Medical Specialties Commons^™

Recovery Time Following Operative Versus Nonoperative Humeral Shaft Fracture Treatment, Susan Wager, Trevor D. Wolterink, Jager Haan, Yash Hedge, Chrystina James, Stephanie J. Muh

Medical Student Research Symposium

INTRODUCTION: Humeral shaft fractures represent approximately 5% of fractures in the United States. Treatment modalities include nonoperative, and operative with open reduction internal fixation (ORIF) or intramedullary nail (IMN). There is no consensus on which option is best. The purpose of this study was to compare the length of time from fracture care to radiographic union between nonoperative, ORIF, and IMN treatments for humeral shaft fractures.

METHODS: This retrospective study analyzed trends in the management of midshaft humerus fracture between July of 2013 and December of 2020. Fracture characteristics and treatment outcomes were recorded from patients with humeral shaft fractures …

A Prospective Study Investigating The Relationship Between Diagnostic Lumbar Medial Branch Blocks And The Use Of Sedation, Hannah C. Milad, Nimesh Patel Md, Ashwin Vaidyanathan Md, Katherine A. Nowak Phd, Rohit C. Aiyer Md

Medical Student Research Symposium

INTRODUCTION: Diagnostic medial branch blocks (MBB) confirm whether the origin of lower back pain is the facet joint, but are prone to false positive results. This study investigates the effects of midazolam sedation on perceived intensity of pain relief following lumbar MBB and determines the frequency of positive results in sedated patients for the corresponding treatment, radiofrequency thermocoagulation (RFTC).

METHODS: This prospective observational study compares pain scores between patients who undergo the MBB procedure with midazolam sedation (treatment) and without (control). Participants reported baseline and post-injection NRS pain scores, and 4, 8 weeks post-RFTC. If >80% pain relief was achieved …

Complications Of Pediatric Cochlear Implant Surgery, Andrew Stefan, Sabrina Bernardo, William Azkoul Ii, Bianca Siegel

Medical Student Research Symposium

Background:

Cochlear implantation (CI) surgery is the standard of care treatment for pediatric patients diagnosed with severe to profound sensorineural hearing loss. While considered a relatively safe operation, any invasive procedure involving the cranium has risks. However, there are few recent studies in the United States that have analyzed complication rates among children who have received CI. Furthermore, existing studies fail to discuss specific risk factors that led to post-operative complications, nor offer solutions to reduce their incidence. This study aims to 1) determine the incidence of specific complications in pediatric CI patients and 2) identify evidence-based risk factors for …

Tumor Vasculature Changes Before Or During Treatment To Predict Response To Systemic Therapy, Avinash Ramkissoon, Faria Ali, Thomas Vander Woude, Stephen Brown, James Ewing, Lisa Rogers

Medical Student Research Symposium

A diagnosis of non-small cell lung cancer (NSCLC) carries a grim prognosis, with 5-year survival rates of 25%. 25-30% of NSCLC patients have brain metastases at initial presentation, which carries an even worse prognosis. New systemic therapies such as targeted-therapies and immuno-therapies have potential to provide better outcomes, but are not without challenges. First, efficacy is limited to a subset of patients. Second, the blood-brain barrier limits penetration, which varies among patients. Third, toxicities can be considerable. Current practice involves waiting 3-6 months to follow-up and assess tumor response; however, by then, it is later than ideal to try other …

Endoscopic Cricoid Split As A Treatment For Subglottic Stenosis: A Systematic Review, Silvia Aluia, Katherine Akers, Michael Chung Md

Medical Student Research Symposium

Introduction: Subglottic stenosis, a fibrotic narrowing of the airway below the vocal cords extending to the lower border of the cricoid cartilage, can be classified as congenital, idiopathic, or acquired in neonates from prolonged intubation. Treatment has more recently expanded from open surgical intervention to include endoscopic procedures. This systematic review aims to evaluate existing literature on anterior and posterior endoscopic cricoid split procedures as a treatment for congenital and acquired subglottic stenosis in order to explore the efficacy of these techniques.

