Medical Specialties Commons^™

Comparing The Outcomes Of Titanium And Stainless Steel Flexible Nails In Repairing Pediatric Long Bone Fractures, Novelpreet Boparai, Suzan Kamel-Elsayed, Ehab Saleh

Posters

• Traditionally, pediatric femoral fracture treatment favored conservative methods.
• Surgical intervention was deferred until age 6, as non-operative approaches often resulted in complications.
• Titanium elastic nailing (TENS) emerged as an effective treatment for diaphyseal femoral fractures in ages 6 to 16. However, the choice between TENS and stainless steel elastic nailing (SSENS) remains debated due to inconsistent findings.

Public Perception Of Robotic Assisted Total Hip Replacement Surgery, Marvee Espiritu, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Moore, Mark Karadsheh

Posters

• Robotic or technology assisted THA has received significant attention recently due to its precision in acetabular cup placement within the Lewinnek safe zone.1
• Few studies have assessed the public’s perception of robotic-assisted THA.3,4 Insight into patients’ perception of robotic-assisted THA may yield valuable information that may impact further integration of the technology within hospitals and surgeon training.

Morbidity Of Tendon Harvest Site For Acl Autograft; A Systematic Review, Jessi Fore, Betina Hinckel, Elijah Auch

Posters

Primary anterior cruciate ligament (ACL) ruptures are highly common and lead to a significant number of primary ACL reconstruction surgeries in the U.S.1. When choosing a graft, surgeons can pick between auto- and allografts2. An autograft can include a bone-patellar tendon-bone (BPTB) graft, a hamstrings tendon (HT) graft, or a quadriceps tendon (QT) graft2. Currently, there is a wide range of research on graft types, but no paper compares all threes graft types directly. This review will compare literature to determine the morbidity associated with each graft type and determine which autograft is best for primary reconstruction.

Metastatic Osteosarcoma Involving The Skin: A Systematic Review Of Patient Demographics, Clinical Characteristics, And Treatment Outcomes, Sarah Fried, Ameen Suhrawardy, Rafey Rehman, Malik Al-Jamal, Drew Moore, Darius Mehregan

Posters

Skeletal osteosarcomas - most common primary malignant bone tumor1 and commonly metastasize to:

• Lungs (95%)2 •

Other bones (50%)2 •

Kidneys (12%)2 •

Rarely to the skin3

Extraskeletal osteosarcomas (ESOS) – soft tissue tumors that may also metastasize to the skin4,5,6

Value in gathering data on this rare phenomenon:

• Informs biology and dermatologic care of patients suffering from this cancer.

This systematic review characterizes metastatic osteosarcomas involving the skin.

Assessing Patient Preferences For Technology-Assisted Versus Traditional Total Knee Arthroplasty Using A Validated Online Survey Marketplace: Before And After Patient Education, Tanner J. Hafen, James E. Feng, Phillip Vartanyan, Drew Moore, Robert Runner

Posters

• Computer (CA) and robotic (RA) assisted TKA has becoming increasingly prevalent in orthopaedic surgery1,2.
• There is limited insight into the public perception of CA and RA3.

Outcomes Of Primary Acl Repair For Proximal Tears: A Systematic Review And Meta Analysis, Collin Braithwaite, Tanner Hafen, Robert Dean, Joseph Guettler, James Bicos

Posters

The purpose of this study was to determine which primary ACL repair technique resulted in the lowest failure rates postoperatively.

Brief Resolved Unexplained Event (Brue), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Increasing Utilization Of Community Resources To Address Social Determinants Of Health Barriers In Patients With Diabetes Mellitus Type 2, Kimberly Williams

The Eleanor Mann School of Nursing DNP Capstone Projects

PURPOSE: To determine if identifying SDOH barriers to care in adults with DMT2 and providing information about community-based resources designed to decrease the impact of these barriers will improve adherence, decrease SDOH barriers, and reduce HbA1c levels.

DESIGN/METHODS: Quasi-experimental design. Participants completed PRAPARE screenings and received handouts detailing contact information for local resources. HbA1c levels were collected prior to or at the initial appointment. Contact was attempted at 4-6 weeks to ensure resources were utilized. 3-month follow up appointments were completed during which PRAPARE screenings were repeated, HbA1c levels were collected, and post-intervention surveys were completed.

