Locations:
Search
The Cleveland Clinic Lerner of College of Medicine of Case Western Reserve University (CCLCM) is a five-year program dedicated to developing the next generation of physician investigators. Students are assigned dedicated physician and research advisors to help ensure they reach their goals. In their fourth year, students work with a mentor to develop a master’s-level thesis in basic science, translational medicine, clinical medicine or health systems. When the students graduate, they each receive an MD with Special Qualification in Biomedical Research from Case Western Reserve University.
The research in which students are involved is critical, timely and often results in presentations at national conferences and publication in scholarly journals. The examples below briefly describe two students’ research projects, one that involves using ketamine to treat concurrent pain and depression, and another that evaluates the performance of a specialized implant in revision total hip arthroplasty, the findings for which were accepted as a podium presentation at the American Association of Hip and Knee Surgeons 2025 Annual Meeting:
“During my research year, I participated in the National Institute of Health's (NIH) Medical Scholars Research Program, a yearlong immersion program that brings medical students to the NIH and supports their professional development into physician-scientists. As part of this, I joined the laboratory of Carlos Zarate, MD, who is the current chief of the Experimental Therapeutics and Pathophysiology Branch at the National Institute of Mental Health (NIMH). Dr. Zarate's group is interested in novel therapeutics that will change how we practice psychiatry. One such therapeutic, and a major part of Dr. Zarate's work, is ketamine. Ketamine was traditionally thought of as an anesthetic, but over the past 20 years it has been recognized for having antidepressant effects as well. Ketamine is particularly exciting as a potential treatment because it has rapid onset (unlike traditional antidepressants) and may offer an alternative to patients who are otherwise resistant to traditional depression treatments.
“Because ketamine is used to treat both pain and depression, I wanted to explore whether patients who had concurrent pain and depression were more likely to benefit from ketamine treatment than those without pain. If patients with pain are, in layman's terms, "super-responders" to ketamine, that would help us better understand how the pathophysiology of pain and depression intersect, and it may provide us with a potent treatment for patients who are historically very hard to treat. My findings indicate that body mass index interacts with pain and ketamine treatment through a mechanism we don't yet understand.”
-Miranda Arakelian (’26)
“Revision total hip arthroplasty (rTHA) is a complex reconstructive procedure performed when a patient’s primary total hip arthroplasty fails. Due to the reconstructive challenges involved in rTHA, the use of specialized implants, including modular fluted tapered (MFT) femoral stems, has gained popularity over the past two decades. These stems provide several advantages in restoring joint mechanics and leg length, leading to improved patient outcomes. However, studies on these stems have been limited by small sample sizes and a lack of radiographic analysis.
“Our study evaluated the performance of MFT stems in aseptic rTHA, focusing on the incidences of reoperation, re-revision and stem subsidence, or loosening over time, and factors associated with these outcomes. The retrospective cohort study included 316 patients who underwent rTHA with MFT stems between 2015 and 2024. Over a 10-year follow-up period, 16.5% of patients underwent reoperation, while 10.1% required re-revision. Radiographic analysis showed that clinically significant stem subsidence occurred in 16% of cases. Additionally, we identified several factors linked to repeat surgeries and stem subsidence. Increasing age was associated with a lower risk of reoperation, while higher BMI was linked to increased risks of reoperation, re-revision and stem subsidence. No radiographic measurement was ultimately associated with any of the outcomes investigated. The results suggest that a femoral stem canal fill of at least 78% is sufficient to prevent reoperation, re-revision and stem subsidence, effectively establishing a threshold of canal fill that surgeons should aim for during aseptic rTHA. Further, younger patients and those with higher BMIs may require additional early follow-up visits or more cautious return to weight-bearing after surgery to reduce the chances of reoperation and stem loosening.”
-Michael Ramos (’26)