Methods: Literature searches were conducted in PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, and Google scholar, which produced …

Time-To-Surgery And Short-Term Outcomes Of Trimalleolar Ankle Fracture During The Covid-19 Pandemic, Gabriel Burdick Bs, Rami Beydoun Bs, Alexander Pietroski Ms, Jonathan Warren Bs, Bushra Fathima Bs, Trevor Wolterink Bs, Michael Mcintosh Bs, Neethi Sriranga Bs, Stephanie Muh Md

Medical Student Research Symposium

PURPOSE: The purpose of this study was to evaluate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on time-to-surgery, complication rates, and functional outcomes of open reduction and internal fixation (ORIF) for trimalleolar ankle fracture.

METHODS: This retrospective cohort study compared patients who underwent ORIF for trimalleolar ankle fracture between April and July of 2020 of the COVID-19 pandemic (COVID group) to a pre-pandemic cohort treated in 2018 (2018 group). Demographic information, fracture characteristics, and surgical outcomes were collected from patients’ medical charts.

RESULTS: The COVID and 2018 groups consisted of 32 and 100 patients, respectively. The two groups …

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Cardio-Net: A Matlab-Based Software For The Display And Diagnostic Utilization Of Vectorcardiograms, Ali H. Mannaa, Domenico Gatti

Medical Student Research Symposium

Background: The 12-lead technique is the standard in ECG, however alternate cardiography modalities such as vectorcardiography (VCG) exist . While the VCG modality offers unique clinical metrics and certain advantages over ECG, it is hardly utilized due to it being more difficult to obtain than ECG. Here we introduce Cardio-Net, a MATLAB-based software that uses standard 12-lead ECG data to generate and visualize VCGs. Furthermore, we demonstrate the diagnostic potential of VCG by utilizing a recurrent neural network (RNN) to accurately classify vectorcardiograms.

Methods: MATLAB version 2019b and the following toolboxes were used for data processing: Deep learning, …

Validation Of The Termination Of Resuscitation Rules In Detroit, Arqam Husain, Adam D. Chalek, Robert Dunne

Medical Student Research Symposium

Introduction: 326,000 patients suffer from an out of hospital cardiac arrest (OHCA) each year. The Termination of Resuscitation (TOR) criteria guides physicians in determining the futility of continuing CPR and transporting patients to the hospital. We examined compliance with current BLS TOR rules and assessed an alternate set of rules to derive improved TOR guidelines for OHCAs in Detroit.

Methods: A retrospective study was conducted utilizing non-traumatic OHCA cases in Detroit from January 1, 2017 to December 31, 2019, which includes time before and after BLS TOR guidelines were implemented. Patients younger than 18 and arrests of traumatic origin or …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Corticosteroid Injection Exhibits Symptomatic Improvement In Cts Patients With Negative Emgs, Brooke G. Garnica, Aaron R. Prater, Elizabeth A. Washnock-Schmid, Alaa Hazime, Dr. Charles S. Day

Medical Student Research Symposium

Introduction

While corticosteroid injections for carpal tunnel syndrome (CTS) are effective in patients with mild EMGs, no literature has examined the effectiveness of injections in patients with negative EMGs. We hypothesized that patients with negative EMGs will have minimal symptomatic and functional improvement.

Methods

The Boston Carpal Tunnel Questionnaire (BCTQ) was administered to patients clinically diagnosed with CTS and a negative or mild EMG prior to corticosteroid injection. The BCTQ comprises functional (FSS) and symptom status (SSS) questions. The patient was re-evaluated at 2-weeks, 1-, 3-, and 6-months post-injection. Data were analyzed via one-way ANOVA tests. A post-hoc Benjamini-Hochberg FDR …

The Short-Term Effects Of Fine Airborne Particulate Matter And Climate On Covid-19 Disease Dynamics, El Hussain Shamsa, Kezhong Zhang

Medical Student Research Symposium

Background: Despite more than 60% of the United States population being fully vaccinated, COVID-19 cases continue to spike in a temporal pattern. These patterns in COVID-19 incidence and mortality may be linked to short-term changes in environmental factors.

