Medical Specialties Commons^™

A Retrospective Review Of Catheter-Directed Therapy For Patients With Intermediate Risk Pulmonary Embolisms, Austin Lehew, Michael Tucciarone

Posters

Each year, hundreds of patients present to the William Beaumont hospital system with intermediate risk pulmonary embolisms (IRPE) with common symptoms of chest pain, shortness of breath, and hypoxia. Conventional treatments include anticoagulants alone, or a more aggressive approach with systemic thrombolytics which come with a higher risk of major bleeding and death. However, in the last few years, catheter-directed therapies (CDT) have been developed to mechanically remove clots in a minimally invasive fashion. The goal of this study is to determine the safety and efficacy of novel CDT at Beaumont Troy and Royal Oak.

Pillow Cpr: Using A Low Resource Method To Teach Hands-Only Cpr To Hispanic Adolescents In A Community Setting, Benjamin Goldstein, Ekaterina Clark, Alan Silverman, Virginia Uhley

Posters

Hands-only Cardiopulmonary resuscitation (CPR) training for adolescents in community settings is often limited by training device availability. This pilot study’s objective was to investigate the feasibility, participant knowledge gains, and attitude changes through hands-only CPR training using a pillow for skill development.

A Novel Neuroinvasive Infection Modality For Francisella Tularensis Elicits Neuroinflammation Resulting In Cellular Damage, Mireya Griselle Ramos-Muniz

Open Access Theses & Dissertations

Francisella tularensis (Ft.) is a gram-negative coccobacillus bacterium that causes the zoonotic disease tularemia in humans. Ft. causes the most severe, often fatal, form of the disease through inhalation. However, Ft. is most commonly transmitted through direct contact with infected animal carcasses such as rodents and rabbits, consumption of contaminated food or water, or through arthropod bites, particularly ticks. Due to its extremely low infectious dose, high mortality rate, and potential use as a biological warfare agent, Ft. is classified by the CDC as a "Tier 1 select agent". Ft. infection triggers an overactive inflammatory response, termed a "cytokine storm", …

Abortion Access And Medically Complex Pregnancies Before And After Texas Senate Bill 8, Whitney Arey, Klaira Lerma, Emma Carpenter, Ghazaleh Moayedi, Lorie Harper, Anitra Beasley, Tony Ogburn, Kari White

School of Medicine Publications

Objective: To evaluate how Texas health care professionals who care for patients experiencing medically complex pregnancies navigate abortion restrictions.

Methods: We conducted qualitative in-depth interviews with health care professionals across Texas who cared for patients with life-limiting fetal diagnoses or who had existing or developed health conditions that adversely affected pregnancy. We conducted the first round of interviews March-June 2021 and the second round of interviews January-May 2022 after the implementation of Texas Senate Bill 8 (SB8), which prohibited most abortions after detection of embryonic cardiac activity. We used inductive and deductive qualitative analysis to identify themes and changes in …

Combining Drip Score And Rapid Diagnostics For Improved Antibiotic Stewardship, Richard Ramirez, Matthew Sims

Posters

Treatment analysis patterns for broad-spectrum antibiotic use in pneumonia revealed that 60% of patients were overtreated, highlighting the need for effective antibiotic stewardship practices. Systems such as the Drug Resistance in Pneumonia (DRIP) score select patients more likely to require broad spectrum antibiotics but still leads to overtreatment as it does not target specific pathogens. Rapid diagnostics such as the Unyvero Lower Respiratory Tract Panel (LRTP) combined with the DRIP score can identify specific pathogens to further narrow antibiotic use.

Review Of Salvage Therapy For Mrsa Bacteremia At Beaumont Health System, Hazem Alakhras, Matthew D. Sims, Tracey A.H. Taylor

Posters

Treating methicillin-resistant Staphylococcus aureus (MRSA) effectively is imperative to reduce mortality rates, as it contributes to a large amount of healthcare-associated bacteremia in the U.S. However, due to the insufficient and sometimes contradicting studies to guide salvage therapy, there is a lack of clear consensus on treatment of MRSA bacteremia after vancomycin failure. The goal of this study is to showcase the salvage therapies of choice for patients with MRSA bacteremia at Beaumont Health System.

