Browsing by Author "Judd, Dallin"
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Item Complications Beyond Borders: A Case Study on a Retained Surgical Towel Leading to an Intra-Abdominal Abscess Post-Hysterectomy(2024-03-21) Oldham, Jake; Judd, Dallin; Hawes, Jaden; Stucki, Brenton; Boyack, BryantBackground: The advancement of surgical techniques and procedures has dramatically improved healthcare outcomes globally. Despite these advancements, surgical interventions inherently carry the risk of complications, some of which can be severe and life-altering. Case Presentation: This report details a severe complication following a hysterectomy performed in Mexico on a 46-year-old woman, who developed an intra-abdominal abscess due to a retained surgical towel—a rare but grave surgical error. Initially, her post-surgical symptoms, including abdominal pain, fever, and malaise, were dismissed by her surgeon in Mexico as typical recovery effects. However, as her condition deteriorated, she sought emergency care in Arizona. A CT scan unveiled a significant abscess in her abdomen, marked by a radio dense ribbon indicative of the forgotten surgical towel. Emergency intervention was necessary to extract the towel and address the abscess, further complicated by the discovery of a multi-drug resistant organism. Conclusion: This incident highlights the paramount importance of adhering to surgical safety standards, the potential hazards of seeking medical procedures abroad, and the necessity for diligent postoperative monitoring and open communication between patients and their medical teams.Item Effectiveness of AI Use in Qualitative Abstract Coding(2024-03-21) Alkhatib, Sarah; Jiwa, Nadiya; Judd, Dallin; Walters, ScottPurpose: As the field of qualitative research continues to evolve, the integration of artificial intelligence (AI) methods into data analysis has garnered increasing attention. This research paper presents a comparative analysis that evaluates the effectiveness, advantages, and disadvantages of utilizing AI methods for qualitative analysis of innovation characteristics of grant abstracts from the NIH RePORTER database, compared to traditional manual approaches. By comparing AI results to manual coding results, this project explores the potential transformative impact of AI on qualitative research. Methods: As part of the NIH HEAL initiative, researchers manually coded over 700 HEAL abstracts to examine innovation characteristics of grants funded. Survey questions included the type of study, study innovation, primary goals, and expected outputs. To explore whether these abstracts, when prompted in ChatGPT v4.0 would yield the same results as a human coder, we will input 100 of the 700 coded abstracts into ChatGPT, entering the same instructions given to the human coders. A comparative analysis will then assess and score the output in terms of detail, depth, relevance, and completeness of the responses. Results: We expect there to be no major differences between human and ChatGPT coding. This would suggest that AI can produce valid qualitative coding outcomes, potentially streamlining some research processes that involve abstracting themes from textual data and opening new possibilities for large-scale qualitative analysis. Conclusions: Ultimately, the findings of this study have the potential to shape the direction of qualitative research, offering valuable guidance to researchers and practitioners on the feasibility and reliability of integrating AI methods into their work. This research will contribute to the ongoing discourse on the role of AI in qualitative research and provide a foundation for future investigations in this rapidly evolving field.Item Hyperemesis Cannabinoid Syndrome Chart Review(2023) Patterson, Tyler; Porter, Cardon; Birky, Jaxton; Judd, Dallin; Zhang, Fan; Espinoza, Anna; Galke, Curtis; Petersen, JamesPurpose: The purpose of this research study is to determine if the combination of Compazine and Benadryl is a superior method of treatment for patients who present with nausea and vomiting symptoms due to a diagnosis of Hyperemesis Cannabinoid Syndrome. Based on patient charts from a regional hospital emergency department in Oklahoma, an analysis was performed to determine if this combination of medications is more effective in quickly reducing the nausea, vomiting, and other symptoms associated with cannabis use.Methods: An agreement was created between a regional hospital in Duncan Oklahoma and The University of North Texas Health Science Center which allowed students at the Texas College of Osteopathic Medicine to review and analyze a total of 75 patients’ charts from the regional hospital. IRB approval was obtained for this project. The chart review process consisted of evaluating the patient's age, chief complaint, abnormal lab values, history of present illness (HPI), and medications administered in the emergency department. The important variables that assisted in this study were drug