Medical Specialties Commons^™

Hiding In The Midgut: A Case Of Small Bowel Diverticular Bleeding In An Elderly Female, Aagamjit Singh, Nishant Aggarwal, Faid Odish

Conference Presentation Abstracts

Introduction Diverticulosis in the colon is a common cause of lower gastrointestinal (GI) bleeding. Non-Meckel diverticula in the small bowel have been reported in the literature; however, they rarely cause significant bleeding. We present a case of an 88-year-old woman with a bleeding jejunal diverticulum that was diagnosed and treated with a push enteroscopy. Case Description An 88-year-old African-American female with a past medical history of colonic diverticulosis and atrial fibrillation on rivaroxaban presented with a 4-day history of melena. She reported having soft, black stools 2–3 times a day, associated with persistent epigastric discomfort and nausea. Her last dose …

Marathon Miles And Melena: Unmasking Acute Gastrointestinal Bleeding In An Endurance Athlete, Usman Bin Hameed, Mujtaba Moazzam, Nathanial Bartosek, Fady Banno, Naveen Reddy

Conference Presentation Abstracts

Gastrointestinal bleeding (GIB) is a recognized complication of endurance sports, particularly long-distance running. While most cases are mild and self-limited, studies indicate that up to 12% of ultramarathon participants experience occult bleeding. Severe or life-threatening GIB, such as ischemic colitis requiring surgery, has been reported but remains rare. Despite its potential significance, exercise-induced GIB remains poorly understood, with limited organized data on its prevalence and mechanisms. A 38-year-old male presented with a three-day history of melena following a recent marathon. Symptoms began with loose stools, progressing to tarry stools, accompanied by fatigue, exertional dyspnea, dizziness, and mild generalized abdominal discomfort. …

Cost Effectiveness Of Sending Of Routine Collection Of Sinus Contents In Skull-Base Patients, Jonathan Grey, Caroline Roberts, Amanda Bachand, Jacob Keeley, Adam Folbe

Posters

• Following endoscopic skull-base surgeries, it is common practice to send sinus contents for histopathological review and examination, in addition to the tumor/pathology itself.
• Histologic analysis of standard surgical specimens has long been thought to enhance diagnostic precision, ensure quality control, and offer procedural documentation.1 However, with rising healthcare costs, the necessity of this practice has been challenged in specific situations, such as this one.1
• In this study, we sought to determine if the regular collection of sinus contents uncovers another disease process or informs clinical decision-making.
• We also determined the cost of routinely sending sinus contents to pathology for evaluation. …

A Quantitative Analysis On The Locations Of Phase 3 Retina Trials In The United States Over The Past 5 Years, Shahrukh Naseer, Tarek Hassan

Posters

• Clinical trials are essential for advancing treatments in ophthalmology, yet comprehensive data on institutional participation in Phase 3 retina trials is not readily available.

• The U.S. National Library of Medicine Clinical Trials database (NLM database) lists individual research sites for each study; however, aggregating and visualizing this data remains challenging.

• The lack of centralized and easily interpretable data on research site participation hinders understanding of institutional contributions to retinal clinical research.

• Identifying geographic and institutional trends can improve resource allocation and research collaboration.

• We aim to

• Quantify the number of unique institutions participating in …

Predicting Coronary Artery Calcium Using Abdominal Aorta And Visceral Artery Calcification, Jared Dixon, Sayf Al-Katib, Kiran Nandalur, Jacob Ghannam, Ali Beydoun, Desiree Clement

Posters

CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin.1 The Multiethnic Study of Atherosclerosis (MESA) demonstrated that a CAC score of 0 represents a less than 5 percent 10-year Atherosclerotic cardiovascular disease (ASCVD) risk. CAC scores 1-299 represent borderline to intermediate risk, and CAC score >300 represents a “high risk” 10 percent or greater 10-year ASCVD risk.2

When used correctly, CAC scoring is a powerful predictor of ASCVD risk and holds the key for many …

Associations Between Health Literacy And Comprehension Of Health Visits In A Community Setting, Amanda Romaya, Adel Andemeskel, Salim Abdul-Razak, Linda Dillon, Victoria Lucia

Posters

Low health literacy is a significant social determinant of health that is associated with poor health outcomes1-3. Bringing attention to health literacy will aid in promoting the health of the population. However little has been done to implement national policies and interventions that address patient health literacy, especially in a community setting4.

