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2016 Poster Winners

The following abstracts and posters were winners in the 2016 AOMA Poster Forum. Posters were submitted in three categories: case , research, and performance/population improvement. They were judged separately and a winners chosen in each category.

Clinical Case Poster Winners

Student Submissions 

1st Place - Fungal Dissemination: A Coccidiodides Story - Yahya Nomaan, OMS III; Tuong C. Ta, MD, PhD; William Peppo, DO, FACOI, FCCP, FACP

   Poster 

Abstract
Coccidioidomycosis goes by multiple names such as Valley Fever, Desert Rheumatism, and San Juaquin Fever and is endemic to the southwestern United States and northern Mexico. This disease is commonly missed or has prolonged time to diagnosis, which can allow the fungal pathogen to disseminate out of its initial site of infection, the lung. The most significant extra pulmonary manifestations are in the central nervous system and include hydrocephalus and basilar meningitis and death. The more common presentations of this disease process can be understood by this case presentation and be help physicians outside of its endemic areas to recognize and treat the disease.

 

2nd Place - Brace Yourself: Legg Calve Perthes and the Benefit of Bracing - Kevin Brown, OMS II; Samual Saunders, OMS II; and Charles Finch, DO, FACOEP

  Poster

Abstract 

Legg Calvè Perthes disease is a rare osteonecrotic disease of the femoral head typically affecting young boys ages 2-12. The incidence ranges from 0.4/100,000 to 29.0/100,000 children <15 years of age depending on race and socioeconomic class (1). It is idiopathic by nature and the common pathology associated with the disease is a lack of blood supply to the femoral head due to a constriction or occlusion of the artery of ligmentum teres femoris. Ischemia in the area causes osteonecrosis of the femoral head leading to arthralgia of the hip and abnormal gait.

Treatment of Legg Calvè Perthes disease is still a somewhat controversial subject due mainly to the lack of scientific data and statistics regarding the long term effects of treatment. Some treatment options follow a more conservative approach such as bed rest or bracing, whereas some follow a more invasive approach such as botox injections or surgical osteotomies (2).

 

3rd Place – A Case of Neurogenic Thoracic Outlet Syndrome Secondary to Anatomical Variation of the Brachial Plexus Identified by Ultrasonography - Vaness Leonhard, OMS III; Riley Landreth, OMS V; Gregory Caldwell, OMS III; Heather F. Smith, Ph.D.; and Richard Geshel, DO

  Poster

Abstract:
Thoracic outlet syndrome is a diagnosis currently plagued by controversy due to its subjective nature. Vascular compression identified with positional testing is the foundation for diagnosis and assumes a classic orientation of neurovasculature. SS presented to her family physician with thoracic outlet syndrome symptoms and due to negative positional testing was without a clinical diagnosis. Our recent cadaveric dissections have identified anatomical variations that could predispose patients to this purely neurogenic thoracic outlet syndrome and clinical misdiagnosis.

    Resident Submissions

    1st Place – Cocci Wars: The Fungus Awakens - A Closer Look at the Virulence of Coccidiomycosis in a Pregnant African Woman - Kendra Gray, DO and Danielle Olla OMS III

     Poster

    Abstract:

    Coccidioides immitis and Coccidioides posadasii are dimorphic fungi endemic to the southwestern desert regions of the United States that cause coccidioidomycosis. Although pregnancy may not be a risk factor for the acquisition of coccidioidomycosis, it is associated with disseminated disease and is strongly associated with the trimester of pregnancy. Dissemination was found in 96% of the cases diagnosed in the third trimester. C. immitis is stimulated directly by serum levels of estradiol and progesterone achieved in pregnant women. African race is also associated with disseminated disease. This, together with the depressed cell-mediated immunity of pregnancy, may account for the virulent nature of coccidioidomycosis in pregnant women.


    2nd Place – Exertional Dyspnea, Orthopnea, and Tachycardia: A Case Report Descriging a Pulmonary Embolus Misdiagnosed as Congestive Heart Failure - Julianne Cameron, OGME-3 and Marc Kaplan, DO

      Poster

    Abstract:  Pulmonary embolism presentation can often be insidious in nature. Symptoms may present classically with a history immobilization, followed by sudden onset tachycardia and dyspnea; or they may present gradually. Without a high index of suspicion pulmonary embolism can be missed. This case report describes a 71 year old gentleman, with a history of aortic valve stenosis and metastatic prostate cancer presenting with progressive dyspnea, orthopnea, and fatigue. He presented to the emergency department and hospital 3 times in the course of 2 months. Initially he was diagnosed with congestive heart failure secondary to aortic valve stenosis. On subsequent visits, he was treated for decompensated heart failure, without ever investigating a possible alternative cause for his symptoms. It was not until he was referred for a transcatheter aortic valve replacement, or TAVR, that a chest CT with contrast was performed to reveal extensive bilateral pulmonary embolus. This case illustrates the importance maintaining a high index of suspicion for pulmonary embolism, especially if there are risk factors present, and of avoiding bias when evaluating the same patient multiple times for similar symptoms.



