Medical Specialties Commons^™

Index Cost Comparison Of Laparoscopic Vs Robotic Surgery In Colon And Rectal Cancer Resection: A Retrospective Financial Investigation Of Surgical Methodology Innovation At A Single Institution, Ekene Ezeokoli, Roula Hilli, Harry J. Wasvary

Posters

Robotic assisted colorectal cancer resection (R-CR) has become increasingly commonplace in contrast to traditional laparoscopic cancer resection (L-CR). The aim of this study was to compare the total direct costs of R-CR to that of L-CR and to compare the groups with respect to costs related to LOS.

Comprehensive Analysis Of Racial Differences In Comorbidities And Prenatal Care Among Pregnant Women, Ryian Owusu, Kurt R. Wharton

Posters

• Research highlights that women of color face significantly higher risks of pregnancy-related morbidity and mortality.¹

• Factors contributing to these disparities include: 2,3

• Access to healthcare

• Health literacy

• Education level • Community support

• Prenatal care plays a pivotal role in mitigating these risks by educating women on healthy lifestyles and identifying those at high risk for complications. 4

• Determining patient satisfaction with their prenatal care could greatly contribute in defining a link between prenatal care services and maternal-fetal outcomes. 4

Identifying Barriers To Covid-19 Vaccination In Hispanic Populations, Saul O. Castillo, Kurt R. Wharton

Posters

Vaccination hesitancy has always been an issue within marginalized communities. This is why it came as no surprise when the COVID-19 vaccine was met with resistance upon its release1. However, it has been many years since the FDA approved the first COVID19 vaccine and on some level, COVID-19 has become a part of our daily lives. This means that people have had time to determine how they feel about the COVID19 vaccine and reflect on their decisions to receive or decline the vaccine.

There are many reasons as to why people choose to receive or decline the COVID-19 vaccine. This …

Clinician’S Perspective On Reproductive Healthcare & Reproductive Health Rights In Southeast Michigan, Skylar Sundquist, Kurt Wharton

Posters

Reproductive healthcare is essential care that includes family planning, assisted reproductive technologies, sexually transmitted infection (STI) screening and treatment, abortion access, and sexual health education. Unfortunately, reproductive healthcare and reproductive rights are often the subject of erosive litigation. This litigation limits individuals’ access to reproductive healthcare thereby inhibiting individuals’ ability to exert autonomy over their health. In June of 2022, the US Supreme Court ruled in favor of Dobbs in the case of Dobbs v Jackson Women’s Health Organization. This ruling effectively overturned the 1973 Roe v Wade decision and ended the protected right to access abortion care. After the …

Custom Gene Panel Sequencing Of Fevr Patients And Family Members, Rima Stepanian, Gabrielle Abdelmessih, Kim Drenser, Antonio Capone Jr, Michael T. Trese, Wendy Dailey, Ken Mitton

Posters

Familial exudative vitreoretinopathy, or FEVR, defines a group of inherited retinal diseases marked by abnormal blood vessel growth in the retina, causing poor vascular development in the peripheral retina. It is linked to increased vessel permeability and may result in retinal ischemia, exudative retinal detachment, and subsequent vision loss. It can be inherited through autosomal dominant, autosomal recessive, or X-linked recessive patterns. There is no definitive treatment or cure, but is treated based on staging of disease on an individual case-by-case basis. Genomics is a rapidly growing field in personalized medicine. Targeted next-generation sequencing (NGS) enables fast and cost-effective identification …

Suture Management Practices In Central Venous Catheters: A Survey Among Healthcare Professionals, Matthew Prevost, Nishaki Mehta

Posters

• Traditional suture methods (Fig. 1) for securing central venous catheters (CVCs) lack standardization, are nonadjustable postsecurement, and require dexterity → increasing risk of catheter micropistoning and central line-associated bloodstream infections (CLABSIs).

• This study examines medical practitioners' experiences and challenges with suturing CVCs

• Our hypothesis predicts that variations in responses and differences in practitioner training may influence experiences and complication rates.