screening values, and the medications administered. The main outcome for which statistical efficacy of drug treatment was measured by duration of stay in the emergency department and whether or not an additional dose of medication was given. Results: This chart review showed that the 12 patients that used the Benadryl and Compazine combination had a decreased time spent in the emergency department by an average of 56 minutes when compared to 38 patients who received alternative medications. The average time spent in the emergency department for those who received Benadryl and Compazine was 127 minutes vs the average time spent for those using an alternative medication was 183 minutes. The typical dose was 50 mg of Benadryl and 10 mg of Compazine. While using an ANOVA statistical analysis these doses showed a significantly statistical relationship by decreasing provider-to-discharge time with a p value of 0.012. It was also found while using a logistic regression analysis that those patients who received this combination as their initial dose were less likely to receive a second dose. This relationship also was statistically significant with a p value of 0.005. It was also noted in the logistic analysis that females were more likely to receive a second dose when compared to men. This relationship also showed a relationship with significance and a p value of 0.037. Conclusions:The findings from this study recommend and encourage providers who are in a setting where Hyperemesis Cannabinoid Syndrome is prevalent to consider the medication combination of 50 mg of Benadryl and 10 mg of Compazine when providing treatment. There may be multiple ways to alleviate the discomfort and symptoms that patients may present with, however the combination stated above appears most effective to reduce provider-to-discharge time 56 minutes and eliminate second doses of medication based off of the data reviewed from the charts provided.Item Multiple Myeloma in a Cadaver: A Case Report(2023) Kalman, Kyra; Judd, Dallin; Hochberg, Dovey; Johnson, Darrian; Jewell, LaurenIntroduction: Multiple Myeloma (MM) is a malignant neoplasm characterized by the abnormal proliferation of monoclonal immunoglobulin producing plasma cells within the bone marrow. The risk of developing MM is 0.76%; however, risk factors include age, BMI, gender, and race. Common complications include destructive bony lesions and renal insufficiency. Extraosseous myelomatous masses are a rare finding, identified in less than 5% of patients with MM, and its presence is associated with more aggressive, advanced stage disease and poor prognosis. These masses can impact many organ systems but most commonly involve the spleen, lymph nodes, liver, and kidneys. Pancreatic involvement, however, is extremely rare. Infiltration of the pancreas by myeloma cells has an incidence of 2.3% based on autopsy studies. Case Information: A medical dissection of a 58 year old woman was performed in the UNTHSC Center for Anatomical Sciences. The donor was 5’4”, 114 pounds, with a BMI of 22.3. The donor presented with a history of chronic tobacco use at 2 packs/day, unspecified broken bones, MM, and chemotherapy. The examination of the cadaveric specimen yielded insight into the systemic ramifications of MM, uncovering various pathological deviations. The donor's lung tissue exhibited signs consistent with prolonged usage of tobacco, as evidenced by the presence of discoloration and mottling. The kidneys displayed extensive scarring and a significant presence of adipose tissue. Most significantly, a large pancreatic tumor measuring 17 x 5.8 x 4 cm and weighing 167.65 g was found encasing the splenic artery. The sectioned tissue sample looked uniformly tan-white, firm, and mottled. Further dissection revealed an additional neoplastic growth on the posterolateral wall of the pelvic cavity. This tumor was situated anterior to a bony lesion on the sacrum and was found to be impinging upon the surrounding neurovasculature. Conclusion: This case exemplifies the complexities and nuances of Multiple Myeloma, highlighting the systemic nature of the disease and the need for a comprehensive understanding of its potential complications. Identification of scarring in the cadaver's kidney indicated that the patient's MM had caused the congregation of monoclonal immunoglobulins in the renal tissue, triggering profibrotic mechanisms and impaired renal function. The sacral bony lesion is a characteristic MM manifestation of heightened bone reabsorption and elevated osteoclast activity. Furthermore, this may have also led to the donor’s history of unspecified fractures in the arm and leg. The discovery of a large pancreatic neoplasm in this case is an extremely rare complication of MM, with an incidence of only 2.3%. Metastatic pancreatic involvement is not normally diagnosed as an aspect of the clinical progressive course of MM and is associated with poorer prognoses. Therefore, this case serves as a call to action