Auburn Research Day 2021

Cl i n i ca l Case Repor t | Med i ca l St udent Metastatic Melanoma and Cancerous Invasion of Brain Tissue

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Alexys Ramos, OMS II; Brynn Hentschel, OMS II; Caroline (Emily) Houston, OMS II Edward Via College of Osteopathic Medicine

Background: Metastatic Melanomas commonly spread through hematogenous or lymphatic routes. In the case reviewed, metastatic melanoma invaded brain tissue. The regulatory mechanisms set in place to protect invasion of the brain parenchyma are extensive which raises questions about the pathogenesis of metastatic melanoma to the brain. Metastatic Melanoma is a disease of advanced ages and white race though cases have been identified in younger, more diverse populations with varying outcomes. Methods: Detailed review of a multitude of cases, articles, studies regarding demographic distribution, prognostic indicators, and pathogenesis of metastatic melanoma of the head and neck Results: Melanoma metastasis to the brain has turned out to be common due to the high levels of metastatic heterogenicity. It has been shown that cutaneous head and neck melanomas have a

poorer prognosis than those of other origins though there have been some noted discrepancies. Most patients with brain metastasis presented with another metastatic lesion in a different site (notably the lung or liver). Conclusions: The ability to invade the brain is incredibly intricate and should be further elucidated to better understand the potential diagnostic and treatment options. There is evidence that further understanding of these processes could assist in developing treatments that are more specific and effective.

Cl i n i ca l Resea rch | Med i ca l St udent Physical Activity Levels Among Hematopoietic Stem Cell Transplant Survivors

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Lacey Mead 1 ; Debra Lynch Kelly, PhD, RN, OCN 2 ; Wendy J Dahl, PhD 1 ; James C Colee 3 ; Zeina Al-Mansour, MD 4 ; Shai J Sewell 5 ; John Mizell 5 ; Michelle P Foley 5 ; John R. Wingard, MD 4 and Nosha Farhadfar, MD 4 (1)Food Science and Human Nutrition, University of Florida, Gainesville, FL, (2)Nursing, University of Florida, Gainesville, FL, (3) Department of Statistics, University of Florida, Gainesville, FL, (4)Department of Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, FL, (5)UF Health Rehabilitation, Acute Care Division, University of Florida, Gainesville, FL

Introduction: Adequate physical activity has been associated with a lower risk of chronic health conditions in the general population, yet no study to date has comprehensively documented the adherence of hematopoietic stem cell (HCT) survivors to the physical activity recommendation set by the American Cancer Society (ACS), specifically designed to provide guidance for individual choices regarding duration and patterns of physical activity. The aims of this study were to evaluate the extent to which HCT survivors adhere to the ACS recommendation of 150 minutes of moderate activity and 75 minutes of vigorous activity weekly and identify the risk factors associated with the lack of compliance. Method: The study included adults who had HCT and were at least 1-year post-HCT. Patients with chronic GVHD were excluded. Physical activity was assessed using a physical activity screening tool of the Block 2014 food frequency questionnaire which was constructed based off National Health and Nutrition Examination Survey (NHANES) data. The activity screener estimates minutes of activity with kilocalorie expenditure from several activity types. The physical activity was measured by the type of activity, frequency and intensity, which was then converted into a metabolic equivalent of task (MET) scores. A MET score of 500-1000 MET min/wk is equated to 150 minutes of moderate and 75 minutes of vigorous activity. A score of 0 – 499.0 MET min/wk indicates “inadequate activity”, 500- 1,000 MET min/wk suggests an “adequate activity” and >1000 MET min/wk indicates “highly vigorous activity.”

Results: The demographic characteristics of the cohort (n=81) are shown in Table 1. Median total physical activity energy expenditure was 531.2 kcal (Table 2). Nearly 85.2% of participants reported daily moderate activity, and 60.5% of participants had daily vigorous activity. A median of 18.0 and 5.9 min/day was spent in performing moderate or vigorous activity, respectively. A minority of survivors (17.3%) reported adequate physical activity defined as 150 min/ wk of moderate to vigorous-intensity physical activity. The median MET score of the entire cohort was 153.4 MET min/wk. The majority of the survivors (83%, n=67) reported an inadequate physical activity (MET min/wk < 500). Of the participants who achieved the recommendations, 3.7% (n=3) had a physical activity above the upper end of MET recommendations (>1000 MET min/wk). Longer time since HCT was the only factor associated with increased physical activity level (P = 0.02). There was no significant difference in physical activity according to race, age, gender, BMI and socioeconomic status. Conclusion: Majority of HCT survivors were not meeting the ACS physical activity recommendations. These findings reinforce the need to incorporate physical activity programs into HCT survivorship care in order to encourage a physically active lifestyle among HCT survivor

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