Medicine and Health Sciences Commons^™

Covid Smell Tracker: A Research-Based Mobile Application To Study Smell Loss In Subjects With Covid-19, John Pueringer, Matthew Brennan, Tory Mcknight, Mindy Rabinowitz, Elina Toskala, Gurston Nyquist, Marc Rosen, Aykut Unsal

Research Day

Introduction: Up to 60% of people infected with SARS-CoV-2 report anosmia or ageusia during their disease course. “COVID Smell Tracker” is a smart phone application (app) developed to elucidate the onset, duration and extent of anosmia and ageusia through questionnaires.

Methods: “COVID Smell Tracker” is publicly available on smart phone devices (www.covidsmelltracker.org). Users complete surveys around demographics, medical history, COVID status and symptomology. Deidentified responses were collated and analyzed using descriptive statistics.

Results: Of the 266 users included, the majority were located in Europe (43%) and North America (33%). Male, Caucasian users were most common (54.9% and 61.7% respectively), followed …

A Short Story - The Effect Of Innovo® Shorts On Pelvic Floor Function, Ruth Maher

Research Day

The silent epidemic of urinary incontinence (UI) is described by the World Health Organization (WHO) as one of the last medical taboos and it interferes with the lives of millions of women. Only 25% of those with UI seek care, and of those, less than half receive treatment. The most common type of UI is stress urinary incontinence (SUI) which affects approximately 40% of community-dwelling women. The International Continence Society defines SUI as the complaint of involuntary leakage of urine on effort or exertion or with sneezing or coughing. This occurs in response to sudden increases in intra-abdominal pressure (IAP) …

Clinical Relevance Of Quantifying Pelvic Lymph Nodes For Predicting And Treating Genital Lymphedema, Shelley Dicecco

Research Day

Anatomical research on the pelvic lymph nodes (LN) is inadequate. According to previous research there are between 41-154 LNs in the pelvic region (Inguinals-Lumbar) based on reported mean values across several studies. This range should be considered too large for a surgeon to decide how many LN to remove for diagnosing cancer without causing unnecessary harm or for a lymphedema therapist to explain expectations of involvement or improvement to a person with lymphedema. A more precise understanding of numbers and LN removed can help guide a therapist’s treatment with genital lymphedema. Muscles can assist in pumping fluid from an involved …

Virtually Building A Community Of Experts In The Medication-Assisted Treatment (Mat) Of Opioid Use Using The Project Echo Model, Matthew Momjian, Justin Canakis, Faraz Yousefian, Hayden Pond, Adrienne White, Gregory Mayer, Alison Essary

Research Day

Purpose: Project Extension for Community Healthcare Outcomes (ECHO) utilizes telemedicine to connect a multidisciplinary team of experts with a network of primary care physicians to enable rapid dissemination of evidence-based guidelines and practices at scale. In this study, the Project ECHO model disseminated the Arizona Pain and Addiction Curriculum to providers in rural Arizona with the goal to educate providers on MAT.

Methods: Participants engaged in biweekly, virtual teleECHO sessions and post-session surveys were used to collect data on provider satisfaction, self-efficacy, knowledge, barriers to change and changes in practice behavior. Results: Between February 2020 – November 2020, the MAT-ECHO …

Measuring The Effect Of A Resuscitation Academy On Out Of Hospital Cardiac Arrest Resuscitation Rates, Matthew Momjian, Jeffrey Kalczynski, Patrick Lombardi, Justin Canakis, Anna Mereminskaya, Thomas Depietro, Josh Baron

Research Day

According to the American Heart Association (AHA), rates of successful resuscitation after out of hospital cardiac arrest (OHCA) vary across the country. Amongst 132 counties in the United States, the rates of CPR survival to hospital discharge ranges between 3.4%-22.0%, and the rates of CPR survival with functional recovery ranges from 0.8%-20.1%. This large degree of variability between regions has been improved through programs that educate Emergency Medical Service (EMS) departments on ways to improve outcomes through an evidence-based lens. The Medic One EMS department in Seattle and King County, Washington developed a resuscitation academy (RA) that improved cardiac arrest …

Analgesic Effect Of Delta-9-Tetrahydrocannabinol On Patients With Chronic Neuropathic Pain During A Four-Week Period: A Pilot Study, Frederick J. Goldstein, Katherine E. Galluzzi, Madeline Brown, Jennifer Smith, Joseph Lubeck

