastroschisis involved a primary or staged reduction of the viscera followed by sutured defect closure. Over the past 20 years, the plastic sutureless closure technique has gained popularity where the defect is covered with a remnant of the umbilical cord and a plastic dressing. However, little investigation has been done to compare the postoperative complications associated with sutured and sutureless techniques. We hypothesize that sutured closures will have a greater complication rate than sutureless closures.

Methods: A search of primary literature was conducted in PubMed, Embase and Cochrane databases using PRISMA criteria in February 2024 …

Inhibitory Effect Of Tanshinone Derivatives Against Sars-Cov-2 3-Chymotrypsin-Like Protease (3clpro) Enzyme, Jenny Wong, Alex Beringer, Devin Lewis, Aribah Ali, Vicky Mody, Shashidharamurthy Taval

Research Day

The lingering consequences of the COVID-19 pandemic continue to manifest as persistent effects on recovering patients. Recent research has identified RNA-dependent RNA polymerase (RdRp), 3-chymotrypsin-like protease (3CLpro), and papain-like protease (PLpro) as crucial components for SARS-CoV-2 replication and the regulation of the host's immune response. Specifically, 3CLpro plays a pivotal role by cleaving 11 non-structural protein (NSPs) sites on the polyprotein of coronaviruses. Consequently, 3CLpro is an attractive target for potential antiviral drug development, with the potential to inhibit viral RNA production in SARS-CoV-2. Our study examined the inhibitory effects of 21 tanshinone derivatives on the SARS-CoV-2 3CLpro enzyme. Among …

Inhibition Of Sars-Cov-2 Papain-Like Protease By Bioactive Compounds Found In Salvia Miltiorrhiza, Alexander Beringer, Jenny Wong, Devin Lewis, Aribah Ali, Shashidharamurthy Taval, Vicky Mody

Research Day

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, remains a substantial global public health threat. Despite widespread vaccination efforts, reinfection rates are rising, necessitating a comprehensive examination of vaccine effectiveness against emerging variants. There is an immediate and pressing need to identify potential therapeutic interventions for combating resistant COVID-19 infections. Research has highlighted the significance of nonstructural proteins, including proteases and polymerases, in viral replication, making them attractive targets for drug development. Among these, the Papain-like protease (PLpro), 3-chymotrypsin-like protease (3CLpro), and RNA-dependent RNA polymerase (RdRp) enzymes play pivotal roles in SARS-CoV-2 replication and are promising candidates …

Promoting The Understanding Of Prerequisites, Training, Career Opportunities, And Practice Philosophy Of Osteopathic Physicians Amongst Students In The Southeastern U.S., Gabrielle I. Oquendo, Sharnikha Saravanan, Hersha Iyer, Joy Zarandy

Research Day

Introduction: Osteopathic medicine is one of the most rapidly growing healthcare professions. Over the past five years, there has been a comprehensive increase in the number of Doctors of Osteopathic Medicine (DO) physicians by 30%, constituting more than 11% of U.S. physicians. Over the past decade, the number of DO students expanded by 77%, representing more than 25% of U.S. medical students today. While future projections predict a continued exponential increase of DO physicians, the understanding of Osteopathic medicine within the general public remains inconsistent among various age ranges and U.S. geographic regions, and few studies have been conducted to …

Case Study Of A Horseshoe Kidney, Jillian Bailey, Jonathan Hughes, Aribah Ali, Tina Alkhazali, Adam Kanawati, Diana Peterson

Research Day

Introduction:

Case report of a horseshoe kidney found in a 62-year-old deceased male during routine cadaveric dissection at PCOM Georgia College of Osteopathic Medicine. Horseshoe kidneys occur in 1:500 individuals.

Methods:

Horseshoe kidney pathology was observed in the medical school gross anatomy laboratory during routine dissection. Specifics about the case were noted and photographed with permission from the donor and university.

