Medicine and Health Sciences Commons^™

Radiated Immediate Prepectoral Direct To Implant Reconstruction: A Retrospective Cohort Study, Kinan Sawar, Tala Al-Saghir, Jamie Hall, Michael Diffley, Madeleine Gonte, Donna Tepper, Vigen Darian, Maristella Evangelista, Amy Tang, Dunya Atisha

Medical Student Research Symposium

Purpose: Increasing use of prepectoral plane in post mastectomy implant-based reconstruction has made immediate direct to implant (DTI) reconstruction more achievable. There has been increased incidence of post mastectomy radiation therapy (PMRT) making it important to understand the complication profile of immediate DTI reconstruction in patients who may require adjuvant radiation therapy.

Methods: A retrospective cohort study of consecutive patients undergoing prepectoral DTI reconstruction with and without PMRT was performed. Patient and treatment level factors, operative, and post-operative outcomes were extracted on both the patient and breast level for the prepectoral radiated and nonradiated patients. The presence of at least …

The Effect Of Anesthetic Drugs During Craniotomy On Patient Outcomes, Thomas Vander Woude, Timothy Nold, Katherine Nowak, Donald Penning

Medical Student Research Symposium

Glioblastoma remains an aggressive, highly malignant brain cancer with poor prognosis despite treatment options including surgery, radiotherapy, and chemotherapy. The objective of this retrospective chart review study was to evaluate if there is a correlation between the type and dose of anesthetic drugs administered during craniotomy surgery for glioblastoma and the time to first postoperative tumor progression and mortality. Based on preliminary data in mice, it was hypothesized that the use of propofol during surgery is associated with slower tumor progression and lower mortality, when compared with other anesthetic drugs. In the observed time frame, 133 patients were diagnosed with …

Evaluating The Role Of Lvi As An Indicator For Adverse Outcomes In Patients With Upper Tract Urothelial Carcinoma And Its Histological Subtypes, Ivan Rakic, Matthew Davis, Nicholas Corsi, Alexander Stephens, Chase Morrison, Sohrab Arora, Taylor Malchow, Akshay Sood, Craig Rogers, Firas Abdollah

Medical Student Research Symposium

Lymphvascular invasion (LVI) is recognized as an adverse prognostic factor in many cancers. Our aim is to assess the prognostic ability of LVI in UTUC urothelial carcinoma (UC) and micropapillary urothelial carcinoma (MPUC) subtypes as a predictor of overall survival (OS) using a large North American cohort.

Our cohort included 9750 cM0 UTUC patients who underwent a radical nephroureterectomy (RNU), between 2004 and 2015, within the National Cancer Database (NCDB). The main variable of interest was LVI status, and its interaction with pathological nodal (pN) status. Kaplan-Meier curves were used to estimate the OS. Cox regression analysis tested the impact …

Is Old Really Gold? Examining The Effect Of Playing Experience In Preventing Professional Athletes’ Injuries, Gautham Pavar, Abdullah Sahyouni, Robert De La Torre, Kinan Sawar, Yasmeen Alcodray, Justin Bennie, Nicole Xu, Harika Bollineni, Bohdan Matsko

Medical Student Research Symposium

Introduction: The literature contains research showing that age increases the risk of injury in individuals who live sedentary lives. Looking at injury rates in individuals who are active for a living can better inform the importance of exercise training regimens in an aging population

Methods: Combing player injury data from thet NFL and player statistics from pro-football-reference.com, we will create a dataset containing variables like seasons played in the NFL and age of player at time of injury. We will include all uninjured players in our dataset for comparison. We will use ANOVA to figure out how much these variables …

Do Lower Extremity Injuries Of Nfl Players Affect Their Contracts?, Shravan Morisetty, Robert De La Torre, Abdullah Sahyouni, Kinan Sawar, Yasmeen Alcodray, Gautham Pavar, Justin Bennie, Nicole Xu, Harika Bollineni, Bohdan Matsko

Medical Student Research Symposium

Introduction: There is likely a correlation between National Football League (NFL) players who endure lower extremity injuries (LEI) and the length and remuneration of subsequent contracts. This kind of data can be useful in training a model to predict how an injury may influence a player’s contracts in the future.