Research Day

Statement of Purpose, Innovation or Hypothesis: The current US Food & Drug Administration (FDA) approved armamentarium for treatment of neuropathic pain (NP) includes calcium channel alpha-2-delta ligands (gabapentin, pregabalin) and a selective serotonin-norepinephrine re-uptake inhibitor (duloxetine); however, tricyclic antidepressants (amitriptyline) and antiepileptic agents (carbamazepine) have also been employed. Most have limited effectiveness and/or cause intolerable adverse reactions, leading to discontinuation. Neuropathic pain patients have also been treated with opioid analgesics, which have their own attendant risks (e.g., addiction, hyperalgesia, endocrinopathy) and limited efficacy. Delta-9-Tetrahydrocannabinol (THC) (dronabinol), C-III, is FDA-approved as an appetite stimulant and antiemetic. Doses ranging from 2.5 mg/day …

Anasam: A Novel Approach To Suds Anamnesis For Medical Students, Mirna Law, Sarah Glisan, Devon Player, Adrienne Fraczkowski, Kaitlyn Blair, Bettina Bernstein

Research Day

Training in substance use disorders and their treatment is important for medical students to develop positive attitudes towards patients struggling with substance abuse. There is substantial evidence demonstrating that physicians in practice fail to recognize a large percentage of patients suffering from substance abuse conditions. Historically, a “negative attitude” of health care providers towards patients struggling with substance abuse may have originated from the lack of recognition of these issues as chronic medical conditions during training. Thus, substance abuse education early in medical training is impactful and should be considered. The proposed curriculum consists of four sessions and aims to …

Problem-Solving Teletherapy For Adults With Visual Impairment: A Feasibility Study To Improve Access And Treatment, Marissa Ferrito, Bradley Michael Rosenfield, Stephanie Ferretti, Michael B. Roberts

Research Day

Introduction: Adults with visual impairment are at increased risk of developing depression and experiencing a decreased quality of life, as compared to vision intact adults. However, there are many barriers to accessing health problems for this population.

Purpose: The purpose of the study is to explore the impact of a virtual group-based intervention utilizing strategies from motivational interviewing and cognitive-behavioral problem-solving therapy to improve attendance and treatment outcome for adults with visual impairment. Specifically, the study will focus on improving previously demonstrated low rates of attendance, as well as improving depression, quality of life, problem-solving skills; and reducing cognitive distortions. …

Rapid Return To Normal Activities At A Residential Summer Camp During Covid-19 Pandemic, Anna Klunk, Rachel Holloway, Arash Babaoff, Eric Jelin

Research Day

Aim: Infection prevention and control (IPC) within residential settings is a central focus of the coronavirus disease 2019 (COVID-19) pandemic. Youth residential summer camps are an excellent model for such environments and have thus far had mixed results. The aim of this report is to describe the successful implementation of a seven-week overnight summer camp with rapid return to normal activities from June to August 2020

Subjects and Methods: This retrospective study includes 427 individuals who traveled from 24 US States. All staff and campers were tested by serial nasopharyngeal PCR tests in the context of strict infection prevention and …

A Case Study Of The Anomalous Extensor Digitorum Brevis Manus, Herve Peacemaker Ineza, Darshan Patel, Jeanine Garcia, Macy Rowan, Leslie Pryor Mcintosh

Research Day

During routine forearm dissection of 12 cadavers, which originated from the PCOM Georgia Body Donor Program, at PCOM South Georgia, an aberrant muscle was discovered on the dorsal surface of the hand of a 72-year-old Caucasian male. The muscle, known as the Extensor Digitorum Brevis Manus (EDBM), was located bilaterally and deep to the tendons of the Extensor Digitorum. On assessment, the left hand of the donor had two EDBM tendons that intersected and attached to the proximal phalanx of the third digit. The right-hand tendons ran parallel and inserted onto the third digit of the proximal phalanx. An investigation …

Pericardial Effusion "Worm-Like Strands" On Transthoracic Echocardiogram, Annamarie Pontier, Andrew Rose Md, Meredith Mcnelis Pa-C

Research Day

Background: Fibrinous Pericardial Effusion is the accumulation of excess fluid in the pericardial fibroelastic sac. It can be a symptom of any pathological process that affects the pericardium from acute pericarditis to systemic disorders. This broad differential poses a diagnostic challenge in the setting of acute fluid accumulation.

