Medicine and Health Sciences Commons^™

Pre-Operative Clinical Variation By Health Insurance Carrier In 12,285 Male Surgical Patients With Moderate Morbid Obesity, Matthew E. Moore, Gus J. Slotman

Rowan-Virtua Research Day

In the ongoing obesity epidemic, every surgeon now treats patients with weight-related medical problems. In managing these medically fragile surgical patients, every clinical insight helps. While variation according to health insurance has been reported in mixed sex bariatric surgery populations, whether or not clinical characteristics in the subset of moderately obese male surgical patients vary by insurance carrier is unknown. The objective of this study was to identify clinical variation by insurance type in moderately obese men.

Results showed that pre-operative clinical characteristics of moderately obese male surgical patients vary by the health insurance coverage type to which they subscribe. …

Ethnic And Demographic Differences In Colectomy Rates And Timing For Ulcerative Colitis: 2007-2014, Daniel Bodek, Alana Persaud, Brian Blair, Ahlawat Sushil

Rowan-Virtua Research Day

Ulcerative Colitis (UC) is a chronic inflammatory disease of the bowel, with one third of patients requiring a colectomy for fulminant disease and tissue dysplasia. In 2007, infliximab was approved for induction and maintenance of remission in UC, with some evidence to suggest a potential reduction in colectomies. The aim of this study is to examine relative colectomy rates for UC among different ethnicities from 2007 to 2014 in order to evaluate for development of new trends or disparities.

Discrepancies in colectomy rates and timing are seen in our models which mirror closely findings in a prior study from 1999-2003 …

The Effects Of Antenatal Betamethasone On Late Preterm Infants, Jennifer Hummel, Abigail Prest, Xinhua Chen

Rowan-Virtua Research Day

Administration of steroids to mothers expected to deliver in the late preterm period has previously been found to decrease neonatal respiratory morbidity. In this retrospective chart review, there were no significant differences between groups in the primary outcome of required respiratory support for the neonate, incidence of periventricular hemorrhage or neonatal death. However, this study found that their rate of hyperbilirubinemia, need for phototherapy, and NICU stays were longer than their counterparts whose mothers did not receive steroids or who only received one dose.These findings may provide support for future protocols directed to improve neonatal morbidity secondary to jaundice.

Chronic Renal Failure, But Why? A Case Report., Palak Patel, Michael Rothberg

Rowan-Virtua Research Day

Renal failure, both acute and chronic, can present from many different etiologies and if diagnosed with diabetes mellitus, it is commonly assumed to be due to diabetic nephropathy. Monoclonal gammopathy of renal significance (MGRS) is a disorder that combines monoclonal gammopathy of undetermined significance with end stage renal disease. Monoclonal immunoglobulins are secreted by B or plasma cells leading to deposition in the kidney causing end organ damage. Several different subtypes fall under this category of renal diseases including, but not limited to, amyloidosis, C3 glomeruopathy, and light chain proximal tubulopathy, or better known as Fanconi syndrome1. Fanconi syndrome, which …

Something Has Fallen: Pelvic Organ Prolapse Or Vaginal Cuff Dehiscence And Evisceration? A Case Report., Alexandra Nutaitis, Laurie Kane

Rowan-Virtua Research Day

="/">Learning Objectives: 1) Recognize late presenting complications of hysterectomy. 2) Include vaginal cuff dehiscence with evisceration (VCDE) in the differential diagnosis of women suspected of having acute pelvic organ prolapse (POP).3) Appreciate the relative rarity of VCDE in younger women.
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/="/">Case Summary: A 36 year old G0P0 female presented to the ED with a chief complaint of sudden onset excruciating epigastric pain, followed by diarrhea and visible vaginal bulge. Pertinent past medical and surgical history includes breast cancer diagnosed 15 months prior, status post bilateral mastectomy, radiation, chemotherapy, and robotic-assisted prophylactic hysterectomy and BSO 6 months prior. …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

The Effect Of Omm On Opioid Users With Chronic Low Back Pain, Danielle Cooley, James Bailey, Deanna Janora, Catherine Fusco, Kishan Patel

