Medical Specialties Commons^™

Comparing Radiological Characteristics Of Neck Pain In Younger Versus Older Patients: A Retrospective Analysis, Jnana Aditya Challa, Abdul Majid Khan, Varna Taranikanti

Posters

INTRODUCTION
Neck pain commonly occurs during the fifth or sixth decade of life due to degenerative changes in the spine. With increased usage of digital technology from a very young age we hypothesized an earlier age of onset of these degenerative changes. There have been no recent epidemiologic studies that investigated difference in radiological changes seen in older versus younger patients presenting with neck pain. Hence, this study is undertaken to analyze the variability in radiological changes seen in the cervical vertebrae between older (>50) versus younger (≤50) patients presenting with the chief complaint of neck pain.

Evaluating The Impact Of Software Distortion Correction On Target Doses In Cranial Stereotactic Radiosurgery, Sharjil Shamim, Zachary Seymour

Posters

INTRODUCTION
Brainlab’s Elements suite proposed a novel MR distortion correction method based on CT imaging. This involves registration of sub-volumes from MR imaging to generate single continuous deformation field maps, creating a corrected MR image set. No literature currently exists studying the impact of software correction on target dose for cranial stereotactic radiosurgery. In this study, we aim to evaluate the impact of Brainlab distortion correction on radiation target dose compared to original treatment plans without distortion correction.

Development Of A Deep Neural Network For Synthesis Of Non-Contrast Cranial T1-Weighted Magnetic Resonance Imaging, Agueda M. Taylor, Evan Porter, Thomas Guerrero

Posters

INTRODUCTION
Although 122 out of 1000 people in the US have MRI’s done each year, there are over 4 million with contraindications that subsequently forgo the diagnostic benefits. Studies in recent years have implemented artificial intelligence (AI) algorithms such as deep neural networks (DNN) for production of synthetic medical imaging. The goals of this project are to develop a DNN, specifically a Generative Adversarial Network (GAN) that will predict synthetic Cranial T1 Weighted MRI from non-contrast CT, and to evaluate the model quality.

Factors Influencing Reintubation In Self Extubated Pediatric Intensive Care Unit Patients, Ahmed Naseem, Ameer Al-Hadidi, Morta Lapkus, Patrick Karabon, Begum Akay, Paras Khandar

Posters

NTRODUCTION
Intubated pediatric patients that self-extubate may be particularly susceptible to reintubation. Identifying factors that increase risk of reintubation allows for better monitoring and response in cases of self-extubation and can potentially identify patients needing reintubation.

Clearance Of The Cervical Spine In Obtunded Pediatric Blunt Trauma Patients: Quality Assessment Of An Existing Clearance Pathway, Rachel Kalthoff, Elizabeth Boudiab, Diane Studzinski, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Posters

INTRODUCTION
Obtunded patients following blunt trauma need clearance of the cervical spine (c-spine) that cannot depend on a clinical exam. Our center’s current pediatric c-spine evaluation pathway includes both Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). The objective of this study was to review our use of both CT and MRI for obtunded pediatric trauma patients to assess the quality of our pathway and utility of MRI.

Relationship Between Smoking And Triple-Negative Breast Cancer: A Retrospective Analysis, Anna Jahshan, Mariam Aoun, Nayana Dekhne, Varna Taranikanti

Posters

INTRODUCTION
Breast cancer is currently the most common cancer by incidence among women in the United States with high mortality. Compared to other specific types, triple-negative breast cancer (TNBC) is considered to be an aggressive cancer with poor prognosis. Hence, it is important to study the risk factors associated with it. Smoking has been implicated in many cancers, including breast cancer. However, there is no evidence in literature that has shown a relationship between smoking and a specific type of breast cancer. The goal of this study is to analyze the relationship between smoking and TNBC so that we may …

Differences Within A Health System: Imaging Use For Suspected Pediatric Appendicitis, Nafisa Bhuiyan, Ryan Nierstedt, Michelle Jankowski, Shanna Jones, Aveh Bastani

Posters

INTRODUCTION
Ultrasound (US) is the first line imaging used for suspected pediatric appendicitis. However, following equivocal US findings and its lower negative predictive value for ruling out appendicitis, Computed Tomography (CT) imaging is often performed in children. This study investigates the differences in imaging utilization between a community hospital (Beaumont Troy) and a children’s ED hospital (Beaumont Royal Oak), making it the first study to evaluate suspected pediatric appendicitis in Beaumont Health System. It also aims to further characterize differences in patient outcomes such as surgery, length of hospital stay, complications of appendicitis, and highlight the need to reduce unnecessary …

