Medical Specialties Commons^™

Publication Trends Among Integrated Plastic Surgery Residency Applicants After The Elimination Of Numeric Step 1 Scores, Forrest Bohler, James Burmeister, Ethan Dimock, Ava Harvey, Zachary Koenig, Kongkrit Chaiyasate, Cameron Davidson

Posters

No abstract provided.

Interactive Module Ror Medical Student Education In Type I Renal Tubular Acidosis, Het Patel, Emelie-Jo Nappo, Akshata Naik, Suzan Elsayed

Posters

No abstract provided.

How Long Must We Wait? A Review Of Adherence To Established Npo Guidelines, Ellen C. Bouaziai, Anthony S. Hernandez, Shashi Sahai, Kerry Peters Mychaliska

Conference Presentation Abstracts

Background: Patients undergoing a procedure with anesthesia are required to be nil per os (NPO) for a defined period to reduce the risk of aspiration of gastric contents. In 2017, the American Society of Anesthesiologists (ASA) published guidelines for preoperative fasting, which allow for consumption of a full meal 8 hours before a procedure; non-human milk, light meal, and infant formulas 6 hours prior; breastmilk 4 hours prior; and clear liquids 2 hours prior to procedure. It is well known that these NPO guidelines are inconsistently applied to pediatric patients. The purpose of this study is to determine the percentage …

Historical Perspectives On Bloodletting In The Management Of Asthma In Children And Adults, Joudeh B. Freij, Bishara J. Freij

Conference Presentation Abstracts

Background: Current asthma management consists of a combination of drugs with different mechanisms of action. Ancient asthma care, by contrast, focused on loosening the humours using remedies such as drinking animal blood, eating rabbit fat and fox lungs, inhaling or consuming certain herbs and plants, bloodletting (including wet cupping), diet (eating raisins, dried figs, vegetables, barley, capers, bread, cake), steaming, baths, wet compresses, and moderate helpings of wine with dinner. Bloodletting was believed to purge the body of noxious humours that caused human disease and thereby reduce inflammation. Here we address the use of bloodletting in asthma management over the …

Low Serum Alkaline Phosphatase Concentrations At Hospital Admission As Markers For Severe Pediatric Sars-Cov-2-Related Acute Illnesses, Sneha Jayadeep, Julie A. George, Bishara J. Freij

Conference Presentation Abstracts

Background: Alkaline phosphatase (ALP) is composed of several isoenzymes. The measured serum (total) ALP is mostly of bone and liver origin. ALP activity changes with growth and puberty, and its level is affected by age and sex. Abnormal ALP levels have been noted in COVID19 patients but its use as a marker of severity has not been assessed to our knowledge.

Objective: Assess if low serum ALP is a marker of disease severity in acute Pediatric SARS-CoV-2-related illnesses.

Design/Methods: Retrospective observational study of children 0-18 years of age hospitalized at Beaumont Children’s Hospital from 3/1/2020-3/31/2022 with positive PCR for SARS-CoV-2 …

Content Analysis Of Food Items In Youtube Videos Viewed By Children, Julie M. Zaituna, Tiffany Munzer, Sarah Morris, Jane Harness, Megan H. Pesch

Conference Presentation Abstracts

Background: Children have historically been a target of the food advertising industry because their preferences for certain foods are known to be shaped by food portrayals in digital media. In the most popular YouTube videos with child influencers, 90% featured ultra-processed and branded food products. Given the algorithmic specificity in YouTube, some children may be differentially exposed to more ultra-processed or branded food content; however, no studies have examined YouTube video characteristics or family characteristics associated with such food content.

Objective: To examine YouTube video characteristics and child and caregiver characteristics associated with greater exposures to ultra-processed or branded food …

Associated Urogenital Injuries Following Pelvic Trauma In Pediatrics, A 15-Year Single-Center Retrospective Studey, Colin Van Wagoner, Ehab Saleh, Sazid Hasan

Conference Presentation Abstracts

OBJECTIVE: The association between pelvic trauma and urogenital injuries in adult patients is well established, whereas literature concerning pediatric patients is sparse. The purpose of this study was to determine the association between pelvic trauma and urogenital injuries in the pediatric population including incidence, and trends in injury modality, treatment patterns, imaging, and outcome. METHODS: This was a single-center, retrospective chart review. Patients aged 0-16 years admitted for pelvic fracture, pelvic dislocation, proximal femur fracture, and injury of urinary and pelvic organs over a 15-year period were included. Primary outcomes included fracture diagnosis, urogenital injury diagnosis, treatment modalities, and mechanism …