Procalcitonin As A Biomarker Of Acute Kidney Injury In Patients With Suspected Bacterial Sepsis In The Acute Care Setting, Austin Kantola, Jose Navas Blanco, Jacob Keeley

Posters

Acute kidney injury (AKI) is a common, life-threatening complication in patients with sepsis and septic shock.→ Approximately one-half of patients with sepsis experience an AKI.4 → One-third of all acute kidney injuries are related to sepsis.4 → Sepsis-associated AKI raises in-hospital mortality eightfold and the risk of chronic kidney disease development threefold.1,2,3. Early identification of AKI could save time and resources, lower costs, improve patient outcomes. Therefore, a biomarker for earlier AKI detection in patients with sepsis would serve an outstanding role in health care.In the setting of bacterial infection, an upregulation of innate immune system gene transcription and translation …

Treatment Rates In A Two-Step Clostridioides Difficile Diagnostic Testing Algorithm, Renee Ringler, Matthew Sims

Posters

Clostridioides difficile is a Gram-positive obligate anaerobe long associated with healthcare-acquired infections in the United States. 1 Clostridioides difficile infection (CDI) has thus become a key metric for assessing facility cleanliness and iatrogenic infection. C. difficile carriage is common, present in approximately 8% of hospitalized patients.2 Therefore, appropriate patient selection for testing and careful testing procedures is crucial to appropriately identify CDI while avoiding the detection of chronic colonization.

Considerable variability exists among institutions regarding standardized CDI laboratory diagnostic methods. Historically, the gold standard for CDI testing was the clinically inefficient toxigenic culture (TC). 3 This was followed by cytotoxic …

Understanding The Effect Of Advanced Patient Age On Outcomes And Complications Of Spinal Surgery, Alexander R. Woznicki, Daniel K. Fahim

Posters

• In 2020, 6.7 million individuals in the United States were older than 85. This is projected to increase to 12.6 million in 20601

• The risk of developing many spinal conditions increases with age2,3,4

• Decreases in disk height changes the loadbearing properties of the spine

• Decreased bone density makes the vertebrae susceptible to fracture

• Weakening of spinal ligaments predispose to disc degeneration

• Hypertrophy of the ligamentum flavum and susceptibility to disk herniation can lead to spinal stenosis

• Damage of the cervical spinal cord can manifest as weakness and clumsiness in the upper extremities and …

Impact Of Pprom Delivery Protocol On Adverse Neonatal Outcomes At Our Institution, Jacqueline Juarez, Sangeeta Kaur

Posters

Traditionally, mothers diagnosed with PPROM (preterm premature rupture of membranes) between 34w0d to 36w6d had immediate delivery. However, newly developed research has shown potential benefit to expectant management through delaying delivery until 37 weeks to reduce adverse neonatal outcomes. Our research showing a lower percentage of respiratory distress, mechanical ventilation, and/or length of NICU stay in expectant management can greatly impact neonatal care. Additionally, this can form a new standard in guidelines on how to manage mothers diagnosed with PPROM between 34w0d to 36w6d.

The Administration Of Antenatal Corticosteroids In The Late-Preterm Period, Sarah O’Mara, Sara Jaber, Kurt Wharton

Posters

The administration of corticosteroids in the late-preterm period (34 to 36+6 weeks' gestation) remains a topic of ongoing debate. The landmark Antenatal Late Preterm Steroids (ALPS) trial demonstrated a significant reduction in neonatal respiratory morbidity with the use of late-preterm corticosteroids, leading to updated recommendations by the Society of Maternal-Fetal Medicine in August 2016 supporting their administration for patients at risk of late-preterm delivery. Given that late-preterm births accounted for 7.4% of live births in the United States in 2020, optimizing neonatal outcomes in this population is a critical public health concern.

Antenatal corticosteroid administration between 24 and 33+6 weeks' …

The Relevance Of Age, Bmi, And Right Versus Left Ear Surgery To The Incidence Of Taste Disturbance After Stapes Surgery, Jonathan Ong, Dennis Bojrab Ii

Posters

• Many factors such as age and body mass index (BMI) have been shown to influence post-operative outcomes in patients undergoing stapedectomy/stapedotomy.

• This study examines these factors to see if they have any impact on the incidence of taste disturbance, a commonly reported complication of stapes surgery.1

• Our study predicts that BMI and age are correlated with the incidence of taste disturbance post-operatively following stapes surgery.

Effects Of Changing The Frequency Of Epidural Steroid Injections For Elderly Patients With Lumbar Radiculopathy/Lumbar Spinal Stenosis, Nitin Venkatesh, Rebecca Clemans, Roy Soto

Posters

Lower back pain is highly prevalent and a significant cause of disability.

50-84% of adults experiencing back pain at some point.