Methods: We examined the NFL’s weekly injury reports for seasons from 2016 to 2020, and recorded players with lower extremity injuries (LEI) (Hamstring, Calves, Groin, or Quadricep). We accessed pro-football-reference.com and spotrac.com to record player identifiers and individual annual salaries 3 years prior to the index injury and up to …

Analysis Of Opioid Prescription Patterns And Postoperative Opioid Use In Opioid-Naïve Patients Undergoing Elective Lumbar Spine Surgery, Tim Nold, Tarek Mansour, Edvin Telemi, Ariel Walker, Nachiket Deshpande

Medical Student Research Symposium

Title: Analysis of Opioid Prescription Patterns and Postoperative Opioid Use in Opioid-Naïve Patients Undergoing Elective Lumbar Spine Surgery

Background: Post-operative opioid prescribing patterns after elective spine surgery is a growing topic of concern, as over-prescribing can lead to potential medication dependence, while under-prescribing can lead to inadequate pain management.

Objective: The primary objective was to develop prescribing guidelines based upon the amount of opioids used in the first 2 weeks after lumbar spine surgery by 80% of patients.

Methods: Utilizing a prospective study design, opioid-naïve patients undergoing elective lumbar spine surgery at our institution were identified each week and preoperatively …

Which Position In American Football Is More Likely To Get You Benched Due To Lei? An Analysis Of Nfl Players Injured In The Years 2016-2020., Robert A. De La Torre, Abdullah Sahyouni, Kinan Sawar, Gautham Pavar, Cristian J. Diaz Alvarenga, Shravan Morisetty, Bohdan Matsko, Justin Bennie, Niyaz Uddin, Olvia Pakula

Medical Student Research Symposium

Title: Which position in American Football is more likely to get you benched due to LEI? An Analysis of NFL Players injured in the years 2016-2020.

Authors: Robert de la Torre, Abdullah Sahyouni, Kinan Sawar, Gautham Pavar, Cris J. Diaz Alvarenga, Shravan Morisetty, Justin Bennie, Bohdan Matsko, Niyaz Uddin, Olivia Pakula

Introduction:

In American Football, there are twenty-four different positional roles that a player may assume. Some positions are unique to offense, such as quarterback and wide receiver. Others are unique to defense, such as cornerback or linebacker. There are also unique positions such as kicker or punter. All of …

Differential Expressed Genes Identified Between African American And European American Keloid Fibroblasts, Bianca Parker Ms, Albert M. Levin Phd, Oghenefejiro Okifo Md, Katherine Buhl Bs, Takahiro Ouchi Bs, Jessica Tan Bs, Xiangguo Dai Phd, Yalei Chen Phd, Nallasivam Palanisamy Phd, Jesse Veenstra Md, Phd, Shannon Carskadon Ms, Jia Li Phd, David Ozog Ozong Md, Christian E. Keller Md, Dhananjay Chitale Md, Mba, Kevin R. Bobbitt Phd, Howard C. Crawford Phd, Nina Steele Phd, Qing-Sheng Mi Md, Phd, Lamont R. Jones Md, Mba

Medical Student Research Symposium

Keloids are benign fibroproliferative tumors due to dysregulation of collagen remodeling and abnormal wound healing. Although worldwide, there is a higher incidence of keloid disease (KD) in skin of color, little is known about this predisposition. In this study, we used one tissue micro array slide comprised of six AA and 6 EA punch biopsies of primary untreated keloid tissue from the head and neck area was created, following the NanoString® DSP Technology Access Program protocol. The GeoMx Human Whole Transcriptome Atlas Assay was performed, using morphology marker FAP. Polygonal region of interests selection strategy for Fibroblast Activation Protein (FAP) …

Towards Standardized, Safe And Efficacious Screening Approaches To Patients With Lower Extremity Peripheral Arterial Disease In The Setting Of Lower Extremity Arthroplasty, Zaina N. Khoury, Adam Pearl, Ahmad Hassan, Mohamed Awad, Khaled Saleh

Medical Student Research Symposium

INTRODUCTION: Peripheral arterial disease (PAD) impedes recovery from lower extremity arthroplasties (LEA) and increases risk of complications/mortality, yet there aren’t standards for screening PAD patients pre-LEA. This review proposes some.