CONClUSIONS: Participants who did …

Ectopic Pregnancy Located At Pelvic Wall And Liver: Two Uncommon Case Reports From Vietnam And Mini-Review Literature, Thanh Hai Pham, Van Hoang Bui, Van Hung Nguyen, Phuc Nhon Nguyen

Faculty, Staff and Student Publications

INTRODUCTION AND IMPORTANCE: Abdominal ectopic pregnancy (AEP) located at hepatic region and pelvic-wall ectopic pregnancy (EP) are rare entities, that provoking a potentially life-threatening condition. Due to insufficient data, a proper management of non-specific types remains a challenge for all gynecologists worldwide.

CASE PRESENTATION: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic …

Understanding The Importance Of Peak Bone Mass, Timothy Hereford, Alec Kellish, Julie Balch Samora, Louise Reid Nichols

Department of Medicine Faculty Papers

Bone mass attained early in life is one of the most important determinants of lifelong skeletal health. Bone mineral content increases exponentially during childhood. In fact, 40%-60% of the total adult bone mass is accrued during puberty. By the end of the first 2 decades of life, peak bone mass has been reached. Between ages 20-50, bone mass has plateaued, but it continues to remodel. This is regulated by parathyroid hormone (PTH), vitamin D3, and insulin-like growth factor 1 (IGF-1). After the age of 50, bone mass begins to decrease. The purpose of this paper is to review the importance …

Exploration Of Resources Women Use To Seek Food And Nutrition Information During Pregnancy, Sydni Hebert

Theses, Dissertations and Culminating Projects

Nutrition is a common concern during pregnancy, yet women often do not meet the recommended nutrient intakes for a healthy pregnancy. Obtaining reliable food and nutrition information is challenging during pregnancy, and women do not know where to find credible information. AIMS: This study aims to investigate the food and nutrition information-seeking behaviors among low-income pregnant women experiencing their first pregnancy and compare these behaviors with pregnant women who are classified as middle and higher-income status. METHODS: A qualitative survey was developed to identify the type of information women seek, satisfaction with information, application of information to their diet choices, …

Corticospinal Inhibition Investigated In Relation To Upper Extremity Motor Function In Cervical Spinal Cord Injury, Tarun Arora, Jia Liu, Akhil Mohan, Xin Li, Kyle O'Laughlin, Teale Bennett, Gregory Nemunaitis, Francois Bethoux, Svetlana Pundik, Kelsey Baker

School of Medicine Publications

Objective: Corticospinal inhibitory mechanisms are relevant to functional recovery but remain poorly understood after spinal cord injury (SCI). Post-injury characteristics of contralateral silent period (CSP), a measure of corticospinal inhibition evaluated using transcranial magnetic stimulation (TMS), is inconsistent in literature. We envisioned that investigating CSP across muscles with varying degrees of weakness may be a reasonable approach to resolve inconsistencies and elucidate the relevance of corticospinal inhibition for upper extremity function following SCI.

Methods: We studied 27 adults with chronic C1-C8 SCI (age 48.8 ± 16.1 years, 3 females) and 16 able-bodied participants (age 33.2 ± 11.8 years, 9 females). …

The Impact Of Severe Obesity On Image Quality And Ventricular Function Assessment In Echocardiography And Cardiac Mri., Akash Goyal, Christopher D Crabtree, Bryan C Lee, Thura T Harfi, Saurabh Rajpal, Vedat O Yildiz, Orlando P Simonetti, Matthew S Tong

Heart and Vascular Articles

This study sought to evaluate the impact of severe obesity on image quality and ventricular function assessment in cardiovascular magnetic resonance (MRI) and trans-thoracic echocardiography (TTE). We studied 100 consecutive patients who underwent clinically indicated cardiac MRI and TTE studies within 12 months between July 2017 and December 2020; 50 (28 females and 22 males; 54.5 ± 18.7 years) with normal body mass index (BMI) (18.5-25 kg/m

Three-Year Outcomes Of The Abre Venous Self-Expanding Stent System In Patients With Symptomatic Iliofemoral Venous Outflow Obstruction., Stephen Black, Marc Sapoval, David J Dexter, Kathleen Gibson, Raghu Kolluri, Mahmood Razavi, Dorian J Defreitas, Hong Wang, Stephanie Brucato, Erin Murphy

Heart and Vascular Articles

PURPOSE: To report 36-month outcomes and subgroup analysis of the ABRE study evaluating the safety and effectiveness of the Abre venous self-expanding stent system for the treatment of symptomatic iliofemoral venous outflow obstruction disease.

