Medical Specialties Commons^™

Impact Of A Mental Health Screening Process In A Pediatric Ed, Bryan Stocker Do, Shobhit Jain Md, Kathryn Worland Msw, Celeste Tarantino Md, Lina Patel Md, Shayla Sullivant Md

Research Days

Background: Up to 20% of children in the United States experience a mental health disorder and suicide is the second leading cause of death among adolescents. Children presenting with mental health concerns to the Emergency Department (ED) can be challenging due to lack of access to trained professionals and long lengths of stay. Specialized teams have shown to be beneficial, but little is known about their impact in the ED.

Objectives/Goal: This study explored the impact of specialized social workers partnering with emergency medicine providers to provide care during an acute mental health crisis.

Methods/Design: We performed this work at …

X-Linked Nephrogenic Syndrome Of Inappropriate Antidiuresis Secondary To Vasopressin Receptor 2 Mutation, Erica Zarse

Research Days

Background: X-linked nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a rare cause of hyponatremia with a similar biochemical evaluation to the syndrome of inappropriate antidiuretic hormone secretion but with suppressed vasopressin (AVP) levels.

Objectives: We present a case of hyponatremia due to NSIAD.

Results: A 25-month-old male with developmental delay became unresponsive 30 minutes after falling off a couch onto a hardwood floor. He presented with tonic-clonic movements and eye deviation requiring antiepileptics. Serum laboratories noted hyponatremia (123 mmol/L), hypoosmolality (262 mOsm/kg) and hypochloremia (90 mmol/L) prompting endocrine consult. Head imaging normal. Urine dilute with specific gravity 1.004, osmolality 160 …

Covid-19: Perspectives From Youth In Detention, April Mcneill-Johnson

Research Days

Background: The COVID-19 pandemic amplified health disparities among youth in detention. Understanding perspectives of these youth on the pandemic and COVID-19 vaccination may identify strategies to mitigate pandemic-related health disparities in this group.

Objectives/Goal: To explore perspectives on the COVID-19 pandemic, effect on detention experience and the COVID vaccine among youth in detention.

Methods/Design: This is a secondary analysis of a study examining healthcare needs and experiences of youth in detention. We recruited a convenience sample of youth (14-17 years) detained in urban midwestern juvenile detention centers from January-November 2021. We conducted semistructured individual interviews & used a thematic analysis …

Gastrointestinal Fibromatosis: A Case Of Successful Oral Tyrosine Kinase Inhibitor Delivery To An Infant With Proximal Duodenal Obstruction, Darius Blanding

Research Days

Background: Infantile myofibromatosis (IM) is a rare disorder characterized by the fibrous proliferation of the skin, bone, muscle, and viscera that usually presents at birth, or soon after. Although IM is a benign condition, significantly higher morbidity and mortality have been reported when the viscera is involved. This case report is of a 6-week-old female who presented with poor feeding along with subcutaneous nodules that were diagnosed as IM. Upper and lower endoscopy were performed for worsening feeding intolerance showing marked nodularity throughout the gastrointestinal (GI) tract, including partial obstruction of the proximal duodenum by biopsy-proven myofibromas, confirming visceral IM …

Subclinical Status Epilepticus In The Setting Of An Acute Covid-19 Infection, Thomas Rieth

Research Days

Background: While COVID-19 commonly presents as an upper respiratory infection, acute COVID infections has the potential to have multisystem involvement. Neurological symptoms, which have mainly been reported in adults, are rare in children and are not well recognized. Better understanding of the neurological manifestations of COVID-19 in children can lead to earlier detection of COVID-19 and help with medical decision making and treatment.

Objectives/Goal: To describe an unusual presentation of COVID-19 in a previously healthy female and explore the neurological presentations of COVID-19.

Results: A 10 year old previously healthy female presented with a 1 day history of altered mental …

Soft Palate Teratoma: 5 Month Old Presenting With Failure To Thrive And Severe Obstructive Sleep Apnea, Anna Lawrence

Research Days

Introduction: Oropharyngeal teratomas are an extremely rare congenital tumor. They are often diagnosed prenatally and can cause significant airway obstruction and feeding difficulties at birth. We present a 5-month old female that was diagnosed with a palatal teratoma that presented with failure to thrive, difficulty feeding and eventually with severe obstructive sleep apnea.

