2022 Research Poster Competition Results

This year Georgia Academy of Family Physicians (GAFP) received a total of 31 research poster submissions from pre-med students, medical students, residents and physicians/fellows. Posters were accessible virtually to attendees and displayed on-site at the Annual Meeting in the Hallway of Learning. The winners in each category were then given the opportunity to present their research on the mainstage during a CME session.

GAFP is excited to share the research poster competition winners and their abstracts.

Assessing Factors that Contribute to Quality of Life of Federally Qualified Health Center Patients During COVID-19​

Lillian Fagan (premed student) at University of Georgia
Additional Author(s) – Reagan Bruce, LaKaiya Campbell, Peyton Matt

Abstract – Patients living in rural, underserved populations are at disadvantages when it comes to receiving adequate healthcare, and the negative impact the COVID-19 pandemic has had on this population only supports this understanding. There has been a lack of research analyzing how patients in Federally Qualified Health Centers (FQHC) in rural areas are affected by their sociodemographic factors while enduring the COVID-19 pandemic.

In the following study, quality of life was assessed in patients surveyed from various FQHC, in the Albany Area to gather data on the role that the patients’ sociodemographic factors play in influencing their overall quality of life.

While not the main focus of the study, the COVID-19 pandemic was studied through a couple of survey items to explore the impact it has had on the patients’ current well-being. The study gathered data from 195 participants with a majority of them being African American (73.16%). The Mental Component Summary (MCS) and the Physical Component Summary (PCS) were analyzed for the patients who completed the survey and allowed the researcher to explore the relationships between the various sociodemographic factors and the patients’ MCS and PCS. Interesting findings were produced from the study with one being the result that patients diagnosed with COVID-19 actually had higher MCS. It is understood that future research is needed to further analyze the comprehensive well-being of patients in the FQHC.

Anti-SARS-CoV2 Antibodies and Relapse of Multiple Sclerosis in a Patient on Anti-CD-20 Antibodies: A Case Report

Matthew Adams (medical student) at Medical College of Georgia
Additional Author(s) – Amy Bailey, M.D.

Abstract – Disease modifying therapies, such as ofatumumab, are life altering for the nearly 400,000 people in the United States living with multiple sclerosis. The COVID-19 pandemic, however, has brought new challenges for patients on these immunomodulatory therapies.

Current guidelines do not address the administration of antibody therapy for COVID-19 concomitant with antibody therapy for multiple sclerosis. A 36 year old non-Hispanic, Caucasian female with a past medical history significant for multiple sclerosis controlled with ofatumumab presented to clinic with a three week history of joint pain, swelling stiffness with associated clumsiness two months after having received sotrovimab to treat mild COVID-19, which also coincided closely with her ofatumumab injection. Physical exam and autoimmune labs were unremarkable. Her symptoms were determined to represent a flair of her multiple sclerosis, likely associated with her concomitant use of two different monoclonal antibody therapies. Despite current evidence suggesting that concomitant use of anti-CD20-monoclonal antibody treatment for multiple sclerosis and anti-SARS-CoV2 antibodies does not increase risk of disability or relapse of multiple sclerosis, the case presented suggests that there may be potential for relapse of multiple sclerosis. Further investigation is needed to assess the interaction between the two therapies.

A Curious Case of Liver Disease

Terrell Jenrette, M.D. (resident) at Atrium Health Navicent
Additional Author(s) – Samarth Patel, Lise Forestal, Sarah N. Choo-Yick

Abstract – Autoimmune Hepatitis (AIH) is a chronic and rare condition that affects 2 out of every 100,000 people worldwide.  This immune-mediated process destroys the liver in an irreversible capacity. This destruction presents in a variety of ways ranging from asymptomatic to acute liver failure. Multiple medications, toxins, viruses and vaccines have demonstrated the capacity to induce AIH in genetically predisposed individuals.

Since 2019, greater than 120 published case reports have documented an association between the COVID-19 vaccine and AIH. This association is not unique to the covid vaccine. It is a reasonable prediction that the prevalence of this condition may increase in the near future.  A missed or significantly delayed diagnosis can result in liver cirrhosis, portal hypertension, hepatocellular carcinoma, liver failure requiring transplant, and ultimately death.

Standard treatment for AIH is steroids with or without azathioprine. Patients with AIH have a good prognosis with early treatment (90% survival at 10 years). Symptomatic patients without treatment have an estimated mortality of 50% at 5 years. Recognizing AIH as a potential differential diagnosis for transaminitis is essential. The rarity of this condition presents the greatest obstacles to timely diagnosis and treatment. AIH must be considered when investigating patients with liver pathology.

Attention Deficit/Hyperactivity Disorder in Older Adults: A Literature Review on Prevalence and Best Practices in Diagnosis and Management

Aparna Mark, M.D. (physician/fellow), Decatur, GA
Additional Author(s) – Alyssa Style

Abstract – There is a significant knowledge gap in research on Attention Deficit/Hyperactivity Disorder (ADHD) in older adults. Emory Primary Care at Downtown Decatur, a community based primary care clinic, cares for a significant number of patients with ADHD across varying age groups, including those over 50 years of age. Concerns regarding cardiovascular side effects of stimulant medications make decision making about pharmacologic treatment of ADHD in older adults challenging and, in some cases, can be a barrier to diagnosis of ADHD in the first place.

We reviewed the literature to ascertain the prevalence of ADHD in older adults and its impact on their quality of life in order to gain awareness of the need for clinical diagnosis and treatment in this particular cohort. We subsequently reviewed the literature on best practices in ADHD management in older adults, including pharmacotherapy.

Estimated prevalence of ADHD in older adults from systematic reviews and meta-analysis is 2.18%. Data shows that ADHD has a negative impact on late life and that older adults may benefit from treatment. Individualized therapy for each patient in this age group is recommended to balance risk/benefit ratio when pharmacotherapy is considered as a treatment. Evidence suggests that older adults have similar beneficial responses to stimulant agents compared to younger patients. Starting at lower doses with slow titration as needed are cornerstone principles when prescribing for these patients. Further research into pharmacologic treatment in the >50 year age group is needed through controlled studies to evaluate risks of stimulant therapy.

Thank you to all who participated in the poster competition as all submissions were exceptional and deserve recognition. Congrats again to this year’s winners – Lillian Fagan, Matthew Adams, Dr. Terrell Jenrette and Dr. Aparna Mark. Please visit the GAFP ePosters site to explore all of the posters that participated in this year’s competetion.