Medical Specialties Commons^™

Evolocumab Is Associated With Lower Mortality When Compared To Statin In Masld/Mash Patients: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Evolocumab is typically used as an add-on or replacement therapy for patients with dyslipidemia who are already on the maximum tolerated dose of statins or are intolerant to statins. While statins are effective in lowering lipid levels and have been shown to improve liver-related outcomes and reduce major adverse cardiovascular events (MACE), statin intolerance is increasingly encountered with their widespread use. The aim of our study is to compare the benefits of using evolocumab as monotherapy versus statins as monotherapy in patients with metabolic-dysfunction-associated steatotic liver disease (MASLD) and metabolic-dysfunction-associated steatohepatitis (MASH).

Rectal Indomethacin Decreases Post-Ercp Pancreatitis In Elderly Patients Without Increasing The Risk Of Acute Kidney Injury, Do Han Kim Md, Donghyun Ko Md, Jose A. Porres, Wilhelm S. Basegoda Md, Carlos Eilzondo-Alatorre Md, Luis M. Nieto Md, Miguel Salazar Md, Paul T. Kroner Md, Pedro Palacios Argueta Md, Frank J. Lukens Md

Posters

This study examines the association of use of rectal indomethacin with clinical outcomes in elderly patients undergoing ERCP using a large population-based multinational database.

Valproate Use Is Associated With Higher Mortality And Hepatic Decompensationin Patients With Masld/ Mash: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate is a widely used anti-seizure medication for treating epilepsy. However, it significantly impacts lipid metabolism by interfering with the beta-oxidation pathway of fatty acids in mitochondria. This disruption is expected to accelerate the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) in patients on chronic valproate therapy. The aim of this study is to determine whether the chronic use of valproate increases the risk of liver-related and cardiovascular events

History Of Bariatric Surgery Is Not Associated With Worse Clinical Outcomes At 5 Years In Patients Who Undergo Liver Transplantation, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Klaus E. Monkemuller, Paul T. Kroner Md

Posters

This study explores and compares outcomes of LT alone with LT in patients with a prior history of RYGB or SG, using a large multinational database.

Sglt-2 Inhibitor Use Is Associated With Lower Mortality In Patients With Alcoholic Cirrhosis And Type 2 Diabetes Mellitus: A Multinational Analysis, Do Han Kim Md, Donghyun Ko, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

In our study, we aimed to investigate whether SGLT2 inhibitors are associated with a reduced risk of all-cause mortality, liver-related events, and cardiovascular outcomes in patients with alcoholic cirrhosis and T2DM.

Valproate Use Is Associated With Lower Hepatic And Cardiovascular Outcomes When Compared To Levetiracetam In Patients With Masld/Mash: A Multinationalanalysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate and levetiracetam are commonly used to manage epilepsy. While valproate is well-documented to significantly affect lipid metabolism, less is known about the effects of levetiracetam. Given this, worse outcomes in MASLD/MASH are anticipated in patients treated with valproate.

The aim of our study is to compare hepatic and cardiovascular outcomes in MASLD/MASH patients treated with valproate versus levetiracetam.

Immune-Related Adverse Events Associated With Pembrolizumab In Dmmr/Msi-H Colorectal Cancer: A Single Arm Safety Meta-Analysis, Joshi Simran, Saman Javid, Gaurav Sharma, Corinne Caissie, Armando Dominguez-Diaz

Posters

Pembrolizumab, a PD-1 checkpoint inhibitor, enhances immune response and has proven effective against various cancers, including melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma.

Clinical trials have also shown its efficacy in treating various types of cancers with different mismatch-repair statuses. However, the spectrum and frequency of immune-related adverse events (irAEs) in the dMMR (deficient mismatch repair) / MSI-H (microsatellite instability-high) colorectal cancer remain underexplored.

Therefore, this meta-analysis aims to evaluate pembrolizumab's safety profile in this colorectal cancer subset.

