Winter 2013: Update on MOCEP Resident & Student Research Grants

POSTED: September 6th, 2013
POSTED IN: Winter 2013,

The goal of the Missouri Chapter, American College of Emergency Physicians Medical Student/Resident Research Grant is to facilitate the academic growth and research expertise of medical students/residents in emergency medicine and to promote research in emergency medicine. A maximum of $5,000 will be available each year. The number of awards granted will depend on the number and quality of proposals submitted. The grant is available to a senior medical student in good standing at any of the six Missouri medical schools planning to pursue a career in emergency medicine or to a resident in good standing in a Missouri ACGME or AOA approved Emergency Medicine Program. Applicants will be reviewed and scored by a panel appointed by the Missouri Chapter, American College of Emergency Physicians Board of Directors. Applications are judged based on the project’s relevance to emergency medicine and appropriateness of study methodology.

2011-2012 Sreeja Natesan, MD with Christopher Carpenter, MD (Washington University) Establishing Evidence for Evidence Based Medicine: A Multicenter Quantitative Analysis of Journal Club in Graduate Medical Education. Attaining Evidence Based Medicine (EBM) proficiency skills including the skill set to search the literature, critically appraise the volumes of material in a time efficient manner, and use the data in real time to answer practical patient-centric questions is becoming a prerequisite as an Emergency Medicine physician. Journal Club serves as a medium to teach EBM skills through systematically graded review of the literature on a monthly basis, however the residents’ retention and application of EBM skills learned in Journal Club is not clear. This study aims to investigate if a structured, systematically graded monthly Journal Club will increase EBM knowledge acquisition over the course of resident training at three EM residency programs (Eastern Virginia Medical School, Lehigh Valley, and Washington University-St Louis MO). Each program administered the Fresno test (a test that evaluates critical appraisal skills) to interns at the start of the year, and a second time just prior to completion of their residency program. The Fresno tests data has been collected and is now being reviewed by a statistician. Results should be available at the start of the new year with plans to publish our findings at the 2013 ACEP Research Forum.

2012-2013 Eva Moses, MD with Stacey House, MD (Washington University) Magnetic Modulation Biosensing for the Determination of Low Concentrations of Troponin I in Emergency Department Patients Being Evaluated for Acute Coronary Syndromes. Chest pain accounts for more than 8 million ED visits per year. Current evaluation for acute coronary syndromes involves electrocardiogram assessment and cardiac biomarker testing. Because of the delay in the rise of cardiac troponin with current troponin assays, serial cardiac biomarker assessment must be performed. As healthcare costs in the United States rise and emergency departments become increasingly crowded, more efficient ways to evaluate patients for acute coronary syndrome without sacrificing sensitivity or specificity are increasingly desired. Our study aims to apply a novel approach to the detection of low concentrations of cardiac troponin I. Magnetic modulation biosensing utilizes concentration of target proteins with magnetic beads which are set into periodic motion to allow the determination of low abundance proteins with high sensitivity. Over a period of 3 months we obtained a consecutive sample of 637 emergency department patients being ruled out for acute coronary syndrome. We collected plasma samples from troponin assays and plan to subject these samples to magnetic modulation biosensing to independently determine cardiac troponin concentration. These values will be compared to the clinical troponin values obtained. To evaluate the ability of a single negative troponin to rule out acute coronary syndrome, we are now completing a retrospective chart review of the patients to assess for a composite thirty day outcome of death, myocardial infarction, and revascularization. Rapid detection of patients suffering from acute coronary syndrome could lead to more rapid intervention and improved outcomes. Additionally, detection of low concentrations of troponin has the possibility of more quickly ruling out acute coronary syndromes which may result in reduced emergency department overcrowding, resource utilization, and healthcare cost.

2012-2013 Mary “Sammi” Paden with Evan Schwarz, MD and Michael Mullins, MD (Washington University) Measurement of 5-oxoproline (pyroglutamic acid) in patients with acute acetaminophen poisoning. Acetaminophen remains a commonly ingested medication with serious ramifications. Our current understanding of acetaminophen pharmacology doesn’t fully explain the clinical picture seen. The project builds on previous case reports that describe high but widely varying concentrations of 5-oxoproline in certain very sick patients with acute APAP poisoning with metabolic acidosis. 5-oxoproline is a by-product of disordered glutathione synthesis and metabolism. What remains still unknown is whether some or all acetaminophen poisoned patients develop oxoprolinemia in the absence of clinically apparent metabolic acidosis. If subclinical oxoprolinemia does occur, is there a dose-dependent relationship?