Medical Student Submissions [M – P]

Basil Muhanna
bmuhan2@uic.edu
Rockford Campus

Drug-induced pancreatitis makes up less than 3% of all acute pancreatitis cases. We present a case of pembrolizumab-induced pancreatitis with biliary stricture due to immune checkpoint inhibitor (ICI) use.

A 40-year-old female with stage I infiltrating ductal breast carcinoma presented with epigastric pain for several days.
MRI MRCP abdomen revealed common bile duct dilation along with significant pancreatic head fullness. Upper EUS revealed an enlarged, edematous, and sausage shaped pancreas, all suggestive of autoimmune pancreatitis (AIP). Fine needle biopsy (FNB) was performed. ERCP revealed a single severe segmental biliary stricture at the distal common bile duct. IgG4 levels returned normal. Etiology of pancreatitis was attributed to her pembrolizumab immunotherapy.

The diagnosis of ICI-related pancreatitis (IRP) from pembrolizumab use involved ruling out other causes. Initially there was suspicion for AIP following upper EUS findings. With pathology, cytology, FISH analysis, and IgG4 levels all being negative “ this implicates pembrolizumab as the cause of this patient’s pancreatitis and development of reactive biliary stricture. Literature dictates IRP and AIP share several features including imaging findings and markers. We bring attention to IRP presenting with normal IgG4 levels. This case demonstrates a unique presentation of IRP from pembrolizumab use “ showing significant improvement with drug discontinuation combined with corticosteroid use.

Laura Navarro
lnavar21@uic.edu
Chicago Campus

Endoscopic spinal surgery (ESS) is a minimally invasive surgical approach to treat spinal pathologies. The approach favors fast recovery and fewer perioperative complications. ESS is conducted in a small fluid-filled cavity, where minor bleeds easily obscure the surgical field. This limitation of ESS slows the procedure compared to its open equivalent, and consequently adoption of the endoscopic technique is difficult for neurosurgeons. This study details a machine-learning model developed for bleeding point detection in ESS, for the purpose of assisting surgeons in quickly identifying and resolving bleeding points before they obscure the visual field.

Methods: The machine learning model was trained using 121 frames from 5 recordings of ESS at a major academic medical center. We performed an analysis of 20 images sourced from 3 endoscopic surgeries with the novel deep learning and convoluted neural network (DL-CNN) model. A one-sided t-test was conducted to analyze the distance of the true bleeding point to the detected bleeding point with a significance level of 0.05.

Results: Of the 20 test images, 80% detected the bleeding point within 5 mm, and the average distance was 1.1312 mm (p= 9.75e-09). The model achieved 95.56% accuracy in determining the background from the bleed point.

Conclusion: The CNN correctly identified the majority of the bleeding points with statistical significance, indicating that our model is able to accurately identify bleeding points in ESS.

Molly Nguyen
mxnguyen@uic.edu
Rockford Campus

Methimazole is associated with congenital malformations, including aplasia cutis congenita (ACC).(1) We report a rare case of ACC in dizygotic twins (DZT) exposed to methimazole during pregnancy. This is the third reported case of ACC in both DZT; one prior case also involved methimazole exposure.(2-3)
DZT, one female and one male, were delivered at 36 weeks via induced vaginal delivery for severe maternal pre-eclampsia. The mother, diagnosed with Graves’ disease, took methimazole (10 mg daily until 9 weeks, paused for one month, then 5 mg daily until one month before delivery). No other exposures or infections were noted. Both infants had scalp ACC but were otherwise healthy. The defects healed with basic wound care, leaving asymmetrical, atrophic scars at 8 months that thickened and darkened by age 2 (Fig. 1).
ACC occurs in 1-3 per 10,000 live births and is characterized by localized absence of skin, often on the scalp.(1-2) In twins, ACC is frequently associated with in utero twin demise, particularly in monozygotic twins (MZT), where shared placental circulation may lead to vascular disruption.(2) While DZT typically have separate circulations, ACC has been reported in surviving DZT with vascular anastomoses or unrecognized fetal loss.(2-5)
Teratogenic exposures like methimazole are strongly linked to ACC.(1,3) This case reaffirms methimazole’s teratogenic risk and highlights the multifactorial etiology of ACC, involving genetic, gestational, and environmental factors.