Differences In Small Bowel Obstruction Outcomes In An Academic Vs Community Hospital., Kelly Fahey, Aveh Bastani, Shanna Jones, Philip Kilanowski-Doroh

Posters

Small bowel obstruction: blockage in small intestine. Adhesions are the most common cause. Accounts for 300,000 hospitalizations in the US annually, and 20% of emergency surgical procedures in patients with abdominal pain. High morbidity and mortality. Average hospital stay of 8 days. 30-day readmission rate of 16%. In-hospital mortality rate of 3%. Costly diagnosis: more than $2 billion spent on admissions for adhesion-related disease in the United States. Clinical presentation: variable, includes abdominal pain, vomiting, constipation, nausea, and abdominal distention. Management. Operative: important if signs of ischemia, peritonitis, or strangulation. Conservative: includes bowel rest, nasogastric decompression, serial examinations, and a …

Cardiac Arrest Patient Length Of Stay And Survival In Michigan Hospitals, Jaemin Song, David A. Berger, James H. Paxton, Joseph B. Miller, Joshua Reynolds, Nai-Wei Chen, Robert Swor

Posters

INTRODUCTION
Current guidelines recommend deferring prognostic decisions for at least 72 hours following admission after Out of Hospital cardiac arrest (OHCA). Most non-survivors experience withdrawal of life-sustaining therapy (WLST), and early WLST may adversely impact survival. We sought to characterize the hospital length of stay (LOS) and timing of Do Not Resuscitate (DNR) orders (as surrogates for WLST) to assess their relationship to survival following cardiac arrest.

A Multimodal Approach To Reducing Opioid Administration In The Emergency Department, Eddie Ford, Vito Rocco, Shanna Jones, Patrick Karabon

Posters

INTRODUCTION
The United States is battling a deadly epidemic against opioid abuse and misuse, which began as a result of pharmaceutical companies purposely downplaying the addictive potential of their opioid medications. In 2016, a Colorado health care system developed a groundbreaking alternative to opioids (ALTO) protocol for acute pain relief in the Emergency Department (ED). This protocol was adapted and implemented in the Beaumont Troy ED and is the focus of this current study. The primary goal of this study is to characterize the impact of the ALTO protocol on the rate of opioid and non-opioid administration in the ED …

Outcomes For Patients With Congestive Heart Failure And Chronic Kidney Disease Receiving Fluid Resuscitation For Severe Sepsis Or Septic Shock, Melany Wiczorek, Ronny Otero, Steven Knight, Kaitlin Ziadeh, James Blumline, Zachary Rollins

Posters

INTRODUCTION
Sepsis core measures are an integral part of sepsis treatment. Current fluid administration guidelines consist of administering at least 30cc/kg of intravenous fluids (IVF) per ideal body weight (IBW) within the first three hours of sepsis diagnosis regardless of pre-existing comorbidities at risk for fluid overload. This study aims to evaluate the outcomes of patients with a history of congestive heart failure (CHF) and/or chronic kidney disease (CKD) who receive fluid resuscitation for the management of severe sepsis or septic shock.

The Current State Of Diagnostic Error Education In U.S. Medical Schools, Dakota Hall, Sandra Lablance, Brett Todd

Posters

Diagnostic error has been identified by the Institute of Medicine as a major cause of patient harm. Despite recent focus on the importance of diagnostic error, little is known about how medical schools are educating future physicians, specifically, the extent to which it is taught. We aimed to investigate the current state of diagnostic error education in U.S. medical schools.

Journal Club In The Pre-Clinical Years During Medical School, Kristin Cuadra, Steven Joseph

Posters

INTRODUCTION
Traditionally, journal clubs have been conducted within graduate medical programs to help integrate evidence-based learning. This study will be focused on beginning to integrate journal club into the pre-clinical years while implementing successful techniques used in past journal clubs. Our hypothesis is that, with a structured review instrument in place to help students analyze clinical articles, students will be able to benefit from monthly journal clubs and fully grasp concepts taught in these pre-clinical years. Overall, the results will contribute significantly in determining the efficacy of journal club and whether or not it can be a valuable tool in …

Acute Post-Operative Pain Following Anterior Cruciate Ligament Reconstruction: A Comparison Of Patellar Tendon Vs Hamstring Autograft, Dustin J Randall, Denise Koueiter, Brandon Luczak, Kyle Anderson

Posters

INTRODUCTION
Choosing between a bone-patellar tendon-bone (BTB) or hamstring tendon (HS) graft for primary anterior cruciate ligament (ACL) reconstruction has long been a topic of debate and discrepancy in orthopaedic literature, with many factors contributing to the decision process. The purpose of this study is to analyze acute post-operative pain scores of patients who underwent ACL reconstruction and compare the results between BTB autograft and the HS autograft techniques.