METHODS: This review searched databases for articles containing relevant terms. Non-English articles, those unrelated to LEA, and duplicates were excluded. Articles were cross-referenced to find other relevant papers for a total of 111.

RESULTS: Up to 49.2% of PAD patients have CAD. Wagner grade III/IV ulcers increase amputations and decrease wound closures. The Wound, Ischemia, and Foot Infection (WIfI) system provides more accurate, and therefore actionable, assessment. Overlooking PAD in …

Xeroform Gauze Is Superior To Silver Sulfadiazine Cream In Promoting Zone Of Stasis Healing For Mixed-Depth Scald Burns In Children, Ryan Nolan, Dominic Allessio-Bilowus, Nishant Kumar, Justin Klein Md, Elika Ridelman Phd, Christina Shanti Md

Medical Student Research Symposium

TITLE: Xeroform^ gauze is superior to silver sulfadiazine cream in promoting zone of stasis healing for mixed-depth scald burns in children

INTRODUCTION: Silver sulfadiazine 1% cream changed daily was historically the mainstay initial treatment at our pediatric burn center. Over recent years, we transitioned to using closed Xeroform^ dressings (3% bismuth tribromophenate in petrolatum-soaked gauze) in the initial care of partial thickness burns. The purpose of this study is to compare patient outcomes between Xeroform^ only and silver sulfadiazine.

METHODS: A retrospective chart review was conducted of patients age 5 years with mixed-depth scald injuries between: 1) …

Mass Cytometry Profiling Of The Peripheral Blood Immunome In Patients With Psoriasis And Psoriatic Arthritis Uncovers Potential Biomarkers Related To Disease Progression, Meyer Gershater, Congcong Yin, Tingting Liu, Yi Yao, Peter Dimitrion, Jugmohit Toor, Kalpana Subedi, Qing-Sheng Mi

Medical Student Research Symposium

Cutaneous psoriasis (PsC) is an auto-immune disorder affecting 60 million people globally, among 30% of whom progress to psoriatic arthritis (PsA), a disease with poorly understood etiology, making diagnosis and treatment difficult. Indeed, a complete systemic immune profile of PsA has yet to be performed. In the study herein, we collected peripheral blood samples from patients with PsC, PsA with or without systemic therapy, and healthy controls (HC), and utilized mass cytometry by time of flight (CyTOF) to acquire immune cell profiles of major leukocyte subsets. We found that patients with PsC and/or PsA exhibited increased frequencies of intermediate (CD14+CD16+) …

Duopa Abbvie® Peg-J Tube: An Educational Case Series On Placement, Complications, And Management For Interventional Radiologists, Anthony Mrocko, Yahya Albeer, Omar Hadied

Medical Student Research Symposium

Introduction

Parkinson’s disease is a neurodegenerative disorder in which the dopaminergic neurons located within the substantia nigra degenerate and gradually overtime will present with the classical symptoms related to the loss of motor control: resting tremor, rigidity, akinesia, postural stooping, and shuffling gait (TRAPS).¹ Standard of care is to begin oral pharmacological therapy that includes Levodopa/Carbidopa.^2,3 When oral therapy is no longer effective or it is precipitating adverse effects, alternative therapy is considered.⁴

Levodopa/Carbidopa intestinal gel (LCIG) therapy allows for continuous delivery of the medication with the goal to limit the amount of time the patient is …