Operative Vs. Non-Operative Treatment Of Z-Type Clavicle Shaft Fractures In Adolescents: A Retrospective Study, Iulio Dobrin, Colin Van Wagoner, Ehab Saleh

Conference Presentation Abstracts

OBJECTIVE: Clavicle fractures are common in both adult and pediatric populations.1 Yet, the literature describes differences regarding treatment in such fractures between these populations, favoring operative treatment for adults and nonoperative treatment for pediatric patients.2 There is particular uncertainty for treating a subgroup of adolescent clavicle fractures known as the Z-type comminuted fracture which, being a completely displaced and complex fracture pattern, can prove to have different healing rates than other midshaft clavicle fractures. Because of concerns about healing and bony prominences, these types of fractures are commonly treated surgically, despite an increasing body of literature indicating equivalent outcomes in …

Metaplastic Breast Cancer: A Retrospective Chart Review Of Clinical Features, Nidhi Navaratna, Mariam Aoun, Nitya Batra, Mohammad M. Chisti

Conference Presentation Abstracts

No abstract provided.

Intraoperative Code Status: Moving From Misinformation To Respect For Patient Autonomy, Jacob Applegarth, Jacob M. Morton, Nathan M. Novotny, Ngan Nguyen, Abram Brummett

Conference Presentation Abstracts

Introduction: Intraoperative code status represents a complicated topic for patients and providers. Prior studies demonstrated a lack of understanding of intraoperative code status, specifically do not resuscitate (DNR) orders. This misunderstanding appears common despite clear professional recommendations. A recent survey of surgery residents at our institution showed variability in understanding of intraoperative code status policy despite clear institutional guidelines. Few studies utilized simulated education for surgeons and surgical residents to navigate intraoperative DNR status. This project aims to create a simulation-based program for residents to navigate intraoperative DNR status ethically and to assess its impact on learning, practice patterns and …

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Case Report Of Surgical Management For Charcot Foot Medial Column Beaming With Stj Arthrodesis, Prachi Patel, Randy Semma

Posters

Medial column beaming is a surgical procedure that involves inserting a metallic beam to the medial column of the foot to treat the Charcot deformity of the foot.

A surgeon will use a large diameter screw to insert a beam into medial column which includes the first metatarsal, medial cuneiform, navicular and talus (fig 3) The beam shares the load of weightbearing with the foot's ligaments and joints, reducing the abnormal loss of structural integrity that can occur in Charcot arthropathy of the foot.

Subtalar joint fusion is often performed concurrently with medial column beaming to enhance the overall stability …

Polymicrobial Prosthetic Joint Infection Including Mycobacterium Tuberculosis: A Case Report, Hernan Andres Yunis, Zachary J. Walker, Matthew E. Charlick, Daniel P. Mccall

Posters

• Usual culprits of PJI affecting total hip and knee arthroplasty are Staphylococcus aureus and streptococcus epidermidis in the acute phase.

• During the chronic presentation, microbes become much more diverse as they may seed due to hematogenous spread from other body sites.

• The purpose of this case study was to illustrate an instance when polymicrobial total hip arthroplasty PJI included Mycobacterium Tuberculosis.

Subclinical Presentation Of Cutibacterium Acnesinfection Following Revision Rotator Cuff Repair: A Case Report, Zachary Walker, David Shuster, David Sosnoski, Ali Hamade, Hussein Saad, Marc Milia

Posters

Cutibacterium acnesis a gram-positive anaerobic bacillus which is commonly found in the sebaceous glands of the skin generally in the axilla, chest and back regions1,2.

Shoulder infections have been reported to occur at 3.4% following arthroscopic or open shoulder surgeries, where they are most commonly due to C. acnes3,4.

This case report demonstrates a unique case and management of a subclinical presentation of confirmed C. acnes infection.

Case Report: Diagnosing & Treating Triple Negative Breast Cancer During Pregnancy, Sydney Mefford, Chloe Page

Posters

• Pregnancy associated breast cancer (PABC) is rare and can be seen in every 1 in 3000 pregnantpatients.It is associated with a high morbidity rate, especially in cases of Triple Negative Breast Cancer (TNBC).
• Prevalence has increasedas society grows to have pregnancies at later ages. Risk is elevated for 1 year after delivery of baby.

