Medical Specialties Commons^™

Physical Activity In Managing Stress Among Managers During The Covid-19 Pandemic – A Systematic Review, Anna Hryniewicz, Anna Gmiąt, Magdalena Jaroch-Lidzbarska, Mariusz Lipowski

Baltic Journal of Health and Physical Activity

Introduction: During the COVID-19 pandemic managers experienced additional stress connected with taking responsibility for workers at the time of a worldwide crisis. Maintaining a high level of physical activity in this specific group possibly could have contributed to keeping both management skills and health condition at a high required standard. The purpose of this review is to verify the range of scientific interest on the subject of physical activity among managers as a stress coping strategy during the pandemic. Materials and Methods: For this systematic review six studies were chosen (two of them are qualitative descriptive, three are cross-sectional, one …

A Cadaveric Case Study On Lung Cancer Pathology, Anna Beth Boyette, Sarah Kate Boyette, Haley Garrett, Janai Groves, Perry Chandler Mullis, Sofia Sirocchi, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Lung cancer is the most commonly diagnosed cancer amongst both genders, currently accounting for about 18% of all cancer deaths.

OBJECTIVES: The overall purpose of this study was to evaluate the pathology associated with the patient’s cause of death, cardiorespiratory failure and lung cancer. The secondary aims of this study were to confirm the presence of malignant neoplasms within a human cadaver, determine the type of cancer present, and take specimens for histological examination to evaluate the patient’s cause of death.

METHODS: This is a case report from one of the cadavers in the Gross Anatomy laboratory at the …

Case Series Of Common Skin Lesions Encountered In Elderly Cadavers: A Dermatopathology Analysis, Tamryn L. Van Der Horn, Brigitte L. Cochran, Savita Arya

Research Day

INTRODUCTION: Gaining hands-on experience in both dermatology and pathology is a common barrier that prevents first and second year medical students from refining skills that are not later taught until residency. This prompted a study to develop gross differential diagnostic skills and how to analyze histopathology slides to diagnose common skin lesions to refine skills in both clinical and histology presentation for medical students.

METHODS: A case series was designed to examine multiple shave biopsies on all abnormal skin lesions observed from nine cadavers used for the first-year medical students gross anatomy lab during the year 2022-2023. Biopsies were stained …

Study Of Liver Based On Histopathological Patterns Of Liver Damage, Destiny Sciuva, Didem Aydin, Savita Arya

Research Day

INTRODUCTION: Liver histopathology patterns are an essential component of the diagnostic process for liver disease. If left untreated, liver disease can lead to liver cancer and liver failure. The American Liver Foundation stated that liver disease and cirrhosis was the twelve leading cause of death in the United States in 2020. As such, this is a significant field of study for further research as this is a primary public health concern.

OBJECTIVE: This study aimed to investigate the histopathological patterns of liver damage and their associations with different liver diseases from elderly cadavers in the South East United States regions. …

Colonic Stenosis In An Elderly Female, Tiffany R. Pittman, Kylie A. Parrish, Grace M. Perry, Oyindamola C. Orekoya, Shiv Dhiman, Savita Arya

Research Day

Introduction

Colonic stenosis is commonly caused by chronic inflammation and is a known side effect of inflammatory conditions, such as diverticulitis and irritable bowel syndrome. Diverticulosis is a common condition where parts of the colon wall become weakened, forming outpouches. These outpouchings may become inflamed, leading to diverticulitis. This chronic inflammation can cause scarring and fibrosis of the colon, resulting in colonic stenosis. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, may also result in scarring and colonic stenosis. The incidence rate of patients developing colonic stenosis is 8-13.5% for Crohn's disease and 1-11% for ulcerative colitis. Patients …

Paradoxical Embolism Entrapped In A Patent Foramen Ovale, Mohammad Malik, Macy Rowan, Lucas Seibolt, Barney Beaver

Research Day

Background: According to the Centers for Disease Control (CDC), venous thromboembolisms affect 900,000 people and cause up to 100,000 deaths yearly. A less common subset of these cases includes those of which the emboli, though originating in venous vasculature, are able to pass through intracardiac defects, including a patent foramen ovale (PFO). PFOs are relatively common in the general population, with an incidence of approximately 20-30%. Though oftentimes asymptomatic, PFOs may present an opportunity for an embolism to bypass the lungs and utilize a more direct route to the systemic circulation, otherwise known as paradoxical embolism. One feared complication of …

A Unique Case Of Atrial Fibrillation Secondary To Squamous Cell Lung Carcinoma, Mohammad J. Malik, Emily K. Wilson, Vijay Bandhakavi