Case Presentation: A 50-year-old male with a past medical history of extensive intravenous drug use complicated by bacteremia and left ankle abscess formation presented to the Emergency Department complaining of mild-moderate chest pain for four days. Within the last month, he presented to the Emergency Department three times for similar symptoms; however, …

The Impact Of Covid-19 On Teledermatology, Cassandra Yeboah, Nailah Harvey, Rohan Krishnan, Jules B. Lipoff

Research Day

The accelerated implementation and use of teledermatology during COVID-19 has been met with successes and challenges. This review explores first, how telemedicine was utilized in dermatology prior to the pandemic, the regulatory adaptions made in response to the pandemic and the effectiveness of the rapid implementation of teledermatology during COVID-19, and finally, how teledermatology has expanded in response to the pandemic. In sum, this review examines lessons learned, how teledermatology’s reliance on digital technologies might paradoxically exacerbate healthcare disparities, and considers the future outlook. Prior to COVID-19, teledermatology was limited due to decreased insurance reimbursement for telemedicine visits, concern about …

Designing For Disability: Making Activities Of Daily Living More Manageable Through 3d Printing, Mashaal Syed, Anne Egan, Denah Appelt

Research Day

Introduction: While there have been many innovations developed for those with physical disabilities in recent years, a multitude of unmet needs still remain. With the advent of new and affordable technologies such as 3D printing, it is now more possible than ever before to bring one’s ideas to life; from creating customized prosthetics to wheelchair attachments for water bottles and umbrellas, we are able to quickly realize potentials otherwise unlikely - and in turn, we have the capacity to make the activities of daily living more manageable for those with physical disabilities.

Objectives: By personally hearing from individuals with physical …

It's All Fun And Games Until Someone Gets Hurt: An Analysis Of Trampoline Injuries In The Pennsylvania Trauma System, Megan Sullivan, Madison Morgan, Lindsey Perea, Frederick Rogers, Eric Bradburn

Research Day

Introduction: It is well known that trampolines can be a particular source of danger, especially in children. We sought to examine the profile of those patients with trampoline injuries. We hypothesized there would be certain injury patterns predicative of trampoline injuries.

Methods: All patients submitted to Pennsylvania Trauma Outcome Study (PTOS) database from 2016-2018 were analyzed. Trampoline injury was determined by ICD10 activity code. Injury patterns in the form of abbreviated injury scale (AIS) body regions were examined in the trampoline injured patients. Patient demographics and clinical variables were compared between those with trampoline injury versus those without.

Results: There …

Direct Oral Anticoagulants And Prosthetic Heart Valves: A Systematic Review Of Case Reports, Tyler Richie, Steven Carter, Jiehyun Lee

Research Day

Background: Direct oral anticoagulants (DOACs) are indicated to treat and prevent venous thromboembolism and to prevent stroke or systemic embolism in patients with non-valvular atrial fibrillation. The introduction of DOACs has provided an alternative to warfarin for patients in need of oral anticoagulation. It is, however, unclear whether DOACs are safe and effective in patients with heart valve replacement. The RE-ALIGN trial published in 2013 did not support the use of dabigatran in patients with mechanical valve replacements; however, there are ongoing studies, such as the PROACT Xa trial and the ATLANTIS trial, investigating the use of other DOACs in …

The Mind-Body Connection: Exploring The Defining Characteristics Of Two Aging Phenotypes, Kiyana Harris, Xue-Lian Sun, Mei-Ling Ge, Qian-Li Xue

Research Day

Introduction: Built on the theory of mind-body connection, there has been a growing interest in phenotypes combining physical frailty and cognitive decline. Two examples are motoric cognitive risk syndrome (MCR) and cognitive frailty (CF). MCR, defined by co-presentation of slow gait and subjective cognitive complaint without dementia or mobility disability, is considered a “pre-dementia syndrome.” CF, defined as having both physical frailty and cognitive impairment in the absence of dementia, is posited to be caused by physical frailty. Although both MCR and CF have been associated with dementia risk, the relationship between the two is unknown. We aimed to (1) …

The Benefits Of Peer-Lead Mock Focused Exam Workshops, Aarushi Kalra, Steve E. Carter, Andrew J. Manhan, Fahad Marmarchi, John Lee, Ali Moradi

Research Day

Context: Mock examinations are commonplace in many academic settings and are offered as a study aid to students with the hope of lowering stress levels and increasing their preparedness for the actual exam. In contrast, mock exams are rarely offered by faculty in clinical training due to their expense and administrative burden (1). Students taking objective structured clinical examinations, (OSCEs), have been proven to benefit from participating in mock exams (2). However, this is something that has not been explored in the context of the Focused Exam Workshop (FEW). While OSCEs focus solely on biomechanical skills, the FEW allows students …

The Sebaceous Gland - Friend Or Foe?, Gelan Shamloul, Frederick Lombard, Marina D'Angelo, Amor Khachemoune

Research Day

Introduction: Sebaceous glands are sebum-secreting components of pilosebaceous units, that play a key role in eccrine emulsification, the impermeability of skin and hair, cytokine, chemokine, interleukin, pheromone, and fatty acid synthesis, acid mantle formation, and hormone production. Although the sebaceous gland has been heavily investigated, many advances in the physiology and pathology of the sebaceous gland have since been identified.

