Faculty Scholarship

The Faculty Scholarship webpage is designed to share the news of faculty accomplishments in medical education including publications, conference presentations, and grants. The webpage may also serve as a resource for faculty looking to identify collaborators with shared research interests. Entries are accepted throughout the academic year, and the page is updated monthly.

December 2020 features:

Publications

1. Bishop, K., Momah, T., Ricks, J. Nephrolithiasis. Primary Care Clinics: Clinics in Office Practice. Vol 47, Issue 4, December 2020, Pages 661-671
   
   Review article demonstrating Nephrolithiasis or kidney stones as the second most common CKD, affecting 12% of all people. Early recognition and treatment of this condition are important to prevent complications that can occur with delayed treatment. Furthermore, increasing prevalence of this disease underlines the importance of correctly diagnosing the causative factors, thereby affecting prevention of recurrence.
   
   
2. Cho, R.J., Senitko, M., Wong, J., Dincer, E.H., Khosravi, H., Abraham III, G.E. Feasibility of using the O-Arm imaging system during ENB-rEBUS-guided peripheral lung biopsy: A dual-center experience. European Respiratory Journal, 2020 56: 1204; DOI: 10.1183/13993003.congress-2020.1204.
   
   Malignant central airway obstruction is a debilitating complication of primary lung cancer and pulmonary metastases occurring in approximately 30% of patients. The goal of therapeutic bronchoscopy is to recanalize an airway to palliate the symptoms and/or to bridge to further cancer therapy. Microwave ablation (MWA) is a field-based technology that heats a tissue by creating an electromagnetic field around an ablation device. We present a case series utilizing MWA via flexible bronchoscopy as a novel, not previously described modality for the management of malignant central airway obstruction. Therapeutic bronchoscopy with a flexible small MWA antenna (MedWaves Inc.) was performed in five cases. We recorded tumor size, number of microwave energy applications, ablation time, amount of energy delivered, rate of successful ablation, use of other ablative techniques, complications, and 30-day follow up. Successful airway recanalization was achieved in all cases. No immediate complications were noted. In one case, tumor in-growth within a silicone stent was ablated with no damage to the stent.
   
   
3. Dhannawat, S.S., Sherwood, C., Bahadur, R. Eyelid Metastasis from Lung Adenocarcinoma, American Journal of Ophthalmology Case Reports, vol. 20, 2020, doi:10.1016/j.ajoc.2020.100991.
   
   This paper provides a report of an unusual case of lung metastasis presenting as an eyelid lesion. An 82-year-old man presented with a right upper lid lesion of 2 weeks’ duration proven to be adenocarcinoma of the lung. Metastasis to the eyelid is a rare occurrence. We present a review of the literature emphasizing factors contributing to its low incidence.
   
   
4. Lucar, J., Navalkele, B., Becker, B.P., Reed, C.D., Parham, J. Health care personnel exposure to a patient with asymptomatic SARS-CoV2 infection during a prolonged surgical intervention. American Journal of Infection Control. 2020 Aug; 48(8):955-957. doi: 10.1016/j.ajic.2020.05.036. Epub 2020 Jun 5. PMID: 32505792; PMCID: PMC7273138.
   
   There is ongoing debate regarding the role of aerosols in the transmission of SARS-CoV2 in the health care environment. Here, we report a case in which multiple operating room health care providers were exposed to a patient with asymptomatic SARS-CoV2 infection during a prolonged orthopedic surgical intervention and had no evidence of COVID-19 during the 14-day post-exposure period.
   