Research Day

Atrial fibrillation (AF) is widely considered to be the most prevalent cardiac arrhythmia with an incidence of roughly 1-2% in the United States alone. The incidence of AF has been known to increase with advancing age and thus presents a significant burden on healthcare systems across the globe. AF arises as a result of several mechanisms including structural changes that occur to the heart overtime. Here we present a case in which a 63-year-old male with no past medical history except heavy tobacco use presented to the emergency department complaining of shortness of breath. He also endorsed having palpitations and …

Liver Cirrhosis, Hydroureter And Splenomegaly In A Cadaver : A Case Study, Steven Li, Manuel S. Linarte, Teighlor N. Livingston, Nahimie K. Louissaint, Tyanna N. Mccladdie, Nishi Patel, Shiv Dhiman, Savita Arya

Research Day

Background: Liver cirrhosis is among the most common causes of death in the United States. Cirrhosis can result from alcoholic liver disease, hepatitis, or non-alcoholic fatty liver disease. Advanced cases of liver cirrhosis may result in complications such as portal hypertension, hepatosplenomegaly, varices, and many others.

Case Presentation: This report describes a case of extensive liver cirrhosis found during the cadaveric dissection of a 71-year-old male. Observation revealed a slightly enlarged, cirrhotic liver with recanalization of the umbilical vein (of the round ligament). The patient also had significant splenomegaly, indicative of portal hypertension, and dilation of the left ureter. In …

A Combined Radio-Immunotherapy Regimen Eradicates Late-Stage Melanoma In Mice., Sritha Moram, Alexander Rakhmilevich, Noah Tsarovsky, Mildred Felder, Amy Erbe, Alex Pieper, Jen Zaborek, Emily Cheng, Cole Witt, Paul Sondel

Research Day

Advanced cancers are typically resistant to treatment, which leads to most experimental cancer immunotherapy approaches being tested against smaller tumors. In this study, we show that even late-stage, weakly immunogenic mouse B78 melanomas, with tumor volumes of 1500-2000 mm3, can be eradicated by a combined radio-immunotherapy regimen (CRIR) which includes local radiotherapy, intratumoral interleukin 12, slow-release systemic interleukin 2 and checkpoint blockade with anti-CTLA-4 antibody. Flow analysis of the tumors revealed a reduction in T regulatory (Treg) cells and an increase in CD8/Treg ratios following CRIR. T cell depletion did not prevent the rapid shrinkage of treated tumors, but suppressed …

Atypical Presentation Of Obstructive Coronary Artery Disease In A Diabetic Female, Alexis Rodriguez, Zhi Kuat, Humaira Bibi, Lawrence Ukpong

Research Day

According to the World Health Organization (WHO), cardiovascular diseases (CVDs) account for 17.9 million deaths yearly and are the leading cause of mortality in the United States. CVDs are heart and blood vessel disorders, including coronary artery disease (CAD), coronary heart disease (CHD), cerebrovascular disease, cardiomyopathy, and more. In 2018, diabetic adults accounted for 1.87 million hospitalizations for major cardiovascular diseases. Diabetes Mellitus (DM) is a global epidemic affecting about 422 million people worldwide. The Centers for Disease Control and Prevention (CDC) has reported more than 37 million people in the United States are diagnosed with DM, and 1 in …

A Postmortem Analysis Of Embalmed Lungs, A Human Cadaver Study, Frederick S. Merdian, Matthew Peterman, Odinaka Osigwe, Vikash Patel, Savita Arya

Research Day

OBJECTIVE: The human cadaveric study is vital to fully understanding lung pathologies and the prevalence of potentially cancerous neoplasms upon death in the general population. Developing an accurate knowledge of human respiratory neoplastic pathology is vital in furthering the field of respiratory medicine. This study aims to analyze a cohort of lung sets belonging to human cadavers for visible potentially pathogenic neoplasms and contrast this with epidemiological data available for representative populations.

METHODS: Cadaveric lungs (n= 20 pairs; 38 individual lungs) were isolated, and gross observations were performed of the parietal surface of both lungs. These samples were part of …

Prevalence Of Hyperostosis Frontalis In Georgia Elderly Cadaver Population, Sara G. Meawad, Tristan C. Henris, Ansley Myrick, Savita Arya, Shiv Dhiman

Research Day

Introduction

Hyperostosis frontalis interna (HFI) is a condition that causes a benign thickening of the frontal bone. Many studies in the past have correlated sex with the incidence of HFI. Additionally, females, especially those postmenopausal, seem to be the predominant group affected. The primary objective of this study is to explore incidence of HFI and how it relates to the different sexes. The secondary objective is to further investigate the correlation of HFI with liver and gonadal pathologies.

