Medical Specialties Commons^™

Post-Operative Day 1 Versus Day 0 Follow-Up For Uncomplicated Cataract Surgeries: A Comparison Of Post-Operative Outcomes And Managements, Harsh Parekh Bs, Shibandri Das Md, Vaama Patel Md, Ryan Freedman Md, Sabba Mansoor Bs, Amanda Ismail Md, Faisal Ridha Al-Timimi Md

Medical Student Research Symposium

Purpose: To compare the postoperative outcomes and management of uncomplicated cataract surgery (CEIOL) patients seen on post-operative day zero (POD 0) versus post-operative day one (POD 1).

Methods: A retrospective chart review of 533 patients who had CEIOL at the Kresge Eye Institute from December 2017 to September 2019 was performed. Visual acuity (VA) and intraocular pressure (IOP) were collected from the pre-operative visit, and the first and second post-operative day visits. In addition, changes in management were recorded from the first post-operative day visit. Patients were excluded if they had a complex cataract procedure, had combined glaucoma filtering surgery, …

A Scoping Review: Overview Of Current Respectful Maternity Care Research By Research Approach And Study Location, Hannah L. Shuman, Annika M. Grupp, Lauren A. Robb, Gurbani Bedi, Miloni Shah, Andrea Janis, Caroline G. Caldart, Ryan Melikian, Urvashi Gupta, Janki K. Vaghasia, Aishwarya Panneerselvam, Aisha Kazeem, Ndidiamaka N. Amutah-Onukagha, Diane L. Levine

Medical Student Research Symposium

Introduction: Disrespectful care during childbirth contributes to poor health outcomes, perpetuates disparities, and encourages childbirth outside of healthcare facilities. To measure disrespectful care, investigators use many research approaches. Most research has focused on low/low-middle income countries. This scoping review aims to 1) summarize current research and research approaches to analyze whether these approaches identify the same types of mistreatment and 2) identify gaps in current research analyzing disrespectful care during childbirth.

Methods: Following PRISMA guidelines, this review utilized search terms to filter articles from the Pubmed database. Using specific criteria, articles were then excluded by title and abstract, then full …

Use Of Prame Immunostaining To Distinguish Melanoma In Situ From Lentigo Senilis, Hailey Olds, Sarah Utz, Darius Mehregan

Medical Student Research Symposium

PRAME (PReferentially expressed Antigen in MElanoma) is an antigen that is expressed by malignant cells in melanoma, as well as other cancers such as breast carcinoma, renal cell carcinoma, and leukemia. PRAME immunohistochemistry has proved effective in identifying malignant melanocytes in melanoma lesions, but it is unclear if it may be used to distinguish melanoma from benign melanocytic conditions, such as lentigo senilis. In particular, melanoma in situ may be confused with lentigo senilis clinically and histologically, thus PRAME immunostaining is potentially useful for differentiating these two lesions. We evaluated 31 samples of lentigo senilis, 26 of melanoma in situ, …

Impact Of Covid-19 On Service Utilization By Those Experiencing Homelessness In Detroit, Anneliese Petersen, Richard Bryce D.O.

Medical Student Research Symposium

Background:

Current research has demonstrated increased levels of fear and anxiety due to the Coronavirus pandemic. While fear can have a significant impact on any individual, fear among individuals experiencing homelessness is particularly impactful as this may affect service utilization and thus the ability of to access basic necessities such as food, shelter and water. This study seeks to understand the impact of fear of contracting COVID on service utilization among those experiencing homelessness in Detroit, MI.

Methods and Results:

From July-August 2020, 35 individuals who self-identified as homeless participated in a multiple-choice survey. 40% of surveyed individuals stated that …

Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To evaluate ophthalmology resident anxiousness and cardiovascular response by tracking resident heart rate (HR) when performing cataract surgery during their last year of residency.

Methods: A prospective analysis of 31 cataract cases, completed by three residents (two females and one male), at the Kresge Eye Institute in August and September 2020 was performed. Inclusion criteria for cases included all cataract cases performed by PGY-4 residents at the Kresge Eye Institute who downloaded the Heart Graph app supported by iOS. Residents with android mobile devices were excluded from the study. Informed consent was obtained from all residents who utilized the …

Understanding M6a’S Role In The Myometrium During Gestation, Lindsay Jenkins, Arren Simpson, Jennifer Condon Phd, Jeyasuria Pancharatnam Phd