for the medical community to continue to explore and understand the underlying mechanisms of extraosseous myelomatous masses and their presentation to improve the diagnosis and treatment of patients with MM. It is a testament to the ongoing need for research, education, and awareness in the fight against this debilitating disease.Item Opioid Crisis Breakdown in Tarrant County(2023) Conley, Mark; Judd, DallinPurpose: It is undisputed that opioids, while they have inherent medicinal value, can be abused recreationally leading to devastating effects. According to the CDC, Texas had the 6th most related deaths from opioids in 2019[1]. There were 3136 opioid related deaths in 2019 in the state of Texas [1]. It has been noted by physicians that Tarrant County in particular has seen a high incidence. The purpose of this research was to quantify the data surrounding opioid use in Tarrant County. Data from the National Institute on Drug Abuse shows that overdose deaths from opioids have risen steadily across the country in the last decade with a sharper increase in the last few years [2]. Methods: Using a database from the Texas Department of State Health Services we identified all calls, visits, and deaths related to opioid use [3]. The following metrics were used: Total opioid related deaths in Tarrant County and opioid deaths filtered by age, sex, race, education status, and marital status in Tarrant County. Total emergency department (ED) visits and ED visits per 100,000 population and per 100,000 ED visits in Tarrant County. The type of opioid related to each ED visit in Tarrant County was quantified as well. Finally, poison center opioid-related calls were totalled in Tarrant County. Results: Out of 254 counties in the state of Texas, Tarrant County recorded the 5th highest number of opioid related deaths in 2019, with 75 total deaths and a rate of 8 per 100,000 population. These opioid related deaths were most focal in the age range of 18-44 (72%). Of the total deaths, 65% of them were white and 68% were male. Of note, 70% of the users who died were not married, while 30% were married. Of these deaths, the most significant portion were by non-heroin opioids (34%), followed by heroin users (15%). In addition, in 2019 there were 244 poison center calls related to opioids. Finally, in 2019 there were a total of 774 ED visits related to opioids, with a rate of 87.5 visits per 100,000 ED visits. Conclusions: As indicated in the results, both the state of Texas and Tarrant County have been negatively impacted by the epidemic rise in opioids. Texas has sought to alleviate some of the disparities, and funding was received by the U.S. government. Beginning in May 2017, under the Texas targeted Opioid Response Program, Texas has received over $280 million in federal funding to address the opioid crisis [4]. However, the data presented in the case report (objective opioid related outcomes in 2019) demonstrates that more needs to be done. In response to the high prevalence of deaths, emergency room visits, and opioid related calls, it is critical that Texas mounts a proportional response. This response may be both systemic and individualistic as people are educated on the effects of opioids and what they can do to prevent negative outcomes.Item Osteogenesis Imperfecta: Implications of Using Micro-CT for Visualizing Developmental Variation in the Middle and Inner Ear of OIM Mice(2023) Judd, Dallin; Stucki, Brenton; Miller, Courtney; Handler, Emma; Menegaz, Rachel A.; Gonzales, LaurenOsteogenesis Imperfecta: Implications of Using Micro-CT for Visualizing Developmental Variation in the Middle and Inner Ear of OIM Mice Dallin R. Judd1, Brenton R. Stucki1, Courtney A. Miller2, Emma Handler3, Rachel A. Menegaz2, Lauren A. Gonzales2 1 Texas College of Osteopathic Medicine, University of North Texas Health Science Center, TX 2 Department of Physiology and Anatomy, University of North Texas Health Science Center, TX 3 Department of Anatomy and Cell Biology, University of Iowa, IA Osteogenesis imperfecta (OI), also known as brittle bone disease, is a genetic bone disorder caused by mutations in the genes COL1A1 and COL1A2, which are responsible for encoding type I collagen. Much is known regarding the effects of the disease on cranial and postcranial elements. However, little is known regarding the pathogenesis and physical manifestations of OI in the ear despite the high rates of hearing loss in patients with OI (~60% of the population is affected). Because ossification or demineralization of structures in the ear may affect the efficacy of certain treatments like cochlear implants, this information deficit limits the treatment options available for OI patients. Thus, the purpose of our research is to visualize and document anatomic variation in the ears of mice bred to have the Type III OI genetic variant in order to better understand the cause of OI-related hearing loss. 3D models of the middle and inner ears were created from micro-CT