Rowan-Virtua Research Day

In the United States, approximately 100 million adults are affected by chronic pain, which reduces their quality of life and productivity, while accounting for billions in health care costs and lost revenue. (1) Opioids are considered the gold standard in the pharmacological treatment for chronic pain conditions, and prescriptions for opiates/opioids increased by 400% from 1999 to 2010. (1,2) Although opioid treatment is warranted during postsurgical and active cancer pain, physicians still commonly overprescribe opioids, which has led to addiction, high deaths rates by overdose, and the spread of communicable diseases. (1)

Since chronic pain is sustained by noxious sensory …

A Case Of Atraumatic Posterior Thigh Compartment Syndrome, Nailah Mubin, Brian Katt

Rowan-Virtua Research Day

Compartment syndrome(CS) occurs when intra-compartmental pressures exceeds to a point where arterial, venous and lymphatic circulation of local tissues, muscles and nerves is compromised. CS is most common after a traumatic injury and usually occurs in the leg or forearm and less commonly in the thigh. Thigh compartment syndrome is rare due to its larger size and more compliant borders. We present a case of nontraumatic compartment syndrome in the posterior thigh associated with rhabdomyolysis and a sciatic nerve palsy which then required emergent fasciotomy. The patient's course was further complicated by acute renal failure due to the rhabdomyolysis and …

A Mathematical Investigation On Tumor-Immune Dynamics: The Impact Of Vaccines On The Immune Response, Jonathan Quinonez, Neethi Dasu, Mahboobi Qureshi

Rowan-Virtua Research Day

Mathematical models analyzing tumor-immune interactions provide a framework by which to address specific scenarios in regard to tumor-immune dynamics. Important aspects of tumor-immune surveillance to consider is the elimination of tumor cells from a host’s cell-mediated immunity as well as the implications of vaccines derived from synthetic antigen. In present studies, our mathematical model examined the role of synthetic antigen to the strength of the immune system. The constructed model takes into account accepted knowledge of immune function as well as prior work done by de Pillis et al. All equations describing tumor-immune growth, antigen presentation, immune response, and interaction …

A Rare Manifestation Of A Bleeding Tubulovillous Duodenal Polyp Presenting As An Upper Gastrointestinal Hemorrhage, Neethi Dasu, Yaser Khalid, Herman Suga, Michael Itidiare, Richard Walters

Rowan-Virtua Research Day

• Duodenal polyps are a group of polyps that are fairly uncommon to find on endoscopic evaluation (1).

• They are histologically classified according to mucin phenotype into intestinal and gastric subtypes; the intestinal-type polyps are morphologically subdivided into tubular and tubulovillous adenomas (2)

• We present a case of a 76-year-old male with recurrent hematemesis who was found to have an intestinal-type pedunculated tubulovillous adenoma (TVA) in the descending duodenum • An isolated occurrence of non-ampullary sporadic duodenal adenomas (SDA)’s are a rare finding and presentation as an upper GI hemorrhage is extremely uncommon (3)

• Furthermore, our patient’s …

What Are The Ods? A Case Of Osmotic Demyelination Syndrome Associated With Hemodialysis In End-Stage Renal Disease, Ellen Colleen Bradley, Yvette Wang

Rowan-Virtua Research Day

Osmotic demyelination syndrome (ODS) is the irreversible demyelination of the central pons, among other areas of the brain, that is most often associated with rapid correction of hyponatremia. Per contra, reversible ODS is a rare state that can be seen in patients with end-stage renal disease (ESRD) on hemodialysis (HD). This clinical case offers an alternative problem representation for acute altered mental status in a patient with ESRD on HD.