Kristi Nguyen
knguye86@uic.edu
Peoria Campus

Introduction: There is an increasing incidence of anterior cruciate ligament (ACL) injuries in adolescent athletes. We use the digital image correlation (DIC) technique to validate and characterize the porcine ACL as a model for human ACL injury.

Methods: Porcine stifle joints were prepared by removing non-ACL ligature via dissection, and an osteotomy of the femoral medial condyle was performed to expose the ACL for imaging. Twenty samples underwent cyclic tensile testing for 100 cycles, ten at 300N and ten at 600N. Force and displacement were recorded using an MTS System tensile loading machine. The tests were recorded with a smartphone, and the footage was processed using HitFilm and MATLAB, using Ncorr DIC.

Results: The first cycles were conducted at 1) 300N taking 4.16±1.45mm to complete, and 2) 600N taking 8.17±2.14mm to complete. The final cycles at 1) 300N had a displacement of 2.65±1.70mm, and at 2) 600N had a displacement of 7.30±6.92mm. Strain between samples was highly variable but consistent across the bundles. The highest strain consistently occurred in the anteromedial bundle of the ACL, consistent with prior clinical findings of ACL failure.

Conclusion: The porcine stifle joint model and DIC imaging are validated with existing clinically-expected behavior for adolescent ACLs. Continued validation of DIC with high-strain biologics can improve material characterization techniques in medical applications.

Mohammad Nizamuddin
mnizamu2@uic.edu
Chicago Campus

Introduction: Cardiothoracic societies are key institutions that drive the direction of outreach, research, and clinical guidelines in the field. This study aggregated key demographic characteristics of presidents from major Cardiothoracic societies as a measure of diversity amongst leadership in the field.

Methods: We compiled age, gender, and race to analyze the demographic breakdown of the following societies (ECSS,AATS,WTS,ABTS,WTSA) using public health records, university biography pages, research sites such as Google Scholar and PubMed, as well as obituaries and other methods.
Results: Of the 5 societies included in our analysis, the WTS presidents were the youngest on average (48; SD: 3.679) and were significantly younger than presidents of every other society. All societies were composed of majority caucasian males, with the ECTSS being the most racially diverse (16.67%) and the ABTS having the largest ratio of female presidents (ABTS). Of the 247 presidents not in the WTS, 6 were female. Of the 262 total, 16 did not have any Caucasian ethnicity.

Conclusion: Our data showed interesting trends and data points indicating variability amongst presidents of Cardio-thoracic societies in the US. As focus on diversity and inclusion of different surgical specialties is highlighted, these trends serve as key markers for measurement of development and integration of the Cardiothoracic field.

Mohammad Nizamuddin
mnizamu2@uic.edu
Chicago Campus

Intro: While the proportion of women in surgery has grown, more than 90% of practicing CT surgeons are men. We sought to examine the current landscape of female representation at different points along the CT surgery training and career path.

Methods: Medical student, resident, and active practice surgeon demographics were obtained from the AAMC. We identified five major U.S. CT surgical societies, noting members of all committees. Gender was probabilistically determined using Gender Guesser (NamSsor SAC LLC, France).

Results: We identified 456 individuals occupying both junior and senior level committee positions across five major US CT surgical societies. Of committee members, 78 (26%) were identified as likely female. Among committee chairs and executive leadership boards, 48 individuals (31%) were likely female. Female ACGME thoracic surgery residents represented 29.5% of the incoming class in 2023. Comparatively, women were noted to account for only 8.3% of active thoracic surgeons. Across a composite of ACS recognized surgical subspecialties with AAMC data women accounted for 29.1% of all practicing surgeons in the US.

Conclusion: While gender distribution in CT surgery shows balance at early career stages, current practice remains skewed. Despite this, women are present and active at junior and senior levels within major CT societies.