Medical Student Research Symposium

Epigenetic modifications, such as DNA methylation, mainly affects the function of genes through regulating the transcription or translation processes, without altering the DNA sequences. The regulation of m⁶A modification is dynamic and reversible and is established by m⁶A methyltransferases (“writers”), such as methyltransferase-like protein 3 (METTL3). It is removed by m6A demethylases (“erasers”), such as α-ketoglutarate-dependent dioxygenase alkB homolog 5 (ALKBH5). The effects of m6A modification on RNA metabolism depend on the recognition by different m⁶A -binding proteins (“readers”), including the YT521-B homology (YTH) domain family and the heterogeneous nuclear ribonucleoproteins (HNRNPs). We believe …

Sex-Based Differences In Depth Of Soft Tissue And Bone Diameter At The Sternal Intraosseous Catheter Insertion Site, Tristan Lemon, Ryan Kelly, Revelle Gappy, Sarah Meram, James Paxton

Medical Student Research Symposium

Background

Intraosseous (IO) catheters are commonly used to rapidly obtain vascular access for critically-ill patients in the emergency department (ED). While the sternum is a common IO insertion site for adult subjects, little is known about sex-based variation in the proper depth of insertion.

Methods

A retrospective cohort study was performed, utilizing CT scans obtained from DMC over a ten-year period (2009-2018) to estimate soft tissue depth overlying the recommended sternal IO insertion site. Depths of soft tissue from skin surface to bone surface (Measurement A) and from skin surface to the opposite bony cortex (Measurement B) were measured using …

Same Day Transportation For Opioid Use Disorder: Impact Of The Crisis Addiction Recovery Transportation (Cart) Program, Katherine Palmer Loveluck, Andrew King

Medical Student Research Symposium

Patients with opioid use disorder (OUD) frequently present to the emergency department (ED). Delays or barriers in referral to recovery programs from the ED may decrease successful linkage to ongoing care. Immediately following discharge is a particularly high-risk time for OUD patients as studies have shown that immediately following a non-fatal overdose there is an increase in death rates¹. To attempt to combat this gap in care The Detroit Medical Center (DMC) partnered with a community program, Team Wellness (TW), to offer direct transportation 18 hours per day to the TW facility. This crisis addiction recovery transportation (CART) …

Does Delay In The Diagnosis Of Rudimentary Horn Pregnancy In Patients With Unicornuate Uteri Impact Treatment Outcomes?, Victoria Webber, Megan Fee, Damla Gonullu, Jessica Rausch, Omosalewa Itauma, Chidinma Abara, Awoniyi Awonuga

Medical Student Research Symposium

OBJECTIVE: Rudimentary horn pregnancy (RHP) is a very rare form of ectopic pregnancy (EP) that tends to rupture in the second trimester. Similar to other EPs, the treatment of RHPs is excision, hence delay in diagnosis (DID) can be detrimental. Our objective is to determine whether DID of RHP in patients with unicornuate uteri (UCU) impacts the treatment outcome.

DESIGN: Retrospective cohort study of published case reports in PubMed database.

MATERIALS AND METHODS: A computerized PubMed search of case reports of RHP from 2007 to 2020 was performed using the key words; unicornuate uterus, rudimentary horn, pregnancy, case. Data was …

Effect Of Trazodone On Upper Airway Resistance In Chronic Spinal Cord Injury, Geoffrey M. Ginter, Sean Carroll, Abdulghani Sankari, Safwan Badr

Medical Student Research Symposium

Background:

Spinal cord injury (SCI) is a known risk factor for sleep-disordered breathing. While device-based therapies such as CPAP are beneficial in these individuals, adherence to these treatments is often low; consequently, pharmacotherapies for sleep-disordered breathing in patients with SCI are in high demand. Trazodone is an atypical antidepressant with a complex mechanism of action, including alpha adrenergic agonist activity and inhibition of serotonin reuptake. Serotonin (5-HT) is a known modulator of respiratory circuitry, which has been shown to influence the ventilatory drive. Trazodone is commonly prescribed as a sleep aid, but its impact on breathing during sleep is still …

The Cardiovascular Manifestations Of Covid-19: A Review Of The Literature And Institutional Experience, Gina Polsinelli, Steven J. Korzeniewski, Oksana M. Doubrovski, James Paxton

Medical Student Research Symposium

The cardiovascular health of those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays a major role in rates of hospitalization, mortality risk, and rates of mechanical ventilation. In patients with COVID-19, acute myocardial injury and history of cardiovascular disease are both independently established risk factors for poor patient prognosis. In addition to myocardial injury, numerous acute cardiovascular manifestations of COVID-19 disease have been identified. Previous work on this topic typically focused either upon a general description of the acute cardiovascular manifestations and sequalae of COVID-19, or upon broad-based clinical outcomes associated with COVID-19 in patients with history of …

