Saint Louis University

Joseph Rutledge
Second-year medical student Joseph Rutledge stands in front of the poster he will present at the 53rd Annual National Student Research Forum. (Photo by Ashley Pitlyk)

ST. LOUIS - Two Saint Louis University second-year medical students have been selected to compete in the 53rd Annual National Student Research Forum (NSRF), an event that gives graduate and medical students the opportunity to receive critical review and recognition of their biomedical research on a national stage. Andrew Melson and Joseph Rutledge will both present their research at the forum April 26-27 in Galveston, Texas.

Melson and Rutledge were selected to represent SLU after winning first place prizes at the School of Medicine's 47th annual Alpha Omega Alpha Medical Student Research Forum in January.

"Andrew and Joseph both produced outstanding research that has the potential to make significant contributions to medicine," said Michael Rauchman, M.D., associate professor in the department of internal medicine and a judge at this year's AOA Research Forum. "Andrew's innovative approach to an important patient care challenge could change the way doctors assess and communicate with their patients to improve compliance with their treatments.  Joseph's study, though looking at a rare disease, could provide new insight into isolated congenital hearing loss in newborns, a very common birth defect."

Beating the Odds

Melson's research was inspired by a desire to learn more about shared decision making between doctors and patients, a growing topic of interest in medicine. Much of the research in this area has looked at issues of health literacy - the capacity to obtain, process, and understand basic health information - which can prevent patients from following medical instructions and having a voice in complex medical decisions.

Similar to health literacy research, Melson chose to investigate health numeracy which refers to a patient's ability to understand and work with numbers. Given medicine's heavy reliance on statistics pertaining to health outcomes, strong numeracy is essential for patients to understand their options and make a medical decision that is right for them.

Melson's study asked patients in emergency departments to answer four basic math questions. He discovered that only four percent of the participants were able to answer all four questions correctly. These findings revealed that commonly used health literacy screening tools do not sufficiently screen for numeracy, which may cause low health outcomes for patients. His research could lay the groundwork for new interventions that will address low numeracy in patients.

Sound Research

Rutledge's study focused on Townes-Brocks syndrome (TBS), a rare genetic condition characterized by abnormally shaped ears, deformity of the hands and malformation of the anus. While these symptoms can usually be treated fairly easily with surgery, there is also a high association of premature hearing loss and kidney failure among TBS patients that can stay with them for the rest of their lives.

Joseph Rutledge
Rutledge analyzes specimens under a microscope. (Photo by Ashley Pitlyk)

Since little research had been conducted on hearing loss in TBS patients, Rutledge investigated the progression of the disease in animal models under the supervision of Michael Anne Gratton, Ph.D. To study the progression, Rutledge used a unique technology called auditory brainstem response (ABR) audiometry, a neurologic test that uses electrodes placed on the scalp to record the electrical activity of the brain in response to an auditory stimulus.

Rutledge also analyzed the cochleae in animal models to further understand the type of hearing loss experienced by TBS patients. He found that there was a significant decrease in hair cells and a decrease in the density of nerve fibers in TBS models than in models without TBS.

Rutledge's study provides the first evidence of the origin and development of TBS related hearing loss. His research suggests scientists might explore potential therapies to prevent the congenital hearing loss or delay the progression of hearing loss in TBS patients. It could also provide an earlier and more reliable diagnosis of TBS since hearing tests for newborns are required in 48 states.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, infectious diseases, liver disease, aging and brain diseases and heart/lung disease.