Designing A Surgical Scorecard To Inform And Evaluate Appropriate Perioperative Antibiotic Prophylaxis, Rehan Tariq, Paul Chittick

Posters

Perioperative antibiotic prophylaxis (PAP) implementation is a widespread strategy used to ensure the minimization of surgical site infections (SSIs) during various surgical procedures including hip and knee replacements and organ transplants. Despite the widespread implementation of PAP, there exists a gap in understanding what is considered appropriate PAP. This may be due in part to the absence of a feedback mechanism that educates physicians on which antibiotics are truly appropriate for preventing the SSIs arising from certain surgical procedures. The goal of this project is to design an informative surgical prophylaxis scorecard that physicians can use to determine which antibiotic …

Outcomes Of Da R-Epoch Versus R-Chop In Treating Patients Diagnosed With Double-Expressor Lymphoma, Phat Duong, Ishmael Jaiyesimi

Posters

Double-expressor lymphoma (DEL) is a subtype of Diffuse Large B-cell lymphoma (DLBCL) that is associated with poor prognosis. The standard treatment for DLBCL is rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). It is hypothesized that the aggressive nature of DEL deserves a more intense regimen such as dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-R-EPOCH). A comparison of outcomes between those two treatments is needed to guide clinical decisions.

Demographics And Survival In Aml Patients Over 60 Years Of Age. A Single Institutional Analysi, Damilola Gbadebo, Nwabundo Anusim, Ishmael Jaiyesimi

Posters

Acute Myeloid Leukemia (AML) is a malignancy of the myeloid cell line. Patients diagnosed with AML, typically exhibit symptoms of neutropenia, anemia and thrombocytopenia. The diagnosis of AML is based on greater than 20 percent of myeloid cells in the bone marrow (1). Some risk factors for acquiring the disease include, but not limited to age, sex, smoking, exposure to certain chemicals, radiation, genetic predisposition and being treated with certain chemotherapeutic agents (2).
AML is frequently diagnosed among people between ages 65-74, with a current relative survival rate for AML being 28.7%. Men account for majority of these cases, at …

Gestational Weight Gain And The Associated Perinatal Outcomes In Middle Eastern Women, Dana Rector, Zeynep Alpay-Savasan

Posters

Gestational Weight Gain (GWG) can impact perinatal outcomes for mothers and infants, especially if the mother gains inadequate or excessive weight during pregnancy. We hypothesized that Middle Eastern women would be more likely to gain inadequate weight, compared to the general population, resulting in adverse perinatal outcomes.

Concern For Authenticity In Rational And Relational Autonomy, Joshua J. Daniel, Abram Brummett, Mark C. Navin, Jason A. Wasserman

Posters

The four principles of bioethics described by Beauchamp and Childress are beneficence, nonmaleficence, justice, and autonomy. Two definitions of autonomy are very commonly used: rational autonomy, which refers to a patient making decisions based on their own beliefs and customs, and relational autonomy, which refers to shared decision making with the input of a patient’s close trusted individuals. Beauchamp and Childress described autonomous actions as those with intention, understanding, and lack of controlling factors. A fourth component that is sometimes included is authenticity, or making decisions true to one’s self. The primary goal of this study is to determine whether …

Changes In Electrocardiographic And Cardiac Implantable Electronic Device Parameters Following Transcatheter Aortic Valve Replacement, Elizabeth Seeley, Luai Madanat, Nishaki Mehta

Posters

Transcatheter aortic valve replacement (TAVR) is known to cause conduction abnormalities leading to the need for permanent pacemaker implantation. However, the impact of TAVR-related conduction abnormalities on cardiac implantable electronic device (CIED) parameters in patients with preexisting devices is not known. We sought to investigate and describe changes in EKG and CIED parameters following TAVR in patients with preexisting CIEDs.