Methods: Nationwide, county-wise measurements for COVID-19 cases and deaths, fine-airborne particulate matter (PM_2.5), and maximum temperature were obtained from March 20, 2020 to March 20, 2021. Multivariate Linear Regression was used to analyze the association between environmental factors and COVID-19 incidence and mortality rates in each season. Negative Binomial Regression was used to analyze daily fluctuations of COVID-19 cases …

How Do Anesthesiologists Prefer To Reduce Preoperative Anxiety In Pediatric Patients?, Arif Musa, Jahan Tajran, Rana Movahedi, Jeffrey C. Wang, David Safani, Christopher Cooke, Guillaume Farah, Syed F. Hussain, Brendan Lynch, Gligor Gucev

Medical Student Research Symposium

250 or less

Ets-Related Gene (Erg) Is Differentially Expressed In Dermatofibroma (Fibrous Histiocytoma) As Compared With Dermatofibromasarcoma Protuberans And Hypertrophic Scars: A Pilot Immunohistochemical Study, Meredith Hengy, Jesse Veenstra, Kyle Perry, David M. Ozog, Ben Friedman

Medical Student Research Symposium

Immunohistochemical staining can be of great utility in differentiating various cutaneous spindle cell neoplasms, particularly when the histomorphological appearance of the lesions is inconclusive. Nuclear staining for ETS-related gene (ERG), a highly sensitive endothelial cell marker, has seldom been studied in the context of cutaneous spindle cell neoplasms. Little is known about its specificity for vascular differentiation. In this pilot study, immunohistochemical analysis for ERG was performed on fifteen dermatofibromas (DF), ten keloids, and nine dermatofibrosarcoma protuberans tumors (DFSP). Consistent nuclear expression of ERG was found in DF [100% (15/15) of the lesions demonstrated >50% labeling of tumor cells with …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Higher Efficacy In The Treatment Of Fibromyalgia With Duloxetine And Pregabalin Combination Than Monotherapy, Joel Rose-Kamprath

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Gilron I, Chaparro LE, Tu D, et al. Combination of pregabalin with duloxetine for fibromyalgia. Pain. 2016;157(7):1532–1540. https://doi.org/10.1097/j.pain.0000000000000558

for a patient with chronic pain due to fibromyalgia

Determining The Optimal Exercise Intensity Level For Adjunctive Treatment Of Major Depressive Disorder, C James Block

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Helgadóttir B, Hallgren M, Ekblom Ö, Forsell Y. Training fast or slow? Exercise for depression: A randomized controlled trial. Prev Med. 2016;91:123-131. https://doi.org/10.1016/j.ypmed.2016.08.011

for a patient seeking an exercise regimen to help with depressive symptoms.

Indications For Esophagogastroduodenoscopy In Anemic Patients Without Overt Signs Of Upper Gastrointestinal Bleeding, Geoffrey M. Ginter

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Majid S, Salih M, Wasaya R, Jafri W. Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms. BMC Gastroenterol. 2008;8:52. https://doi.org/10.1186/1471-230X-8-52

for a patient with a complicated presentation of severe anemia

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Mantsios A, Murray M, Karver TS, et al. Efficacy and Freedom: Patient Experiences with the Transition from Daily Oral to Long-Acting Injectable Antiretroviral Therapy to Treat HIV in the Context of Phase 3 Trials. AIDS Behav. 2020;24(12):3473-3481. https://doi.org/10.1007/s10461-020-02918-x

for a young adult patient struggling with adherence.

Renal Replacement Therapy May Be Initiated In Patients With Hepatorenal Syndrome Who Are Not Transplant Candidates, Laura Donohue

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Allegretti AS, Parada XV, Eneanya ND, et al. Prognosis of Patients with Cirrhosis and AKI Who Initiate RRT. Clin J Am Soc Nephrol. 2018;13(1):16-25. https://doi.org/10.2215/CJN.03610417

for a patient being considered for RRT who was not yet a candidate for liver transplant.

Copper Intrauterine Device Is An Appropriate Method Of Contraception For A Patient With A History Of Systemic Lupus Erythematosus, Sydney E. Daviskiba

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Sánchez-Guerrero J, Uribe AG, Jiménez-Santana L, et al. A Trial of Contraceptive Methods in Women with Systemic Lupus Erythematosus. N Engl J Med. 2005;353(24):2539-2588. https:/doi.org/10.1056/nejmoa050817

for a patient with systemic lupus erythematosus choosing a method of contraception.