A Rare Case Of A Non- Functioning Pancreatic Neuroendocrine Tumor, Yaser Khalid, Neethi Dasu, Richard Gordon

Rowan-Virtua Research Day

Pancreatic neuroendocrine tumors (PNET) are very rare and represent about 1–2% of all pancreatic tumors. Non-functional PNET (NF-PNET) is incidentally discovered in most cases. Most NF-PNETs are found at an advanced stage because patients are mostly asymptomatic. We present a case of 32-yr-old female who initially presented with increasing abdominal girth, decreased mobility, and lower extremity swelling up to the hip and was found to have an advanced NF-PNET with metastatic disease to the pelvis and liver. There have been few studies directed toward early detection and management; Computed tomography (CT) is the imaging modality of choice as well as …

Physician Comfort And Competence In Treating The Lgbtq Population, Deborah White, Emma White

Rowan-Virtua Research Day

There are multiple studies showing that the LGBTQ population is a minority population with special healthcare considerations. Our underlying hypothesis was that OBGYN physicians feel they could provide better healthcare treatment to the LGBTQ population if they had more training. To gain more information, we sent asurvey to obstetrician/gynecologists asking questions about their own patient population, amount of training, and desire for further education regarding the LGBTQ community. We found that a majority of OBGYN physicians would use more information on the LGBTQ population if it were available to them. This information could be used in planning future continuing medical …

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz

Rowan-Virtua Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …

Maternal Morbidity Outcomes In Idiopathic Moyamoya Syndrome In New York State, Hajere J. Gatollari, Amelia K. Boehme, E. Sander Connolly, Alexander M. Friedman, Mitchell S.V. Elkind, Joshua Z. Willey, Eliza C. Miller

Rowan-Virtua Research Day

Background: Pregnancy is associated with an increased risk of stroke in young women. Idiopathic moyamoya syndrome (IMMS) is a rare condition characterized by progressive narrowing of large cerebral arteries resulting in flimsy collaterals prone to rupture or thrombosis. Data are limited on pregnancy outcomes in women with IMMS. We hypothesized that IMMS would be associated with increased pregnancy morbidity, including stroke.

Conclusion: Pregnancies within 1 year prior or any time after IMMS diagnosis did not have increased maternal morbidity compared to unexposed pregnancies after adjusting for age and clustering of women with multiple pregnancies. Prospective studies are needed to better …

The United States' Relationship With The Insanity Defense Before And After United States V. Hinckley, Natalie R. Peterman

Young Historians Conference

The United States legal system has had a fluctuating relationship with the insanity defense for decades, and the trial of United States v. Hinckley was a critical milestone for this development. Before John Hinckley, Jr. attempted to assassinate President Ronald Reagan in 1981 and the jury of his trial found him not guilty, American society generally supported the insanity defense, but both the public and the government were outraged after Hinckley’s verdict. This outrage and the subsequent political backlash against the insanity defense were motivated by progress in the area of mental illness treatment in the United States. In the …

Unplugged, Krisha Patel '21, Jonathan Gao '21, Jason Li '21

Student Leadership Exchange (SLX)

Technology has infiltrated every aspect of our lives. Regardless of financial conditions, most people have a cellphone in their hands at all times—usually a smartphone. TVs are installed in almost every single room in the typical American household and very often powered up with a marathon of a favorite show, playing episode after episode without pause. Kids become obsessed with the latest video game consoles and games, paying exorbitant amounts to be the first of their friends to get their hands on them. Even many parents compulsively check and post updates to a variety of social media sites throughout the …

Mental Health And Drug Use At Imsa, Megan Ptak '21, Melena Braggs '21, Emma Darbro '21, Brooke Bolsinger '21

Student Leadership Exchange (SLX)

Within our campus, there is an evident problem relating to drug use and to underlying mental health issues among students. It is known that the students at IMSA use drugs and alcohol as a coping mechanism for their mental health issues; however, this issue is not discussed on our campus. While many measures have been put into action on campus to prevent drug use, there has been no action to solve the root of the problem, mental health issues. This leads to a continuous problem of drug use within our student body and has a lasting effect on the mental …

The Teen Vaping Crisis, Jayavignesh Ganesan '21, Cynthia Mu '21, Carolina Seoane '21

Student Leadership Exchange (SLX)