Case Study: Injectable Bone Cement In Treatment Of Orif Calcaneal Fractures, Michael Flores, Siraj Panchbhaiya

Posters

No abstract provided.

Covid-19 And Incidence Of Necrotizing Fasciitis: A Case Study, Tehreem Sajjad, Carmen Johnson, Janet Baatile-Ajrouche

Posters

COVID-19 manifests as a flu-like respiratory infection affecting multiple organ systems. Symptoms range from mild viral illness to severe acute respiratory infection. There is no definitive relationship between COVID-19 and cellulitis, inflammatory myositis, vasculitis, or necrotizing fasciitis. It is interesting to note that angiotensin-converting enzyme 2 (Receptor for SARS-CoV-2) is present on endothelial cells in multiple organs, including dermal blood vessels and arterial smooth muscle cells. There are several theories that have formed to explain the relationship between COVID-19 and a necrotizing fasciitis infection. This study presents one unique case of an unvaccinated COVID+ patient and the necrotizing fasciitis infection …

Filleted Toe Flap For Closure Of Neuropathic Wound With Osteomyelitis, Robert Boguski, Danniyal Shahid

Posters

No abstract provided.

A Study To Compare Baseline Functional Residual Capacity And Forced Vital Capacity As Predictors Of Mortality And Hospitalization In A Cohort Of Mild To Moderate Interstitial Lung Disease, Olga R. Gomez Rojas, Ehsun Naeem, Filip Ionescu, Edward Castillo, Girish B. Nair

Posters

Forced Vital Capacity (FVC) is a common parameter used to assess disease progression in patients with Interstitial lung disease (ILD) and acts as a surrogate for mortality. Previous studies suggest Functional Residual Capacity (FRC) may be an earlier predictor of disease progression in ILD. In this study, we compared predictive ability of baseline FRC to FVC to predict one-year-mortality and respiratory related hospitalization in patients with mild to moderate ILD

Lumbar Motion Is Maintained With Paraspinous Tension Band For Degenerative Spondylolisthesis: Results From 24-Month Fda Study, Kee D. Kim, Rick Sasso, Serena Hu, Alan Villavicencio, S Tim Yoon, William Lavelle, Harvinder Sandhu, Hyun Bae, Jeffrey Fischgrund, Mick Perez-Cruet

Conference Presentation Abstracts

Introduction

Durable outcome for degenerative spondylolisthesis (DS) usually requires decompression and fusion. Fusion, however, places greater stress at adjacent levels with increased incidence of adjacent segment disease. A novel interspinous tension band is proposed for segmental stabilization after decompression for DS, as an alternative to fusion. An FDA IDE study (NCT03115983) compares decompression and stabilization with the tension band (treatment group) to decompression and transforaminal interbody instrumented fusion (control group) for symptomatic DS.

Methods

Prospectively enrolled IDE study subjects with 24 months postoperative radiographic follow-up were included in this analysis. X-rays obtained during the follow-up period for both the treatment …

The Current State Of Diagnostic Error Education In Us Medical Schools, Dakota Hall, Brett R. Todd, Sandra Lablance

Conference Presentation Abstracts

Background: Diagnostic error has been identified by the Institute of Medicine as a major cause of patient harm. Despite this recent focus on the importance of diagnostic error, little is known about how medical schools are educating future physicians on diagnostic error, specifically if diagnostic error is taught, when in the curriculum it is taught, and the format for teaching. We aimed to investigate the current state of education on diagnostic error in US medical schools. Methods: We conducted an anonymous survey of deans of medical education at US MD and DO medical schools utilizing Qualtrics. The study was distributed …

Anti-Nmda-Receptor Encephalitis In A Patient With Ovarian Teratoma, Harboring Brain Histology Of Varying Developmental Stages, Seyedalireza Fatemi, Joseph Fullmer