Antibiotics And Antimicrobial Resistance In The Covid-19 Era: Perspective From Resource-Limited Settings, Mentor Ali Ber Lucien, Michael F. Canarie, Paul E. Kilgore, Gladzin Jean-Denis, Natael Fénélon, Manise Pierre, Mauricio Cerpa, Gerard A. Joseph, Gina Maki, Marcus J. Zervos, Patrick Dely, Jacques Boncy, Hatim Sati, Ana Del Rio, Pilar Ramon-Pardo

Department of Pharmacy Practice

The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence …

Evaluation Of Time-Dependent Camber And Deflections In Bridge Girders, Furkan Cakmak

Wayne State University Theses

A methodology to predict each stage of camber and displacements in composite prestressed concrete and steel bridge superstructures from inception to end of service life including a prediction of rebound in deck replacement projects is presented. The methodology invokes the use of multiple creep curves and allows the proper simulation of various construction activities each of which feature unique loading events. The proposed method captures the influence of several factors, such as creep and shrinkage of beam and deck concrete as well as prestresses losses induced because of these phenomena. Additionally, the prediction methodology offers the capability to quantify the …

Low-Dose Psoralen–Uv-A Maintenance Therapy Prolongs Disease-Free Remission Rates In Mycosis Fungoides Patients, Joshua M. Brady

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using Vieyra-Garcia P, Fink-Puches R, Porkert S, et al. Evaluation of Low-Dose, Low-Frequency Oral Psoralen–UV-A Treatment With or Without Maintenance on Early-Stage Mycosis Fungoides. JAMA Dermatology. 2019;155(5):538. https://doi.org/10.1001/jamadermatol.2018.5905 for a patient weighing whether to continue treatment in light of socioeconomic circumstances.

Improved Tolerability And Efficaciousness Of Miralax-Gatorade When Compared To Golytely In The Outpatient Setting, Bassem Farah

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using Gu P, Lew D, Jung OS, et al. Comparing the Real-World Effectiveness of Competing Colonoscopy Preparations: Results of a Prospective Trial. Am J Gastroenterol. 2019;114(2):305-314. https://doi.org/10.14309/ajg.0000000000000057 for a patient reluctant to undergo colonoscopy screening due to concerns about GoLYTLEY's tolerability.

Il-1 Inhibitor Anakinra Is An Effective Alternative To Standard Treatments For Reducing Pain Due To Acute Gout Flare, Cheryl Craig

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Janssen CA, Voshaar MAHO, Vonkeman HE, et al. Anakinra for the treatment of acute gout flares: a randomized, double-blind, placebo-controlled, active-comparator, non-inferiority trial. Rheumatology. 2019;58(8):1344-1352. https://doi.org/10.1093/rheumatology/key402 for a patient with an acute gouty attack refractory to standard treatment.

Clinical Approach To A Request For Phentermine-Topiramate In A Young Woman With A History Of High-Risk Eating Behavior, Erin Spencer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Safer DL, Adler S, Dalai SS, et al. A randomized, placebo-controlled crossover trial of phentermine-topiramate ER in patients with binge-eating disorder and bulimia nervosa. Int J Eat Disord. 2019;(September):1-12. https://doi.org/10.1002/eat.23192 to inform the clinical decision of whether or not to prescribe phentermine-topiramate to an overweight 27-year-old woman who endorses risky eating behaviors.

Medication Assisted Treatment With Buprenorphine/Naloxone Or Methadone: Comparitive Outcomes In Patients With An Opioid Addiction, Deepti Shanbhag

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Hser YI, Evans E, Huang D, et al. Long‐term outcomes after randomization to buprenorphine/naloxone versus methadone in a multi‐site trial. Addiction. 2016;111(4):695-705. https://doi.org/10.1111/add.13238 for a patient with addiction to prescription opioids.