In today’s society, many teens have the idea that is is cool to vape. This has led to an exponential increase in the number of teenagers addicted to nicotine. This increase is directly caused by nicotine companies, specifically vape companies, presenting their products with appealing and misleading packaging. Indeed, nicotine packages are required to have a warning. However, the warning is usually not taken into consideration, as the warning is not eye-catching. Because of this, we propose that all products containing nicotine, including e-cigarettes, must follow plain packaging regulations. Under plain packaging regulations, companies would be required to have the …

Depiction And Function Of Madness In Elizabethan And Jacobean Literature, Yeiji Seo

Young Historians Conference

Since the ancient times of Israel, Greece, and Rome, people with mental illnesses have been regarded as different from others in society. This paper aims to analyze the motives of authors of medical and dramatic texts of Elizabethan and Jacobean literature in regards to mental illness by specifically observing William Shakespeare’s King Lear and Robert Burton’s The Anatomy of Melancholy. This paper also considers the views of other scholars of the field to compose a complete insight on Shakespeare and Burton’s goals in depicting mental illness and finally advocates further research and understanding to positively contribute towards disability reform today.

“Unprecedented Times”: The Impact Of Funding Structure On Grant Projects Through The Violence Against Women Act, Amanda Guiliano

GW Research Days 2016 - 2020

Millions of dollars in grants are awarded annually through the Violence Against Women Act (VAWA). This study examined the impact of the funding structure on program implementation, both for current program periods and over time. A dual-methods survey was sent to recipients of 2018 grants for three programs to identify any modifications made to the planned programs due the project period length and potentially unreliable funding. Anticipated results are that grant recipients with the shortest project periods will be more likely to have made program modifications due to project length, and organizations that have received VAWA grants over multiple years …

Intersex Wildlife As Sentinels For Human Health And Endocrine Disruption Near Superfund Sites: A Systematic Review, Olivia Anderson, Melissa Perry

GW Research Days 2016 - 2020

Fish and wildlife are often used as sentinels for human health. This systematic review examines one aspect of wildlife health, intersex (both ovarian and testicular tissue) animals and their prevalence or severity near Superfund sites (EPA designated toxic waste sites). The body of evidence demonstrates some evidence of this indicator and more research is needed, specifically a meta-analysis that is outside the scope of this study.

Low-Calorie Sweetened Beverage Consumption Does Not Reduce Total Energy Or Sugar Intake Among Children, Talia E. Zimmerman, Allison Sylvetsky Meni, Janet Figeuroa, Susan E. Swithers, Jean A. Welsh

GW Research Days 2016 - 2020

Beverages containing low-calories sweeteners (LCSB) are used as alternatives to sugar-sweetened beverages (SSBs), yet their effects on the overall diet and effectiveness for weight management are unclear. The objective of this analysis was to examine energy and macronutrient intake among children who report LCSB and SSB consumption. The findings of this analysis challenge the utility of LCSB consumption as a strategy for weight management in children.

Factors Related To Icu Admissions Of Childhood Cancer Patients In Tertiary Preferred Hospital In The Private Sector Of India, Harleen Marwah, Ramandeep Arora

GW Research Days 2016 - 2020

This study was performed to assess the predictive factors of Intensive Care Units (ICU) admission in newly diagnosed pediatric oncologic patients and in patients under ongoing oncologic treatment. Methods used to explore the research question included a retrospective analysis of children admitted to the ICU of the MAX Saket Superspecialty Hospital between March 1, 2013 and May 2018 in order to identify those patients with an oncologic condition who were admitted to an ICU. This subgroup was further evaluated for factors associated to ICU admissions, including: diagnosis, risk factors, complications leading to Pediatric ICU (PICU) admission, PICU therapy, and mortality …