We hypothesized that our assessment of the identified patient population’s health literacy will not meet adequate standards and will indeed demonstrate a need for community-focused interventions

An Analysis On Gender And Race For Burnout Among Michigan Internists, Elan Pszenica, Jookta Basu, Esha Ahmed, Hugo Davila

Posters

Burnout among physicians, particularly in the field of internal medicine, has become a significant concern in recent years. This condition is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, which can have detrimental effects on both healthcare providers and patient care. 1 While burnout is a recognized issue globally, its impact on internal medicine physicians in Michigan has not been comprehensively studied. Understanding the unique stressors faced by these physicians is critical for developing targeted interventions to reduce burnout rates and improve the overall healthcare environment. Internal medicine physicians often face intense workloads, long hours, administrative …

The Impact Of Physician Vaccine Recommendation On The Pregnant Chaldean Population, Sylvia Kashat, Nelia Afonso

Posters

• A variety of factors contribute to modern vaccine hesitancy, including balancing the risks and benefits of vaccination and delayed negative outcomes. • An important population to consider are pregnant women and their fetus, as the immune compromised state may increase the burden of disease. • It is the duty of healthcare providers to properly educate mothers on the effectiveness of vaccination on vaccinetreatable and vaccine-preventable diseases. • A subgroup that has been impacted by this greatly in the metro-Detroit area is the Chaldean community. • With the Michigan Chaldean population being greater than 160,000, and most of the community …

The Effect Of Covid-19 On Total Joint Arthroplasty, Hailey Worstman, James E. Feng, Alex Miller, Drew Moore

Posters

• Arthritis is debilitating disease that is common throughout the U.S. For patients with refractory disease, total hip and knee arthroplasty, collectively known as total joint arthroplasty, are used for definitive management.1 •

Total joint arthroplasty, TJA, is one of the most common procedures in the U.S. and is typically inpatient in order to start physical therapy and promote joint mobility as soon as possible.

• Elective procedures, including total joint arthroplasties, were halted in March 2020 due to the pandemic.2,3

• When TJAs resumed they shifted towards outpatient procedures and at home physical therapy.4

• The impact of the …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty, Daniel Nikolaidis, Devin Young, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infections (PJI) can arise anytime in the lifetime of a patient. Therefore, patients who have multiple prosthetic joints are at risk for developing multiple PJIs. Polyarticular PJI can be classified as either synchronous or metachronous. Synchronous PJIs present simultaneously in two or more joints. Metachronous PJIs (MPJI) occur in two or more joints after a disease-free period. Incidence of MPJI varies in the literature from 8-20%.1

Known risk factors associated with MPJI include Rheumatoid Arthritis, sepsis or SIRS, infection with MRSA, ≥3 revision arthroplasties, longer length of stay in the hospital, and an index TKA PJI.2

Only a …

A Review Of Risk Factors For Postoperative Failure After Isolated Primary Medial Patellofemoral Ligament Reconstruction, Bilal Tarar, Ameen Suhrawardy, Clark Yin, Leonardo Cavinatto, Elizabeth Dennis, Jeffrey Fischgrund, Betina B. Hinckel

Posters

• Medial patellofemoral ligament reconstruction (MPFL-R) is a surgical treatment for patellar instability [1].

• Cases of post-operative recurrent dislocation and persistent instability may occur due to preexisting anatomic risk factors and technical errors in the procedure.

• Current rates of recurrent dislocation are reported to be up to 20% [2].