Mohammad Nizamuddin
mnizamu2@uic.edu
Chicago Campus

Pulmonary mucormycosis (PM) is a rare and life-threatening condition, most prevalent in immunocompromised patients. Early signs and symptoms are often nonspecific. A high index of suspicion in at risk patients should prompt early infectious work-up, including bronchoscopy, followed by aggressive antifungal therapy and early surgical resection when indicated. We demonstrate these core tenants of diagnosis and management of PM via two patient presentations, the first involving a kidney transplant recipient who presented with a mild cough, found to have a lung lesion with rapid growth over a few weeks; the second involving a patient with acute lymphoblastic leukemia who presented with hemoptysis and imaging revealing a 5 cm perihilar mass obliterating the left pulmonary artery. Both patients were managed with aggressive surgical therapy.

Fatima Nizamuddin
fnizamu2@uic.edu
Peoria Campus

Lung cancer is the most common cause of cancer related deaths. Common presenting symptoms include shortness of breath, cough, and unintentional weight loss. Risk factors include smoking, chronic obstructive pulmonary disease, and environmental exposures. Early diagnosis is one of the keys to better survival and prognosis.

We present a case of a 53-year-old man with twelve-month history of chest pain associated with a hyperpigmented, reticular rash on his left chest wall. Additional history and physical exam revealed an extensive 80-pack year smoking history, significant unintentional 40-pound weight loss, pandigital nail clubbing and a palpable left suprascapular mass. The rash was secondary to prolonged heating pad use to help alleviate the chest pain. X-ray and CT imaging were remarkable for a 10 cm mass-like consolidation in the apex of the left lung. Following biopsy, he was diagnosed with poorly differentiated pulmonary adenocarcinoma and referred to Oncology for treatment.

This case highlights the atypical presentation of lung cancer with chronic chest pain and skin rash from heating pad use. It also highlights that despite extensive screening guidelines in place, sometimes patient and healthcare access factors dictate the quality of care delivered which can result in delay in diagnosis.
In addition to screening patients with high risk for lung cancer, a good awareness of both typical and atypical presentations may help with early detection and better health outcomes.

Fatima Nizamuddin
fnizamu2@uic.edu
Peoria Campus

Research indicates that incorporating spirituality into clinical medicine is associated with improved patient outcomes and is aligned with core principles of patient-centered care. This prioritization of diversity allows students to develop the tools needed to effectively engage with and support an array of patient demographics. Yet, there remains a lack of standardized methods for integrating spirituality and religion into formal medical education and clinical care.
At a multi-systems level, we sought to deliver educational training programs that outlined the value of spirituality and religion in clinical practice. Qualitative feedback from 131 medical students and staff who attended the medical student colloquium and 13 responses from the faculty development session highlighted the importance developing an understanding of how spirituality influences patients’ medical decisions. The Spirituality and Health clinical elective will help to better equip students in identifying and assessing a patient’s unique spiritual needs. The refinement process for the spiritual history assessment screening tool is ongoing, with the aim of establishing an effective and efficient way to incorporate a patient’s religious and spiritual values into formal history-taking practices and electronic health records. These scholarly programs are designed to empower medical students, faculty, and staff to enhance their ability to provide holistic, patient-centered, culturally responsive care.

Eilidh O’Brien
eobrie3@uic.edu
Peoria Campus

Standard of care for early stage breast cancer following breast conserving surgery includes whole breast irradiation (WBI). More recently, accelerated partial breast irradiation (APBI) has become a popular option for patients due to its shorter treatment regimen, lower cost, and increased patient compliance. APBI has shown equivalent ipsilateral tumor recurrence rates and overall survival to WBI. In patients with left sided breast cancer treated with whole breast irradiation, long term cardiotoxicity is a concern, as each Gy delivered to the heart leads to a 7.4% increase in adverse coronary events. APBI has been shown to be superior to WBI in reducing cardiotoxicity. Studies evaluating radiation induced cardiotoxicity continue to be limited and have yet to examine cardiotoxicity in the APBI-IMRT-Florence regimen. In this retrospective chart review, we aim to compare mean heart dose (MHD) and left anterior descending artery (LAD) dose between patients who underwent APBI-IMRT-Florence regimen and WBI in patients with early stage left sided breast cancer. Of the 90 patients included in the study, 67 underwent WBI and 23 underwent APBI. We hypothesize APBI-IMRT-Florence regimen to be superior to WBI in reducing mean heart dose and LAD dose. This study will bring considerable value as the APBI-IMRT-Florence regimen provides a more shortened treatment regimen compared to other APBI techniques, which would further reduce barriers to care.

