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2024

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Full-Text Articles in Internal Medicine

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve Jan 2024

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.


Subacute Defibrillator Lead Associated Right Ventricular Perforation In A Young Individual With Non-Ischemic Cardiomyopathy: A Unique Clinical Case, Jackson V. Littlejohn, Aditya Sharma, Marisha R. Sharma, Kamran Rizvi Jan 2024

Subacute Defibrillator Lead Associated Right Ventricular Perforation In A Young Individual With Non-Ischemic Cardiomyopathy: A Unique Clinical Case, Jackson V. Littlejohn, Aditya Sharma, Marisha R. Sharma, Kamran Rizvi

North Texas GME Research Forum 2024

Pacemaker-lead associated complications are often documented in elderly populations with ischemic heart disease. Acute perforations within 24 hours of implantation are the most common, and immediate life-threatening complications are most likely to occur during an acute perforation. Subacute perforations between 1 day and 30 days after implantation are less common and carry a lower risk of life-threatening complications. Here, we present a unique case of subacute right ventricular perforation in a young individual with non-ischemic cardiomyopathy, challenging the conventional understanding of such an occurrence. Further adding to the intrigue of our case, the patient had recurrent hospital visits both before …


Discharge Implementation Project: Ascertaining If Discharge Implementation Orders Overall Improves Discharge Metrics At A Texas Hospital, Zachary Paras, Omar Nawab, Komthorn Cunvong, Jackson V. Littlejohn Jan 2024

Discharge Implementation Project: Ascertaining If Discharge Implementation Orders Overall Improves Discharge Metrics At A Texas Hospital, Zachary Paras, Omar Nawab, Komthorn Cunvong, Jackson V. Littlejohn

North Texas GME Research Forum 2024

There are several factors preventing discharges out of the hospital within 24 hours that ultimately affects metrics for both hospital systems and physicians. These factors include pending labs, imaging, or procedures; pending placement approval at a facility outside of the hospital upon discharge; notification of family and caretakers; secured funding for devices and medicines; and others. In an attempt to mitigate preventable extra days spent in the hospital once a patient is medically ready for discharge, a Texas hospital implemented a discharge order set for providers to utilize that informs all involved parties including case management, PT/OT, social work, nurses, …


Myelodysplastic Syndrome With An Unusual De-Novo Gata1 Mutation In An Elderly Caucasian Male: A Case Report, Minh-Triet Nguyen, Maryam Fallahi, Talha Riaz Jan 2024

Myelodysplastic Syndrome With An Unusual De-Novo Gata1 Mutation In An Elderly Caucasian Male: A Case Report, Minh-Triet Nguyen, Maryam Fallahi, Talha Riaz

North Texas GME Research Forum 2024

Myelodysplastic syndrome (MDS) is a disorder of blood cell proliferation that has been shown to have multiple risk factors for pathogenesis. One risk factor well documented in existing literature is a mutation in GATA-binding factor 1 (GATA1) which is classically seen in younger individuals with Down syndrome. However, in our case report, we present an unusual presentation of MDS with a de novo GATA1 mutation in a 75-year-old male with no history of Down syndrome, who initially presented with isolaterombocytopenia. A 75-year-old male presented for evaluation of unexplained asymptomatic thrombocytopenia found incidentally on outpatient laboratory evaluation. Further evaluation of the …


Mast Cell Colitis Associated With Yersinia Enterocolitica, Olufemi Osikoya, Gregory Brennan Jan 2024

Mast Cell Colitis Associated With Yersinia Enterocolitica, Olufemi Osikoya, Gregory Brennan

North Texas GME Research Forum 2024

Introduction: Mast cells (MCs) have many functions including regulation of GI epithelial homeostasis, cross talk of the brain gut axis, host immune defenses, and inflammatory pathways. MCs are found in all layers of the GI tract and have been implicated in various gastrointestinal diseases. Although previously described in the literature, mast cell colitis is not considered a distinct clinical entity. This poses a challenge to the gastroenterologist who encounters such pathologic findings. Case Presentation: This is a case of a 76-year-old woman who was referred to the gastroenterology clinic for evaluation of a new diagnosis of colitis. The patient …


Gut Fermentation Syndrome: Unraveling The Enigma Of Auto-Brewery Syndrome., Jatin Sadarangani, Vaishnavi Singh, Sathish Karmegam Jan 2024

Gut Fermentation Syndrome: Unraveling The Enigma Of Auto-Brewery Syndrome., Jatin Sadarangani, Vaishnavi Singh, Sathish Karmegam