At-Home Aerobic Exercise Improves Functional Ability Of Patients With Rheumatoid Arthritis With Limited Exercise Options, Daniel Harris

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Neuberger GB, Aaronson LS, Gajewski B, et al. Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. Arthritis Rheum. 2007;57(6):943-952. https://doi.org/10.1002/art.22903

and its application for a patient with rheumatoid arthritis.

Characterizing The Post-Translational Modifications Of The Pro-Oncogenic Type Ii Transmembrane Serine Protease Tmprss13, Carly Elizabeth Martin

Wayne State University Dissertations

TMPRSS13, a type II transmembrane serine protease discovered at the turn of the century, has recently been shown to be significantly overexpressed in both breast cancer (BCa) and colorectal cancer (CRC), and to mediate chemoresistance in cell lines from both cancer types. Furthermore, loss of TMPRSS13 in a genetic model of mouse mammary carcinoma significantly reduced tumor burden and growth rate, and increased overall tumor-free survival. Its location on the cell surface as well as its low expression in normal breast and colon make TMPRSS13 an attractive candidate as an oncogenic biomarker and therapeutic target in cancer. However, little is …

Dextromethorphan-Quinidine Is Helpful For Pseudobulbar Affect Disorder In Stroke Patients, Michael Francis, Mira Hamame, Md, Mariam Nasrallah, Md, Alison Nesbitt, Do, James Peter Meza, Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using

Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury. BMC Neurology. 2016;16:89. https://doi.org/10.1186/s12883-016-0609-0

for a patient with pseudobulbar affect following stroke

Substance Abuse Relapse Is Not About Willpower But Is The Culmination Of Psychological And Socioeconomic Stress, Paul A. Steffes

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the impact of non-judgmental listening on patient care outcomes.

The Efficacy Of A Sumatriptan And Naproxen Combination Pill In A Patient With Chronic Migraines Who Discontinued Triptan Therapy In The Past Due To A Self-Reported Poor Response To Sumatriptan Monotherapy, Ethan M. Cohen

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Mathew NT, Landy S, Stark S, et al. Fixed-dose sumatriptan and naproxen in poor responders to triptans with a short half-life. Headache. 2009;49(7):971-982. https://doi.org/10.1111/j.1526-4610.2009.01458.x

for a patient with chronic migraines who had self-reported poor response to sumatriptan monotherapy.

Neuroimaging Referral For Reassurance In Evaluation Of Headache With Low-Risk Features, Omar E. Fernandez

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Howard L, Wessely S, Leese M, et al. Are investigations anxiolytic or anxiogenic? A randomised controlled trial of neuroimaging to provide reassurance in chronic daily headache. J Neurol Neurosurg Psychiatry. 2005;76(11):1558-1564. https://doi.org/10.1136/jnnp.2004.057851

for a patient with daily headache.

Complications And Dosing Frequency Of 5% Imiquimod For Genital Warts In A Young Man, Sebastian A. Hoak

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Fife KH, Ferenczy A, Douglas JM Jr, et al. Treatment of external genital warts in men using 5% imiquimod cream applied three times a week, once daily, twice daily, or three times a day. Sex Transm Dis. 2001;28(4):226-231. https://doi.org/10.1097/00007435-200104000-00007

for a patient with genital warts and an unstable social support network.

Implementation Of High Intensity Interval Training Offers Opportunity To Enhance Glycemic Control In Patients With Type 2 Diabetes, Emily Lau

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Alvarez C, Ramirez-Campillo R, Martinez-Salazar C, et al. Low-Volume High-Intensity Interval Training as a Therapy for Type 2 Diabetes. Int J Sports Med. 2016;37(9):723-729. https://doi.org/10.1055/s-0042-104935

for a patient with newly diagnosed diabetes mellitus type 2.

Lifestyle Intervention Is Superior To Metformin In Prevention Of Microvascular Complications Of Diabetes In Women, But Socioeconomic Barriers May Lead To Use Of Combination, Katanya C. Alaga, Jesse Haddad

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: The Diabetes Prevention Program Outcomes Study. Lancet Diabetes Endocrinol. 2015;3(11):866-875. https://doi.org/10.1016/S2213-8587(15)00291-0

for a patient with pre-diabetes who is concerned about the prevention of microvascular complications through lifestyle intervention while managing her busy schedule as a traveling house cleaner.