Elisheba Odei
eodei3@uic.edu
Peoria Campus

This case involves a 10-year-old male presenting with fatigue and lymphadenopathy. Two weeks prior, the patient visited an outside ED for fatigue, increased bruising, weight loss, frequent shortness of breath, and night sweats. He was diagnosed with a bacterial infection and prescribed antibiotics; however, symptoms persisted. Two weeks later, a repeat ED visit revealed concerning findings: WBC 102, Hgb 12.5, Plt 28, and a chest X-ray suggesting a large mediastinal mass. A CT scan indicated widespread cervical lymphadenopathy. He was transferred to OSF Peoria for further evaluation.

On admission, additional laboratory tests revealed WBC 115, K+ 6.5, Uric Acid 13.8, LDH 2708, and markers for previous EBV and CMV infections but no acute infection. Imaging and laboratory findings raised concern for malignancy, with a differential diagnosis including leukemia (likely T-cell leukemia), lymphoma, viral infection, or an autoimmune inflammatory reaction. The patient’s presentation, coupled with laboratory and imaging findings, supports a working diagnosis of T-cell leukemia.

Austin Oglesby
aogles3@uic.edu
Rockford Campus

Maffucci’s syndrome is a rare congenital condition characterized by the presence of multiple enchondromas and cavernous hemangiomas throughout the body, with only approximately 200 cases having been reported since its discovery. Ollier’s syndrome is a rare condition which presents similarly to Maffucci’s but is defined by enchondromas alone and must be differentiated from Maffuci’s syndrome when making a diagnosis. While endrochondromas are benign growths, roughly half of the patients with Maffuci’s syndrome may develop malignant growths. We present a case of a 47-year-old man diagnosed with Ollier’s syndrome as a child that presented with a growing digital mass with notable skin ulcerations. Prior MRI’s had shown several hemangiomas in the same hand. Thus, the diagnosis was modified to Maffucci’s syndrome. A sarcoma conference discussion resulted in a recommendation for left fifth digit amputation. After consent was obtained, the patient underwent surgical removal of the finger. With diagnostic imaging using X-ray, enchondromas appear as osteolytic lesions with endosteal scalloping and thinned cortex. In addition, hemangiomas can be distinguished with the use of color Doppler ultrasound. Phleboliths are considered as diagnostic criteria for Maffucci’s and are identified via X-ray as small round calcifications within soft tissue. Patients with bone or soft tissue swellings should be evaluated radiographically in order to establish early diagnosis of Maffuci’s syndrome.

Austin Oglesby
aogles3@uic.edu
Rockford Campus

The prevalence of total hip replacements (THR) has shown a steady upward trend in recent years, with an estimated yearly incidence of over 450,000 cases in the United States. It primarily involves the use of metal components, namely Cobalt Chromium-Molybdenum (CoCrMo) and Titanium-based alloys. However, it is important to note that significant clinical evidence has brought attention to cases of early THR failures and the possible negative impacts on patients (locally and systemically) resulting from the release of metal particles and ions. In our previous abstract, we reported the possible risk of toxicity on liver cells under static conditions, with short time exposed to higher concentration. In this study, we hypothesis that under dynamic condition, CoCrMo wear particle may cause liver toxicity even in low concentration with longer period of exposure. Hence, the objective of the study is to investigate and compare the toxicity effect on the liver cells at 10 ppm of CoCrMo particles with 3 days of exposure. Our findings of altered cell morphology and lower viability in both the dynamic and static treatment cultures compared to control cultures suggest that CoCrMo particles do have some degree of toxic effect to hepatocytes. Furthermore, dynamic cultures might more closely mimic toxicology research from implant derived CoCrMo particles to hepatocytes as it has the ability to stimulate the constant blood flow the liver receives in vivo.