Case Description: We present a 5 month old term, otherwise healthy female who initially was breastfeeding well. After an episode of RSV at one month old she become stridulous and had difficulties with feeding. She was seen by an otolaryngologist at 3 months old who performed both …

A Case Of Fibrous Hamartoma In Term Neonate, Elizabeth Perry

Research Days

Case report abstract: Fibrous hamartoma of infancy (FHI) is a rare, benign lesion characterized as a tumor of myofibroblastic origin that has characteristic features of triphasic histology. FHI was first described in 1956 by Reye and formally named by Enzinger in 1965 (1, 2). The lesion is defined as a hamartoma due to the histologic presentation of disorganized mesenchymal, fibrous, and adipose tissue with absence of mitotic figures; this combination of derived tissue without evidence of anaplasia is diagnostic for FHI. These lesions typically arise as a single, solitary mass, are most commonly located on the extremities, trunk, sacrum, or …

Early Onset Obesity In A 4-Year-Old Female Found To Have Variants In Both The Single-Minded Homolog 1 And Sh2b Adaptor Protein 1 Genes, Erica Zarse

Research Days

No abstract provided.

Angiotensin Receptor Blockers Associated Enteropathy- Brief Report, Falgun Gosai, Neha Gosai

Journal of Community Hospital Internal Medicine Perspectives

The current literature has shown equivocal results regarding the association of Olmesartan and other angiotensin receptor blockers (ARBs) use and the presence of Celiac sprue-like enteropathy (CSLE). Various factors affecting the association are- patient population under study, geographic area, and duration of use of medication. Various case reports/ case series and observational studies have shown the mixed results regarding an association. We have tried to answer a question what exists in the literature regarding the angiotensin receptor blockers related sprue like enteropathy.

The Racial Divide: A Follow Up Study On Racial Disparity Amongst Covid-19 Survivors In An Urban Community, Christopher Millet, Emily Racoosin, Spandana Narvaneni, George Horani, Sherif Roman, Alisa Farokhian, Arslan Chaudhry, Sohail Chaudhry, Yezin Shamoon, Humberto Jimenez, Patrick Michael, Jin Suh

Journal of Community Hospital Internal Medicine Perspectives

Background Studies have shown that COVID-19 has had a disproportionate effect on minority groups in both the clinical and social settings in America. We conducted a follow up study on patients previously diagnosed with COVID-19 one year ago in an urban community in New Jersey. The purpose of the study was to evaluate the socioeconomic impact of COVID-19 as well as assess for receptiveness towards COVID-19 vaccination amongst various ethnic groups.

Methods This was a prospective cohort study consisting of patients who had recovered from COVID-19 one year prior. The patients included in the study had a confirmed COVID-19 diagnosis …

Neurosyphilis: A Monkey Among Men, Cameron Rowe Do, Nathan Buckley Do, Bhaskar Chhetri Md, Suresh Paudel Md

Journal of Community Hospital Internal Medicine Perspectives

Neurosyphilis is the progression of the untreated sexually transmitted infection caused by Treponema pallidum. When the initial infection is not adequately treated, progression of primary syphilis can lead to a wide variety of serious health sequelae. While neurosyphilis can appear up to 10-30 years after the initial infection, syphilis can invade the nervous system at any stage of infection and can imitate symptoms of many other diseases. This variety of symptoms is why syphilis has been called “The Great Pretender” or “The monkey among diseases” (12). This is a case report of an 83-year-old female with a history of multiple …

Development Of A Community Hospital Medicine Affiliated Inpatient Rotation For Family Medicine Residents - A Collaborative Success, David M. Gallagher, Anthony J. Viera, William E. Bynum, Poonam Sharma, John W. Ragsdale, Jeffrey Eschbach, Lalit Verma

Journal of Community Hospital Internal Medicine Perspectives

Background: Hospitalists perform key roles as inpatient educators for family medicine residents. For the past decade, Duke University Family Medicine Residency Program had its inpatient family medicine resident rotation at non-Duke facilities.

Objective: The authors describe the steps taken in 2020 to develop an inpatient Duke family medicine rotation at a North Carolina community hospital, Duke Regional Hospital, and provide outcomes data.

Methods: Duke Family Medicine Residency and Duke Regional Hospital Medicine collaborated in addressing key issues to develop an inpatient rotation for family medicine residents. Performance metrics of patients cared for by both the family medicine inpatient resident team …

The Future Of Targeted Kinase Inhibitors In Melanoma, Signe Caksa, Usman Baqai, A E Aplin

Department of Cancer Biology Faculty Papers

Melanoma is a cancer of the pigment-producing cells of the body and its incidence is rising. Targeted inhibitors that act against kinases in the MAPK pathway are approved for BRAF-mutant metastatic cutaneous melanoma and increase patients' survival. Response to these therapies is limited by drug resistance and is less durable than with immune checkpoint inhibition. Conversely, rare melanoma subtypes have few therapeutic options for advanced disease and MAPK pathway targeting agents show minimal anti-tumor effects. Nevertheless, there is a future for targeted kinase inhibitors in melanoma: in new applications such as adjuvant or neoadjuvant therapy and in novel combinations with …

Duchenne’S Muscular Dystrophy & Occupational Therapy, Vanessa Sagredo, Meagan C. Romero

Client Educational Handouts

No abstract provided.