Methods

A study is designed to explore the prevalence of hyperostosis frontalis interna among sexes in a sample of cadavers (n=38) at …

A Cadaveric Case Study On Metastatic Breast Cancer Pathology, Janai L. Groves, Haley B. Garrett, Savannah J. Finley, Jada M. Glenn, Itza M. Garcia, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Breast cancer is the second most common cancer among women in the United States. The exact etiology of breast cancer is unknown, but over 70% of breast cancer cases involve only two risk factors: being a woman and being over the age of 50. Women with a family history of breast cancer, as well as women who experience early menopause, have an even greater risk of developing this disease. When considering racial demographics, African-American women have a 4-8% lower incidence rate of breast cancer than Caucasian women but are 40% more likely to die from the disease. Breast cancer …

Cadaveric Study: Sign Of Leser-Trélat Associated With Breast Cancer, Brigitte L. Cochran, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Seborrheic keratoses (SK) is considered the most common benign skin lesions found in individuals that are middle aged and older. In dermatology practice, these lesions pose no threat to the individual but can be concerning for cosmetic and underlying malignancy reasons when they cover most of the skin surface. Of specific concern is the sign of Leser-Trélat, which has been documented as a cutaneous harbinger of underlying malignancy associated with proliferation of the size and/or number seborrheic keratoses. This rare sign is usually caused by malignancies such as gastrointestinal adenocarcinoma and lung, kidney, liver, pancreatic cancer or malignant melanoma. …

Widespread Cutaneous Metastasis Of Oropharyngeal Cancer, Drew Fidler, Britany Dyer, Makayla Farr, Youmna Elkamhawy, Sammy Elmor, D’Angelo Stokes, Savita Arya

Research Day

INTRODUCTION

Oropharyngeal Cancer (OC), primarily caused by squamous cell carcinoma, has risen recently. OC is often categorized into HPV-associated carcinoma or non-HPV-associated carcinoma. Environmental factors such as tobacco and alcohol use significantly increase risk of OC and are associated with non-HPV-associated OC. While research has investigated common gene mutations associated with an increased risk of OC, there are only a few cases highlighting genes that lead to its cutaneous spread, which represents less than 10% of cases.

OBJECTIVE

This study's primary objective was to determine what genetic/environmental factors may have contributed to the development of multiple OC metastatic tumors with …

A Radiologic Analysis: Relationships Of The Thoracic Spine To Aid Palpation Of The Thoracic Transverse Processes, Christopher Baker, Darshan Patel, Michael B. Roberts, Kristie Petree, Randall L. Mcgill

Research Day

Introduction: In the field of osteopathic manipulative medicine, palpation is an important skill used by physicians to localize structures to diagnose and treat patients with somatic dysfunction throughout the musculoskeletal system. Specifically, in the thoracic spine, physicians can use the more superficial spinous process of each vertebra to assist in locating the deeper, more challenging to palpate, transverse process of the vertebra. Historically, the “rule of threes”, proposed by Mitchell et al in 1979, describing the relationships between spinous processes and transverse processes of the thoracic spine has been taught in osteopathic medical schools. However, another model was more recently …

Rare Presentation Of Metastatic Hepatocellular Carcinoma In The Finger: Case Report And Review Of Literature, F. Rhana Mousavi, Bassem Bekheit, Emon Alavi, Nick A. Hirad, Abanoub Gabra

Research Day

Hepatocellular carcinoma (HCC) is a primary tumor of the liver that primarily develops in the setting of chronic liver disease. HCC is difficult to diagnose due to it requiring the use of multiple imaging modalities with the goal to detect tumors when they are less than or equal to 2 cm in size to allow all possible treatment options to be used. Herein, we discuss a 69-year-old male with stage IV liver cancer residing in hospice presenting with left middle finger osteomyelitis and extreme pain. Radiology revealed a destructive lesion but pathology provided the diagnosis of metastatic hepatocellular carcinoma in …

Management Of Patient With Impaction Secondary To Undigested Sunflower Seed Bezoar: A Case Report, Sufia Ahmed, Anthony Adetomiwa

Research Day

Introduction: Bezoars are aggregates of undigested plant fibers, hair, or seeds that may impact in any portion of the GI tract. These bezoars if left can lead to significant complications, including perforation and peritonitis.