Previously, patients with chronic lumbar radiculopathy received a maximum of 6 injections a year (q8w).

On Dec 2021, Medicare Coverage of ESIs was updated to limit ESIs to a max of 4 a year (q12w).

Improving Treatment For Infant Perianal Abscesses, Artem Dadamyan, Nathan Novotny, Ngan Nguyen

Posters

Perianal abscesses: • Tender masses located at the anal verge, typically in the 3 o’clock and 9 o’clock positions1

• Develop due to infection in abnormally deep crypts of Morgagni 1

• If left untreated, can extend into the ischioanal space or intersphincteric space since these areas are continuous with the perianal space.2

• Some may develop into fistula in ano, which can be difficult to treat3 Treatment:

• The standard has always been incision and drainage (I&D), but non-invasive management of Sitz baths is increasingly being used.

Prostatic Urethral Length On Mri As A Predictor Of Late Genitourinary Toxicity After Prostate Cancer Radiation, Kyu Kim, Joseph Lee, Allison Hazy, Sayf Al-Katib, Hong Ye, Nathan Kolderman, Abhay Dhaliwal, Daniel Krauss, Thomas Quinn, Kimberly Marvin, Kiran R. Nandalur

Posters

Radiation therapy (RT) is a widely used treatment for prostate cancer.1 While effective, some patients develop late genitourinary (GU) toxicity, which can impact quality of life.2,4 Identifying pre-treatment factors that predict toxicity risk may help improve clinical decision-making. Recent studies suggest that prostatic urethral length (PUL) seen on MRI is associated with an increased risk of late GU toxicity.3 Understanding this relationship could enhance risk stratification before treatment.

Toxicity And Clinical Outcomes Following Brachytherapy Using 3-D Dosimetric Planning In Patients With Cervical Cancer: An Institutional Experience, Nikita M. Patel, Jacob F. Oyeniyi, Maha Saada Jawad

Posters

• Cervical cancer is the most common gynecological cancer worldwide.1

• The standard of care for locally advanced cervical cancer (LACC) includes primary chemoradiation, brachytherapy, and external-beam radiotherapy.2

• Brachytherapy (BT) involves the targeted delivery of radiation to the cervix (Fig 1). However, radiation can be toxic to surrounding structures, most commonly affecting the gynecological, genitourinary, and gastrointestinal systems.3

• Historically, brachytherapy was planned using a 2-D approach, which had limitations in accuracy and increased toxicity to the adjacent bowel and bladder. 3-D planning using CT or MRI has been shown to have improved dose precision and reduced toxicity.4

• …

Low Cpap Adherence Amongst The African American And Arabic Population In Patients With Obstructive Sleep Apnea, Nikki Nguyen, Bhavinkumar Dalal

Posters

• Obstructive sleep apnea (OSA) is a breathing disorder that occurs from a recurring decreased or completely blocked airflow during sleep leading to symptoms including excessive daytime sleepiness and impaired cognitive function1.

• Primary treatment for moderate to obstructive sleep apnea is continuous positive airway pressure (CPAP) reducing daytime sleepiness, improves neurocognitive function, and improves quality of life2.

• Current literature shows that compliance varies from 40-85% with poor adherence reducing the treatment’s effectiveness in preventing chronic health problems3.

• Although more CPAP use is generally associated with subjective and adherence is typically defined as at least 4 hours of …

Do Critically Ill Patients With Guardianships Receive More Aggressive Treatment?, Misha Haq, Jacob Keeley, Enrique Calvo-Ayala

Posters

• Patients suffering from certain conditions can become unable, unwilling, or unavailable to make decisions regarding their end-of-life care1.
• • In these cases, a court appointed guardian is responsible for carrying out medical decisions on behalf of the patient2.
• Patients with guardians tend to receive more aggressive care, regardless of the benefit, because it is perceived as safer 3.
• Guidelines and laws for medical decision-making for patients with guardians are inconsistent, leaving this population vulnerable4.