METHODS: The ABRE study was a prospective, multicenter, nonrandomized study that enrolled and implanted Abre venous stents in 200 participants (mean age 51.5 years [SD ± 15.9], 66.5% women) with symptomatic iliofemoral venous outflow obstruction at 24 global sites. Outcomes assessed through 36 months included patency, major adverse events, stent migration, stent fracture, and quality-of-life changes. Adverse events and imaging studies were adjudicated by independent clinical …

Turn Up The Heat: A Case Report Of Malignant Hyperthermia During Ambulatory Surgery., Alexander Luong, Vincent Relli-Dempsey, Elizabeth Johnson, Dyanni Price, Andrew Gable, Matthias J Franzen

Surgery Articles

Malignant hyperthermia is a rare complication of general anesthesia involving the uncontrolled release of calcium when exposed to triggers such as depolarizing muscle relaxants or volatile anesthetics. It presents as a hypercatabolic skeletal muscle syndrome that results in tachycardia, hyperthermia, hypercapnia, muscle rigidity, acidosis, rhabdomyolysis, and hyperkalemia. This report presents the case of a 67-year-old female without a personal or family history of complications with anesthesia who experienced malignant hyperthermia during an elective hysterectomy. The patient was given multiple doses of dantrolene, with the ultimate resolution of her symptoms several days after surgery. She was discharged one week after surgery.

Guidance For Assessment Of The Inflammation Etiologic Criterion For The Glim Diagnosis Of Malnutrition: A Modified Delphi Approach., Tommy Cederholm, Gordon L Jensen, Maria D Ballesteros-Pomar, Renee Blaauw, M Isabel T D Correia, Cristina Cuerda, David C Evans, Ryoji Fukushima, Juan Bernardo Ochoa Gautier, M Cristina Gonzalez, Andre Van Gossum, Leah Gramlich, Joseph Hartono, Steven B Heymsfield, Harriët Jager-Wittenaar, Renuka Jayatissa, Heather Keller, Ainsley Malone, William Manzanares, M Molly Mcmahon, Yolanda Mendez, Kris M Mogensen, Naoharu Mori, Maurizio Muscaritoli, Guillermo Contreras Nogales, Ibolya Nyulasi, Wendy Phillips, Matthias Pirlich, Veeradej Pisprasert, Elisabet Rothenberg, Marian De Van Der Schueren, Han Ping Shi, Alison Steiber, Marion F Winkler, Rocco Barazzoni, Charlene Compher

Ambulatory and Primary Care Articles

BACKGROUND & AIMS: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the …

An Atypical Facial Eruption In Skin Of Color: A Rare Presentation Of Histiocytoid Sweet Syndrome., Brittany Ehlert, Lauren Shegos, Matthew Franklin, Kaila Buckley, Jaimie Rodger

Ambulatory and Primary Care Articles

No abstract provided.

Primary Focal Segmental Glomerulosclerosis In A Patient With Ankylosing Spondylitis: A Rare Presentation Requiring A Broad Differential In Nephrotic Syndrome., Pooya Zardoost, Sana Tyabuddin, Austin Cantu, Musa Abu-Jubara, Jackson Mittlesteadt, Henry Wehrum

Ambulatory and Primary Care Articles

Ankylosing spondylitis (AS) presents with renal failure and proteinuria in a minority of cases, usually due to secondary amyloidosis or IgA nephropathy. While focal segmental glomerulosclerosis (FSGS) is less common, it should still be in the differential regardless of the patient's clinical profile.