North Texas GME Research Forum 2024

A disorder known as "auto-brewery syndrome" or "gut fermentation syndrome" occurs when bacteria or fungus in the urinary, oral, or gastrointestinal tract ferment endogenously, producing ethanol. Patients with auto-brewery syndrome frequently report eating a diet heavy in sugar and carbohydrates and exhibit many of the symptoms and indicators of alcohol intoxication while disputing alcohol consumption. Research on Nonalcoholic Fatty Liver Disease indicates that endogenous alcohol synthesis may have bacterial roots; these bacteria may also be the causative agents in GFS. Probiotics, low-carb diets, anti-fungal medications, and antibiotics are currently used as therapies for GFS. Fecal microbiota transplantation may also have …


A Bullous Eruption In An 81-Year-Old Male, Garrett S. Furth, Christian J. Scheufele, Carlos S. Bahrami, Stephen E. Weis Jan 2024

A Bullous Eruption In An 81-Year-Old Male, Garrett S. Furth, Christian J. Scheufele, Carlos S. Bahrami, Stephen E. Weis

North Texas GME Research Forum 2024

INTRODUCTION: When a patient presents with a blistering rash arriving at the diagnosis can seem overwhelming. Bullous Pemphigoid (BP) is the most common autoimmune blistering disease and tends to affect older individuals, with a mean age of presentation of eighty. It is caused by antibodies targeting the basement membrane zone, the structure between epidermis and dermis, specifically affecting the BP180 (Type-XVII collagen) and BP230 (a plakin) proteins. Antibody-antigen complexes lead to complement activation and destruction of these transmembrane proteins, causing separation of the epidermis and dermis, and formation of tense, subepidermal blisters and bullae. Identification of key clinical features and …


The Impact Of Tamsulosin And Duration In Catheter-Associated Uti (Cauti) At Weatherford, Feeza Hasan, Diana Steedley, Maria Guerrero, Muhammad Siddique Jan 2024

The Impact Of Tamsulosin And Duration In Catheter-Associated Uti (Cauti) At Weatherford, Feeza Hasan, Diana Steedley, Maria Guerrero, Muhammad Siddique

North Texas GME Research Forum 2024

Among Catheter-Associated Urinary Tract Infections (CAUTI) acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). The most important risk factor for developing a CAUTI is prolonged use of the urinary catheter. Therefore, catheters …


Stop Horsing Around: A Case Of Cenbuterol Toxicity, Justin Sanchez, Mark Cheneler, Alexandra Villacres Jan 2024

Stop Horsing Around: A Case Of Cenbuterol Toxicity, Justin Sanchez, Mark Cheneler, Alexandra Villacres

North Texas GME Research Forum 2024

Introduction: Clenbuterol is a medication that is relatively unknown outside of the equestrian and bodybuilding worlds. It acts as a sympathomimetic compound with beta-2 agonism and can cause tachycardia and bronchodilation. It is utilized for this bronchodilation as a means of improving equestrian performance. Its sympathomimetic effects were utilized in the bodybuilding community as a weight loss medication by increasing catabolic metabolism. Here we present a case of intentional clenbuterol toxicity for weight loss. Case presentation: A 34-year-old woman with past medical history of migraines presented to the emergency department for evaluation of palpitations and an EKG showed sinus …


Improving The Screening For Abdominal Aortic Aneurysm At Grand Prairie Internal Medicine Clinic ​, Riddhi H. Patel, Danielle Ford Jan 2024

Improving The Screening For Abdominal Aortic Aneurysm At Grand Prairie Internal Medicine Clinic ​, Riddhi H. Patel, Danielle Ford

North Texas GME Research Forum 2024

Introduction: An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. This QI project will involve MCA residents and Grand Prairie clinic attending to incorporate screening for abdominal aortic aneurysm guidelines used by USPSTF and attempt to encourage all our established and new patients who fit into the criteria for …


Cyanide Toxicity Induced By Apricot Kernel Consumption: A Case Report, Jatin Sadarangani, Vaishnavi Singh, Benjamin K. Kingsly Jan 2024

Cyanide Toxicity Induced By Apricot Kernel Consumption: A Case Report, Jatin Sadarangani, Vaishnavi Singh, Benjamin K. Kingsly

North Texas GME Research Forum 2024

Functional foods are food items that should be consumed as part of a regular diet in order to provide advantages beyond what are typically referred to as traditional nutritional benefits. Furthermore, in order to support the better function claim or the decreased illness risk claim, these positive outcomes must be scientifically proven. Foods with particular health benefits have been referred to as "superfoods" more recently. Superfoods are conceptually defined as foods with high biological value because of their high concentration of bioactive components and high concentration of nutrients, as well as their high bioavailability and bioactivity in the body. As …


