Medical Specialties Commons^™

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 …

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 …

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 …

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 …

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: …

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 …

The Mechanisms Of Trail Resistance In Triple-Negative Breast Cancer, Julio Macias Pimentel

Wayne State University Dissertations

Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer that lacks targeted therapies. Previous studies have shown that TNBC cells are highly sensitive to tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), making it a promising agent for treating TNBC. However, the development of TRAIL resistance limits its further clinical development, and the underlying mechanisms are not fully understood. In this study, we report the role of PD-L1 and inflammation in TRAIL resistance. Specifically, we found that TRAIL treatment increases PD-L1 expression in TRAIL-sensitive cells and that basal PD-L1 expression is increased in acquired TRAIL-resistant cells. Mechanistically, we found …

Mechanistic Insights Into The Therapeutic Potential Of Adjunctive Thymosin Beta-4 Treatment In Pseudomonas Aeruginosa-Induced Keratitis, Yuxin Wang

Wayne State University Dissertations

Tβ4, a naturally occurring 43-amino acid protein, has been found to promote wound healing and reduce corneal inflammation. Topical Tβ4 as a therapeutic agent in conjunction with ciprofloxacin improves the outcome of Pseudomonas aeruginosa-induced keratitis by regulating the cellular functions of PMNs and MΦs and enhancing the production of SPMs. Understanding the mechanisms of Tβ4 provides valuable insights and novel therapeutic potential for resolving disease pathogenesis not only in the cornea but also in other infectious and immune-regulated inflammatory conditions.

Partial Outpatient Oral Antibiotic Treatment Of Infective Endocarditis Is Non-Inferior To Inpatient Intravenous Antibiotic Therapy, Nicholas J. Murphy

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Iversen K, Ihlemann N, Gill SU, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019; 380:415-424. https://doi.org/10.1056/NEJMoa1808312

for a patient with infective endocarditis and intravenous drug use with desire to leave the hospital.

Pregabalin May Reduce Neuropathic Pain In Burn Victims, Caroline Nikolaidis

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Gray P, Kirby J, Smith MT, et al. Pregabalin in severe burn injury pain: a double-blind, randomized placebo-controlled trial. Pain. 2011;152(6):1279-1288. https://doi.org/10.1016/j.pain.2011.01.055

for a patient with burn injury pain.

Indwelling Pleural Catheterization Maximizes Functionality And Quality Of Life In Management Of Recurrent Malignant Pleural Effusions, Avinash Ramkissoon

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: The TIME2 randomized controlled trial. J Am Med Assoc. 2012;307(22):2383-2389. https://doi.org/10.1001/jama.2012.5535

for the management of recurrent malignant pleural effusions in a patient with metastatic renal cell carcinoma.

Exploring Alternative Treatment Options For A Patient With Heavy Menstrual Bleeding And Mistrust Of The Healthcare System, Rachel A. O'Dell

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Tinelli A, Gustapane S, D’Oria O, Licchelli M, Panese G. Nutraceuticals in fibroid management after ulipristal acetate administration: An observational study on patients’ compliance. International Journal of Gynecology and Obstetrics; 2022;156(1):133-138. https://doi.org/10.1002/ijgo.13692

for a patient with chronic, symptomatic anemia with menorrhagia and uterine fibroid.

Prevalence And Effect Of Cannabis Use In Acute Pancreatitis Of Unknown Etiology, Hanna Tran

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Simons-Linares CR, Barkin JA, Wang Y, et al. Is There an Effect of Cannabis Consumption on Acute Pancreatitis?. Dig Dis Sci. 2018;63(10):2786-2791. https://doi.org/10.1007/s10620-018-5169-2

for a patient with cannabis-associated acute pancreatitis.

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

Opioids For Dyspnea End Of Life Review, Lindsey Obarzanek, Wendy Wu, Victoria Tutag-Lehr

Library Scholarly Publications

Objective: The objective of this systematic review is to consolidate the existing evidence on opioid use, including administration, dosing and efficacy, for the relief of dyspnea at end-of-life. The overarching goal is to optimize clinical management of dyspnea by identifying patterns in opioid use, improving opioid management of dyspnea, and to prioritize future research.

Background: Opioids are commonly used in the management of dyspnea at end of life; yet specific administration guidelines are limited. A greater understanding of the effectiveness of opioids in relieving end-of-life dyspnea with consideration of study design, patients, and opioids, including dyspnea evaluation tools …

The Decision I Never Thought I Would Have To Make, Mary Nixon

Clinical Research in Practice: The Journal of Team Hippocrates

A brief essay on how the COVID pandemic has changed how we think about medicine and our patients.