Guidance For Assessment Of The Inflammation Etiologic Criterion For The Glim Diagnosis Of Malnutrition: A Modified Delphi Approach., Tommy Cederholm, Gordon L Jensen, Maria D Ballesteros-Pomar, Renee Blaauw, M Isabel T D Correia, Cristina Cuerda, David C Evans, Ryoji Fukushima, Juan Bernardo Ochoa Gautier, M Cristina Gonzalez, Andre Van Gossum, Leah Gramlich, Joseph Hartono, Steven B Heymsfield, Harriët Jager-Wittenaar, Renuka Jayatissa, Heather Keller, Ainsley Malone, William Manzanares, M Molly Mcmahon, Yolanda Mendez, Kris M Mogensen, Naoharu Mori, Maurizio Muscaritoli, Guillermo Contreras Nogales, Ibolya Nyulasi, Wendy Phillips, Matthias Pirlich, Veeradej Pisprasert, Elisabet Rothenberg, Marian De Van Der Schueren, Han Ping Shi, Alison Steiber, Marion F Winkler, Rocco Barazzoni, Charlene Compher

Ambulatory and Primary Care Articles

BACKGROUND & AIMS: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the …

Special Anatomy Series. Imaging Inner Ear Structures With High-Frequency Ultrasound: Application To Physical Rehabilitation Space Medicine., Jeffrey Strakowski, Han Zhang, Millard Reschke, Faye Y Chiou-Tan

Neuroscience Articles

OBJECTIVE: The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.

METHODS: Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.

RESULTS: The images were best optimized with 17 MHz and 22 MHz …

Summary Of: Feasibility Of Continuous Home Monitoring Of Particulate Matter And Lung Function In Patients With Chronic Obstructive Lung Disease Who Are Exposed To Wood Smoke, S Wayne, K Cowan, L.M. Paulin, J Emery, D.A. Kaminsky

Northern New England Clinical & Translational Research

Particulate matter (PM) contains microscopic solids or liquids that are so small they can be inhaled and cause serious health problems. Examples include smoke, dust, soot, and fumes.

There is increasing evidence that small particles have harmful effects on people’s breathing. Wood stoves are a source of indoor PM.

Understanding The Perspectives And Attitudes Of 12-Step Participants Towards Medication-Assisted Treatment, Christopher Scott

Electronic Theses, Projects, and Dissertations

Background: The effects of living with a substance use disorder (SUD) are vast. Medication-assisted treatment (MAT) has grown increasingly popular as a recovery tool among substance users but does not align with the popular 12-step model, which demands complete abstinence from narcotics and mind-altering substances. Objective: The primary aim of this phenomenology study was to explore the perspectives and attitudes towards MAT among 12-step participants. The secondary aim was to compare the responses of treatment and non-treatment professionals. Methods: This study used non-probability sampling methods to recruit participants who reported regular participation in a 12-step program. Semi-structured …

Fatty Acid Concentrations In Preterm Infants Fed The Exclusive Human Milk Diet: A Prospective Cohort Study, Lindsay F Holzapfel, Jana P Unger, Pam Gordon, Heeju Yang, Joanne E Cluette-Brown, Laura A Gollins, Amy B Hair, Camilia R Martin

Faculty, Staff and Student Publications

OBJECTIVE: Quantify blood fatty acids and growth outcomes in preterm infants fed the exclusive human milk diet.

METHODS: A prospective cohort study of 30 infants 24-34 weeks gestation and ≤1250 g fed the exclusive human milk diet. Blood fatty acids were quantified at two time points. Comparisons were made using two-sample t-tests and Wilcoxon rank sum.

RESULTS: Donor human milk-fed (n = 12) compared to mother's own milk-fed infants (n = 18) from birth to after 28 days of life, had an increased interval change of linoleic to docosahexaenoic acid ratio (5.5 vs. -1.1 mole percent ratio, p = 0.034). …

Association Of Maternal Body Mass Index And Maternal Morbidity And Mortality, Mara J Dinsmoor, Lynda G Ugwu, Jennifer L Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa

Faculty, Staff and Student Publications

Objective: This study aimed to assess the association of maternal body mass index (BMI) with a composite of severe maternal outcomes.