Glp1 Ra Reverses The Harmful Association Of Body Weight Variability With Cvd Outcomes Across Different Metabolic Profiles, Sarpong Boateng, Yussif Issaka Md, Basile Njei

Posters

This study aimed to investigate the impact of GLP1 RA on this known negative relationship between BMI variability and cardiovascular (CVD) outcomes across different metabolic profiles.

Glp-1ra Use Is Not Associated With Immediate Worse Outcomes In Patients Undergoing Ercp: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Carolos Elizondo Altorre, Luis M. Nieto Md, Miguel Salazar Md, Paul T. Kroner Md, Pedro Palacios Argueta Md, Frank J. Lukens Md

Posters

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to treat biliary and pancreatic conditions with increased therapeutic utilization over recent decades. Limited evidence exists regarding the potential impact of glucagon-like peptide-1 receptor agonists (GLP-1RA) on post-ERCP pulmonary outcomes. Increasing concern for retention of gastric contents has led to recent recommendations on holding these agents prior to upper endoscopic intervention. The aim of this study is to assess if use of GLP-1RA prior to ERCP leads to worse cardiopulmonary outcomes.

Untreated Subclinical Hypothyroidism Is Associated With Higher Mortality And Hepatic Decompensation In Patients With Masld/Mash: A Multinational Analysis, Do Han Kim Md, Donghyun Ko Md, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

This study aims to explore whether subclinical hypothyroidism contributes to the progression of MASLD/MASH, reflected as an increased risk of liver-related outcomes.

A Curious Case Of Heart Failure With Reduced Ejection Fraction In A Lupus Patient, Farah Khan Md

Posters

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with cardiovascular risks, including coronary artery disease (CAD) and typically heart failure (HF) with preserved ejection (HFpEF). We report an SLE patient with ventricular arrhythmias and HF with reduced ejection fraction (HFrEF) due to myocarditis, responding positively to Guideline-Directed Medical Therapy (GDMT) for both conditions

Impact Of Post-Operative Radiation Therapy On Survival In Nsclc Patients With Incomplete Surgical Resection, Farrah R. Khan Md

Posters

Postoperative radiation therapy (PORT) has a limited role in the management of resectable non-small cell lung carcinoma (NSCLC). A relatively strong indication for its use is in the presence of residual tumor after surgical resection, as PORT has been shown to improve survival in such patients. However, it is unclear how much of the survival detriment of incomplete resection PORT is able to offset compared to negative margins. We aim to answer this question in our study

A Fatal Triad: Concurrent Pulmonary Infections With Candida, Mucorales, And Aspergillus In An Immunocompromised Patient With Underlying Vasculitis And Diabetes, Paridhi Ghai, Kavitha Gopalratnam

Posters

We present a case of disseminated fungal disease involving simultaneous infections with Candida, Mucorales, and Aspergillus.

All Clear For Virtual Simulation In Transition To Practice, Stephanie Barrett Msn, Rn, Onc, Rebecca Riznyk Msn, Rn, Cne, Npd-Bc

Posters

The goal of this innovative project was to increase new graduate nurses’ comfort with emergency management, improve communication with the interdisciplinary team, and provide a valuable and engaging experience in a TTPP at a large health care system

Contamination To Clarity: Reducing Blood Culture Contaminations By Implementing An Initial Specimen Diversion Technique, Giovanna Tiago Bsn, Rn, Jaclyn Godfrey Msn, Rn, Judson Mary, Cj Lucia, Jacqueline Laird, John Brennan, Mason Everlith, Stacey Peace Rn, Anne M. Aquila

Posters

The aims of this initiative were:

• Target a unit with high blood culture contamination rates, with secondarily high central line utilization rates.
• Implement an evidence-based initial specimen diversion technique.
• Determine if technique had an impact on a unit’s blood culture contamination rate.
• Revisit the literature and modify as needed

Key Diagnostic Factors In Steatotic Liver Disease And Their Longitudinal Impact On Overall Mortality, Do Han Kim Md, Donghyun Ko Md, Pojsakorn Danpanichkul, Meena B. Bensal Md, Mazen Noureddin, Karn Wijarnpreecha, Mark Muthiah

Posters

This study evaluates the effect of diagnostic criteria on overall mortality across the SLD spectrum.