Methods: We report a case of a 4-year-old female patient who presented to the emergency department with constipation and severe lower abdominal pain following unsupervised consumption of a large unknown volume of sunflower seeds. Initial radiograph revealed an undigested bezoar of seeds in the sigmoid colon and rectum. The patient was managed with mineral oil enema and manual disimpaction under conscious sedation. Subsequent radiographs revealed a …

A Comparison Of Large Tbsa Scald Versus Flame Burns In Young Children, Ashley Daniel

Research Days

Background: It is generally accepted that of children with the same total body surface area of burns, those with flame burns seem to have longer lengths of stay and more complications than those with scald burns. Anecdotally we have seen the opposite to be true. Among a consortium of five US pediatric burn centers participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC), young children with scald burns seem to experience disproportionately more frequent and severe complications compared to their older counterparts and compared to patients of a similar age with flame burns.

Objectives/Goal: In this multi-institutional study, we compared …

Relationship Between Rurality And Access To Care For Families Of Hospitalized Children, Zoetta L. Mcloughlin Md

Research Days

Background: At Children’s Mercy Hospital, greater than 1 in 5 hospitalized children are from rural areas. Rural families often travel long distances for hospitalization at free-standing children’s hospitals, a median of 70 miles according to recent work. Rural families are more likely than non-rural families to experience financial insecurity, and these baseline hardships may be intensified during hospitalization due to out-of-pocket costs, lost work, inability to meet family needs, and removal from social support. However, little is known about the differences in healthcare access and resulting burdens between rural and non-rural families.

Objectives/Goal: To describe differences in demographics, health care …

Rural And Urban Caregiver Experiences Of Financial Strain And Food Insecurity During Pediatric Hospitalizations, Rachel E. Granberg

Research Days

Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.

Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.

Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was …

Female Authorship Concordance In Academic Pediatrics, Roxana Guggenmous, Jessica L. Bettenhausen, Jessica L. Markham

Research Days

Background: Gender disparities are well described in medicine and academia. Despite a catalyzed movement towards gender equity, female physician-scientists remain at risk for experiencing biases in hiring practices, compensation, promotion, appointment to leadership positions, and achievement of extramural funding through the National Institutes of Health. In pediatrics, the female workforce has grown consistently over time, with female physicians comprising 72.3% of the workforce as of 2021, yet prior work suggests that this growth is not fully reflected in academic publications. Achieving gender parity in academic publication may help reduce gender-based disparities impacting career advancement. Therefore, we sought to describe the …

A Novel Therapy For Refractory Cbfa2t3::Glis2-Associated Amkl Using Stro-002 And Plerixafor, Amy Johnson Md, Mba, Alan S. Gamis, Arturo Molina, Soheil Meshinchi, Karen Lewing

Research Days

Background: CBFA2T3::GLIS2-associated AML (CBF/GLIS AML) is an aggressive form of AML often associated with AMKL and recognized by its unique RAM phenotype by flow. It has a very poor prognosis, frequently refractory to standard of care regimens, with extreme marrow localization of leukemic blasts likely mediated by high CXCR4 (CD184) expression. The CBFA2T3::GLIS2 fusion gene is the most common oncogenic transcript in pediatric AMKL and universally results in high expression of FOLR1 surface antigen. STRO-002, an antibody drug conjugate targeting FOLR1, is currently in Phase I clinical trials for adults with refractory ovarian and endometrial malignancies A summary of 17 …

Understanding Home Visitor Attendance At Well Child Checks: A Mixed Methods Study, Rachel Segal, Sommer Rose, Marcia Dutcher, Tyler Myroniuk, Mary Moffatt, James Anderst

Research Days

Background: Early childhood home visiting programs have variable outcomes on child health across models and studies. Given this variability, novel approaches are needed to foster consistent positive outcomes. One approach is attendance of a home visitor (HV) at medical provider well child checks (WCCs) to provide a stronger link between home visiting and the medical home. This process may be assessed in an exploratory study evaluating the qualitative perceptions and initial quantitative effects of the intervention.

Objectives/Goal: Qualitatively explore perspectives of HVs attending WCCs and quantitatively evaluate effects of the practice on (1) family compliance with American Academy of Pediatrics …

Pediatric Educational Outreach To A Community Based Emergency Department: Clinical Management Of The Febrile Infant, Jess Parker, Frances Turcotte Benedict, Emily Hillman, Ryan C. Jacobsen, Ashley K. Sherman, Arjun Sarin

Research Days

Background: Multiple studies have shown variability in the approach to treatment of febrile infants ≤ 60 days of age in community emergency departments (EDs), and the American Academy of Pediatrics (AAP) recently published new guidelines on management of febrile infants. Therefore, an opportunity exists to provide evidence-based recommendations for the care of this patient population to providers in community EDs.