Thymoma With Paraneoplastic Myasthenia Gravis, Dallin Beus, Sherwin Thomas, Amnah Andrabi Jan 2024

Thymoma With Paraneoplastic Myasthenia Gravis, Dallin Beus, Sherwin Thomas, Amnah Andrabi

North Texas GME Research Forum 2024

Background: Myasthenia gravis is an autoimmune neuromuscular disorder characterized by muscle weakness and fatigue. Paraneoplastic myasthenia gravis, a rare manifestation of this condition, is often associated with underlying malignancies, such as thymic tumors. We present the case of a 51-year-old female patient with a mediastinal mass who developed paraneoplastic myasthenia gravis, highlighting the diagnostic challenges and therapeutic considerations in such cases. Case Description: A 51-year-old female presented with a one-month history of progressive muscle weakness, diplopia, and dysphagia. Clinical examination and serological tests led to the diagnosis of myasthenia gravis. Computed tomography (CT) imaging revealed a 6 cm mediastinal mass, …


Streptococcocal Induced Toxic Shock Syndrome: Importance Of Diagnosis And Initiating Life Saving Treatment, Lincy Sakwa, Danielle Ford Jan 2024

Streptococcocal Induced Toxic Shock Syndrome: Importance Of Diagnosis And Initiating Life Saving Treatment, Lincy Sakwa, Danielle Ford

North Texas GME Research Forum 2024

Toxic Shock Syndrome (TSS) is a toxin induced illness characterized by fever, rash, and hypotension. TSS low incidence report and rapid onset of clinical symptoms makes getting to the diagnosis critical so that treatment can be started as soon as possible. A 65-year-old woman was brought into the emergency department (ED) after being found on the floor unresponsive during a well fair check. It was noted that she has not been seen or heard from by her family members in the last five days. She has no known past medical history and she was unresponsive and hemodynamically unstable in the …


Early Implementation Of Chf Orders And Physician Education​, Qazi Haider, Tapannita Padhi, Hunter Thornberg, Barry Brown, Alexandra Villacres Jan 2024

Early Implementation Of Chf Orders And Physician Education​, Qazi Haider, Tapannita Padhi, Hunter Thornberg, Barry Brown, Alexandra Villacres

North Texas GME Research Forum 2024

Each year, 700,000 patients are hospitalized with acute decompensated congestive heart failure. In order to effectively treat these patients, they require delicate management of volume status. Measuring volume status incorporates the following components: recording strict inputs and outputs of urine/fluids, recording daily standing weights and fluid restriction. This project focused on recording daily weights as a measure of accurate volume status and how that affected length of hospital stay. Data will be gathered by patient chart review including patient's admitted from Jan 2023 -Jan 2024 at Medical City Weatherford admitted with a primary/admitting diagnosis of congestive heart failure. Using PDSA …


Rare Rectal Lipoma Case Report, Victoria Nguyen, Sean Sojdie, Kunal Elete, Justin Richardson, Long Hoang Jan 2024

Rare Rectal Lipoma Case Report, Victoria Nguyen, Sean Sojdie, Kunal Elete, Justin Richardson, Long Hoang

North Texas GME Research Forum 2024

INTRODUCTION: Colonic lipomas are rare, benign non-epithelial lesions of the gastrointestinal (GI) tract that predominantly affect elderly females and often found in the ascending colon. They are least common in the rectum, with a prevalence of 3.4%. Lipomas can grow to cause abdominal pain, bleeding, or obstruction. We report an incidental finding of a rectal lipoma in a patient presented with rectal bleeding. CASE: A 70 year-old male with a history of migraines presented to the hospital for two weeks of rectal bleeding and syncopal episode prior to arrival. Patient had visited the emergency department two weeks prior, but hemoglobin …


Increasing Online Reviews And New Patients In Clinic With Qr Codes, Tristan Fun, Danielle Ford Jan 2024

Increasing Online Reviews And New Patients In Clinic With Qr Codes, Tristan Fun, Danielle Ford

North Texas GME Research Forum 2024

Introduction: Patient census at the Medical City Internal Medicine Grand Prairie clinic has been lower comparatively to other HCA Healthcare clinics. Although the cause can be multifaceted, the clinic’s online presence (e.g. Google Maps) is minimal. One initial issue with the clinic’s online presence was the lack of reviews on the Google page for the clinic. One way to increase online reviews is to provide Quick Response (QR) codes in the clinic for patients to scan on their smartphone. The goal of this project is to increase the number of Google reviews for the clinic through QR codes to at …