Radiation Therapy For Older Women With Early Breast Cancer: An Unnecessary Hardship, Lauren E. Shawver

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Kunkler IH, Williams LJ, Jack WJ, Cameron DA, Dixon JM; PRIME II investigators. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial [published correction appears in Lancet Oncol. 2015 Mar;16(3):e105]. Lancet Oncol. 2015;16(3):266-273. https://doi.org/10.1016/S1470-2045(14)71221-5

for an older patient seeking treatment for Stage 1 Ductal Breast Carcinoma

Enhanced Recovery After Surgery (Eras) Protocols Decrease Length Of Hospital Stay And Maintain Functional Independence In Elderly Patients Undergoing Colorectal Surgery, Kristen Hawes

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Ostermann S, Morel P, Chalé JJ, et al. Randomized controlled trial of enhanced recovery program dedicated to elderly patients after colorectal surgery. Dis Colon Rectum. 2019;62(9):1105-1116. https://doi.org/10.1097/DCR.0000000000001442

for an elderly patient undergoing colorectal surgery.

Descriptive Analysis Of Acute Ischemic Stroke In Covid-19 Patients Through The Course Of The Covid-19 Pandemic, Amman Bhasin, Jay Liuhong Liu, Keval Shah, Amin Marji, Ricky Sareini, Shishir Rao, Wazim Mohamed, Kumar Rajamani, Parthasarathi Chamiraju, Ayaz Khawaja

Medical Student Research Symposium

Coronavirus disease 2019 (COVID-19) has been associated with Acute Ischemic Stroke (AIS). Here, we characterize our institutional experience with management of COVID-19 and AIS. Baseline demographics, clinical, imaging, and outcomes data were determined in patients with COVID-19 and AIS presenting within March 2020 thru October 2020, and November 2020 thru August 2021, based on institutional COVID-19 hospitalization volume. Of 2512 COVID-19 patients, 35 (1.39%, mean age 63.3 years, 54% women) had AIS. AIS recognition was frequently delayed after COVID-19 symptoms (median 19.5 days). Four patients (31%) were on therapeutic anticoagulation at AIS recognition. AIS mechanism was undetermined or due to …

Mortality From Aspiration Pneumonia: Incidence, Trends, And Risk Factors, Trisha Gupte, John D. Cramer M.D., Arthur Knack Phd, Ccc-Slp

Medical Student Research Symposium

Aspiration pneumonia is a potentially preventable, aggressive type of pneumonia. Little is understood on the burden in mortality from aspiration pneumonia. Our objectives were to first examine the burden of mortality from aspiration pneumonia in the United States and second investigate comorbidities associated with aspiration pneumonia to understand risk factors. We conducted a case-control study of individuals who died of aspiration pneumonia matched to those who died of other causes. We analyzed all deaths in the United States using the Multiple Cause of Death Dataset from 1999-2017. Cases were matched with controls based on age, sex, and race. We calculated …

Acetyl Isogambogic Acid Activates Unfolded Protein Response And Apoptosis In Head And Neck Cancer, Mehrnoosh Ghafouri, Chester Gauss, Yue Xi Phd, Thomas Jetmore Md, Jordyn Lucas Md, Michael U. Callaghan Md, Andrew M. Fribley Phd

Medical Student Research Symposium

Head and neck squamous cell carcinoma (HNSCC) develops in the mucous membranes of the mouth, nose, and throat. HNSCC is the sixth most common malignancy in the world with 650,000 new diagnosis and 350,000 death every year. Current treatments are chemotherapy and radiation however, the 5-year survival rate for patients at stage 3 or 4 is less than 50%. There is an urgent unmet clinical need to investigate novel treatments for these patients. HNSCC is characterized by dysregulated cell growth rate and aberrant protein synthesis which leads to increased protein folding demand and the need for chaperones. This high protein …

Meta-Analysis Of 175 Patients With Covid-19 And Seizures, Status Epilepticus, Or Cortical Myoclonus: An Individual Patient Data Analysis, Aditi Kappagantu Bs, Helena A. Brantz Ms, Amman Bhasin Ba, Cristina Jageka Bs, Rooqash Ali Md, Izzy Saef Md, Brittany M. Stopa Mph, Ayaz Khawaja Md

Medical Student Research Symposium

Objective

To characterize management and outcomes of seizures, status epilepticus, and cortical myoclonus in COVID-19, with individual patient data analysis of published literature.

