Auburn Research Day 2022

12 Dr. Matthew Johnson, MD, Co-Author; Collin R. Vargas, OMS III, Co-Author; Kenneth NW. Appel, OMS III, Co-Author Fort Walton Beach Medical Center, Fort Walton Beach, FL; VCOM – Auburn Campus Cl i n i ca l Case Repor t | Med i ca l St udent Rhabdomyolysis And Compartment Syndrome in the Setting of Amphetamine Overdose and Prolonged Imobilization

Background: An increase in illicit drug use and abuse has continued to plague the United States. It has been noted that young men around age 35 and younger have been one of the most impacted groups, with substance abuse more than doubling in this population over the past decade [2]. In this case, the patient was found to have compartment syndrome with concomitant rhabdomyolysis after having been found down due to ingesting an unknown amount of amphetamine. Cases like this continue to increase as drug abuse epidemic escalates. Methods: Detailed review of a multitude of cases, articles, studies regarding etiology, pathophysiology and clinical features of both rhabdomyolysis and compartment syndrome individually and in the setting of illicit drug use.

Results: Compartment syndrome may have an insidious onset when paired with illicit drug use. It has been shown that early recognition and identification of compartment syndrome can lead to improved outcomes for the patient. Conclusions: Physicians should give great consideration of compartment syndrome to patients found down post-illicit drug use in order to promptly identify and treat the condition and to prevent negative outcomes. Attention should be given to patients in this population who complain of pain and motor/sensory deficits.

Cl i n i ca l Case Repor t | Med i ca l St udent Hemothorax and Laceration of the Left Ventricle 13

Kenneth NW. Appel, OMSIII, Cristina N. Negoescu, OMSIII, Julian A. Aguilar, OMSIII, Alexys N. Ramos, OMSIII, Collin R. Vargas, OMSIII, (2) Dr. Matthew Johnson M.D. (preceptor) Edward Via College of Osteopathic Medicine – Auburn Campus; Fort Walton Beach Medical Center

A patient surviving a hemothorax with a laceration of the left ventricle is an extremely rare patient case and associated with a low in-hospital survival rate. Early recognition and implementation of life-sustaining measures is paramount to the survival of traumatic injuries, especially to the heart. This study details the case of a 16-year-old male who presented to the ER with a 6-cm penetrating laceration just above the left costal margin in the anterior axillary line. The patient was hypotensive, but alert and combative with wounds that suggested a massive hemothorax, with suspicion for cardiac, diaphragmatic and lung injury. Upon insertion of a left chest tube,

copious amounts of blood were obtained. The patient’s fast exam revealed a collection of pericardial fluid. The patient underwent an emergent sternotomy with a laparotomy and thoracotomy, which showed a laceration of the left ventricle and inferior lobe of the left lung. The patient was placed on cardiopulmonary bypass, the cardiac laceration was sutured, and the left lower lobe of the lung was partially resected. Two thoracostomy tubes and one mediastinal tube were placed, and the patient was admitted to the ICU for recovery.

Cristina M Gaudioso, MD; Adam Nguyen, MPH; Emmanuelle Waubant, MD; and Eoin P Flanagan, MBBCh Washington University Pediatric MS and other Demyelinating Disease Center, St. Louis, MO; Department of Neurology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Edward Via College of Osteopathic Medicine -Auburn Campus; UCSF Regional Pediatric MS Center, San Francisco, CA B i omed i ca l Resea rch | Med i ca l St udent Frequencies of AQP4 And Mog Antibodies Among Pediatrics with Multiple Sclerosis: A Case-Control Study 14

Objective: Using a prospective cohort we aimed to determine the frequency of myelin oligodendrocyte glycoprotein (MOG)-IgG and aquaporin-4 (AQP4)-IgG among pediatric-onset multiple sclerosis (POMS) patients and healthy controls, compare outcomes in seronegative vs seropositive children, and identify predictors of final diagnosis. Methods: POMS patients and healthy controls were enrolled at 14 U.S. sites through a prospective case-control study on POMS risk factors. Serum AQP4-IgG and MOG-IgG were assessed using live cell-based assays.

Results: We included 1196 participants, 493 POMS and 703 controls. AQP4-IgG was negative in all participants. MOG-IgG was positive in 30/493 cases (6%) and 0/703 (0%) controls. Twenty-five of 30 MOG-IgG positives (83%) had MOG-IgG-associated disease (MOGAD) while 5/30 (17%) maintained a diagnosis of MS on re- review of imaging and medical records. Conclusion: MOG-IgG and AQP4-IgG were not identified among controls confirming their high specificity for pediatric CNS demyelinating disease. Five percent of those with prior POMS diagnoses ultimately had MOGAD; none had AQP4-IgG positivity.

13 2022 Via Research Recognit ion Day