Custom Ampliseq Targeted Sequencing Panel For Orphan Pediatric Retinal Diseases: Norrie Disease, Fevr, And Retinoschisis, Michael Sun, Wendy Dailey, Amanda Petrilli Cicerone, Jennifer Felisky, Kaylee Moyer, Naomi Haque, Alvaro Guzman, Kendra Mellert, Kimberly Drenser, Kenneth P. Mitton

Posters

INTRODUCTION
DNA-sequencing is not readily available in countries with little research resources or where health insurance does not cover the costs. This is especially true for very rare (orphan) inheritable retinal diseases. We wanted to develop a rapid targeted-sequencing protocol for eight genes involved in Familial Exudative Vitreo-Retinopathy (FEVR), Norrie Disease, and Retinoschisis, at greatly reduced cost.

Effects Of State-Wide Mandatory Automated Prescribing System On Safe Medication Disposal, Helen E. Huetteman, Elie Mulhem

Posters

INTRODUCTION
In June 2018, Michigan lawmakers passed new legislation to restrict and monitor controlled substance prescriptions, leading to a significant decrease in the prescribing of opioids. This project aims to evaluate effects of this legislation on safe medication disposal trends throughout the state.

The Influence Of Blm And The Death Of George Floyd On Medical And Pre-Med Students And Their Views On Institutional Racism, Asia Susko, Jason A. Wasserman

Posters

INTRODUCTION
Racial inequalities present in medical education in a multitude of ways, including basing disease prevalence on majority populations and using images that disproportionately represent white patients. George Floyd’s death was not only a sentinel event of police violence, but underscored broader systemic racism, including medicine’s potential for complicity. This study highlights the perspectives of premedical and medical students in light of George Floyd’s death and the Black Lives Matter movement. Their views help elaborate ways to better support students and staff of color in medical education.

Emergency Department Recidivism Due To Skin Lesions Among The Homeless Population, Kylee Jb Kus, Jason A. Wasserman

Posters

INTRODUCTION
Ample research supports the correlation between homelessness and poor health generally. Individuals experiencing homelessness face a higher risk of dermatological health problems due to exposure and sanitation concerns and comprise a disproportionately large share of emergency department (ED) visits. This study assesses whether and how the interaction between homelessness and dermatological health contributes to ED recidivism.

The Divergence Of Medical Ethics And State Laws Regarding Life Sustaining Treatment, Hannah Vandusen, Jason A. Wasserman

Posters

INTRODUCTION
Research reveals that cardiopulmonary resuscitation (CPR) rarely leads to prolonged survival in patients with chronic illnesses in whom death is expected in the relative near-term. There is strong ethical consensus favoring a physician’s right to refuse to provide CPR when it is physiologically futile or medically inappropriate. State laws governing medical treatment, however, sometimes diverge from this guidance. This study examines laws related to life sustaining treatment, analyzing both physician and surrogate authority in decision making about resuscitation orders in the national context.

Investigating The Effectiveness Of A Mindfulness Based Stress Reduction Course Within Healthcare: A Qualitative Methods Study, Patrick Herndon, Michael Moussa, Alyssa Heintschel, Scott Sabbagh, Ruth Lerman

Posters

INTRODUCTION
Mindfulness practice has emerged as a promising means to address stress in healthcare workers (HCW). Virtually all HCW studies of the standardized, validated Mindfulness Based Stress Reduction (MBSR) curriculum have been conducted using homogeneous (HCW only) populations. This work examines the novel approach of comparing the effects of heterogeneous MBSR classes: HCW, oncology patients and family members (HCW-HE) as compared to homogeneous classes HCW and their family members only (HCW-HO)

Exploring The Effects Of Mindfulness Based Stress Reduction On Pre-Clinical Medical Students: A Qualitative Methods, Longitudinal Pilot Study, Alyssa Heintschel, Scott Sabbagh, Patrick Herndon, Michael Moussa, Ruth Lerman

Posters

INTRODUCTION
Mindfulness Based Stress Reduction has become an increasingly popular practice in healthcare-affiliated populations. MBSR is a course designed to promote mindfulness and awareness within oneself through a combination of formal and informal practices. Studies suggest healthcare workers are at higher risk of experiencing stress and burnout; this is prevalent among pre-clinical medical students due to the rigorous nature of medical school coursework. The primary objective of this study is to evaluate the effectiveness and feasibility of implementing an MBSR program to facilitate improvements in key areas of mental health among medical students throughout their training.

Investigating The Effects Of A Mindfulness Based Stress Reduction Course On A Grouping Of Oncology Patients, Health Care Workers And Their Families On Measures Of Stress And Burnout In Health Care Workers: A Randomized Control Trial, Michael Moussa, Patrick Herndon, Alyssa Heintschel, Scott Sabbagh, Ruth Lerman

Posters

INTRODUCTION
Mindfulness Based Stress Reduction (MBSR) can improve the mental health of health care workers (HCW). How will the inclusion of oncology patients (OP) in MBSR classes for HCW affect the mental health of HCW?