Physicians' Knowledge And Attitudes Of Disordered Eating Behaviors Among Patients With Diabetes, Nayiri Khatchadourian, Lowell Schmeltz, Michael Brennan, Virginia Uhley

Posters

Patients diagnosed with type 1 and type 2 Diabetes Mellitus (DM) are at increased risk for developing clinical disordered eating behaviors (DEBs). Although research supports this higher incidence and the impact on health outcomes, few studies have assessed physicians’ knowledge, attitudes and training to identify and treat these conditions. The American Diabetes Associations’ 2021 Standards of Care included a new section about DEB, further highlighting the importance of addressing this issue. Our goal was to assess physicians’ level of training, comfort and attitudes towards providing clinical care to patients diagnosed with DM and their experience in assessing, identifying, and treating …

Tumor Locations Impact On Cardiac Toxicity In Women That Received Partial Breast Irradiation, Sara Diltz, Muayad Almahariq, Joshua Dilworth

Posters

Accelerated partial breast irradiation (APBI) is an appropriate modality for select women with low-risk breast cancer. While APBI delivers radiation dose to a smaller volume of breast tissue compared to whole breast irradiation, dose to the heart and coronary vessels may be relatively high, depending on the proximity of the treatment device to these structures. The primary goal of this study is to determine if the risk of adverse cardiac events depends on tumor location in women receiving APBI.

High Dose Rate Brachytherapy Monotherapy Versus External Beam Radiotherapy With Hdr Brachytherapy Boost For Unfavorable Intermediate Prostate Cancer Patients, Doyle Lang, Benjamin Willen, Daniel J. Krauss, Sirisha R. Nandalur

Posters

Prostate cancer is the most common male malignancy by incidence in the world. Treatment differs by the patient’s risk stratification. For the treatment of unfavorable intermediate-risk prostate cancer, external beam radiotherapy with high-dose-rate brachytherapy boost was the accepted treatment but high-dose-rate brachytherapy as monotherapy has been proposed as a potentially viable treatment option. External beam radiotherapy treatment involves shooting high-energy photons or particle radiation through normal healthy tissue to hit the tumor directly. High-dose-rate brachytherapy involves inserting radioactive seeds into the tumor. Studies are needed to compare toxicity profiles and relative outcomes between the two treatment options.

Outcomes Of Locally Advanced Lung Cancer Patients Treated With 60 Gy Vs. 70 Gy, Batoul Nasser, Muyad Almahariq, Inga Grills

Posters

The standard form of treatment for locally advanced lung cancer is to prescribe the conventional dose of 60 Gy radiation therapy (RT) concurrently with chemotherapy. However, five-year overall survival is still less than 20%. These outcomes remain poor due to both distant and local regional recurrence. The literature suggests that local regional control and overall survival is strongly associated with doses of radiotherapy that are higher than 60 Gy. However, when escalating radiation dose was prescribed exceeding 70 Gy, the overall survival rates plateaued. The primary goal of this study is to determine if there is a marked difference in …

Dose To The Left Anterior Descending Artery Correlates With Cardiac Events After Irradiation For Breast Cancer, Brittany Silverman, Andrew Zureick, Vincent Grzywacz, Muayad Almahariq, Aleksander Vayntraub, Joshua Dilworth

Posters

Although global heart dose has been associated with late cardiac toxic effects in patients who received radiation therapy for breast cancer, data detailing the clinical significance of cardiac substructure dosimetry are limited. We investigated whether dose to the left anterior descending artery (LAD) correlates with adverse cardiac events.

Influence Of Pretreatment Magnetic Resonance Imaging On Local Therapy Decisions For Intermediate-Risk Prostate Cancer Patients, Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel Krauss

Posters

Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. With minimal data regarding utility on diagnosis and treatment planning for intermediate-risk prostate cancer, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer.