Sole Searching: The Mystery Of A Left Foot Mood Swing Unraveled Patient, Kaitlin Sebranek

Posters

About 0.2% of patients in the Diabetic population have Charcot Neuroarthropathy.

When the gold standard of offloading in a total contact cast fails for CN patients, surgical treatment can be considered to achieve a stable, plantigrade, and functional foot.

Due to the complexity of the condition, potential complications such as hardware breakage, nonunion, and infection can result over time.

The Diagnosis Of Polyarteritis Nodosa In The Setting Of Lower Extremity Lesions: A Case Report, Eric Li, Jihan Toma

Posters

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries, involving multiple organs, with the most frequently affected tissues being skin and peripheral nerves (1). The distinct pearl neckless pattern led to the naming of this condition (2). Cutaneous polyarteritis nodosa (CPAN) is a variant of PAN confined to the skin, muscles and peripheral nerves in the absence of any systemic involvement (1). This rare form of systemic necrotizing vasculitis is limited to the medium-sized arteries of the skinand has a more favorable prognosis (1). PAN is also linked to Hepatitis B(2).The current diagnostic criteria for CPAN were proposed …

Stepping Into Relief: Conquering Rheumatoid Arthritic Foot Pain With Podiatric Management, Natalie Diaz, Marshall Solomon, Inocencio Cuesta

Posters

Rheumatoid arthritis (RA) is a chronic multifactorial autoimmune disease that causes progressive joint destruction along with causing cutaneous manifestations such as nodules. RA negatively impacts life by producing pain, impairing quality of life and biomechanical function of the lower extremities.

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Kaposi Sarcoma: Case Study, Mohamed Elshebiny, Marshall G. Solomon

Posters

Kaposi Sarcoma (KS) is a vascular tumor usually caused by a herpestype virus HHV-8

Lesions often appear as flat or raised purple-colored, and depending on the stage may be nodular and break the skin when they ulcerate.

Stages of KS are Patch stage (early stage), Plaque stage, and Nodular stage (tumor/late stage).

Can be one of four types:

–AIDS related KS – infected with HIV (AKS)

– Transplant-associated – in immunosuppressed pts

Classic – often in pts Eastern-European, Mediterranean/Middle Eastern descent

– Endemic

The Curious Case Of Ainhum Dactolysis Spontanea, Jesse Miller, Michele Bertele-Semma, Randy Semma

Posters

HPI

• 46 yoAfrican male, no major PMH.
• Pt presents with severe pain in the right 5thtoe.
• Pt had used a corn remover at home treatment 2 years ago which they stated started the progression in the pain of the patient.
• Pt states that the toe has progressively become more constricted and painful.
• Pt states that they want their toe amputated to relieve the pain.

Repair Of Achilles Tendon Re-Rupture With Fhl Transfer: A Case Study, Taylor Allison, Joshua Kazdan

Posters

The Achilles tendon consists of the soleus muscle and two heads of the gastrocnemius muscle. Loss of its function can result in loss of plantarflexion strength, which can impact activities of daily living. In a study by Scheller et al, Achilles tendon ruptures were missed on initial evaluation on 25% of their patients. Other studies have reported a similar incidence of misdiagnoses. Patients may also delay treatment due to decreased pain after the initial injury. Ruptures diagnosed 4 weeks from injury are often considered chronic, and many of these patients benefit from surgical repair. A flexor hallucis longus (FHL) transfer …

Complications And Formation Of Sinus Tracts Due To Presence Of Lead From Foreign Bodies Insoft Tissue: A Case Report, Peter J. Godoy, Marshall G. Solomon

Posters

A cornerstone of lower extremity limb salvage is to avoid development of wound complicationsinvolved in soft tissue infections .

Predicting probability of sinus tract development due to presence of lead in soft tissues from foreign bodies. Inthis particular case a bulletfragment from a previous gunshot wound was noted to be the catalyst disrupting multiple biologic processes and impairing the function of soft tissues to heal. Predicting a level of contamination in this particular case leadbelieved to cause oxidative stress and inflammation and prompt excisional removal canavoid sinus tract formations and complications.