Objective: The primary objective of this publication was to perform an updated literature review of the embryology, evolution, structure and function, and pathophysiological disorders associated with the sebaceous gland.

Methods: We performed a literature search using PubMed database with keywords …

Development Of Humanized Mouse Model For Organ Transplantation, Daniel D. Horuzsko, Ashwin Ajith, Laura Mulloy, A. Musa, Valia Bravo-Egana, Imran Gani, Anatolij Horuzsko

Research Day

Purpose of Study: Solid organ transplantation has been a life-saving procedure for thousands of patients worldwide. Recent advances on improving donor-screening diagnostics have aimed at identification of the most compatible donor for the transplant recipient to maximize allograft survival. Current standards of donor selection relies on HLA typing and in vitro mixed lymphocyte reaction (MLR) which do not take into account the in vivo environment and recipient’s adaptive immune response. Humanized mouse models are an appealing alternative that permits personalized investigation of the immunocompatibility of potential donor tissues for the recipient human immune system without putting patients at risk. By …

Strabismus Decompensation As A Possible Neurological Manifestation Of Covid-19: A Case Report, Tyler Stevens

Research Day

A 27-year-old female presents to the emergency room with acute onset horizontal binocular diplopia and a history of COVID-19 infection two weeks prior. She has a history of longstanding intermittent right esotropia. Before her COVID-19 infection she only had diplopia after extended reading and typically sees clearly. After the infection, she has constant double vision which started acutely and worsened over several hours. Her only other symptom at the time was increased fatigue. During examination of eye tracking, there was a left esotropia when looking left and a right esotropia when looking right. She was discharged with a Medrol Dosepak …

Bridging The Gap: The Lived Experience Of Women With Diastasis Recti Abdominis, Jennifer Wiley, Ruth Maher

Research Day

Research on Diastasis recti abdominis (DRA) has primarily focused on diagnostic tools, surgical and conservative treatments. Despite the association of significant physical symptoms and impact on quality of life, evidence is absent regarding knowledge or education provided to women about this condition.

Purpose: This study explored the lived experience of women who either self-identified or were medically diagnosed with DRA. A deeper insight into the experience of women with DRA may serve to enhance the patient-provider interaction during this critical time.

Methods: Qualitative methodology with a basic interpretive approach and purposive sampling was used. Participants shared their experiences through a …

Utilization, Utility, And Variability In Usage Of Adjunctive Hyperbaric Oxygen Therapy In Spinal Management: A Review Of The Literature, Kurt Knepley, Jennifer Mao, Patrick Laird, Nicholas Imperato, Asham Khan, Justice Agyei, Tim O'Conner, John Pollina, Jeffrey Mullin

Research Day

The objective of this review was to understand the clinical utilization, utility, and variability in the usage of adjunctive hyperbaric oxygen therapy (HBOT). Surgical site infection is associated with high morbidity and mortality, increased health care expenditure, and decreased quality of life. With the increasing prevalence of adult spinal deformity and spinal fusion surgery, it is imperative to understand the potential benefits of adjunctive treatments. HBOT is a safe and common procedure indicated to treat various medical conditions. We conducted a literature search across 3 databases for English articles published between December 1, 2019 and December 1, 2000. Thirteen studies …

Conus Medullaris Termination In Adult Females, Vishwant Tatagari, Elizabeth Brehman, Jacob Newman, Deonnie Huang, Kerin M. Claeson

Research Day

Objective: The primary objective of this study was to determine the termination level of the spinal cord in a sample population of adult female cadavers.