• Research Question: What anatomic and technical risk factors are associated with increased rates of recurrent dislocation after primary MPFL-R?

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Assessing Disparities In Sep-1 Bundle Compliance At Corewell Health, Zachary Awad, Mark Munir, Paul Bozyk, Ramin Homayouni

Posters

Sepsis, a life-threatening condition resulting from a dysregulated immune response to infection, carries significant mortality. To improve sepsis management, the Centers for Medicare & Medicaid Services (CMS) introduced the SEP-1 bundle, outlining critical interventions within specified timelines. This study aimed to investigate disparities in SEP-1 bundle compliance, examining variations among septic patients based on sociodemographic factors like age, race, and area deprivation index (ADI), as well as clinical factors like chronic health conditions.

Dido Times In Anterior Lvo Ischemic Stroke, Greg Palmateer, Anthony Gasparotto, Angelique Manasseh

Posters

• Acute ischemic stroke is a major cause of death and disability. Every 30 minute delay in time from onset to treatment lowers the likelihood of a good outcome.1

• Door-in-door-out (DIDO) is defined as the duration from time of arrival at a primary stroke center (PSC) to time of discharge to a comprehensive stroke center (CSC) for mechanical thrombectomy(MT). Shorter DIDO time relates to improved outcomes.

• There is no standardized DIDO for ischemic stroke, though the American Heart Association (AHA) offers an ideal DIDO time of < 90 minutes for 50% or more of patients.2

Index Cost Comparison Of Laparoscopic Vs Robotic Surgery In Colon And Rectal Cancer Resection: A Retrospective Financial Investigation Of Surgical Methodology Innovation At A Single Institution, Ekene Ezeokoli, Roula Hilli, Harry J. Wasvary

Posters

Robotic assisted colorectal cancer resection (R-CR) has become increasingly commonplace in contrast to traditional laparoscopic cancer resection (L-CR). The aim of this study was to compare the total direct costs of R-CR to that of L-CR and to compare the groups with respect to costs related to LOS.

Comprehensive Analysis Of Racial Differences In Comorbidities And Prenatal Care Among Pregnant Women, Ryian Owusu, Kurt R. Wharton

Posters

• Research highlights that women of color face significantly higher risks of pregnancy-related morbidity and mortality.¹

• Factors contributing to these disparities include: 2,3

• Access to healthcare

• Health literacy

• Education level • Community support

• Prenatal care plays a pivotal role in mitigating these risks by educating women on healthy lifestyles and identifying those at high risk for complications. 4

• Determining patient satisfaction with their prenatal care could greatly contribute in defining a link between prenatal care services and maternal-fetal outcomes. 4

Identifying Barriers To Covid-19 Vaccination In Hispanic Populations, Saul O. Castillo, Kurt R. Wharton

Posters

Vaccination hesitancy has always been an issue within marginalized communities. This is why it came as no surprise when the COVID-19 vaccine was met with resistance upon its release1. However, it has been many years since the FDA approved the first COVID19 vaccine and on some level, COVID-19 has become a part of our daily lives. This means that people have had time to determine how they feel about the COVID19 vaccine and reflect on their decisions to receive or decline the vaccine.

There are many reasons as to why people choose to receive or decline the COVID-19 vaccine. This …

Clinician’S Perspective On Reproductive Healthcare & Reproductive Health Rights In Southeast Michigan, Skylar Sundquist, Kurt Wharton

Posters

Reproductive healthcare is essential care that includes family planning, assisted reproductive technologies, sexually transmitted infection (STI) screening and treatment, abortion access, and sexual health education. Unfortunately, reproductive healthcare and reproductive rights are often the subject of erosive litigation. This litigation limits individuals’ access to reproductive healthcare thereby inhibiting individuals’ ability to exert autonomy over their health. In June of 2022, the US Supreme Court ruled in favor of Dobbs in the case of Dobbs v Jackson Women’s Health Organization. This ruling effectively overturned the 1973 Roe v Wade decision and ended the protected right to access abortion care. After the …