This study presents a unique case that demonstratesbeneficial patient …

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosisand candidiasis from the fungus Candida albicansare both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Increasing Patient Age And General Anesthesia Are Risk Factors For Failure Of Same-Day Discharge Total Hip Arthroplasty, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: As cost containment efforts in orthopedic surgery increase, there has been a rise in same-day discharge total hip arthroplasty (THA). Same-day discharge THA has been further accelerated by the COVID-19 pandemic and the removal of THA from the Medicare inpatient only list. This study sought to evaluate risk factors for readmission following same-day discharge THA. METHODS: From 2012-2021, the National Surgical Quality Improvement Project database was used to identify all patients undergoing elective THA discharged the day of surgery to their home. Demographic, comorbid, and operative variables were collected, as displayed in Table 1. Readmission within 30-days of surgery …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty: Risk Factor Assessment, Daniel Aris Nikolaidis, Devin Young, Robert Runner, Mark S. Karadsheh, Andrew Steffensmeier

Conference Presentation Abstracts

INTRODUCTION: The risk factors for developing a periprosthetic joint infection (PJI) are well described. However, those associated with developing a second-site or metachronous PJI (MPJI) following a subsequent primary arthroplasty are poorly understood. The purpose of our study is to determine (1) prevalence and (2) risk factors associated with developing a second-site PJI in patients with a prior history of PJI who undergo a subsequent THA or TKA. METHODS: A retrospective, single-center case-control study identified 77 patients treated for an index PJI (hip or knee) between 2013-2022, and who also underwent another primary arthroplasty after completing treatment for their first …

Neuraxial Vs. General Anesthesia In Total Hip Arthroplasty For Femoral Neck Fracture: A Comparison Of Post-Operative Complications, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: Rates of complications with differing anesthetic choices has not been directly compared for patients undergoing total hip arthroplasty (THA) for femoral neck fractures. This study sought to directly compare neuraxial vs. general anesthetic use and compare post-operative outcomes for patients undergoing THA for a femoral neck fracture. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing THA for a femoral neck fracture. Anesthetic type was identified and categorized as neuraxial (spinal, epidural) or general. Demographic and comorbid variables were collected. Days from admission to surgery was also identified. Postoperative complications …

Epigastric Hernia Containing Incarcerated Gallbladder, Katelyn R. Ward, Melanie Ermler, Kathryn M. Ziegler

Conference Presentation Abstracts

Introduction: Epigastric hernias represent 1.6–3.6% of all abdominal hernias, and usually contain preperitoneal fat and occasionally omentum or small bowel. Rarely, epigastric hernias may contain portions of other organs, such as colon or stomach. We report an unusual case of a patient whose incarcerated epigastric hernia contained her stone-filled gallbladder.over a million performed in the US, and over 20 million worldwide annually. We aim to study and compare interest trends in the US and the World for IHR techniques (open, laparoscopic, robotic) using GT. Methods: The following search topics were analyzed from January 2010 to August 2024 in ‘‘US’’ and …

Left Behind: A Rare Case Of True Gallbladder Sinistroposition And Surgical Implications, Daniel Finn, Jacob Applegarth, Jacob Mesiti, Mario Villalba

Conference Presentation Abstracts

Objectives: Encountering aberrant biliary anatomy is a known risk factor for inadvertent injury while performing biliary surgery. One described anatomic aberrancy, sinistroposition of the gallbladder (also known as ‘‘left sided gallbladder’’), is a rarely seen anatomic abnormality with an incidence of 0.2% to 1.1%. Given the infrequent encounters with this abnormality and its association with other anatomic anomalies, extreme care and caution should be exercised when performing a cholecystectomy in this patient population. Methods: We present the case of a 37-year-old male who presented with abdominal pain and was diagnosed with Tokyo Grade I acute calculous cholecystitis. An ultrasound of …

Serum Metal Ion Levels In Patients Undergoing Revision Should Arthroplasty, Rishi Chatterji, Brandon Fisher, Avianna Elizabeth Arapovic, Yuying Xing, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Shoulder arthroplasty systems are transitioning towards more modular prosthesis options with the goal of reducing complication profiles and increasing range of motion. Modularity may increase the potential for fretting, corrosion, and subsequent release of metal ions. These events have been associated with adverse reactions in hip and knee arthroplasty, but not in the setting of revision shoulder arthroplasty. The purpose of this study was to identify associations between implant designs, metallurgy, patient characteristics, and serum metal ion levels in patients undergoing revision shoulder arthroplasty. METHODS: 51 patients that underwent revision shoulder arthroplasty were retrospectively reviewed based on prospectively collected …