Cyclosporine Shows Benefit As Compared To Methotrexate For Treatment Of Pediatric Atopic Dermatitis Refractory To Topical Medications When Rapidity Of Clinical Response Is Of Key Importance To The Patient, Connor R. Buechler, Steven Daveluy Md

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

Myomectomy Has Better Reproductive Outcomes Than Uterine Artery Embolization For Patients With Symptomatic Leiomyomas Who Wish Maintain Fertility, Suha Syed

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Mara M, Maskova J, Fucikova Z, Kuzel D, Belsan T, Sosna O. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovascular and interventional radiology. 2008;31(1):73-85. https://doi.org/10.1007/s00270-007-9195-2

Little Is Known About Cannabidiol For Improving Severe Behavioral Symptoms Of Autistic Spectrum Disorder, Keerteshwrya Mishra

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Barchel D, Stolar O, De-Haan T, et al. Oral cannabidiol use in children with autism spectrum disorder to treat related symptoms and co-morbidities. Frontiers in Pharmacology. 2019;9. https://doi.org/10.3389/fphar.2018.01521

Subcutaneous Immunoglobulin Proves To Be An Effective Alternative To Intravenous Immunoglobulin In The Treatment Of Chronic Inflammatory Demyelinating Polyneuropathy, Benjamin Ross

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising van Schaik IN, Bril V, van Geloven N, et al. Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 2018;17(1):35-46. https://doi.org/10.1016/S1474-4422(17)30378-2

Clinical Decision Science Requires Doctors To Examine Their Own Inner World, Janice C. Lau

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the importance of preparation for difficult conversations with patients and their families after finding herself unprepared to compassionately communicate a clinical decision for a pediatric patient.

Transanal Irrigation Is More Beneficial In Symptomatic Management Of Neurogenic Bowel Disease Than Conservative Bowel Management, Chi-Lan Tran

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Christensen P, Bazzocchi G, Coggrave M, et al. A Randomized, Controlled Trial of Transanal Irrigation Versus Conservative Bowel Management in Spinal Cord–Injured Patients. Gastroenterology. 2006;131(3):738-747. https://doi.org/10.1053/j.gastro.2006.06.004

Changing Guidelines: Recommendation Of Early Peanut Introduction For Prevention Of Peanut Allergy In Infants With Severe Eczema, Alexandra H. Zetye

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. New Eng J Med. 2015;372(9):803-813. https://doi.org/10.1056/nejmoa1414850

Inpatient Motivational Interviewing For Adolescent Type 1 Diabetics With Poor Glycemic Control Is Ineffective, Andrew L. Roberts

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Wang Y-C, Mackenzie M, Nakonezny PA, et al. A randomized controlled trial comparing motivational interviewing in education to structured diabetes education in teens with type 1 diabetes. Diabetes Care. 2010;33(8):1741-1743. https://doi.org/10.2337/dc10-0019.

Trends In Legionnaires' Disease-Associated Hospitalizations, United States, 2006-2010, Gayathri Mudali, Paul E. Kilgore, Abdulbaset Salim, Shawn P. Mcelmurry, Marcus Zervos

Department of Pharmacy Practice

Background: Legionella pneumophila is a waterborne cause of both healthcare-associated and community-acquired pneumonia. Legionella pneumophila serogroup 1 is responsible for 80% of infections. There is currently limited published disease burden data on Legionnaires' disease-associated hospitalization in the United States.

Methods: In this study, we estimated the annual incidence of Legionnaires' disease-associated hospitalizations in United States and identified demographic, temporal, and regional characteristics of individuals hospitalized for Legionnaires' disease. A retrospective study was conducted using the National Hospital Discharge Survey (NHDS) data from 2006 to 2010. The NHDS is a nationally representative US survey, which includes estimates of inpatient stays in …

Antiviral Prophylaxis May Not Provide Benefit In Patients With Posner-Schlossman Syndrome, Patrick Lee

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Chee SP, Jap A. Cytomegalovirus anterior uveitis: outcome of treatment. Br J Ophthalmol. 2010 Dec;94(12):1648-52. https://doi.org/10.1136/bjo.2009.167767 for a patient on antiviral prophylaxis for recurrent episodes of Posner-Schlossman Syndrome.

Covid-19, Colleagues, Confusion, And Conversations, Nathanael R. Sanchez M.D., Katherine S. Lee , M.D., Karen Weaver M.D.

Clinical Research in Practice: The Journal of Team Hippocrates

During the COVID-19 pandemic, doctors in a community hospital reflect on their decision-making regarding treatment options for COVID-19. Whether to use hydroxychloroquine is the treatment discussed in most detail.

When Rationing Becomes Part Of Clinical Decision-Making, Christopher A. Hopper, Mitra Bahaee

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical practice-based reflection on Noack DP, Newton G. Compared to maximal current management standards, oscillating positive expiratory pressure devices have not been shown to improve clinically relevant outcomes in COPD patients with acute exacerbation. Clin. Res. Prac. 2017;3(2):eP1516. doi: 10.22237/crp/149886732.