Venlafaxine Exposure In Pregnancy And Its Association With Pre-Eclampsia Development, Jhanvi Patel

Posters

Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), is widely used to manage depression and anxiety, including in pregnant women. However, its known hypertensive side effects raise concerns about a potential link to pre-eclampsia, a serious pregnancy complication characterized by new-onset hypertension and proteinuria. Pregnant women with psychiatric disorders already have an increased risk of hypertensive disorders, and while untreated depression can lead to adverse outcomes such as preterm birth and fetal cortisol elevation, the safety of venlafaxine remains uncertain. Current research lacks wellcontrolled studies assessing its association with hypertensive complications in pregnancy. This systematic review aims to evaluate whether venlafaxine use …

Safety And Utility Of Robotics In Pediatric Surgery: Implementation, Luke J. Man, Kristin Lemarbe, Nathan Novotny, Anthony Stallion, Begum Akay, Pavan Brahmamdam

Posters

• Minimally invasive laparoscopic surgery is considered standard of care for adult and pediatric patients .

• Robotic surgery (RS) for adult patients has been widely adopted due to superior ergonomics, visualization, depth perception, and access to deeper anatomical structures2,3.

• Historically, RS is associated with longer operative times, higher cost, and lacks haptic feedback1,2.

• RS has had inconsistent adoption in the pediatric surgery community2.

Impact Of Michigan Public Act 246 On Opioid Prescribing For Pediatric Surgical Patients, Madison Saunders, Pavan Brahmamdam

Posters

1. Opioid misuse is an epidemic in the U.S. affecting 3.1% of pediatric patients.2,3.

2. Most common way adolescence obtain access to opioids is by their own prescription or a family member. 3,4 3.

3. In December 2017, Michigan enacted Public Act 246 (P246) in an attempt to address rising opioid misuse.

4. P246 states that as of June 1, 2018, a prescriber of a controlled substance must discuss the risks of opioid usage minor and the minor’s parent or guardian and sign a consent form.

A Retrospective Pilot Study Assessing The Concordance Between Referral Diagnoses, Referring Physician Specialty, And Emg/Ncv Results, Bodrul Islam, Daniel L. Menkes

Posters

• Electromyoneurography (EMG/NCV) combines nerve conduction studies and needle electromyography.1 Patients are referred with a diagnostic hypothesis to be tested.
• Nerve conduction studies assess large myelinated fibers, and needle EMG evaluates type I muscle fibers. Conditions affecting small fibers (e.g., neuropathic pain) or type II fibers (e.g., steroid myopathy) typically yield normal results, limiting the utility of EMG/NCV for their evaluation.1,2,3
• Moreover, many patients are referred for EMG/NCV testing for nonspecific symptoms such as pain or numbness, often without objective neurological deficits.
• This study was conducted to determine the concordance of the EMG referral with the provider’s specialty and the final …

Safety Profile Of Spinal Cord Stimulator Paddle Lead Revision And Replacement, Saini Kethireddy, Michael Staudt

Posters

• Spinal cord stimulation (SCS) is a neuromodulatory treatment for patients experiencing chronic pain resistant to conservative therapies. It is often used for postlaminectomy syndrome, complex regional pain syndrome, and neuropathic pain.
• SCS leads can be categorized into percutaneous leads and paddle leads, the latter requiring a laminectomy for implantation.
• The advantages of paddle leads include lower migration rates and more efficient energy delivery.
• Revision surgery may be required in instances of lead failure, migration or misplacement. Paddle lead replacement can be challenging due to extensive scar tissue formation, often requiring additional dissection.
• Reoperation for paddle leads has raised concerns about …

Advances In Minimally Invasive Hepatobiliary Interventions For Non-Operative Candidates, Tulasi Talluri, Philip Cieplinski, Kristian Loveridge

Posters

Cholangioscopy is a technique used for diagnosing and treating patients with pathologies of the gallbladder, liver, and pancreas. It has been available since 1976 but with limited use in interventional radiology (IR) due to issues with steerability, irrigation capabilities, requirement for more than one operator, and poor percutaneous access options; however, direct intraluminal visualization of the gallbladder, common bile ducts, and even the ampulla and duodenum has become more practical with the advent of single operator percutaneous systems. Access to the biliary system can now be made through smaller 11 French sheath/delivery systems allowing for improved maneuverability into the common …

Comparison Of Two Adjuvant High-Dose Rate Vaginal Cuff Brachytherapy Dose Fractionation Regimens For Treatment Of Early-Stage Uterine Cancer, Catherine Raciti, Hong Ye, Allison J. Hazy, Maha Saada Jawad

Posters

• Endometrial cancer is the most common gynecologic malignancy in the United States, with peak incidence at 63 years of age.¹

• PORTEC-2 trial established VBT alone as an effective modality for select high-intermediate risk patients.2

• There was no strict ABS guideline for dose fractionation; our institution adopted a 30Gy in 6 fractions regimen based on radiobiological calculations.3,4

• COVID-19 pandemic led to a shift towards 22Gy in 4 fractions

• Objective: Compare oncologic outcomes and toxicity between the 30Gy/6fx and 22Gy/4fx regimens.