Custom Gene Panel Sequencing Of Fevr Patients And Family Members, Rima Stepanian, Gabrielle Abdelmessih, Kim Drenser, Antonio Capone Jr, Michael T. Trese, Wendy Dailey, Ken Mitton

Posters

Familial exudative vitreoretinopathy, or FEVR, defines a group of inherited retinal diseases marked by abnormal blood vessel growth in the retina, causing poor vascular development in the peripheral retina. It is linked to increased vessel permeability and may result in retinal ischemia, exudative retinal detachment, and subsequent vision loss. It can be inherited through autosomal dominant, autosomal recessive, or X-linked recessive patterns. There is no definitive treatment or cure, but is treated based on staging of disease on an individual case-by-case basis. Genomics is a rapidly growing field in personalized medicine. Targeted next-generation sequencing (NGS) enables fast and cost-effective identification …

Suture Management Practices In Central Venous Catheters: A Survey Among Healthcare Professionals, Matthew Prevost, Nishaki Mehta

Posters

• Traditional suture methods (Fig. 1) for securing central venous catheters (CVCs) lack standardization, are nonadjustable postsecurement, and require dexterity → increasing risk of catheter micropistoning and central line-associated bloodstream infections (CLABSIs).

• This study examines medical practitioners' experiences and challenges with suturing CVCs

• Our hypothesis predicts that variations in responses and differences in practitioner training may influence experiences and complication rates.

Procalcitonin As A Biomarker Of Acute Kidney Injury In Patients With Suspected Bacterial Sepsis In The Acute Care Setting, Austin Kantola, Jose Navas Blanco, Jacob Keeley

Posters

Acute kidney injury (AKI) is a common, life-threatening complication in patients with sepsis and septic shock.→ Approximately one-half of patients with sepsis experience an AKI.4 → One-third of all acute kidney injuries are related to sepsis.4 → Sepsis-associated AKI raises in-hospital mortality eightfold and the risk of chronic kidney disease development threefold.1,2,3. Early identification of AKI could save time and resources, lower costs, improve patient outcomes. Therefore, a biomarker for earlier AKI detection in patients with sepsis would serve an outstanding role in health care.In the setting of bacterial infection, an upregulation of innate immune system gene transcription and translation …

Treatment Rates In A Two-Step Clostridioides Difficile Diagnostic Testing Algorithm, Renee Ringler, Matthew Sims

Posters

Clostridioides difficile is a Gram-positive obligate anaerobe long associated with healthcare-acquired infections in the United States. 1 Clostridioides difficile infection (CDI) has thus become a key metric for assessing facility cleanliness and iatrogenic infection. C. difficile carriage is common, present in approximately 8% of hospitalized patients.2 Therefore, appropriate patient selection for testing and careful testing procedures is crucial to appropriately identify CDI while avoiding the detection of chronic colonization.

Considerable variability exists among institutions regarding standardized CDI laboratory diagnostic methods. Historically, the gold standard for CDI testing was the clinically inefficient toxigenic culture (TC). 3 This was followed by cytotoxic …

Understanding The Effect Of Advanced Patient Age On Outcomes And Complications Of Spinal Surgery, Alexander R. Woznicki, Daniel K. Fahim

Posters

• In 2020, 6.7 million individuals in the United States were older than 85. This is projected to increase to 12.6 million in 20601

• The risk of developing many spinal conditions increases with age2,3,4

• Decreases in disk height changes the loadbearing properties of the spine

• Decreased bone density makes the vertebrae susceptible to fracture

• Weakening of spinal ligaments predispose to disc degeneration

• Hypertrophy of the ligamentum flavum and susceptibility to disk herniation can lead to spinal stenosis

• Damage of the cervical spinal cord can manifest as weakness and clumsiness in the upper extremities and …

Impact Of Pprom Delivery Protocol On Adverse Neonatal Outcomes At Our Institution, Jacqueline Juarez, Sangeeta Kaur

Posters

Traditionally, mothers diagnosed with PPROM (preterm premature rupture of membranes) between 34w0d to 36w6d had immediate delivery. However, newly developed research has shown potential benefit to expectant management through delaying delivery until 37 weeks to reduce adverse neonatal outcomes. Our research showing a lower percentage of respiratory distress, mechanical ventilation, and/or length of NICU stay in expectant management can greatly impact neonatal care. Additionally, this can form a new standard in guidelines on how to manage mothers diagnosed with PPROM between 34w0d to 36w6d.