Description Of Urban Emergency Department Patients With Elevated D-Dimer Levels, Paige E. Hammis, Anneliese Rademacher, James Paxton Md, Sarah Meram, Elizabeth Dubey Md, Brian Reed

Medical Student Research Symposium

“Description of Urban Emergency Department Patients with Elevated D-Dimer Levels”

Authors

Anneliese Rademacher, Paige Hammis, Sarah Meram, Elizabeth Dubey MD, Brian Reed, James Paxton MD

Introduction

Venous thromboembolism (VTE) can cause conditions including deep venous thrombosis (DVT) and pulmonary embolism (PE). D-dimer is an assay used to detect VTE, with a level of 0.5 or higher being a positive result. However, many other factors can influence D-dimer levels. The purpose of our study is to describe the characteristics associated with an elevated D-dimer level among patients treated in two urban emergency departments (EDs).

Methods

This is a retrospective study utilizing …

“Community Members Have More Impact On Their Neighbors Than Celebrities”: Leveraging Community Partnerships To Build Covid-19 Vaccine Confidence, Maria Tjilos Mph, Autumn L. Tamlyn, Elizabeth J. Ragan Mph, Sabrina A. Assoumou Md, Mph, Katherine Gergen Barnett Md, Petrina Martin Mba, Rebecca Perkins Md, Msc, Benjamin P. Linas Md, Mph, Mari-Lynn Drainoni Phd, Med

Medical Student Research Symposium

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. We accessed and analyzed nine publicly available recordings of the community-engaged conversations which were held between Mar 2021-Sep 2021 (n=8-122 attendees). We employed a Consolidated Framework for Implementation Research-driven codebook to code our data and utilized …

Effects Of Armed Conflict On Maternal And Infant Health: A Case Study Of Armenia And The 2020 Nagorno-Karabakh War, Lara Rostomian

Medical Student Research Symposium

Introduction: Armed conflict is a major cause of ill health and mortality which disproportionately impacts women and children. The 2020 War between Armenia and Azerbaijan over the territory of Nagorno-Karabakh occupied by ethnically Armenian population, provides an example of how conflict impacted health during COVID-19. We hypothesize that exposure to crises will correspond to decreased healthcare utilization rates and worse health outcomes of the maternal and infant population in Armenia, and that these trends will be compounded during the pandemic period.

Methods: Following a historic case study approach, we used ecological level data from 1980-2020 to evaluate trends in battle …

Discovering And Validating Enriched Signaling Pathways Associated With Organ-Specific Breast Cancer Metastasis, Dawei Chen

Medical Student Research Symposium

Breast cancer is one of the most prevalent and devastating malignancies in the United States. Owing to its systemic nature and resistance to therapy, metastatic breast cancer is currently considered to be incurable and has a five-year survival rate of 29%. The specific pathways delegating the breast cancer metastatic cascade and tissue-specific breast cancer metastasis has much to explore and offers potential targets for therapeutic intervention. Breast cancer commonly metastasizes to four sites: brain, lung, liver and brain. Each of these sites have niche microenvironments. We hypothesize that unique adaptations and signaling pathways are required for successful metastasis at each …

Risk Factors Of Not Reaching Mcid After Elective Lumbar Spine Surgery: A Case Control Study, Travis Hamilton Md, Scott Lim Md, Edwin Telemi Md, Ho Jun Yun Mms, Mohamed Macki Md, Lonni Schultz Phd, Hsueh-Han Yeh Phd, Kylie Springer Ms, Kevin Taliafero Md, Miguelangelo Perez-Cruet Md, Ilyas Aleem Md, Paul Park Md, Richard Easton Md, David Nerenz Phd, Jason Schwalb Md, Muwaffak Abdulhak Md, Victor Chang Md