Grace Ogungbile
gogung2@uic.edu
Chicago Campus

Acute chest syndrome is a severe pulmonary complication of sickle cell disease and is the leading cause of respiratory failure and mortality in these patients. We hypothesize that hemin-induced necroptosis causes pro-inflammatory cytokine release, endothelial cell barrier dysfunction, and pulmonary edema, an effect that is regulated by toll-like receptor 4 (TLR4). Mice were pretreated with the TLR4 inhibitor M62812 (20 mg/kg x 2 doses), the necroptosis inhibitor necrostatin-1 (3 mg/kg), or vehicle DMSO control. Evan’s blue dye perfused through the pulmonary artery catheter then washed out was used to determine capillary leak. Effluent fluid collected from the left atrial catheter was used for measurement of interleukin-6 (IL-6) concentrations. ANOVA was used for statistical analysis of two or more experimental groups. Hemin treatment in the isolated-perfused murine lung model is associated with increased pulmonary artery pressure, pulmonary capillary leak with edema formation, and secretion of IL-6. These effects are mitigated by the TLR4 inhibitor M62812. TLR4 may be an important mediator of acute hemolysis-induced lung injury and acute chest syndrome in sickle cell disease, warranting further investigation.

Olufunmilola Oyelola
ooyelo2@uic.edu
Chicago Campus

TITLE: Postpartum well-visit attendance: How residential distance and social determinants of health may be associated with care

AUTHORS: Olufunmilola Oyelola, B.Sc, M.S., Quetzal A. Class, PhD

Introduction
Postpartum well-visits are important to prevent maternal mortality and ensure wellness. However, attendance rates are low. We examine factors associated with 2-and 6-week postpartum well-visit attendance in a high-risk, inner-city sample.

Methods
We gathered EMR data from 9/2020 to 3/2022. This included demographic, social determinants of health (SDoH), delivery complications, and medical comorbidities. We used descriptive and multivariable logistic regressions to predict attendance.

Results
Of 3684 births, attendance rates were 79.7% for the 2-week and 72.3% for the 6-week postpartum visit. In multivariable logistic regression, Black race (OR=1.48, 95% CI 1.17-1.89), cesarean delivery (OR=1.23, 95% 1.02-1.49), and SDoH risk (OR=1.98, 95% CI-1.42-2.75), were associated with elevated odds of 6-week attendance while public health insurance (OR=0.61, 95% CI 0.50-0.74) and living further from the hospital (OR=0.71, 95% CI 0.60-0.85) were associated with decreased odds of attendance. Rates of attendance for both 2-and 6-week visits were higher for telemedicine compared to in-person, (e.g., X2(1)=197.13, p<.0001).

Conclusion
Provider knowledge of barriers to attendance may spur creative patient support including utilizing telemedicine in the postpartum period.

Emma Pappano
pappano2@uic.edu
Chicago Campus

Introduction: Complement activation may lead to organ damage in sickle cell disease (SCD). We evaluated risk factors for elevated sC5b-9, a complement activation biomarker, in SCD patients.

Methods: We collected clinical data and measured sC5b-9 levels by ELISA (Novus Biologicals, CO) from 114 SCD adults. We performed univariate analyses by Mann-Whitney or Fisher’s exact test and multivariable analyses using linear or logistic regression.

Results: Median cohort age was 35 years, 55% were male, and 46% were on hydroxyurea. On univariate analysis, HbSS/SB0 genotype (813 vs 610ng/mL, P=0.047), hemoglobinuria (826 vs 761ng/mL, P=0.049), and higher LDH (Beta 0.52 ± 0.21, P=0.01) were associated with increased sC5b-9; hydroxyurea was associated with decreased sC5b-9 (720 vs. 847ng/mL, P=0.009). HbSS/SB0 (Beta 0.41 ± 0.12, P=0.001) and hydroxyurea (Beta -0.24 ± 0.08, P=0.004) were independently associated with sC5b-9 levels.
Increased sC5b-9 was associated with tricuspid regurgitant jet velocity (TRJV) 3+ m/s (914 vs 789, P=0.02) and VCAM1 levels (Beta 0.18 ± 0.089, P=0.0499). Adjusting for covariates, sC5b-9 predicted TRJV 3+ m/s (OR 14.0; 95% CI: 1.1-175.4; P=0.04).