scans that also employed two new contrast-enhanced methods to visualize the cochlea and middle ear (malleus, incus, and stapes). All CT scanning were done on the UNTHSC campus using the new Small Animal Imaging Facility (SAIF) as part of a previous study. The scan resolution was approximately 20μm. The studied WT and OIM mouse samples include three time points intended to capture a developmental sequence: 0-day-old (WT=20, OIM=29), 7-day-old (WT=23, OIM=23), and 14-day-old mice (WT=22, OIM=18). The visualization software Avizo was then used to digitally segment the bone of the inner ear and middle ear. Gross anatomic differences are currently being documented for each region. Previous work has shown higher levels of ossification and marked bony encroachment of the otic capsule onto the cochlea in the adult OIM mouse model, potentially damaging the soft tissue of the membranous labyrinth. This research uses micro-CT imaging designed to capture a developmental sequence, giving us the potential to elucidate how and when the bony intrusions are impacting surrounding structures. Insight into this anatomical damage may help further clarify OI-related pathology, including the distinction between hearing loss associated with the middle ear (conductive hearing loss) vs. hearing loss associated with the inner ear (sensorineural hearing loss). Furthermore, a preliminary analysis of the developmental sequence should provide insight into when these anatomical changes are first occurring. Upon completion, this research will demonstrate the efficacy of using these new imaging approaches for studying minute structures of the ear and may markedly advance our understanding of the pathogenesis of OI-related hearing loss.Item Resources and Opportunities Available for Allopathic and Osteopathic Medical Students Pursuing Otolaryngology: A Comprehensive Analysis(2024-03-21) Stucki, Brenton; Patel, Arpan; Judd, Dallin; Bruner, WilliamIntroduction: Otolaryngology, commonly known as Ear, Nose, and Throat (ENT), is a surgical subspecialty dedicated to addressing conditions of the head and neck. It is no surprise that matching into surgical subspecialties such as otolaryngology - head and neck surgery becomes more and more competitive each year. Data indicates that each year on average, students are performing at higher levels than years previous. This increase in competitiveness prompts the development of resources including specialty-specific information to be made more readily available to students. This review aims to identify key ENT organizations in the United States that may provide pivotal tools for medical students. Through an analysis of these organizations, this study reveals opportunities available to medical students through organizations such as research opportunities, conference scholarships, mentorship programs, and avenues for leadership roles. Furthermore, emphasizes the significance of research experience, leadership roles, academic performance, and compelling letters of recommendation, which are crucial in the application process. By focusing on these critical aspects, the primary aim is to highlight resources that can equip medical students with the necessary skills and experiences to apply for an ENT residency successfully.Methods:147 organizations were identified by the University of North Texas Health Science Center (UNTHSC) Gibson Library. A search conducted then by three independent researchers via Google Search contributed an additional 30 organizations. The combination of these sources resulted in a preliminary list of 177 organizations. Three duplicates were eliminated, thus decreasing the list to 174 unique organizations. The next stage of screening was predicated on the relevance of these organizations to the field of Otolaryngology. Three independent researchers excluded 129 entities sourced from the UNTHSC Gibson Library. Further reviews were conducted and a finalized cohort of fourteen national otolaryngology - head and neck surgery organizations were selected for comprehensive evaluation. Information regarding the following information was gathered and compiled for review and comparison: Organization Focuses on a Subspecialty of Otolaryngology, Organization Allows Both MD and DO Student Membership, Medical Student Cost to Join Organization, Annual Meeting, Research Presented at Annual Meeting, Medical Students can Present at Annual Meeting, Medical Student Registration Fee for Annual Meeting, Annual Meeting Registration / Travel Scholarships Available for Medical Students, Mentorship Available Within the Organization for Medical Students, Leadership Opportunities Available for Medical Students, Scholarships/Grants Available for Medical Students, Educational Material Available to Medical Students. Results: The comprehensive analysis highlighted resources and opportunities available for allopathic and osteopathic medical students pursuing otolaryngology. These entities offer numerous benefits, including research