Study design: Secondary analysis of a cohort of deliveries on randomly selected days at 25 hospitals from 2008 to 2011. Data on comorbid conditions, intrapartum events, and postpartum course were collected. The reference group (REF, BMI: 18.5-29.9kg/m2), obese (OB; BMI: 30-39.9kg/m2), morbidly obese (MO; BMI: 40-49.9kg/m2), and super morbidly obese (SMO; BMI ≥ 50kg/m2) women were compared. The composite of severe maternal outcomes was defined as death, intensive care unit (ICU) admission, ventilator use, deep venous thrombosis/pulmonary embolus (DVT/PE), …

Low Absolute Risk Of Thrombotic And Cardiovascular Events In Outpatient Pregnant Women With Covid-19, Behnood Bikdeli, Darsiya Krishnathasan, Candrika Khairani, Antoine Bejjani, Julia Davies, Nicole Porio, Anthony Tristani, Andre Armero, Ali Assi, Victor Nauffal, Umberto Campia, Zaid Almarzooq, Eric Wei, Marcos Ortiz-Rios, Valeria Zuluaga-Sánchez, Aditya Achanta, Sirus Jesudasen, Bruce Tiu, Geno Merli, Orly Leiva, John Fanikos, Elvira Grandone, Aditya Sharma, Samantha Rizzo, Mariana Pfeferman, Ruth Morrison, Alec Vishnevsky, Judith Hsia, Mark Nehler, James Welker, Marc Bonaca, Brett Carroll, Samuel Goldhaber, Zhou Lan, Gregory Piazza

Division of Cardiology Faculty Papers

INTRODUCTION: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.

MATERIALS & METHODS: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and …

Pediatric Upper Cervical Spine Trauma: A 10-Year Single Center Retrospective Study, Sazid Hasan, Muhammad Waheed, Shahrukh Naseer, Jad G. Khalil, Ehab S. Saleh

Posters

This study seeks to answer whether or not there is a significant association between mechanism of injury and patient age, and to elucidate any notable differences in overall outcomes based on various treatment modalities.

Accuracy Of Ora And Newer Generation Formulas For Iol Power Calculation After Prior Refractive Surgery, Raheel Khan, Mark Rolain

Posters

• Patients with cataracts have cloudiness of the lens that impairs vision.
• It must be replaced with a prosthetic lens however the lens’ refractive power has to be calculated using formulas to predict the kind of lens that will be implanted for best visual outcomes.
• Patients that have had prior refractive surgery of the cornea do not have as good refractive outcomes after cataract surgery.1
• The concern is that there is not a goldstandard formula that can be used for this population to predict the refractive power of the lens that should be implanted.
• Optiwave refractive analysis (ORA) is a new …

Coats And Coats-Like Retinopathy In Female Patients, Zara Saleem, Drew Scoles, Antonio Capone Jr

Posters

To report the presentation, stage, clinical characteristics, and course of female patients with Coats and Coats-like retinopathy.

Breaking Up Prolonged Sitting To Improve Cardiometabolic Risk: A Comparative Analysis Of Muscle Strengthening Exercise And Treadmill Walking, Grace E. Anderson

Honors College Theses

Purpose: To examine the effectiveness of brief bouts of treadmill walking and bodyweight-based muscular strengthening exercises to mitigate the effects of sedentary behavior on blood pressure, blood glucose, cognitive performance, and perceived fatigue. Methods: Healthy young adults (n = 9) completed 3 experimental trials consisting of 4-hour sedentary periods. The trials consisted of an uninterrupted sedentary period (control), treadmill walking every 30 minutes for 5 minutes, and bodyweight-based muscular strengthening exercises every 30 minutes for 5 minutes. Blood glucose was measured at baseline and every 30 minutes thereafter. Blood pressure and fatigue were measured at baseline and every hour thereafter. …

Fractionated Radiosurgery Associated With High Rates Of Local Control For Large Volume Intact Brain Metastases, Ryan Ko, Hong Ye, Peter Chen, Zachary Seymour, Kuei Lee, Inga Grills

Posters

Radiosurgery is a well-established treatment modality for patients with intact brain metastases, and there is a known impact of tumor size and volume on tumor control. Utilizing our single-institution database, we investigated outcomes for patients with intact brain metastases treated with FSR using LINAC or GK modalities.