   
5. Kidnie R., Momah, T. Invasive adenocarcinoma of the ileum presenting as a small bowel obstruction: Case report. West African Journal of Medicine, vol. 37, No. 7, December, 2020
   
   A case report on Invasive adenocarcinoma of the ileum highlighting it as a rare tumor with an incidence of 0.59 per 1 million. Given its location in the distal portion of the small bowel, it is difficult to diagnose early and is often only discovered during surgery. This challenge leads to late diagnoses and poor prognoses. Surgical resection is the gold standard for treatment, with adjuvant therapy occasionally playing a supporting role. We present the case of a 62-year-old male with a complex past medical history, including non-small cell lung cancer with metastases to brain and treated with irradiation and left parietal craniotomy 13 years prior to presentation. Our patient presented to a community hospital complaining of abdominal pain. Findings on abdominal computerized tomography (CT) with intravenous (IV) contrast was consistent with a mechanical obstruction of the small bowel. The patient was admitted to the general medical floor for non-operative management. However, after three days of unsuccessful non-operative management, he was taken to the operating room for diagnostic laparoscopy. Surgery revealed an obstructing mass in the distal third of the ileum, which was excised and found to be invasive adenocarcinoma on histology. Adenocarcinoma of the ileum is very difficult to diagnose preoperatively. As a result, it often leads to delays in treatment and a poor prognosis in many patients, including ours. Because of its very low prevalence, a high index of suspicion is required to make an early diagnosis and obtain definitive treatment.
   
   
6. Secco, A.A., Akselrod, H., Czeresnia, J., Levy, M., Byrne, M., Monroe, A., Lucar, J., Horberg, M., Castel, A.D., Doshi, R., Rivasplata, H., Squires, L., Parenti, D., Benator, D.; DC Cohort Executive Committee. Sexually transmitted infections in persons living with HIV infection and estimated HIV transmission risk: trends over time from the DC Cohort. Sexually Transmitted Infections. 2020 Mar; 96(2):89-95. doi: 10.1136/sextrans-2019-054216. Epub 2020 Jan 6. PMID: 31907326; PMCID: PMC7031010.
   
   A rise in incidence of STIs has been noted in the USA and in the District of Columbia (DC). We aim to describe changes in incident STIs among persons in care for HIV in Washington, DC as well as trends in HIV viral load among those with incident STIs. We conducted a retrospective DC Cohort analysis (n=7810) measuring STI incidence (syphilis, gonorrhoea and chlamydia) as well as in-care viral load (ICVL) and percentage with all viral loads less than the limit of detection (%<LLOD) by year (2012-2016) among those with incident STIs. From 2012 to 2016, the incidence of STIs increased: chlamydia from 2.1 to 3.4 cases/100 person-years (p=0.0006), gonorrhoea from 2.1 to 4.0 (p<0.0001), syphilis from 1.7 to 2.6 (p=0.0042) and any STI episode from 5.3 to 8.8 (p<0.0001). STI incidence rates increased for those aged 18-34 (from 13.2 to 23.2 cases/100 person-years, p<0.0001), cisgender men (from 6.5 to 11.5, p<0.0001), non-Hispanic whites (from 8.6 to 16.1, p=0.0003) and men who have sex with men (from 9.3 to 15.7, p<0.0001). During 2012-2016, the ICVL among those with incident STIs improved from 108 to 19 copies/mL and %<LLOD from 23.6% to 55.1%. However, even in 2016, younger participants, cisgender and transgender women, non-Hispanic blacks and Hispanics had higher ICVLs and lower %<LLOD. Rates of incident STIs rose among persons in care for HIV in Washington, DC, with improved but not optimal measures of HIV viral suppression. These findings inform focused interventions towards preventing STI transmission and ending the HIV epidemic.
   
   
7. Sherman, J., Kemp, A., Momah, T., Cloy, A. Prescribing Patterns and Identification of Risks with Metoclopramide in a Family Medicine Clinic. Journal MSMA. vol. 11:4 2020.
   
   The purpose of this study was to analyze risk factors for developing tardive dyskinesia (TD) for patients in a family medicine clinic who were prescribed metoclopramide.  Patients receiving metoclopramide for greater than 12 weeks (GT12) were compared versus those receiving metoclopramide for 12 weeks or less (LT12). Further comparisons were made versus baseline after a brief educational intervention. Charts were reviewed retrospectively for all patients receiving at least one prescription for metoclopramide for a two-year period. Demographic data and patients at risk for TD were identified. Physician analyses of adverse effects were compared for the two groups, including use of the Abnormal Involuntary Movement Scale or any assessment of involuntary movements. Both groups were compared again eight months after a brief educational intervention. Patients in the GT12 group were more likely to have another risk factor for TD (p < 0.05). Physician assessment for involuntary movements significantly increased (p < 0.05) eight months after a brief educational intervention. Also, the number of patients continued on metoclopramide significantly decreased. Patients in the GT12 group were more likely to have a risk factor for TD. A brief educational intervention decreased the number of patients on metoclopramide and increased physician assessment of involuntary movements.
   