Conclusion: We demonstrate severe SCD (HbSS/SB0) and hydroxyurea impact complement activation. Additionally, SCD patients with increased sC5b-9 levels have a 14-fold greater risk of TRJV 3+ m/s, a marker of pulmonary hypertension. This suggests that complement activation may be an important biomarker for SCD severity.

Rebecca Paszkiewicz
rpaszk3@uic.edu
Chicago Campus

The DaVinci SP robotic system provides single-port surgical access through a single incision. Under a research protocol at UIH, we created a database of patients who underwent surgery using the SP system for not-yet-approved procedures. The most pressing question for the new technology is the incidence of complications, namely incisional hernias (IH). Based on the data collected from over 400 patients, the rate of IH following single-port surgery (1.6%) is less than the average rate of IH for laparoscopic surgery (2.9-8.5%). Further, this project was set up to analyze risk factors associated with IH. IH for laparoscopic procedures are known to be increased with age, male sex, obesity, various comorbidities, previous bowel surgery, and re-laparotomy. Using a subset of patients with complete comorbidity data, we compared the age, sex, BMI, history of abdominal surgery, comorbidities, and smoking status between the population subset and the patients with post-operative IH. Compared to the general cohort, IH patients had elevated BMI and a higher rate of diabetes, hypertension, renal disease, and non-IH post-operative morbidity. Data collection for the database is ongoing with future work aimed at addressing mitigating factors associated with single-port IH incidence.

Nehal Patel
npate489@uic.edu
Peoria Campus

Stroke and myocardial infarction (MI) are leading causes of mortality in the United States and early recognition of symptoms and prompt action, such as calling 9-1-1, are critical for improving outcomes. However, limited data exists on MI and stroke symptom awareness among Asian American (AsA) adults. We conducted a secondary analysis of the 2014 and 2017 National Health Interview Survey among 3,355 Asian American adults identifying as Asian Indian, Chinese, Filipino, or “Other Asian” (Japanese, Korean, Vietnamese, others). Awareness of all MI and stroke symptoms and calling 9-1-1 was analyzed using a multivariable logistic regression adjusting for sociodemographics and “high-risk” social determinants of health (SDOH).Filipino adults had the highest awareness of MI (OR: 1.41, 95% CI: 1.05–1.90) and stroke symptoms (OR: 2.06, 95% CI: 1.53–2.78) compared to Asian Indian adults. Chinese adults had higher odds for stroke awareness (OR: 1.51, 95% CI: 1.14–1.99) but lower MI awareness (OR: 0.75, 95% CI: 0.52–0.93) compared to Asian Indian adults. High-risk SDOH was associated with reduced MI (OR: 0.65, 95% CI: 0.58–0.74) and stroke awareness (OR: 0.66, 95% CI: 0.58–0.75) among all AsA adults. Male AsA adults had lower MI awareness (OR: 0.68, 95% CI: 0.56–0.83) compared to female adults. Awareness disparities highlight the need for targeted public health interventions. Filipino adults’ heightened awareness could guide community-specific campaigns for less aware subgroups.

Clairice Pearce
cpear@uic.edu
Chicago Campus

Complete motor spinal cord injury is a devastating condition that renders individuals completely paralyzed below the level of neurological injury. Currently, no FDA-approved treatment to rescue motor function for these patients exists. Endeavors have begun to explore the potential of using epidural spinal cord stimulation to improve motor outcomes in these patients. Because this work is still in its infancy, there is a need to analyze the literature to better understand how features of injury influence outcomes. In this meta-analysis, we have sought to address this question, and we investigate patient presentation variables that may predict the greatest motor score and volitional movement benefit in patients using this therapy. Using PRISMA guidelines, we performed a comprehensive search in Pubmed, GoogleScholar, Cochrane Library, Web of Science, EMBASE, and Cinhal databases. We selected studies focused on epidural spinal cord stimulation effects on subjects with complete motor (AISA or AISB) spinal cord injury. We selected clinical trials that assess motor function. A total of 4 studies were identified, and we found that all subjects showed improved functional outcomes with stimulation on. However, motor scores that increased from baseline with stimulation off could not be explained by training nor extent of spinal cord damage. Our work suggests this treatment is effective with sustained use. Additional trials should be pursued to validate true effects of treatment.