Methods

Systematic literature review was conducted in accordance with PRISMA guidelines. Criteria included new-onset seizures, status epilepticus, and/or cortical myoclonus with concomitant COVID-19. COVID-19 severity was dichotomized into mild and severe cases. Good outcome was defined as discharge without severe deficits, and/or return to baseline.

Results

A total of 105 studies reporting 176 patients (male 56.3%;mean age 47.8,SD 25.6) were included. Status epilepticus occurred in 47 patients (26.7%) and myoclonus in 41 (23.3%). Severe COVID-19 occurred in …

Impact Of Delayed Dermatology Consultation On Inpatient Care, Andrew S. Kao, Andrew D. King, Redina Bardhi, Meghan Mansour, Steven Daveluy

Medical Student Research Symposium

Introduction: Dermatology consultation for inpatient skin disorders enhances care by changing diagnoses, management plans, and reducing length of stay. Our goal is to quantify the time delay from primary team to dermatology consult, and its impact on hospital course as well as overall patient care.

Methods: Retrospective chart review of all inpatient dermatology consults from October 1, 2013 to December 31, 2016 at five hospitals within the Detroit Medical Center. Data included demographics, diagnosis, management plans from primary and consulting teams, and timing of initial recognition of skin problem to dermatology and other specialties consultations.

Results: 873 consultations met criteria …

Improving Satisfaction Of Patients Living With Hidradenitis Suppurativa Through Administration Of An Intake Form, Emilia M. Clementi, Steven Daveluy

Medical Student Research Symposium

Background

Hidradenitis suppurativa (HS) is an incurable, chronic inflammatory skin that is caused by follicular occlusion and affects around 1% of people in the United States ¹. Because of its chronic, grave nature, patients may be dissatisfied with their care. Improving the fecundity of HS patients’ interaction with their physicians may be an important step towards improving patient outcomes. Currently, there is no standardized patient intake form for HS patients at Wayne Health. The intake form describes key patient details, such as their current treatments, pain level, and associated symptoms. This project measures the efficacy of this tool after …

Predictive Factors For Length Of Hospital Stay In Pediatric Dog Bite Patients, Dominic Alessio-Bilowus, Nishant Kumar, Elika Ridelman Ph.D, Christina Shanti Md

Medical Student Research Symposium

Title: Predictive Factors for Length of Hospital Stay in Pediatric Dog Bite Patients

Authors: Alessio-Bilowus D¹, Kumar N², Ridelman E¹, Shanti C^2
1Wayne State University, Detroit, MI; ²Children’s Hospital of Michigan, Detroit, MI

Introduction: Dog bite injuries are a source of significant morbidity in the United States, with children being at increased risk compared to adults, yet there is a lack of published data on factors affecting hospital length of stay (LOS) in pediatric patients.

Methods: A full-text retrospective chart review was conducted of all patients presenting to our urban, academic …

Functional Attenuation Coefficient Imaging Of Rod Inner Segment: The Shape Of Things To Come, Cole Goodman

Medical Student Research Symposium

Purpose: Dysfunction of mitochondria and their linked processes within the rod cell (i.e., the rod energy-landscape) are leading hypotheses for rod atrophy in retinitis pigmentosa (RP). It remains unclear how to translate the detailed information available from isolated cell / mitochondria studies into how mitochondria are functioning and responding to treatment in vivo. Here we present a new rod energy-landscape biomarker that can help address this problem using a common clinical tool.

Methods: In mice, OCT data was converted into attenuation coefficients (AC) to map the light-scattering of mitochondria within the inner segment (IS), which fills ~75% of its volume …

Identifying Predictors For Inflammation-Induced Preterm Birth: A Murine Study, Tzu Ning Liu Bs, Jose Galaz Md, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Introduction: Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. A large proportion of preterm deliveries is affected by intra-amniotic inflammation, which can occur in the presence (intra-amniotic infection) or absence (sterile intra-amniotic inflammation) of microbes. Studies have shown an association between intra-amniotic inflammation, cervical shortening, and changes in the cervicovaginal microbiome. However, their causal relationships are unknown. This study aims to determine the causality of intra-amniotic inflammation, cervical shortening, and cervicovaginal microbiome alterations.

Methods: Pregnant C57BL/6 dams received an ultrasound-guided intra-amniotic injection of an endotoxin lipopolysaccharide (LPS) or the alarmin interleukin-1 alpha (IL-1 alpha) on 16.5 …