Functional Lung Segmentation From Computed Tomography Images Using Deep Learning, Duyen M. Quach, Evan Porter, Thomas M. Guerrero

Posters

INTRODUCTION
Functional avoidance treatment planning allows radiation oncologists to intentionally minimize radiation dose to higher-functioning lung areas while favoring radiation dose towards lower-functioning regions. This treatment planning method has been shown to reduce pulmonary toxicity for patients receiving radiation therapy. Functional lung information, traditionally ventilation or perfusion SPECT scans, is required to plan for functional avoidance.

Prospective Qualitative Analysis Of Minimally Invasive Repair Of Pectus Excavatum, Timothy Elton, Diane Studzinski, Robert S. Morden, Pavan Brahmamdam

Posters

INTRODUCTION
Pectus Excavatum is the most common chest wall deformity and is frequently corrected with the Nuss procedure. Although this procedure has existed for several decades, new strategies are being adapted to reduce complications and improve efficiency. The aim of this study is to perform a qualitative review of the patient experience after minimally invasive repair of Pectus Excavatum.

Spontaneous Pneumomediastinum In Children Is Not Associated With Esophageal Perforation, Kevin Roby, Catherine Barkach, Diane Studzinski, Nathan Novotny, Begum Akay, Pavan Brahmamdam

Posters

INTRODUCTION
We hypothesize that esophageal perforation is not a common etiology for spontaneous pneumomediastinum (SPM), and that SPM is a self-limited disease not requiring routine admission.

Perioperative Antibiotic Use In Neonatal Surgery, Lior Kopel, Patrick Karabon, Nathan Novotny, Begum Akay, Pavan Brahmamdam

Posters

INTRODUCTION
The ideal duration of perioperative antibiotic prophylaxis to prevent surgical site infection (SSI) in neonates is undetermined. The aim of this study is to evaluate the association between the duration of perioperative antibiotics and SSIs in the neonatal surgical population.

Defining Functional Shoulder Range Of Motion In Middle-Aged To Elderly Populations To Guide Shoulder Surgical Treatment, Tyler Sargent, Justin Smith, Christie Smith, John Krauss, Michelle Jankowski, J Michael Wiater

Posters

INTRODUCTION
Functional range of motion (ROM) is defined as the minimal required mobility of a joint to complete activities of daily living (ADL). Defining functional ROM will allow surgeons to decide which aging patients would benefit from surgical intervention aimed at improving shoulder functionality.

Applying The Periprosthetic Joint Infection Consensus Definition To Ankle Implant-Associated And Infection-Suspected Procedures To Assess Diagnosis, Jackson Harley, Erin Baker, Corinn K. Gehrke, David Ciufo, Zachary M. Vaupel, Paul T. Fortin

Posters

INTRODUCTION
Periprosthetic joint infection (PJI) affects 2-3% of all total joint replacement cases. In 10-30% of these cases, the organism is unidentifiable, which may impact treatment planning and outcomes. In this study, suspected periprosthetic infections of foot and ankle procedures treated by four foot and ankle-trained orthopedic surgeons were retrospectively reviewed to determine culture status and applicability of the 2018 International Consensus Meeting on Orthopedic Infections (ICM) classification system.

Evaluating Taper Junction Fretting And Corrosion In Reverse Total Shoulder Arthroplasty, Ian R. Penvose, Erin A. Baker, J. Michael Wiater, Corinn K. Gehrke, Jonathan O Wright, Omar N. Khatib, Brett P Wiater

Posters

INTRODUCTION
Taper junction fretting and corrosion (F&C) has been identified in total hip arthroplasty (THA) as an implant failure mode. Studies have reported taper F&C in in anatomic total shoulder arthroplasty (ATSA) implants, but limited literature has described comparable analyses in reverse shoulder arthroplasty (RTSA) implants. In this study, taper junction F&C in retrieved RTSA implants was assessed and analyzed.

Effectiveness Of Prenatal Screening Tests On Predicting Cardiac Anomalies, Stephanie Y. Wong, Zeynep Alpay Savasan

Posters

INTRODUCTION
Congenital heart disease (CHD) is the leading cause of birth defect-associated infant death. With 1 in 111 newborns born with CHD and an elevated infant mortality rate of 30-50%, early detection is imperative. Current prenatal screening mainly focuses on detecting chromosomal anomalies. However, the accuracy of these exams on detecting fetal cardiac abnormalities is not well researched. The primary goal of this study is to compare three prenatal screening tests’ potential, i.e anatomy ultrasound, nuchal translucency (NT), and cell-free DNA (cfDNA), in identifying risk for fetal cardiac anomalies.