Navya Peddireddy
npeddi2@uic.edu
Peoria Campus

Gun violence (GV) presents a significant public health challenge in the United States, yet its impact on low birth weight (LBW) remains underexplored. This study examines GV severity as an independent risk factor for LBW and its variability across high-risk U.S. counties. County-level data (2017–2019), linked via FIPS codes, included firearm fatality rates (Wisconsin DHS), birth outcomes (CDC natality files), and socioeconomic indicators (U.S. Census). GV rates were categorized into tertiles (low, medium, high), and counties classified as high-risk (Z-score > 0) or low-risk (Z-score ≤ 0). Maternal risk factors were analyzed, and multivariable regression estimated LBW relative risks (RR) across GV tertiles. LBW prevalence was 37.37%, 42.40%, and 54.96% in low, medium, and high GV tertiles, respectively. Medium-tertile counties had an RR = 1.13 (CI: 0.87–1.47, p = 0.0041), and high-tertile counties had an RR = 1.47 (CI: 1.13–1.47, p = 0.3445). Adjusted analysis showed high GV tertiles had an RR = 1.40 (CI: 1.10–1.70, p < 0.02), while medium tertiles showed no significant difference (RR = 1.10; CI: 0.90–1.40, p = 0.33). High GV counties had elevated rates of maternal age < 20 (59.40%), education < 12 years (51.24%), unmarried status (58.95%), WIC enrollment (67.08%), diabetes (67.91%), and smoking (59.60%) (p < .0001). GV severity is independently associated with increased LBW, underscoring the need for targeted interventions to improve birth outcomes in high-GV areas.

Cameron Pedersen
cpeder4@uic.edu
Chicago Campus

Recent rapid advances in Artificial Intelligence (AI) technology have spurred increasing utilization in healthcare, particularly in ophthalmology. Significant progress has been made in the research and development of AI-based screening modalities specifically for diabetic retinopathy. AI-based screening provides an accessible and potentially cost-effective alternative to in-person and traditional telemedicine-based screening amidst a shortage of trained specialists. However, utilization of these technologies may be limited due to healthcare regulatory approval and potential concerns regarding the cost-effectiveness of utilizing AI. This review aims to highlight the current literature on cost-effectiveness of AI-based DR screening technologies and identify potential areas for future research. We examine studies from PubMEd, Google Scholar, and EMBASE that explore the cost-effectiveness of AI-based DR screening. The studies examined support the cost-effectiveness of AI-based screening from a societal, healthcare, and patient perspective analyzing both commercialized and non-commercialized software. Further research should examine the impact of model efficacy, patient adherence, and secondary outcomes on cost-effectiveness of AI screening modalities.

Madison Pineda
mpined23@uic.edu
Chicago Campus

Immigration to the US has been associated with deterioration of mental health in Hispanic individuals but the impact of immigration on psychosocial health has not been well studied in those with chronic kidney disease (CKD). We compared the psychosocial health of Mexican adults with CKD living in Chicago compared to those with CKD living in Mexico City using data from 302 participants in the Chicago-based Hispanic Chronic Renal Insufficiency Cohort (CRIC) and 411 adults in the Mexico City-based Mexico CRIC. We evaluated three psychosocial measures: a) depressive symptoms using the Beck Depression Inventory; b) health-related quality of life (HRQOL) using the Short Form-12; and c) social support using the Medical Outcomes Study-Social Support Survey. Compared to adults with CKD in Mexico City, those in Chicago were more likely to be female, have diabetes, higher body mass index, lower estimated glomerular filtration rate and higher proteinuria. About 80% of those in Chicago had Spanish language preference and 86% were non-US born. Compared to Mexicans with CKD in Mexico City, those in Chicago had higher prevalence of depressive symptoms, low HRQOL, and low social support. Future research is to better understand factors responsible for these differences.