    Research Poster Winners

    Student Submissions  

    1st Place – Treatment of Drug-Resistant Breast Cancer Cells with a Novel Lipid-Based Nanocarrier Formulation Containing Genistein and Paclitaxel - Trung Nguyen, OMS II; Omar Jawhar, OMS II; Bernardo Chavira, BS; Tamer Elbayoumi, PhD; and Vinay J. Nagaraj, PhD

       Poster

    Abstract: The major molecular mechanism for drug resistance in cancer cells is the upregulation of the cell surface drug efflux pump P-glycoprotein. Strategies that involve effective drug delivery to cancer cells while inhibiting the action of P-glycoprotein offer an opportunity to overcome drug resistance and effectively treat cancer. Formulations of a novel lipid-based nanocarrier containing the commonly used chemotherapeutic agent Paclitaxel along with the P-glycoprotein inhibitor Genistein were tested for their ability to effectively deliver drugs to drug resistant breast cancer cells in this study.


    2nd Place – Improved Functional Recovery Following Spinal Cord Compression in Rates Treated with Losartan is Associated with Reduced T Cell Influx into the Injury Site - Matthew Hardman, OMS III; A Kajioka, OMS III; E. A. Robbins, DO; C. B. Jones, PhD; and T. B. Jones, PhD

      Poster

    Abstract:  Renin-angiotensin system (RAS) inhibition is neuroprotective in Parkinsons, Alzheimers and stroke. One proposed mechanism is inflammation modulation. Inflammation has also been implicated in degenerative cascades initiated by trauma to the spinal cord, thus we sought to determine whether a protective effect of RAS inhibition would occur following cord injury (SCI). We hypothesized that treatment of spinal cord-injured rats with losartan would improve functional recovery associated with modulation of the intraspinal T-cell and macrophage response.

     

    3rd Place – Sanuinarine and TRAIL Combination Therapy for Treatment of Human Papilloma Virus-Infected Cervical Cencer Cells -  Justin Chen, OMS III; Whitney Wilson, OMS IV; Eric Romney, OMS IV; Anjali Taneja, OMSIII; Bernardo Chavira, BS; and Vinary J. Nagaraj, PhD

      Poster

    Abstract: Infection of normal cervical cells by the human papilloma virus (HPV) can transform these cells into radiation and chemotherapy resistant cancerous cells. Induction of apoptosis in the transformed cells is a key strategy in successfully treating HPV-induced cervical cancer. TRAIL (tumor necrosis factor related apoptosis-inducing ligand) has been shown to selectively induce apoptosis in cancer cells by binding to death receptors and activating extrinsic pathways for apoptosis. However, certain cervical cancers, such as the cultured cell line SiHa, are remarkably resistant to TRAIL. In this study, we have explored the use of sanguinarine, an extract from the plant Sanguinaria canadensis, to sensitize SiHa cells to TRAIL. Sanguinarine has been shown to induce apoptosis in cancer cells by activating multiple cell death pathways, including the upregulation of death receptors via reactive oxygen species.

     

    Performance/Population Improvement Poster Winner

    1st Place - Developing Osteopathic Manipulative Medicine as an Adjunct Tool for Community Health Workers in four Remote Underserved Peruvian Amazon Communities - Jenni Adams, OMS III; Julian Hirschbaum, OMS III; Daniel Ebbs, OMS III; Stanton Jasicki, OMS III; Jeanette Lovato, OMS III; Starr Matsushita, OMS II; Sam Waggoner; Joy Lewis, DO; and Deborah Heath, DO.

      Poster

    Abstract:

    Osteopathic Manipulative Medicine (OMM) provides a low-risk and cost effective option to Community Health Workers (CHWs) for the treatment of musculoskeletal related complaints, especially in the context of resource limited settings. This study explores the use of OMM as an adjunct tool for CHWs working within four communities serving approximately 500 people in a region with little to no access to health care: the Loreto Region of the NE Peruvian Amazon Jungle. The study measures the effect of Information Communication Technology (ICT) on CHW long-term retention of OMM knowledge and skills. During the initial training workshop in November of 2014, six CHWs were instructed on how to perform and record the Osteopathic Structural Exam and the Abdominal Plexus Release, and their competencies were assessed and documented. Following the initial training workshop, CHWs were instructed to utilize the OMM knowledge and skills to treat members of their respective communities. They were provided with ICT in the form of handheld computer tablets pre-programmed with educational podcast materials to review the OMM curricula and document OMM treatment. Six months after the initial training, CHW retention of the previously taught OMM material was reevaluated. CHWs were scored using rubrics created based upon the information taught in November of 2014. Overall, the CHWs demonstrated a higher retention rate for understanding and performance of the Abdominal Plexus Release (85%) than for the Osteopathic Structural Exam (56%). Subsequently, CHWs were re-taught how to perform the OMM techniques and were reminded to use their handheld computer tablets in order to support knowledge retention of the landmarks needed to complete the Structural Exam. Retention of this material will continue to be assessed in November of 2015, one year after the initial training. Furthermore, application of OMM techniques by CHWs, as documented through their handheld computer tablets, will be measured and reevaluated in November of 2015.