Objectives/Goal: To assess 1) alignment of community ED provider practices with an AAPinformed Clinical practice guideline (CPG) for management of febrile infants ≤ 60 days of age. 2) change in comfort level and degree of alignment after targeted education.

Methods/Design: …

Inpatient Insulin Management For Severe Hypertriglyceridemia In Pediatrics, Erica Wee, Ryan Mcdonough, Matthew M. Feldt

Research Days

Background: Severe hypertriglyceridemia (SHTG) is defined as triglyceride (TG) >= 1000 mg/dL and increases the risk of developing acute pancreatitis. Insulin activates lipoprotein lipase which accelerates chylomicron degradation leading to a rapid decrease in TG levels. There is a paucity of pediatric standard of care for insulin use to treat SHTG.

Objectives/Goal: Our objective was to develop a protocol to standardize SHTG management using insulin infusion and decrease the duration of SHTG resolution while preventing hypoglycemia.

Methods/Design: Endocrinology, Evidence-Based Practice, Hospital Medicine, Critical Care, Gastroenterology, Pharmacy, and Nursing met to develop the protocol. Pediatric and adult literature were reviewed, and …

Socioeconomic Factors And Picu Interventions In High Mortality Risk Asthmatics, Hanh Ho, Paul N. Bauer, Jade B. Tam-Williams

Research Days

Background: Asthma mortality rates are overall lower in children, but studies estimate 5-10% of asthmatics have refractory mortality prone asthma. Asthmatics with repeat pediatric intensive care unit (PICU) admissions are believed to be at high mortality risk with increased health care utilization and socio-economic challenges.

Objectives/Goal: We aim to identify patients with repeat PICU admissions for status asthmaticus and characterize the levels of interventions and socio-economic status.

Methods: A retrospective chart review was done on patients with the following inclusion criteria: age 0- 18, PICU admission between January 2010 to December 2015, and a diagnosis of status asthmaticus on admission. …

Supporting Families Impacted By Adverse Childhood Experiences (Aces), Jennifer Paumen, Laura Plencner, Jacqueline Kitchen

Research Days

Background: Adverse childhood experiences (ACEs) impact a majority of individuals, with approximately two-thirds of adults having experienced 1 or more ACE.1 The health consequences of ACEs are significant, including cardiovascular disease, cancer, autoimmune diseases, and mental illnesses.1 These health impacts can even start as early as childhood, leading to an increased risk of learning and behavioral concerns.2,3 Recent evidence has also identified the impact that parental ACEs may have on parenting and child development,4,5,6 which in turn may lead to an intergenerational transmission of ACEs.4,7 As a nurturing caregiver relationship is key for buffering adversity,2,8 it is imperative to address …

Pediatric Serum-Like Sickness: A Multicenter Analysis, Maya Gibson, Sarah Suppes, Jared Lovins, Emma Monique, Keith Feldman, Jennifer Goldman

Research Days

Background: Serum sickness-like reaction (SSLR) is a type III immune hypersensitivity reaction that presents 5-21 days following exposure to a medication. SSLR has nonspecific symptoms including fever, rash, and joint involvement. There are no standardized diagnostic criteria or treatment for SSLR, making this a challenging diagnosis.

Objectives/Goal: Our objective was to describe pediatric SSLR clinical manifestations, medical encounter types, and treatment strategies.

Methods/Design: A retrospective chart review across 2 freestanding children’s hospitals was used to identify patients 0-21 years of age diagnosed with SSLR by ICD-9/10 codes [T80.69XA, 999.59], SNOMED codes [1782626019, 3293325014], or pharmacovigilance review in the emergency department …

Social Determinants Of Health Among Family Caregiver Centered Outcomes In Lung Cancer: A Systematic Review, Dede K. Teteh, Madeleine Love, Marissa Ericson, Marissa Chan, Tanyanika Phillips, Aroona Toor, Betty Ferrell, Loretta Erhunmwunsee, Susanne B. Montgomery, Virginia Sun, Jae Y. Kim

Health Sciences and Kinesiology Faculty Articles

Background: Lung cancer is the leading cause of cancer death globally. Both lung cancer patients and family caregivers (FCGs) have unmet quality of life (QOL) needs. An understudied topic in lung cancer research is the role of social determinants of health (SDOH) on QOL outcomes for this population. The purpose of this review was to explore the state of research on SDOH FCGs centered outcomes in lung cancer.

Methods: The databases PubMed/MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association (APA) PsycInfo were searched for peer-reviewed manuscripts evaluating defined SDOH domains on …