Medical Student Research Symposium

Background

The therapeutic effect of spine surgery has been traditionally evaluated by physical examination, radiographic findings, and general perception of patient’s health status. However, these assessments are often insufficient to represent surgical outcomes.Patient-reported outcomes (PROs) are tools developed to measures quality outcomes following spinal surgery. Examples include the Patient-Reported Outcomes Measurement Information System Function 4-item Short Form (PROMIS-PF), Visual Analogue Scale (VAS), ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey), and EQ-5D (EuroQuol-5D). The minimum clinically important difference (MCID) is an assessment tool to note the smallest clinical difference in PROs and provides the threshold where patients experience clinical …

The Impact Of Reforming The Medical Student Admissions Training Process On Medical Student Interviewers., Sean Mccarthy, Iyanna Peppers, Kevin Sprague Md, Abhinav Krishnan Phd.

Medical Student Research Symposium

• Title: The Impact of Reforming the Medical Student Admissions’ Training Process on Medical Student Interviewers.

• Authors: Sean McCarthy1, Iyanna Peppers1, Kevin Sprague, M.D.1, Abhinav Krishnan, PhD1

1.Wayne State University School of Medicine

• Purpose: The Medical Student Admissions Interview Committee (MSAIC) at Wayne State University School of Medicine (WSUSOM) conducts over 1500 interviews per year. Medical student interviews are a core component of the admissions process, along with faculty/alumni interviews and multiple-mini-interviews. The continuous quality improvement (CQI) subcommittee of MSAIC aids in identifying, improving, and managing compliance. Following suggestions provided by a CQI survey about perceptions of the …

Staged Laser Interstitial Thermal Therapy For The Surgical Treatment Of Insular Glioma: A Case Series, Bhargav Ayloo, Ian Y. Lee Md, Hassan Fadel Md, Adam Robin Md, Kelly Shaftel Md, Jacob Pawloski Md, Sameah Haider Md

Medical Student Research Symposium

Staged Laser Interstitial Thermal Therapy for the Surgical Treatment of Insular Glioma: a Case Series

Introduction

Insular gliomas pose one of the most significant challenges in neurosurgical oncology due to the complexity of the surrounding functional and microvascular anatomy. Despite current surgical and technological advancements, resection of insular gliomas can lead to potentially severe neurological morbidities. Laser Interstitial Thermal Therapy (LITT), either alone or combined with surgery, presents a less invasive cytoreductive approach for treating insular gliomas.

Objective

In this work we describe the first-ever reported series of patients with insular gliomas treated with staged LITT operations with or without …

Sleep Timing And Neurocognitive Networks In Youth, Aneesh Hehr, Edward Huntley, Hilary A. Marusak

Medical Student Research Symposium

Sleep timing, particularly later midpoint of sleep, has been linked to emotion dysregulation and psychopathology. Prior adult studies link poor sleep (e.g., shorter duration, later midpoint), to altered resting-state functional connectivity (rs-FC) within and between key neurocognitive networks, particularly the default mode network (DMN), which is involved in internal thought and rumination. Importantly, many psychiatric disorders begin during adolescence, a period of shifted sleep schedules. We explored associations between midpoint of sleep and rs-FC of the DMN and other core neurocognitive networks in youth. Sleep timing was measured in 3,798 youth (11.9±0.6 years, 47.5% female) from the Adolescent Brain Cognitive …

Replacing Adjunctive Medications For Treatment-Resistant Depression Using Repetitive Transcranial Magnetic Stimulation: Case Report, Anita Vaishampayan Bs, Bassem Saad Md, Daniel Amarasinghe Bs, Carly Brin Lmsw, Richard Balon Md, Nicholas Mischel Mdphd

Medical Student Research Symposium

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. As the left prefrontal cortex activity is linked to depression, rTMS induces blood flow in the left dorsolateral prefrontal cortex (dlPFC). Long acting psychostimulants are sometimes prescribed as an adjunctive antidepressant treatment throughout rTMS therapy. We used rTMS to treat resistant depression in a middle-aged male patient over a twelve month period where a psychostimulant medication was also discontinued. He had been consistently taking duloxetine 60 mg BID, clonazepam 0.5 mg BID, and dextroamphetamine-amphetamine extended release 30 mg once daily prior to the onset of rTMS treatment. The patient …