A Rare Case Of Adolescent Epiglottitis Secondary To Streptococcus Dysgalactiae, Kedar Tilak, Mohamed Aashiq Abdul Ghayum, Douglas Swanson, Rana El Feghaly

Posters

Streptococcus dysgalactiae causes pharyngitis, cellulitis, necrotizing soft tissue infections, sepsis, and streptococcal toxic shock syndrome • It can lead to both toxin-mediated and immune-mediated diseases • Mostly seen in adults, rare in pediatric patients • Here we present a 15-year-old with S. dysgalactiae- associated septicemia, and epiglottitis with extensive neck infection

Cost Effectiveness Of Sending Of Routine Collection Of Sinus Contents In Skull-Base Patients, Jonathan Grey, Caroline Roberts, Amanda Bachand, Jacob Keeley, Adam Folbe

Posters

• Following endoscopic skull-base surgeries, it is common practice to send sinus contents for histopathological review and examination, in addition to the tumor/pathology itself.
• Histologic analysis of standard surgical specimens has long been thought to enhance diagnostic precision, ensure quality control, and offer procedural documentation.1 However, with rising healthcare costs, the necessity of this practice has been challenged in specific situations, such as this one.1
• In this study, we sought to determine if the regular collection of sinus contents uncovers another disease process or informs clinical decision-making.
• We also determined the cost of routinely sending sinus contents to pathology for evaluation. …

A Quantitative Analysis On The Locations Of Phase 3 Retina Trials In The United States Over The Past 5 Years, Shahrukh Naseer, Tarek Hassan

Posters

• Clinical trials are essential for advancing treatments in ophthalmology, yet comprehensive data on institutional participation in Phase 3 retina trials is not readily available.

• The U.S. National Library of Medicine Clinical Trials database (NLM database) lists individual research sites for each study; however, aggregating and visualizing this data remains challenging.

• The lack of centralized and easily interpretable data on research site participation hinders understanding of institutional contributions to retinal clinical research.

• Identifying geographic and institutional trends can improve resource allocation and research collaboration.

• We aim to

• Quantify the number of unique institutions participating in …

Predicting Coronary Artery Calcium Using Abdominal Aorta And Visceral Artery Calcification, Jared Dixon, Sayf Al-Katib, Kiran Nandalur, Jacob Ghannam, Ali Beydoun, Desiree Clement

Posters

CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin.1 The Multiethnic Study of Atherosclerosis (MESA) demonstrated that a CAC score of 0 represents a less than 5 percent 10-year Atherosclerotic cardiovascular disease (ASCVD) risk. CAC scores 1-299 represent borderline to intermediate risk, and CAC score >300 represents a “high risk” 10 percent or greater 10-year ASCVD risk.2

When used correctly, CAC scoring is a powerful predictor of ASCVD risk and holds the key for many …

Associations Between Health Literacy And Comprehension Of Health Visits In A Community Setting, Amanda Romaya, Adel Andemeskel, Salim Abdul-Razak, Linda Dillon, Victoria Lucia

Posters

Low health literacy is a significant social determinant of health that is associated with poor health outcomes1-3. Bringing attention to health literacy will aid in promoting the health of the population. However little has been done to implement national policies and interventions that address patient health literacy, especially in a community setting4.

We hypothesized that our assessment of the identified patient population’s health literacy will not meet adequate standards and will indeed demonstrate a need for community-focused interventions

An Analysis On Gender And Race For Burnout Among Michigan Internists, Elan Pszenica, Jookta Basu, Esha Ahmed, Hugo Davila

Posters

Burnout among physicians, particularly in the field of internal medicine, has become a significant concern in recent years. This condition is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, which can have detrimental effects on both healthcare providers and patient care. 1 While burnout is a recognized issue globally, its impact on internal medicine physicians in Michigan has not been comprehensively studied. Understanding the unique stressors faced by these physicians is critical for developing targeted interventions to reduce burnout rates and improve the overall healthcare environment. Internal medicine physicians often face intense workloads, long hours, administrative …