Introduction: The conus medullaris represents the tapered, distal-most end of the spinal cord. It tends to be found somewhere between the L1-L2 lumbar vertebrae and can sometimes be higher or lower. Studies report the conus medullaris can be found anywhere from the lower third of T11 to the upper third of L3 with the average termination point around the lower third of L1. We aim to describe the level of conus medullaris termination in a …

Bleeding After Endoscopic Peg-Tube Removal On Patient Taking Clopidogrel, Sahil Patel, Michael Steinbook

Research Day

A 64-year-old man who is taking Clopidogrel was getting his PEG-tube removed endoscopically. Post-procedure, he started profusely coughing up blood clots. As a result, a repeat esophagogastroduodenoscopy had to be performed and revealed no blood in the esophagus or stomach. Upon further evaluation, the source of his blood clots was an ongoing episode of epistaxis which started following his COVID-19 test via nasopharyngeal swab three days prior. With the increasing need for COVID-19 testing, screening for epistaxis prior to performing out-patient procedures can help differentiate epistaxis from other procedurally-related complications

Often Overlooked Risk Factors Of Suicide In The Transgender Population: A Case Report And Review, Tarik Zeid, Jeremy Castro

Research Day

Transgender people have a gender identity or gender expression that differs from the sex that they were assigned at birth. Of note, the transgender population has been starting to get more attention from the psychiatric community due to the unique circumstances that transgender people have. Personal challenges can include dynamics of family rejection, bigotry, internalized transphobia, being denied proper bathroom assignments and housing access, among many others. This case illustrates the importance of recognizing that the transgender population has particular suicide risk factors that often go overlooked. Though there are many personal challenges and risk factors that may contribute to …

Psychological Impact Of Covid-19 On Individuals With Prior Trauma, Marzena Podkalicka, Susan Panichelli Mindel

Research Day

The new coronavirus disease (COVID-19) was first recognized in December 2019 in Wuhan, Hubei Province, China. The World Health Organization Emergency Committee declared the COVID-19 outbreak to be a global health emergency and a pandemic in early 2020. Due to the lack of unequivocally effective methods of treatment for the coronavirus disease, governments enforced nonpharmacological interventions to decrease the transmission of the coronavirus including social distancing, isolation, and shelter in place to stop the spread of COVID-19. The scale of the pandemic, the speed of the spread, and high mortality rate created a sense of panic, stress, and helplessness among …

Assessment Of Patient And Employee Mental Health During Covid-19, Lanerica Rogers, Tammy Phillips, Aerial Petty, Gabriana Freire, Carline Denis-Barnes

Research Day

Background: Many individuals in the United States have anecdotally reported a decline in their mental health due to worry and stress over the COVID-19 pandemic. Although much research has been dedicated to populations across the country, patients and employees at community health centers have been overlooked in terms of the effect of pandemic conditions on their mental health. The present study seeks to understand how the mental health of these populations has been impacted and offer recommendations for what can be done to address any unmet mental health needs.

Methods: Survey responses were compiled from patients and employees of the …

The Association Between Trauma History And Body Image, Depression, Posttraumatic Stress, And Relationship Satisfaction In Postpartum Women, Kristen Hawk-Purcell, Michelle R. Lent

Research Day

The postpartum period can be a time of significant change and transition. Little is known regarding how a history of trauma may impact functioning during this critical time. The literature is consistent regarding the relationship between trauma and body image-related issues, but this has not been investigated with this population. While posttraumatic stress symptoms are considered a significant public health concern, the association between depression and interpersonal concerns has not been thoroughly explored. The purpose of this observational, cross-sectional study is to explore the relationship between trauma and body image, mood, and relationship satisfaction in postpartum women.

Proposed Methods: English …

Soft Tissue Chondroma Of The Thumb, Harsha Upadhya, Darshdeep Singh

Research Day

A chondroma is a slow-growing, benign cartilaginous tumor. When a chondroma occurs in soft tissue without any involvement of the surrounding bone, it is known as a soft tissue chondroma which is an especially rare type of malignancy that has a predilection for the hands and feet. A soft tissue chondroma originates from either the synovial sheath of long tendons, para-articular tissues, or paratendinous soft tissues. This type of tumor can often be misdiagnosed as several different pathologies, including but not limited to, a ganglion cyst, osteochondroma, synovial chondromatosis, or even malignant examples such as a chondrosarcoma or synovial sarcoma. …

Anatomical Investigation Following Incidental Horseshoe Kidney Finding, Alexandra Cain, Brannan De Voto Noonan, Sara Eliseo, Anthony Sciuva, Leslie Pryor Mcintosh

Research Day

Horseshoe kidneys are congenital anomalies that result from the fusion of the right and left kidneys across the midline of the abdomen after both kidneys failed to ascend during fetal development. During a standard educational dissection of 12 donor bodies from the Body Donor Program at PCOM Georgia, a horseshoe kidney was discovered in an 88-year-old female with a reported fatality related to left lung carcinoma, encephalopathy, and hypercalcemia. The circumstances of this discovery presents an opportunity to explore the anatomical arrangement of the congenital malformation in detail. Anatomical dissection and analysis of the neurovascular and renal organization was documented …