opportunities, educational materials, annual meetings, and access to subspecialties. These organizations can provide a competitive edge to medical students who take advantage of these benefits. Conclusion: In conclusion, this analysis underscores the vital support that professional organizations offer to medical students pursuing otolaryngology, highlighting the significance of mentorship, research opportunities, and educational materials. It urges medical students to actively engage with these organizations to enhance their career prospects in this field. However, identified gaps in mentorship, travel financial aid, and leadership roles point towards areas needing enhancement.Item The Opioid Epidemic: A Review of the Contributing Factors, Negative Consequences, and Best Practices(Cureus, Inc., 2023-08-11) Judd, Dallin; King, Connor R.; Galke, CurtisThe opioid epidemic is a significant public health crisis that has caused extensive harm and devastation in the United States. This literature review aimed to identify the contributing factors and negative consequences of the epidemic, as well as best practices for healthcare providers in managing the epidemic. Overprescribing opiates and opioids, lack of education and opportunity, and being unmarried or divorced were some of the identified contributing factors to dependence on opioids. The epidemic's negative consequences are substantial, leading to increased access to opioids for vulnerable populations, which consequently cause accidental death among men and the degradation of rural community health services. As part of the literature review, we also analyzed the best practices for healthcare providers, including implementing prescription drug monitoring programs (PDMPs). However, we found that while PDMPs resulted in a decrease in opioid overprescription and an increase in provider confidence when prescribing medication, the evidence for their effectiveness in improving rural community health services or reducing opioid overdoses and opioid-related deaths was inconclusive. Our review highlights that the greatest challenge to overcome is a lack of legal mandates and proper education for healthcare providers on best practices for addressing the epidemic. To regulate and control opioids effectively, tracking and standardizing prescription models by federal agencies and medical institutions is necessary but not enough. Legal action is vital for the successful containment of the opioid crisis.Item Variant Blood Supply of the Superficial Face: A Case Report(2024-03-21) Stucki, Brenton; Fowers, Rylan; Judd, Dallin; Van Alfen, Braden; Rosales, Armando; Lovely, RehanaIntroduction: The facial and transverse facial arteries provide the major arterial supply for the superficial face. The facial artery arises from the external carotid artery, in the carotid triangle of the neck, and crosses the angle of the mandible as it ascends the anterolateral face. Following a distinctive course, it continues by running along the oral commissure where it gives off the superior and inferior labial branches. Continuing its trajectory, the artery ascends along the nasolabial sulcus, providing the lateral nasal branch, and concludes its course by terminating as the angular branch near the medial aspect of the eye. The transverse facial artery, which arises from the superficial temporal artery, has a significant role in lateral face vascularization by supplying blood to the parotid gland, masseter, and integument and terminating near the buccal area. Case Presentation: During a unilateral dissection of a previously hemisected head of a 78-year-old donor from the UNTHSC Willed Body program, variations of the facial and transverse facial arteries were observed. The superficial and deep structures of the face were subsequently dissected and cleaned to expose arterial origins and terminations. The variant anatomical structures were then noted and photographed. The facial artery arose from the external carotid between the lingual and occipital arteries. After crossing the angle of the mandible, the variant facial artery terminated below the oral fissure, supplying blood to the lower face only. The transverse facial artery arose from the superficial temporal, running deep to the parotid gland extending across the lateral face. It then continued in the typical path of the facial artery, following the nasolabial sulcus supplying the muscles and tissues above the oral fissure. It was observed that this variant transverse artery supplied blood to the superficial face instead of the facial artery. Conclusion: The face, like the rest of the human body, has a variety of documented anatomical variations. The observed anatomical variations of the facial and transverse facial arteries highlight the complexity and diversity regarding the vascular supply of the face. The documentation of such variations serves as vital information in clinical and surgical practice to yield the best patient outcomes during treatment.