Promis Mcid And Scb Achievement In Rotator Cuff Repair, Nikhil Yedulla, Joseph S. Tramer, Alexander Ziedas, Sreten Franovic, Mit Patel, Stephanie Muh, Eric C. Makhni

Medical Student Research Symposium

The purpose of this study was to establish threshold score changes to determine minimal clinically important difference (MCID) and substantial clinical benefit (SCB) in PROMIS computer adaptive test (CAT) scores following rotator cuff repair (RCR). Patients undergoing arthroscopic RCR were identified over a 24-month period. PROMIS CAT forms for upper extremity physical function (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) were utilized. Analysis of variance testing with post hoc least significant difference pairwise comparisons and Tukey’s B subset analysis were used in determining if anchor question responses showed statistically significant differences between answers. These findings were used to establish two …

Factors Associated With Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study, Katerina A. Furman, Amy Loree Phd, Leah Hecht Phd, Katerina Furman Md Candidate, Lyuba Gavrilova Bs, Hsueh-Han Yeh Phd, Catherine Frank Md, Brian Ahmedani Phd

Medical Student Research Symposium

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss

Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide.

Results: …

Effects Of The Covid-19 Pandemic On Physical Activity In Children: A Systematic Rapid Review, Alex Ramirez B.S., Ashley Rapp Mph, Abigail C. Radomsky B.S., Sara Santarossa Phd

Medical Student Research Symposium

Background: Prolonged lockdowns, put in place to mitigate the spread of COVID-19, may have altered physical activity (PA). The goal of this systematic rapid review was to synthesize the global impact of the COVID-19 pandemic on PA of children.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used to conduct a database search on 03/29/2021. Included studies were peer- reviewed, in English language, and encompassed both a measure of PA during the COVID-19 pandemic and PA data for children aged 18 and younger. The database search yielded 677 unique citations and, ultimately, 69 articles were included …

The Role Of Vigorous And High Intensity Interval Training Physical Activity Counseling In Prenatal Care, Emily Lau, Brendan T. Lynch, Sonia Hassan

Medical Student Research Symposium

Background: Physical activity is becoming a more common component of preventative medicine and patient counseling; however, the prevalence of physical activity counseling and specific social determinants of health have prevented women, namely prenatal patients, from receiving this counseling from their providers¹. Physical activity, including high intensity interval training (HIIT), has been shown to be feasible for implementation in patient counseling³ and shown to be safe for pregnant women, even into the third trimester². We hypothesize that the current percentage of patients, including prenatal patients, being counseled on physical activity is lacking. In addition, we hypothesize …

Effects Of Michigan Opioid Laws On Prescriber Practices In The Emergency Department, Lydia Ross, Gary Kanner, Claire Pearson

Medical Student Research Symposium

Introduction: Opiate analgesics (OA) are responsible for more overdose deaths than any other medication class. Michigan is among the states most greatly affected by the opioid epidemic, and in late 2017, the Michigan Opioid Laws were passed in efforts to decrease opioid associated addiction and overdose deaths. This set of laws provides regulation of OA prescriptions and to increase patient awareness of the associated risks of opioid use. These laws collectively require a physician to educate the patient on harms of opiates, provide substance abuse disorder services in the setting of an overdose, establish a relationship with the patient, obtain …

Hip Disarticulation In Wound Care: A Case Series, Kara Klomparens, Fuad Abbas, Sway Lamaj, Naveen Rehman, Richard Simman Md

Medical Student Research Symposium

Introduction

Hip disarticulation (HD) is a radical lower extremity amputation performed by carefully transecting all muscles and nerves surrounding the hip joint and separating the leg at the joint capsule. This procedure accounts for only 0.5% of all lower extremity amputations in the United States. It is generally performed due to malignant tumors, trauma and limb ischemia. However, it also has a role to play in wound care including management of severe lower extremity infections. It is considered a last resort to be used as a life-preserving measure under emergent circumstances due to high rates of morbidity and mortality.