   
8. Walker, C.S., Walker, B.H., Brown, D., Buttross, S., & Sarver, D.E. (In press). Defining the role of exposure to ACEs in ADHD diagnosis: Examination in a nationally-representative sample of children. Child Abuse and Neglect.
   
   Clinical presentations of ADHD vary according to biological and environmental developmental influences. An emerging field of research has demonstrated relationships between exposure to adverse childhood experiences (ACEs) and ADHD prevalence, particularly in high-risk samples. However, research examining the combined role of traditional risk factors of ADHD and ACEs is limited, and reliance on high-risk samples introduces sampling bias. We examined the influence of ACEs on ADHD diagnosis using nationally representative samples (2017 and 2018) of 40,075 parents from the National Survey of Children’s Health (NSCH). We conducted logistic regression models to examine the association of ACEs and ADHD diagnosis, controlling for child and parent demographic variables and other risk factors. Results indicated exposure to ACEs was significantly associated with parent-reported ADHD diagnosis, controlling for known parental and child-risk factors of ADHD. The association followed a gradient pattern of increased ADHD prevalence with additional exposures. Compared to children with no ACEs, the odds of an ADHD diagnosis were 1.39, 1.92, and 2.72 times higher among children with one, two and three or more ACEs. The ACE most strongly associated with the odds of ADHD was having lived with someone with mental illness closely followed by parent/guardian incarceration. Results further strengthen the evidence that ACEs exposure is associated with increased ADHD prevalence. Clinicians should assess ACEs in the diagnosis of ADHD. Furthermore, results of the study lend support to the efforts of agencies (both institutional and state-level) promoting routine screening of ACEs in children.
   
   
9. Winthrop, K.L., Brunton, A.E., Beekmann, S., Polgreen, P., Baddley, J., Saag, K.G., Calabrese, C., Calabrese, L., Robinson, P.C., Wallace, Z.S., Curtis, J.R. COVID-19 Study Team*. SARS CoV-2 infection among patients using immunomodulatory therapies. Annuals of the Rheumatic Diseases. 2020 Aug 5:annrheumdis-2020-218580. doi: 10.1136/annrheumdis-2020-218580. Epub ahead of print. PMID: 32759259.
   
   The risk of coronavirus disease 2019 (COVID-19) and disease progression among patients using immunomodulatory therapy is unclear. Accordingly, we implemented an active surveillance project with USA/Canada Infectious Disease specialists via the Emerging Infections Network (EIN) to identify COVID-19 cases occurring in patients who use immunomodulatory therapy and to describe their clinical outcomes.

Grants

1. DULCE Planning Grant: Implementation in a Southern, African-American Community Center for the Study of Social Policy 
   
   Role: Courtney S. Walker, Ph.D., Principal Investigator; Co-PI: Sarah Jones, MD
   
   Status: Funded
   
   Project Description: The DULCE program is a universal, early relational approach to strengths-based, family-centered child health care during the critical first six months of life. The purpose of the proposed grant will be to conduct the initial planning needed for implementation of DULCE into general pediatric clinics at University of Mississippi Medical Center.
   
   
2. Rankin County Capacity Enhancing Project: Child-Parent Psychotherapy Zero to Three Infant/Toddler Court Program
   
   Role: Courtney S. Walker, Ph.D., Principal Investigator
   
   Status: Funded
   
   Project Description: Successful proposal submitted to Zero to Three. The overall goals of the project are to 1) increase the number of providers trained in CPP, with the ultimate goal of 2) increasing access to evidence-based trauma interventions for young children and their families who are involved in the Rankin County Infant Toddler Court program.