The Meaning Of Pediatric Assent: A Critical Scoping Review, Natalie Liogas, Amelia Najor, Jason Wasserman, Stephanie Swanberg, Abram Brummett, Naomi Levanthal

Posters

The moral obligation to include children and adolescents in medical decisions has been long recognized. Soliciting pediatric assent is a component essential to this effort. Despite the AAP characterization of assent (AAP 1995; AAP 2016), there appears to be a lack of consensus regarding the operational and conceptual meanings of pediatric assent. This this critical scoping review provides an analysis of the varied meanings of pediatric assent in the clinical context.

Pediatric Assent In Clinical Practice: A Critical Scoping Review On The Ethical Justifications For Assent, Amelia Najor, Natalie Liogas, Jason Wasserman, Stephanie Swanberg, Abram Brummett, Naomi Laventhal, Mark C. Navin

Posters

Pediatric assent is an important ethical construct, yet there is little agreement on what precisely it means, including the ethical justifications for assent. The term is used to indicate everything from acquiescence to an analogue of informed consent itself. The primary goal of this study is to assess the range of ways that pediatric assent is specified in the clinical ethics literature, as well as what different conceptions intimate about its moral value. This systematic review will summarize the normative claims about pediatric assent in recent literature. Analysis will map divergent constructs and various moral and ethical justifications for pediatric …

Impact Of Structured Reporting Template On The Quality Of Hrct Radiology Reports For Interstitial Lung Disease, Han G. Ngo, Girish B. Nair, Sayf Al-Katib

Posters

This QI study compared the completeness of HRCT radiology reports before and after the implementation of a disease-specific structured reporting template for suspected cases of interstitial lung disease (ILD).

Evaluation Of Phenobarbital In The Treatment Of Alcohol Withdrawal In The Intensive Care Unit, Sienna J. Ringgenberg, Vishal K. Patel

Posters

Alcohol withdrawal syndrome (AWS) is typically managed using the Clinical Institute Withdrawal Assessment (CIWA) protocol which includes benzodiazepines, supportive care, and close clinical monitoring. Alternatives to benzodiazepines such as phenobarbital provide several advantages including less frequent dosing, longer tapering off of doses, and additional glutamate inhibition. The purpose of this study is to evaluate the effectiveness and potential benefit to using phenobarbital in addition to CIWA protocol in the treatment of AWS at Beaumont, Royal Oak.

Evaluating The Accuracy And Quality Of The Information On Pulmonary Rehabilitation Videos Shared On Youtube Amidst The Covid-19 Pandemic, Payaum Fotovat-Ahmadi, Bilal M. Ali, Bhavinkumar Dalal

Posters

YouTube is a visual library that is growing at incredible pace, especially with the rise of COVID-19 pandemic. Pulmonary rehabilitation refers to the rehabilitation treatment of patients with chronic pulmonary diseases. YouTube has made it possible to practice remote rehabilitation, the effectiveness of which have been proven non-inferior to traditional approaches.

A Survey Of Medical Student Experiences During The Covid-19 Pandemic, Stephanie Gappy, Girish Nair, Dwayne Baxa

Posters

During the COVID-19 pandemic, medical students switched from an in-person to virtual curriculum. This shift placed stress on medical schools to find alternatives to train students. Students relied on recorded lectures, emails, and video-conferencing to stay up-to-date with schoolwork. Understanding student experiences during the pandemic will help prepare students and administrators for repeat lockdown events. The goal of this study is to understand the experiences of medical students during the pandemic.

Family/Decision Maker Perception Of Patient Care And Withdrawal Of Life Sustaining Treatment, Joshua Paul, Revelle Gappy, Tracy Wunderlich-Barillas, Robert A. Swor

Posters

Withdrawal of life sustaining treatment (WLST) is the process by which a patient has life supporting measures removed when a decision is reached that further care if futile. This process is a complex interplay of medical science, the healthcare teams’ past experiences, and communication with the patient’s family/decision maker Family members are commonly called upon to make critical decisions regarding the provision or withdrawal of patient care. Our objective was to describe the perceptions and experiences of the family members of patients who were admitted to an intensive care unit after resuscitation from an Out of Hospital Cardiac Arrest (OHCA).