Cases …

Multivisceral Transplant Prognosis And Complications In Patients With Metastatic Neuroendocrine Tumor, Austin Mueller, Syed-Mohammed Jafri

Medical Student Research Symposium

Neuroendocrine tumors (NETs) are a rare subset of cancers that most commonly arise in the gastrointestinal tract, but can also arise in the pancreas, lungs, ovaries, thyroid, pituitary gland, and adrenal gland. When patients present with metastatic NETs, physicians have a variety of therapeutic options. Considering these options, transplant specialists are often involved due to the profound therapeutic effects of multi-organ transplantation. However, little information is available on prognosis/complications for patients that receive multi-organ transplants due to severe metastatic NETs.

With the incidence of NETs in the United States trending in an upward direction, researchers and physicians must understand the …

Differences In Depth Of Soft Tissue At The Proximal Tibia Intraosseous Catheter Insertion Site Based On Sex And Bmi, Thomas Sprys-Tellner, John Kulka

Medical Student Research Symposium

Introduction

Intraosseous (IO) cannulation is commonly used for emergent vascular access in unstable patients treated in the emergency department (ED). However, inappropriate depth of IO insertion may be associated with increased risk of complications associated with IO catheter use, including extravasation and subsequent compartment syndrome. Our objective was to characterize the thickness of soft tissue overlying the proximal tibial IO insertion site according to patient sex, body mass index (BMI), and common medical comorbidities.

Methods

Retrospective chart review was performed for patients who received x-ray imaging of the proximal tibia at the study site. Patients were excluded if they had …

Histological Changes Of Bronchopulmonary Dysplasia And Pulmonary Hypertension: An Autopsy Series Of 42 Preterm Infants, Amelia Stone Md, Janet Poulik Md, Sara I. Koussa, Y Xin, A Sharma, Beena Sood Md, Ms

Medical Student Research Symposium

Background: Bronchopulmonary Dysplasia (BPD), a significant cause of perinatal morbidity and mortality, leads to disrupted pulmonary vascular growth and ultimately pulmonary hypertension (PH). The diagnosis of BPD is made by oxygen requirement for at least first 28 days of life. We hypothesized that histologic changes of BPD are evident before 28 days of age.

Methods: All live born preterm infants born <37 weeks of gestational age (GA), who received an autopsy between 2010 and 2017 at Children’s Hospital of Michigan or Hutzel Women’s Hospital, were identified by autopsy records. Infants with major congenital defects were excluded. Clinical data were extracted from electronic medical records. Autopsy specimens of lung and heart tissue were examined by a single pathologist, and classified according to presence or absence of defining features of BPD and PH.

Results: Of the 42 preterm infants that met the study criteria, 79% were <32 weeks GA, 55% were male, 55% were African American, 33% were SGA, and 17% were twins. Infants that died at <28 days of life were statistically more likely to be African American and receiving high frequency ventilation and were less likely to have preterm premature rupture of membranes (PPROM) and an echocardiogram obtained as part of their clinical workup.

Of infants <32 weeks GA, 61% died at <28 days of age; histological BPD was observed in 25% of infants and PH was observed in 65%. Of infants <32 weeks GA, 39% died at ≥28 days; histological BPD was observed in 92% and histological PH was observed in 85% of subjects.

Of infants ≥32 weeks GA, 78% died at <28 days of age; histological BPD was observed in 0% of infants and PH was observed in 71%. Of infants ≥32 weeks GA, 22% died at ≥28 days; histological BPD and PH were both observed in 50% of subjects.

Histological changes of BPD observed in 5 infants born <32 weeks GA who died before 28 days of age were identified as early as 6.73 days of age. Histologic PH was identified in 4 of the 5 infants with the earliest evidence being observed in an infant that died at 6.73 days of age.

Conclusion: Histologic changes consistent with BPD …