Conference Presentation Abstracts

Anti-NMDA-receptor encephalitis is a subacute, autoimmune disorder thought to be caused by autoantibodies directed against the N-methyl-D-aspartate (NMDA) receptor. Although NMDAR encephalitis is a familiar entity to psychiatrists and neurologists, it is less commonly reported in the pathology literature. Clinical symptoms of anti-NMDAR encephalitis may mimic schizophrenia and psychotic spectrum disorders or substance-induced psychosis. Although initially described in association with ovarian teratomas in women, anti-NMDAR encephalitis has been reported in individuals without paraneoplastic association, as well as in males. Previous literature has suggested NMDA receptor expressing teratoma neurons are densely aggregated and are smaller in size. Ki-67 index can be …

Clinical Pathways Leading To Antibiotic Initiation In Patients With Suspected Infection And Their Association With Delays And Mortality, X Han, C Lopez-Espina, P A. Verhoef, A Spicer, A Bhargava, L Schmalz, Matthew Sims, Alexandra Halalau, Nicholas Maddens, Aimee Espinosa

Conference Presentation Abstracts

Rationale: Delayed antibiotic therapy is associated with increased mortality in patients hospitalized with infection. The decision toinitiate therapy in patients with suspected infection is influenced by a variety of information, such as vital signs, and laboratoryresults. Identifying different patterns of events that lead to initiation is necessary to discover factors that could serve as targets forinterventions to expedite this process. We aimed to identify the most common sequences of events that precede antibioticordering and to quantify the time intervals between each event that contribute to antibiotic delays. Methods: This was aretrospective study of adult patients hospitalized at 4 community hospitals …

Spontaneous Pneumomediastinum In Children Is Not Associated With Esophageal Perforation, Kevin Roby, Catherine Barkach, Diane Studzinsk, Nathan M. Novotny, Begum Akay, Pavan Brahmamdam

Conference Presentation Abstracts

Purpose: We hypothesized that esophageal perforation is not a common etiology for spontaneous pneumomediastinum (SPM), and that SPM is a self-limited disease not requiring routine admission. Methods: We performed a retrospective review of patients, ages 0 to 21 years, diagnosed with SPM in one hospital system (five hospitals) from 2009 – 2019. Cases were identified using ICD9 and 10 codes and confirmed through chart review. Cases were excluded for trauma, severe infections, or subsequent development of SPM after admission for a separate diagnosis. Data regarding patient characteristics, diagnostic tests, and outcomes were collected, and summary statistics were performed. Results: We …

Feasibility Of Acute Hematologic Toxicity Model-Based Patient Selection For Proton Beam Therapy, P Liu, X Cao, X Gao, S Shang, J Liu, Z Wang, Xuanfeng Ding

Conference Presentation Abstracts

Purpose or Objective To investigate the potential clinical benefit of utilizing IMPT to reduce acute hematologic toxicity for locally advanced nonsmall cell lung cancer (NSCLC) patients and explore the feasibility of a model-based patient selection approach via the normal tissue complication probability (NTCP). Materials and Methods Twenty patients with locally advanced NSCLC were enrolled.[ld1] Volumetric modulated arc photon therapy (VMAT) and intensity-modulated proton therapy (IMPT) plans were generated with a prescription dose of 60 Gy in 30 fractions. A wide range of cases with varied tumor size, location, stations of metastatic lymph nodes were selected to represent the general cancer …

Feasibility Of Utilizing Spot-Scanning Proton Arc (Sparc) Therapy For Whole Lung Irradiation, Lewei Zhao, Gang Liu, An Qin, Di Yan, Craig Stevens, Xiaoqiang Li, Rohan Deraniyagala, Xuanfeng Ding

Conference Presentation Abstracts

Purpose or Objective We reported the first feasibility study of utilizing spot-scanning arc therapy (SPArc) whole lung irradiation for a pediatric patient to reduce cardiac toxicity. Materials and Methods A 13 year-old patient with metastatic Ewing sarcoma treated with Volumetric Modulated Arc Therapy (VMAT) in our institution was selected (Figure 1A). The clinical VMAT plan used three 360-deg arcs with 6 MV based on the Elekta HD. Intensity Modulated Proton Therapy (IMPT) plan was generated using 2 iso and 4 treatment fields (Figure 1B) based on the single field optimization approach in a clinical treatment planning system (TPS) (RayStation version …