Andrea Pinto
apinto8@uic.edu
Chicago Campus

Incidence of a congenital heart disease (CHD) is the most common congenital anomaly in the United States, affecting 8-10 per 1000 live births. 1,2 D-transposition of great arteries (d-TGA) is the second most common cause of cyanotic CHD in infants. With improved advances in surgical interventions, there has been an increased number of adults living with CHD. Here, we report the case of a 36-year-old man presenting with an initially unknown cyanotic congenital heart repair and severe pulmonary hypertension which posed many potential challenges for the Neuroanesthesiologist. History obtained showed a history of surgical correction of cyanotic heart disease during infancy. Cardiology workup revealed an atrial flutter from ECG and an estimated right ventricular systolic pressure (RVSP) greater than 95 mmHg on a transthoracic echocardiogram (TTE). The patient was scheduled for a thoracotomy for anterior approach T10-T11 discectomy, requiring lung isolation. In light of the elevated right ventricular dysfunction, one lung ventilation posed a risk for the paitent and further cardiology workup was necessary. Bubble study was performed and showed a Mustard repair for dextro-transposition of the great arteries. As a result of this anomaly, the initial RVSP of 95mmHg was concluded to be the systemic blood pressure instead. Despite these challenges, the patient tolerated one lung ventilation with bronchial blockers and the surgery was successful without complications.

Carson Potts
cpotts6@uic.edu
Chicago Campus

Background: Single anastomosis duodeno-ileal bypass (SADI) has emerged as a safe and effective bariatric procedure. Its simplicity and robust weight loss outcomes have contributed to its increasing popularity. While traditionally performed as an inpatient procedure, recent trends towards ambulatory surgery have prompted interest in outpatient SADI.

Objective: This study aims to assess the safety profile of outpatient SADI cases reported in the MBSAQIP database, providing valuable insights into the feasibility and potential benefits of this approach.

Methods: This retrospective study analyzed data from the MBSAQIP database. Patients who underwent SADI and were discharged on the same day of surgery were included. Demographic, medical history, and postoperative outcomes, including readmission, complication, and reoperation rates, were analyzed.

Results: A total of 192 patients who underwent SADI and were discharged on the same day of surgery were included. The majority of patients were female, with a mean age of 44.3 years. 30- day readmission and reoperation rates were 4.69% and 2.6%, respectively.

Conclusion: Outpatient SADI can be a safe and effective option for appropriately selected patients, with similar complication and readmission rates to inpatient SADI and other outpatient bariatric procedures.

Prarthana Prashanth
ppras2@uic.edu
Chicago Campus

The indispensable amino acid serine plays an important role in cancer cell growth due to its diverse biosynthetic functions, supplied primarily through the serine synthesis pathway (SSP) and exogenous serine. In our previous work, we discovered the lineage-specific silencing of PSAT1 in human luminal breast tumors, rendering luminal breast cancer cells sensitive to serine deprivation both in vitro and in vivo. At present, the only way to reduce serine availability for tumors in vivo is through dietary serine starvation. Although well-tolerated by mice, consumption of a 100% synthetic protein-free diet may prove challenging for humans. Additionally, dietary serine starvation only achieves a 50% reduction in circulating serine levels, limiting its use in cancer patients. Due to the inherent challenges associated with dietary serine starvation, we engineered human serine dehydratase. The injection of our engineered eSDH enzyme, can achieve a long-term, near-complete (>90%) reduction in circulating serine levels. As expected, eSDH treatment of serine auxotrophic cells and tumor in vitro and in vivo respectively leads to cell death and tumor regression. Additionally, we will assess the efficacy of eSDH treatment when combined with endocrine therapy, the established standard of care for almost all luminal/ER+ cancer patients. In conclusion, our new modified version of SDH provides us an opportunity to clinically starve the serine auxotrophic cells ultimately slowing tumor growth.