• Hypothesis: Both regimens are well-tolerated and equally effective.

• Impact: Findings will inform clinical practice …

Allergies Coinciding With Central Sensitization Syndromes (Access), Jacqueline Morey, Alemu Fite, Carl Lauter, Matthew Sims

Posters

Significance of Reported Allergies: Many reported drug allergies are mislabeled side effects or misinterpretations, leading to suboptimal treatment, antibiotic resistance, and worse patient outcomes.¹

Central Sensitization Syndromes (CSS): CSSs are chronic pain conditions linked to altered sensory perception, including pain, fatigue, and neurologic dysfunction.² These patients may be more likely to misattribute medication side effects as allergies.

Previous Findings & Hypothesis: Prior research found high allergy reporting in interstitial cystitis and fibromyalgia—both CSS conditions.⁴ We hypothesized that other CSS diagnoses also correlate with increased allergy reporting, emphasizing the need for better allergy evaluation.

Epic Best Practice Alerts Increases Sep1 Orderset Usage, Mark Munir, Zachary Awad, Paul Bozyk, Ramin Homayouni

Posters

Sepsis is a massive, system-wide inflammatory response to an infection that can lead to multisystem organ failure.1 Sepsis has a very high mortality rate of 20-50% in patients with severe sepsis and is the 10th leading cause of death in the United States.2 One of the most significant ways of reducing mortality from sepsis is timely detection and initiation of treatment in septic patients.3

Electronic medical records such as Epic have implemented sepsis warning algorithms and alerts to facilitate quicker detection of sepsis and thus earlier initiation of treatment. The goal of this study is to determine if an Epic …

Aquablation Compared With Simple Prostatectomy For Prostate Volumes >80 Grams, Joshua Kuperus, Minhaj Jabeer, Aidan Kennedy, Paul Horning, Greg Palmateer, Bernadette M.M. Zwaans, Jason Hafron, Kenneth M. Peters

Posters

• Benign prostatic hyperplasia (BPH) is the most common benign urological disease in men. 1

• Moderate-to-severe lower urinary tract symptoms (LUTS) from BPH affect 30% of men over 502 and medical treatment often fails for men with moderate-to-severe symptoms, leading them to seek surgical options. 3

• Transurethral resection of the prostate (TURP) remains the gold standard for prostates less than 80 mL; simple prostatectomy (SP) remains the standard for larger prostates.

• Aquablation (Aqua) is a novel BPH procedure that may be used for both small and large prostates from 50 to 150 mL. 4

• Although TURP …

Bisphosphonate Treatment In Pediatric Patients With Rare Ovarian Malignancy And Hypercalcemia: A Case Series, Seth Lamb, Samhita Bhattarai, Jennifer Boyd

Posters

Objective: To describe the presentation, management, and outcomes of severe hypercalcemia in two adolescent females secondary to ovarian malignancy. Methods: The case series includes two adolescent female patients, aged 11 and 16, diagnosed with rare ovarian malignancies and associated hypercalcemia. The 11-year-old female was diagnosed with small cell carcinoma of ovary while the 16-year-old was diagnosed with dysgerminoma. Both patients presented with abdominal pain, nausea and constipation. The 11-year-old received zoledronic acid while the 16-year-old received pamidronate. Serum calcium level, symptoms and adverse effects were monitored before and after both medications. Results: Both patients presented with severe hypercalcemia. The 11-year …

Physician Use Of Progesterone In Transgender Adolescents: A Survey, Samhita Bhattarai, Michelle Knoll

Posters

Objectives To evaluate the current perspective and clinical practices of physicians regarding the use of synthetic progestins as an adjunct to estrogen therapy in transfeminine adolescents. The survey focuses on perceived benefits, risks and overall efficacy in gender affirming hormone therapy. Methods A cross sectional survey was conducted among physicians who care for transfeminine patients. The survey included questions regarding their specialty, practice setting, age range of patients. Data was also collected regarding their indication for use, perceived benefits (e.g. breast development) and rationale if not using progestins for this purpose. Results Of 110 physicians who participated in the survey, …