Results:

While most horseshoe kidney cases are asymptomatic, no data is present to determine whether kidney symptoms were present in this specific case. The man died of a middle cerebral artery stroke that is unrelated to the kidney pathology. …

Cultural Responsiveness And Inclusion Tool For Health-Related Simulation, Beth F. Hallmark, Taryn Mccoy

Faculty Scholarship Symposium

The Cultural Responsiveness and Inclusion Evaluation Tool for Health-Related Simulation is a comprehensive instrument our team designed to evaluate effectiveness of culturally responsive teaching within simulation scenarios. This tool seeks to evaluate how the inclusion of diverse patient scenarios and culturally congruent information enhances the learner experience in health-related simulations. This tool was developed in conjunction with faculty from Bangalore Baptist Hospital Rebekah Ann Naylor Institute of Nursing, a leading nursing school in India and key partner of Belmont University. Through co-creation and co-development of this tool, we were able to create common definitions related to cultural congruence, psychological safety, …

Interprofessional Education Through Home Modification, Cathey P. Norton, Kelly R. Gore

Faculty Scholarship Symposium

Creating safe and accessible environments for all people, including physical, sensory, and cognitive disabilities is an important part of training students in occupational therapy, physical therapy, and interior design. Approximately 125 students from these disciplines worked together during a unique interprofessional experience, to perform everyday tasks with a simulated disability, then collaborated as interprofessional teams to make recommendations for home environment modifications to improve safety and accessibility for individuals with physical challenges. This was a unique opportunity for all the students to learn about other disciplines and the expertise that each brings to the table to help our clients.

Pausing For More: Help Your Students Avoid Burnout With 1 Classroom Presentation, Sara E. Wigal

Faculty Scholarship Symposium

Undergraduate students suffer under increasing stressors despite enhanced on-campus wellness offerings at many institutions. In this presentation, participants will learn that a replicable innovative 60-minute in-classroom intervention can help measurably increase student mindfulness and sense of classroom belonging, which in turn are proven burnout-avoidance mechanisms. Learn how students who are taught to practice mindfulness paired with productivity skills can better connect with faculty in the classroom for a healthier college experience conducive to learning.

Assessing Quality Of Health-Related Social Needs Screening Across Jefferson Hospital’S Clinical Sites, Aparna Sarin, Md, Mph, Olivia Quinn, Mph, Nolan Chiles, Bs

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Assess the rate of completed health-related social needs (HRSNs) screenings at different TJUH sites
• Compare screening outcomes across TJUH clinical sites

Background

- Centers for Medicare and Medicaid (CMS) is mandating Health Related Social Needs (HRSNs) screening for all admitted patients

- First-year Sidney Kimmel Medical College (SKMC) students screen patients at four different Jefferson clinical sites alongside Community Health Workers (CHWs) as part of their ‘Clinical Experience’ curriculum

- SKMC screens 7 domains

• Food*
• Housing*
• Utilities*
• Transportation*
• Medication expenses
• Primary care
• Insurance
  
  *Screened by CMS, as well as interpersonal safety

- The data is gathered from:

• inpatient floors …

Virtual Support For Bereaved Parents: Acceptability, Feasibility, And Preliminary Efficacy Of Hope Group, Emma Archer, Bs, Amelia Hayes, Mpg Ccls, Kristin Drouin, Lcsw, Elissa G. Millier, Md, Aimee Hildenbrand, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• Bereaved parents demonstrate increased risk for long-term psychological problems and poorer overall quality of life. Bereavement support programs can promote improved coping and are positively received by parents but remain underutilized.
• Virtual programs may help address barriers to accessing bereavement resources, such as families’ physical distance to the hospital and trauma reactions when exposed to a setting where the child received care.
• The objective of this quality improvement study is to examine caregivers’ bereavement experiences and perspectives on HOPE Group, a virtual group program for bereaved caregivers administered by the palliative care team at Nemours Children's Hospital, Delaware.