Effect Of Comorbidities And Choice Of Treatment On Overall Survival In Elderly Patients With Acute Myeloid Leukemia: A Beaumont Experience, Bilal M. Ali, Emma Herrman, James Huang Huang, Mohammad Muhsin Chisti

Posters

First line therapy for Acute Myeloid Leukemia (AML) is 7+3 regimen. It often cannot be used in elderly patients due to intensity. Venetoclax + hypomethylating agent (HMA) is approved for AML treatment in these patients. We investigate the efficacy of this treatment in a community setting where patients do not have the same resources available to them as a large academic center. Primary outcome was survival of patients greater than 60 years of age with a diagnosis of AML who received 7+3 therapy versus those who received venetoclax + HMA. Secondary outcomes included characteristics of those who received the two …

The Effects Of Bmi On The Development Of Radiation Cystitis Onset: A Pilot Study, Kelsa G. Kazyak, Bernadette Mm Zwaans

Posters

Radiation cystitis (RC) is a debilitating adverse side effect of pelvic radiation therapy. Despite advancements within the field of radiation oncology, the location of the bladder makes it difficult to avoid during radiation and approximately 5-10% of cancer survivors with a history of pelvic radiation are at risk. While RC is not common, the long-term effects can be crippling and we hope to provide more information on the risk factors to help survivors and inform clinicians.

Examining Ndufab1 Expression In Head And Neck Squamous Cell Carcinoma, Addison L. Stevens

Honors Theses

Head and neck squamous cell carcinoma (HNSCC) accounts for around 4% of all cancers in the USA. HNSCC includes cancers of the oral cavity, oropharynx, nasopharynx, hypopharynx, and larynx. Reprogramming of mitochondrial metabolism has been known to promote oncogenesis. NDUFAB1, a nuclear encoded subunit of respiratory complex I (RCI) in the inner mitochondrial membrane, is abundantly expressed at the mRNA level in HNSCC patients. Based on this finding, we hypothesize that NDUFAB1 protein expression is high in HNSCC and that NDUFAB1 expression predicts a poor prognosis in HNSCC patients. We determined NDUFAB1 expression in HNSCC using immunohistochemistry and pathology guided …

Decreasing Hospital Readmission Rates Of Heart Failure Patients: An Evidence-Based Quality Improvement Project, Elizabeth Rodriguez

DNP Projects

BACKGROUND: Teach back is an evidence-based health literacy intervention that encourages patient engagement in own treatment, adherence to treatment, medications, and quality of care. Implementation of teach back method could positively impact readmissions to the hospital in patients experiencing heart failure and any other chronic diseases and it could improve patient’s outcomes.

OBJECTIVE: The objective of this project was to implement teach back method in a home care agency in the Hartford area in patients with HF to prevent readmission to the hospital.

METHODS: The IOWA model was used and PSDA as tools to support EBP project.

RESULTS: Pre and …

Serum Amyloid A Augments The Atherogenic Effects Of Cholesteryl Ester Transfer Protein, Ailing Ji, Andrea C. Trumbauer, Victoria P. Noffsinger, Frederick C. De Beer, Nancy R. Webb, Lisa R. Tannock, Preetha Shridas

Saha Cardiovascular Research Center Faculty Publications

Serum amyloid A (SAA) is predictive of CVD in humans and causes atherosclerosis in mice. SAA has many proatherogenic effects in vitro. However, HDL, the major carrier of SAA in the circulation, masks these effects. The remodeling of HDL by cholesteryl ester transfer protein (CETP) liberates SAA restoring its proinflammatory activity. Here, we investigated whether deficiency of SAA suppresses the previously described proatherogenic effect of CETP. ApoE¡/¡ mice and apoE¡/¡ mice deficient in the three acute-phase isoforms of SAA (SAA1.1, SAA2.1, and SAA3; “apoE¡/¡ SAA-TKO”) with and without adeno-associated virus-mediated expression of CETP were studied. There was no effect of …