The Impact Of Physician Vaccine Recommendation On The Pregnant Chaldean Population, Sylvia Kashat, Nelia Afonso

Posters

• A variety of factors contribute to modern vaccine hesitancy, including balancing the risks and benefits of vaccination and delayed negative outcomes. • An important population to consider are pregnant women and their fetus, as the immune compromised state may increase the burden of disease. • It is the duty of healthcare providers to properly educate mothers on the effectiveness of vaccination on vaccinetreatable and vaccine-preventable diseases. • A subgroup that has been impacted by this greatly in the metro-Detroit area is the Chaldean community. • With the Michigan Chaldean population being greater than 160,000, and most of the community …

The Effect Of Covid-19 On Total Joint Arthroplasty, Hailey Worstman, James E. Feng, Alex Miller, Drew Moore

Posters

• Arthritis is debilitating disease that is common throughout the U.S. For patients with refractory disease, total hip and knee arthroplasty, collectively known as total joint arthroplasty, are used for definitive management.1 •

Total joint arthroplasty, TJA, is one of the most common procedures in the U.S. and is typically inpatient in order to start physical therapy and promote joint mobility as soon as possible.

• Elective procedures, including total joint arthroplasties, were halted in March 2020 due to the pandemic.2,3

• When TJAs resumed they shifted towards outpatient procedures and at home physical therapy.4

• The impact of the …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty, Daniel Nikolaidis, Devin Young, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infections (PJI) can arise anytime in the lifetime of a patient. Therefore, patients who have multiple prosthetic joints are at risk for developing multiple PJIs. Polyarticular PJI can be classified as either synchronous or metachronous. Synchronous PJIs present simultaneously in two or more joints. Metachronous PJIs (MPJI) occur in two or more joints after a disease-free period. Incidence of MPJI varies in the literature from 8-20%.1

Known risk factors associated with MPJI include Rheumatoid Arthritis, sepsis or SIRS, infection with MRSA, ≥3 revision arthroplasties, longer length of stay in the hospital, and an index TKA PJI.2

Only a …

A Review Of Risk Factors For Postoperative Failure After Isolated Primary Medial Patellofemoral Ligament Reconstruction, Bilal Tarar, Ameen Suhrawardy, Clark Yin, Leonardo Cavinatto, Elizabeth Dennis, Jeffrey Fischgrund, Betina B. Hinckel

Posters

• Medial patellofemoral ligament reconstruction (MPFL-R) is a surgical treatment for patellar instability [1].

• Cases of post-operative recurrent dislocation and persistent instability may occur due to preexisting anatomic risk factors and technical errors in the procedure.

• Current rates of recurrent dislocation are reported to be up to 20% [2].

• Research Question: What anatomic and technical risk factors are associated with increased rates of recurrent dislocation after primary MPFL-R?

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Assessing Disparities In Sep-1 Bundle Compliance At Corewell Health, Zachary Awad, Mark Munir, Paul Bozyk, Ramin Homayouni

Posters

Sepsis, a life-threatening condition resulting from a dysregulated immune response to infection, carries significant mortality. To improve sepsis management, the Centers for Medicare & Medicaid Services (CMS) introduced the SEP-1 bundle, outlining critical interventions within specified timelines. This study aimed to investigate disparities in SEP-1 bundle compliance, examining variations among septic patients based on sociodemographic factors like age, race, and area deprivation index (ADI), as well as clinical factors like chronic health conditions.

Dido Times In Anterior Lvo Ischemic Stroke, Greg Palmateer, Anthony Gasparotto, Angelique Manasseh

Posters

• Acute ischemic stroke is a major cause of death and disability. Every 30 minute delay in time from onset to treatment lowers the likelihood of a good outcome.1

• Door-in-door-out (DIDO) is defined as the duration from time of arrival at a primary stroke center (PSC) to time of discharge to a comprehensive stroke center (CSC) for mechanical thrombectomy(MT). Shorter DIDO time relates to improved outcomes.

• There is no standardized DIDO for ischemic stroke, though the American Heart Association (AHA) offers an ideal DIDO time of < 90 minutes for 50% or more of patients.2