Intimate Partner Violence Curriculum At Gw, Brynne Ichiuji, Jim Blatt

GW Research Days 2016 - 2020

Domestic violence is identified as a global epidemic, where 1 in 3 women throughout the world will experience physical and/or sexual violence (WHO 2013). Medical education research around the world has included DV curriculum studies to determine how to most effectively train medical students to understand, screen, and manage DV (Wathen et al. 2009)(Daniel and Milligan 2013)(Ogunsiji and Clisdell 2017). However, the published studies target varying healthcare specialities, trainee age groups, and study design, thus rendering comparison of specific curriculum inclusions statistically unattainable. Instead, this literature review identified common themes in the conclusions drawn from various studies to isolate reasonable, …

Survey Of Medical Student Perceptions And Preparedness On The Study Of Medical Cannabis During Medical School, Abraham Benavides, Mikhail Kogan, Nicholas Gregorio, Puneet Gupta

GW Research Days 2016 - 2020

Introduction: Professional education on medical cannabis lags behind growing public interest and increasing legal availability of medical and recreational cannabis; most US adults now have access to some form of legalized cannabis. The Cannabis as Medicine Interest Group (CANMIG) at GW SMHS believes that future physicians should be adequately prepared to handle patients’ questions about cannabis as it relates to their health and well-being. This study investigated the extent to which medical students wish to learn about medical cannabis and assessed their subjective preparedness to counsel patients on this topic.

Methods: One-hundred and five allopathic medical students completed an online …

Glygen: Computational And Informatics Resources And Tools For Glycosciences Research, Jeet Vora, Raja Mazumder

GW Research Days 2016 - 2020

Although ongoing technical advances are accelerating the pace and sophistication of data acquisition in glycoscience, the transformation of these data to glycobiology knowledge, insight, and understanding is slowed by the limited number of tools that facilitate their integration with biological knowledge. Thus, to fill in the critical gaps, there is a need for a broadly relevant and sustainable glycoinformatics resource that can provide tools and data to address specific glycoscience questions. GlyGen is an integrated, extendable and cross-disciplinary glycoinformatics resource that will facilitate knowledge discovery in basic and translational glycobiology by integrating multidisciplinary data and knowledge from diverse resources. It …

Florida Red Tide Exposure: Analyzing The Respiratory Effects Experienced By The Gulf Coast Population, Katrina Zdanowicz, Cindy Liu

GW Research Days 2016 - 2020

Background: Florida red tide occurs in the Gulf of Mexico annually and has been linked to complaints of negative respiratory symptoms. Little is known about the exact association and long term effects of the exposure. Objectives: We applied the Navigation Guide to conduct a systematic review of the existing body of literature on Florida red tide exposure and respiratory effects. Methods: We applied inclusion criteria to studies found through searches of 5 scientific databases. Included studies were analyzed for risk of bias and overall strength and quality of evidence. Included studies provided self-reported symptoms and quantitative measurements of pulmonary function …

Lightning Talk: Can This Be Redacted? Developing An Institutional Repository And Addressing Privacy Issues, Pamela Pierce

Digital Initiatives Symposium

“Can This Be Redacted? Developing an Institutional Repository and Addressing Privacy Issues” will explore privacy issues in terms of patient health information that have emerged as Oregon Health & Science University expands their institutional repository beyond theses and dissertations. The lighting talk presentation will focus specifically on student projects from the physician assistant program, School of Nursing, and the Northwest Native American Center, a center specifically focused on the health care needs of Native Americans in the U.S. The impact of a migration out of Bepress and into Samvera will also be discussed.

Forecasting Model For Disease Propensity Using Ehr Data, Soodabeh Sarafrazi, Omar Sharif, Matthew Domingo, Jie Han, Michael Chang, Omid Khazaie, Anil Kemisetti

Creative Activity and Research Day - CARD

Many diseases such as diabetes and cardiovascular diseases are actionable, i.e. they are preventable by early intervention. One to two years of early warning would represent a huge advance in dealing with these conditions and could help prevent further complications such as heart disease, stroke, kidney failure, blindness, and amputation. In this project, we are developing an extensible condition forecasting model to assess the risk of diabetes and heart problems in patients in advance. Using TensorFlow, Elastic MapReduce (EMR), and AWS Sagemaker, we are training a Wide and Deep Neural Network on a dataset of more than 170 million electronic …