The Administration Of Antenatal Corticosteroids In The Late-Preterm Period, Sarah O’Mara, Sara Jaber, Kurt Wharton

Posters

The administration of corticosteroids in the late-preterm period (34 to 36+6 weeks' gestation) remains a topic of ongoing debate. The landmark Antenatal Late Preterm Steroids (ALPS) trial demonstrated a significant reduction in neonatal respiratory morbidity with the use of late-preterm corticosteroids, leading to updated recommendations by the Society of Maternal-Fetal Medicine in August 2016 supporting their administration for patients at risk of late-preterm delivery. Given that late-preterm births accounted for 7.4% of live births in the United States in 2020, optimizing neonatal outcomes in this population is a critical public health concern.

Antenatal corticosteroid administration between 24 and 33+6 weeks' …

The Relevance Of Age, Bmi, And Right Versus Left Ear Surgery To The Incidence Of Taste Disturbance After Stapes Surgery, Jonathan Ong, Dennis Bojrab Ii

Posters

• Many factors such as age and body mass index (BMI) have been shown to influence post-operative outcomes in patients undergoing stapedectomy/stapedotomy.

• This study examines these factors to see if they have any impact on the incidence of taste disturbance, a commonly reported complication of stapes surgery.1

• Our study predicts that BMI and age are correlated with the incidence of taste disturbance post-operatively following stapes surgery.

Effects Of Changing The Frequency Of Epidural Steroid Injections For Elderly Patients With Lumbar Radiculopathy/Lumbar Spinal Stenosis, Nitin Venkatesh, Rebecca Clemans, Roy Soto

Posters

Lower back pain is highly prevalent and a significant cause of disability.

50-84% of adults experiencing back pain at some point.

Previously, patients with chronic lumbar radiculopathy received a maximum of 6 injections a year (q8w).

On Dec 2021, Medicare Coverage of ESIs was updated to limit ESIs to a max of 4 a year (q12w).

Improving Treatment For Infant Perianal Abscesses, Artem Dadamyan, Nathan Novotny, Ngan Nguyen

Posters

Perianal abscesses: • Tender masses located at the anal verge, typically in the 3 o’clock and 9 o’clock positions1

• Develop due to infection in abnormally deep crypts of Morgagni 1

• If left untreated, can extend into the ischioanal space or intersphincteric space since these areas are continuous with the perianal space.2

• Some may develop into fistula in ano, which can be difficult to treat3 Treatment:

• The standard has always been incision and drainage (I&D), but non-invasive management of Sitz baths is increasingly being used.

Prostatic Urethral Length On Mri As A Predictor Of Late Genitourinary Toxicity After Prostate Cancer Radiation, Kyu Kim, Joseph Lee, Allison Hazy, Sayf Al-Katib, Hong Ye, Nathan Kolderman, Abhay Dhaliwal, Daniel Krauss, Thomas Quinn, Kimberly Marvin, Kiran R. Nandalur

Posters

Radiation therapy (RT) is a widely used treatment for prostate cancer.1 While effective, some patients develop late genitourinary (GU) toxicity, which can impact quality of life.2,4 Identifying pre-treatment factors that predict toxicity risk may help improve clinical decision-making. Recent studies suggest that prostatic urethral length (PUL) seen on MRI is associated with an increased risk of late GU toxicity.3 Understanding this relationship could enhance risk stratification before treatment.