Colon Cancer Symptom Progression In A Non-Adherent Patient: A Case Report, Nasima Mehraban, Bradley Gustafson, Saad Hussain, Amjad Awan Jan 2024

Colon Cancer Symptom Progression In A Non-Adherent Patient: A Case Report, Nasima Mehraban, Bradley Gustafson, Saad Hussain, Amjad Awan

North Texas GME Research Forum 2024

BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer mortality and third leading cause of incidence worldwide; accounting for one in ten cancer cases and deaths. Thirty-three percent of people between the age of 50 and 75 are not up to date on screening for colon cancer. Depending on the stage of CRC at the time of presentation, the range of chief complaints that bring patients to seek care for this single etiology is diverse, therefore, a thorough work-up is essential for diagnosis. CASE PRESENTATION: A 55-year-old patient presents to the hospital three times over the course …


Acute Mesenteric Ischemia In Patients With Covid-19, Tristan Fun, Natalie Hurlock, Danielle Ford Jan 2024

Acute Mesenteric Ischemia In Patients With Covid-19, Tristan Fun, Natalie Hurlock, Danielle Ford

North Texas GME Research Forum 2024

Introduction: Patient with COVID-19 are more likely to have thrombotic events, including deep vein thrombosis (DVT), pulmonary embolism (PE), and disseminated intravascular coagulation (DIC). There have been many case reports of patient with acute mesenteric ischemia (AMI) in the setting of COVID-19. Incidences of AMI occur in about 0.1% of acute hospital admissions. Short term mortality from AMI range from 26-86%. Therefore, early diagnosis and treatment are essential, yet diagnosis is difficult and AMI can often go unrecognized as a cause of death. This study attempted to establish the risk of patients with COVID-19 having acute mesenteric ischemia and compare …


Infectious Causes Of Cavernous Thrombosis: A Rare Case Of Mastoiditis, Koshin Ahmed, Suresh Antony Jan 2024

Infectious Causes Of Cavernous Thrombosis: A Rare Case Of Mastoiditis, Koshin Ahmed, Suresh Antony

Central & West Texas GME Research Day 2024

No abstract provided.


Controversies In Care: A Complex Case Of Infective Endocarditis In Bicuspid Aortic Valve, Cassandra Knott, Erik Aranda-Michel, Sreenidhi Chintalapani, Mary Achim, Bryce Rhodehouse Jan 2024

Controversies In Care: A Complex Case Of Infective Endocarditis In Bicuspid Aortic Valve, Cassandra Knott, Erik Aranda-Michel, Sreenidhi Chintalapani, Mary Achim, Bryce Rhodehouse

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.


Case Report Of Cortisol-Induced Pancreatitis, Jehidy Batista Michelena, Valentine Mwangi, Payal Passi, Oscar Garcia Jan 2024

Case Report Of Cortisol-Induced Pancreatitis, Jehidy Batista Michelena, Valentine Mwangi, Payal Passi, Oscar Garcia

Central & West Texas GME Research Day 2024

No abstract provided.


Saftey Of Doac Treatment In Splanchnic Vein Thrombosis, Allen Swanson, Trevi Mancilla, Hemantha Walaliyadda, Joshua White, Jonathan Sidlow Jan 2024

Saftey Of Doac Treatment In Splanchnic Vein Thrombosis, Allen Swanson, Trevi Mancilla, Hemantha Walaliyadda, Joshua White, Jonathan Sidlow

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.


Non-Invasive Ventilatory Support, Tube Feeding & Risk Of Aspiration Pneumonia, Jason Mae Chacon, Zuhaib Murtaza, Sarah Barraza, Judy Jin, Payal Passi Jan 2024

Non-Invasive Ventilatory Support, Tube Feeding & Risk Of Aspiration Pneumonia, Jason Mae Chacon, Zuhaib Murtaza, Sarah Barraza, Judy Jin, Payal Passi

Central & West Texas GME Research Day 2024

No abstract provided.


Can Clinical Reasoning Be Taught To Resident Physicians? Evaluating The Effectiveness Of A Clinical Reasoning Course On Residents' Cognitive Knowledge And Analytic Ability, Kenneth Krell, Sreenidhi Chintalapani, Kevin Trappett Jan 2024

Can Clinical Reasoning Be Taught To Resident Physicians? Evaluating The Effectiveness Of A Clinical Reasoning Course On Residents' Cognitive Knowledge And Analytic Ability, