Medical Specialties Commons^™

Type 1 Cryoglobulinemia Secondary To Primary Plasma Cell Leukemia, Antonio Faieta, Khatoon Tawhida

Conference Presentation Abstracts

Primary plasma cell leukemia (pPCL) is a rare and aggressive form of plasma cell dyscrasia that comprises 1% of the plasma cell dyscrasias. Even more rare is its association with type 1 cryoglobulinemia which management can be challenging. A 63-year-old African American male with no past medical history presented with severe burning pain in his legs, necrotizing rash, constitutional symptoms and severe acute kidney injury (AKI). HIV, hepatitis B and C were negative. Serum electrophoresis revealed an M-spike of 5.67, IgG of 7000, free lambda of 152.10 with a K/L of 0 and cryoglobulin of 81%. CT revealed extensive lytic …

Rare Case Of Recurrent Hyperhemolysis Syndrome (Hhs) And Methemoglobinemia In A Patient With Sickle Cell Anemia, Ashbina Pokharel, Pradeep Khanal, Dilip Khanal, Samikshya Pandey, Bipin Ghimire

Conference Presentation Abstracts

Hyperhemolysis syndrome (HHS) is a rare but serious and potentially life-threatening complication of red blood cell (RBC) transfusion and has been described in both sickle cell disease and non-sickle cell disease patients. It is characterized by destruction of both donor and host RBC. Methemoglobinemia is another rare condition leading to cyanosis, tissue hypoxia and potentially death. We present a middle-aged female with sickle cell anemia who developed methemoglobinemia and hyperhemolysis after a surgical procedure. 41 yo female with sickle cell anemia (SC type) was hospitalized for elective right total hip resection arthroplasty. Patient received 3 units blood transfusion during the …

Very Late Relapse Of Hodgkin Lymphoma 18 Years After Remission, Bana Antonios, Markie Zimmer, Emma Herrman, Shiva Shrotriya, Ishmael Jaiyesimi

Conference Presentation Abstracts

A 72-year-old male with a history of protein C and protein S deficiency, factor V Leiden mutation, DVT/PE, and stage IIIB nodular sclerosis Hodgkin lymphoma (diagnosed 18 years back) presented with shortness of breath. EKG showed complete heart block and a transvenous pacemaker was placed. Laboratory studies showed severe normocytic anemia with hemoglobin of 6.2 g/dL, WBC of 2.6 bil/L, platelets of 113 bil/L, and INR of 2.8. The direct antiglobulin test was positive for Anti-IgG and negative for Anti-C3D. LDH was normal and haptoglobin was elevated, contrary to hemolysis. Computed tomographic scan of the abdomen and pelvis showed extensive …

Potts Puffy Tumor: A Rare Complication Of Rhinosinusitis, Bipin Ghimire, Omar Jameel, Sumesh Khanal, Ryan Owen, Ashbina Pokharel, Samiksha Pandey

Conference Presentation Abstracts

Pott's puffy tumor is a sub-periosteal abscess of the frontal bone with associated osteomyelitis. It arises as a complication of untreated or partially treated frontal sinusitis. Overall prevalence has decreased due to timely treatment with antibiotics. It is largely limited to the pediatric population and is rare in adults. A 46-year-old Caucasian male with a history of chronic rhinosinusitis presented with one-week history of progressive painful swelling over the left forehead without any other systemic signs of infection. He was started on intravenous ampicillin-sulbactam and given one dose of dexamethasone due to concern for intracranial involvement. Facial CT showed 3 …

Effectiveness Of Prenatal Screening Tests On Predicting Cardiac Anomalies, Stephanie Wong, Zeynep Alpay Savasan

Conference Presentation Abstracts

INTRODUCTION Congenital heart disease (CHD) is the leading cause of birth defect-associated infant death. With 1 in 111 newborns born with CHD and an elevated infant mortality rate of 30-50%, early detection is imperative. Current prenatal screening mainly focuses on detecting chromosomal anomalies. However, the accuracy of these exams on detecting fetal cardiac abnormalities is not well researched. The primary goal of this study is to compare three prenatal screening tests’ potential, i.e anatomy ultrasound, nuchal translucency (NT), and cell-free DNA (cfDNA), in identifying a risk for fetal cardiac anomalies. METHODS A retrospective chart review utilized a convenience sample of …

A Broken Heart: A Case Of Stress Induced Cardiomyopathy Precipitated By Community Acquired Pneumonia, Adam Foglesong, Abdulla Kara Balla, A Neil Bilolikar

Conference Presentation Abstracts

Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a syndrome characterized by a transient reduction of systolic cardiac function generally in response to emotional or physical stressors. Stress-induced catecholamine excess is believed to be the main factor driving myocyte dysfunction. Most patients are female and postmenopausal. We present a case of a 62-year-old Caucasian male with a past medical history of hypertension who presented to the ED with the chief complaint of squeezing chest pain followed by multiple episodes of productive cough and epigastric discomfort. ECG showed sinus tachycardia with premature supraventricular complexes. Chest X-ray showed severe pulmonary vascular congestion. Labs showed …

Acute Renal Failure And An Acid-Base Dilemma, Kamil Sardarli, Russell Leong, Matthew Weatherhead, Bhavinkumar Dalal

Conference Presentation Abstracts

Introduction: Acute renal failure (ARF) is well-recognized to result in metabolic acidosis. The acidosis of ARF is associated with decreased ammoniagenesis and anion excretion. Alkalosis in the presence of ARF presents diagnostic uncertainty and therapeutic challenges. This vignette describes a case of ARF resulting in several electrolyte imbalances and metabolic alkalosis. Case Description: A 54-year-old female with past medical history of small bowel resection with colostomy presented for nausea and vomiting for two weeks. On presentation, she was noted to be tachycardic and lethargic. Her workup revealed a serum creatinine of 6.8 mg/dL, blood urea nitrogen of 147 mg/dL, bicarbonate …

Does Losing 5-7% Of A Prediabetic’S Body Weight While Completing The Diabetes Prevention Program Decrease Ascvd Risk?, Molly Kucera, T Marchewka, A Craib

Conference Presentation Abstracts

Purpose: According to the Centers for Disease Control (CDC), one-third of adults have prediabetes and are at risk for developing type 2 diabetes, a leading risk factor for cardiovascular disease. The Diabetes Prevention Program (DPP) focuses on lifestyle modifications to help participants lose 5-7% of their body weight and prevent type 2 diabetes. The purpose of this study is to determine whether successful completion of the DPP is associated with a decrease in atherosclerotic cardiovascular disease (ASCVD) risk.
Methods: One-site, prospective cohort study. The DPP was implemented on-site at Farmington Village Family Practice and virtually via Zoom from January 2020 …

The Evolving Effectiveness Of Biologics In Avoiding Surgery In Children With Ulcerative Colitis., Mohineesh Kumar, Samuel K. Osei, Ayesha Fatima, Rachel N. Harvey, Alexander Menning, Anthony Stallion, Nathan Novotny

Conference Presentation Abstracts

Purpose

Pediatric ulcerative colitis (UC) treatment has changed dramatically with the introduction of multiple biologics in recent years. The purpose of this study was to assess effectiveness of biologic agents in achieving remission and incidence of surgery.

Methods

We retrospectively analyzed UC patients that were seen at gastroenterology clinic between January 2012-August 2020. We analyzed demographic characteristics, colonoscopy, clinic and hospital records. Patients were divided into four groups: 1) patients treated medically without biologics or surgery; 2) patients treated with one biologic; 3) patients treated with multiple biologics; and 4) patients that underwent colectomy. Pearson Chi-square test was used to …

Triggers And Outcomes Of Takotsubo Cardiomyopathy In Cancer Patients, Antoine Addoumieh, Dinu Balanescu, Teodora Donisan, Juan Lopez-Mattei, Peter Kim

Conference Presentation Abstracts

Background: Takotsubo cardiomyopathy (TC) is a well described entity characterized by transient and reversible left ventricular (LV) systolic dysfunction. Primary TC is triggered by psychological or emotional stress, whereas secondary TC could be due to trauma, surgery or medications. We aimed to compare outcomes in primary TC and secondary TC in cancer patients. Methods: We retrospectively identified 80 patients who presented with TC to MD Anderson between December 2008 and January 2019. Baseline characteristics were obtained. We identified the triggers leading to TC. Univariate analysis was done using Cox regression. Kaplan Meier method (KM) was used to compare survival based …

Covid-19 Vaccine Hesitancy Among Medical And Dental Students, Arati Kelekar, Neila Afonso, Victoria Lucia, Ana Karina Mascarenhas

Conference Presentation Abstracts

No abstract provided.

Hyperlipasemia Does Not Confer Worse Clinical Outcomes In A Retrospective Cohort Of Novel Coronavirus (Covid-19) Patients, Zaid Imam, Inayat Gill, Bana Antonios, Andrew Aneese, Gaurav Kakked, Faisal Kamal, Bara Al Kurdi, Alexandra Halalau

Conference Presentation Abstracts

Abstract Background Gastrointestinal manifestations and hyperlipasemia commonly occur as part of novel coronavirus infection (COVID-19), while data on acute pancreatitis is limited to case reports. We aimed to study the prevalence of hyperlipasemia and acute pancreatitis in a large inpatient cohort of COVID-19 patients and their impact on clinical outcomes. Methods Retrospective chart review of all hospitalized patients with confirmed COVID-19 at an 8-hospital health system in Michigan, USA was performed between February 1,2020 through April 1,2020 with inclusion of patients with obtained lipase levels. Univariate analyses were performed to evaluate associations between hyperlipasemia and degree of hyperlipasemia and clinical …

A Look Into Medical Students' Knowledge On Adverse Childhood Experiences, Lara Fawaz, Neila Afonso

Conference Presentation Abstracts

No abstract provided.

Geriatric Emergency Medicine Assessment In The Emergency Department Results In Yearly Savings Of $3 Million, Sarah Keene, Lauren Cameron-Comasco

Conference Presentation Abstracts

Background and Objectives: Older adult patients admitted to the hospital from the Emergency Department (ED) have a longer length of stay in the hospital on average compared to younger patients. Geriatric patients make up an increasing percentage of the patient population, and almost all health care for geriatric patients in the United States is paid for by Medicare. The cost of the inpatient care of geriatric patients is a significant contributor to the total cost of health care in the United States. Methods: We conducted a case-control study looking at the impact of a Geriatric Emergency Medicine Assessment (GEMA) team …

Current Challenges In Covid-19 Triaging: A Global Perspective, Mauli Patel, Robin Sudandiradas, Trini Mathew, Paul Kilgore, Mahadev Rao, Chiranjay Mukhopadhay, Marcus Zervos

Conference Presentation Abstracts

Background and Objectives: Although countries around the world have been combatting the same COVID-19 pandemic over the last year, the triage approach taken by various Emergency Departments (ED) is unique. This paper outlines the guidelines followed by two tertiary care hospitals in Detroit, USA and Manipal, India. By comparing hospital triage implementation protocols, this paper offers insight regarding similarities and differences between Detroit and Manipal ED, as well as strategies to overcome respective challenges. Methods: Triage algorithms from the Detroit Medical Centre in Detroit and Kasturba Medical College Hospital in Manipal were contrasted to illustrate the similarities and differences in …

Pegloprastide-Based Ratiometric Fluorescence Imaging Detects Intraoperative Positive Margins In Real-Time, Sarah A. Mclaughlin, M Catherine Lee, Sheldon M. Feldman, Barry Rosen, Valerie P. Grignol, Anne M. Wallace, Nayana S. Dekhne

Conference Presentation Abstracts

Background/Objective: Positive margins detected after breast conservation surgery can result in the need for a re-excision or completion mastectomy. We hypothesized that pegloprastide combined with a ratiometric fluorescence imaging system would allow surgeons to detect positive margins in real time. Methods: Pegloprastide (AVB-620) was to be administered to patients 3-20 hours before the start of surgery. During the operation, initial primary tumor removal was performed unaided. Following primary resection, a fluorescence imaging system optimized for use with pegloprastide was used to assess the primary specimen and the cavity. Cavity shaves were taken when fluorescence above pre-specified thresholds were noted. Additional …

Trends Contributing To Disparities In Inflammatory Breast Cancer, Anna Lehrberg, Nayana Dekhne, Amita Desai, Sayee Kiran

Conference Presentation Abstracts

Background/Objective: Breast cancer overall survival rate in Black American (BA) women is lower compared to White American (WA) women. Inflammatory breast cancer (IBC) is a rare but aggressive subtype of breast cancer that is found at higher incidence in the BA patients. The objective of this study was to evaluate trends and identify factors that contribute to racial disparities in outcomes of women with IBC. Methods: The National Cancer Database (NCDB) was used to evaluate patients with Stage III IBC from 2004 to 2014. Patient demographics, tumor characteristics, treatments and survival trends were stratified by race for comparison. Results: A …

Developing A 2-Week Surgery Bootcamp: A Needs Assessment Of Aspiring General Surgeons, Darci C. Foote, Victoria A. Roach

Conference Presentation Abstracts

No abstract provided.