From Head To Hilum: Angiosarcoma With Pulmonary Metastasis, Tanaz Salimnia, Lauren A. Abplanalp, Raashi Chawla, K Hughes, R Ghandchi, Matthew Weatherhead, Sanjay Dogra

Conference Presentation Abstracts

With an estimated five-year survival of less than 40 percent, angiosarcomas are rare and often misdiagnosed fataltumors originating from blood or lymphatic vessels with a predilection for the head and neck. They account for 1percent of all soft tissue sarcomas and are often mistaken for benign mimickers leading to the late-stage diagnosiswhen the body is already riddled with metastatic disease with the lung being the most common site of metastases.This case illustrates the myriad of pulmonary complications associated with this uncommon but fatal vasoformativemalignancy. The patient is a 73-year-old male diagnosed with angiosarcoma of the right scalp status post excision,reconstruction, …

Hydrogel Matrix Human Stem Cell Based Nucleus Pulposus Intervertebral Disc Regeneration, Mick J. Perez-Cruet, Siddharth Ramanathan, Rasul Chaudhry, Leon Chieng, Christina Mckee, Aaron Rapp

Conference Presentation Abstracts

Introduction

Degenerative disc disease (DDD) is one of the leading causes of chronic debilitating low back pain. DDD is characterized by changes in cellular characteristics resulting in loss of extracellular matrix(ECM) water holding capacity of the nucleus pulposus(NP). DDD can lead to translation of physiological loads from the anterior 2/3 of the spinal column to the posterior 1/3, resulting in increased stress on the facets and ligamentum flavum causing facet hypertrophy and canal stenosis. Novel stem cell regenerative therapies could restore the anterior column load via NP regeneration.

Methods

A hydrogel scaffold was created composed of self-assembling polyethylene glycol(PEG) functionalized …

Google Translate "Schwartzfahrer" And The Exploration Of Racism And Belonging In A Different Culture, James P. Meza, Daniel Tanbakuchi, Robin Zehner, Andrea Daniel, Jianming Lau

Conference Presentation Abstracts

This project is based on the premise that observing a different culture enables a less politicized discussion of racism in the America. Using the short film "Schwartzfahrer" by Pepe Danquart, this project proposes convening focus groups to uncover layers of meaning and differing perspectives on topics that include race, identity, immigration, societal belonging-exclusion, and civic courage. The film is 12 minutes long. Participants will be asked to examine non-verbal and para-linguistic attributes portrayed. The second layer of meaning will be elicited by adding English subtitles and viewing the film again. The facilitator will elicit a list of overt racist utterances …

Scholarly Activity And Academic Writing For Practicing Clinicians, James P. Meza, Nicholus H. Yee, Ethan O. Cohen, Milan V. Pantelic, Thomas Przybycien, Tyler Russeth, Krupa Patel, Scott Baughan

Conference Presentation Abstracts

This roundtable discussion brings the executive editorial board of Clinical Research in Practice: The Journal of Team Hippocrates into direct contact with prospective authors to provide editorial support with the goal of coaching participants to be successful when submitting a manuscript to Clinical Research in Practice: The Journal of Team Hippocrates. The aims and scope of the journal focus on clinical decision science (CDS). CDS explores how the complex, interacting aspects of clinical care are described, understood, shared, and explained. This includes both biomedical and medical social sciences, in addition to other ways of understanding human experience. This is a …

Mri-Based Synthetic Ct Images For Impt Treatment Planning Of Nasopharyngeal Carcinoma Patients, Shupeng Chen, Y Peng, Y Liu, C Zhao, X Deng, An Qin, Di Yan, Craig Stevens, Rohan Deraniyagala, Xuanfeng Ding

Conference Presentation Abstracts

Purpose or Objective To investigate the feasibility of using an MRI-based synthetic CT image (SCT) generated via a generative adversarial network (GAN) for intensity-modulated proton therapy (IMPT) treatment planning of nasopharyngeal carcinoma (NPC) patients. Materials and Methods T1-weighted MR images and paired CT (PCT) images were obtained from 158 NPC patients with radiotherapy immobilization. Deformable image registration was performed between each MR and PCT image for each patient to create an MR-CT pair. Thirteen pairs were randomly chosen as independent test sets and the remaining 145 pairs (10 for validation and 135 for training) were used to build a conditional …