Structure Sparsity Of The Spot Optimization In Proton Arc Therapy, Lewei Zhao

Conference Presentation Abstracts

Radiation therapy is one of the main cancer treatments that uses radiation to kill cancer cells. Proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate tumor volume. Beaumont proton therapy center research group invented the first robust and delivery-efficient spot-scanning proton arc (SPArc) therapy in 2016. Based on our beam modeling platform, we have found that the spot switching time (SSWT) is proportional to spot numbers. We aim to develop a direct mathematical optimization method to reduce the spot numbers for SPArc based on an independent optimization method to reduce …

Ocular Surface And Fornix Reconstruction: Flaps, Grafts And Blood Supply, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Advances In The Treatment Of Congenital Ptosis, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

The Many Uses Of 5-Fluorouracil In Oculoplastic Surgery, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Orbital Vascular Anomalies: Classification And Treatment, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Advances In The Treatment Of Thyroid Eye Disease, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Immune Thrombocytopenia In Covid Pneumonia: A Case Report Of The Oldest Patient, Samiksha Pandey, Kamil Sardarli, Candace Franklin, Ashbina Pokharel, Sumesh Khanal, Bipin Ghimire, Feroze A. Momin

Conference Presentation Abstracts

Introduction: COVID infection has shown to cause thrombocytopenia with multiple different mechanisms including the destruction of platelets with immune system stimulation similar to ITP with little evidence for optimal management. Here, we present a COVID infected patient presented with idiopathic thrombocytopenia with a partial delayed response to the treatment. Case Presentation: A 92-year-old man with a past medical history of coronary artery disease status post remote coronary artery bypass graft, hypertension, diabetes mellitus presented with petechiae, epistaxis, and was found to be profoundly thrombocytopenic with a platelet count of 1x109/L. He also had an asymptomatic COVID 19 infection, a normal …

Mosaic Pattern Of Progenitor Cell Marker Cd133 Expression To Identify Podocyte Proliferation Supports Collapsing Variant Of Focal Segmental Glomerulosclerosis (Fsgs), A Xiao, H Kanaan, W Li, P Zhang

Conference Presentation Abstracts

Introduction: Previous studies using immunofluorescent methods indicate that both the cellular crescents in crescentic glomerulonephritis and the podocyte proliferation in collapsing FSGS may both originate from parietal epithelial cells, which serve as CD133 positive progenitor cells. We have previously confirmed positive CD133 staining in the cellular crescents of crescentic glomerulonephritis. However, the role of CD133 expression in highlighting the proliferative podocytes in collapsing FSGS has not been adapted to the renal pathology practice. Methods: We have identified 19 collapsing FSGS from our archive over past 10 years (out of 3942 renal biopsies, 0.5 %). The collapsing FSGS cases were either …

The Use Of Actigraphy And Its Impact On Perceived Sleep Quality And Activity Levels In Individuals With Traumatic Brain Injury In An Inpatient Rehabilitation Setting., Lina Shkokani, Amanda Reyes, Bachar Hazim, Jason Kisser, Philip T. Roskos

Conference Presentation Abstracts

No abstract provided.

Cerebral Perfusion Using The Resistive Index On Doppler Ultrasound In Extremely Premature Newborns With Ventriculomegaly, Rawad Obeid, Marni Jacobs, Taeun Chang, An N. Massaro, Dorothy Bulas, Anna Penn

Conference Presentation Abstracts

Background: In extremely premature newborns, the effect of ventriculomegaly, as seen on cranial ultrasound (CUS), on cerebral perfusion is not well studied. The resistive index (RI) (Figure-1) is a marker of change of the flow velocity on Doppler ultrasound that could be used to understand this effect.

Objective: To identify the following: 1- The normal RI values in premature infants without intraventricular hemorrhage (IVH), 2- The relation between the RI in the major intracerebral arteries and the ventricular size on CUS using the fronto-temporal horn ratio (FTHR) in newborns with and without IVH, and 3-The association with white matter injury …

Identifying Predictors Of Peripheral Intravenous Catheter Failure Using A Novel Combination Of Clinical And Ultrasonographic Assessments, Amit Bahl, Steven Johnson, Nicholas Mielke, Patrick Karabon

Articles

No abstract provided.

Illumina Trusight Oncology 500 Sequencing Panel Validation At A Large Community Based Hospital, Sandeep Kumar, John Schwartz, Mitual Amin, Jennifer Kilbourn, Hlee Vue, Susan Daraiseh, Kausar Jabbar

Conference Presentation Abstracts

Background: With growing efficacy of targeted therapy, it is critical to have comprehensive tumor profiling. TruSight Oncology 500 (TSO500) is a hybrid capture based next generation sequencing (NGS) assay that enables comprehensive genomic profiling of tumor samples. TSO500 includes 523 cancer-related genes which provides identification of pertinent single nucleotide variants (SNV), insertions and deletions (Indels), splice variants, fusions, copy number variants (CNV), tumor mutational burden (TMB) and microsatellite instability (MSI), from genomic DNA and RNA. Design: We evaluated the performance of TSO500 using a combination of 102 formalin fixed paraffin embedded (FFPE) tumor types, 41 hematologic samples and 27 reference …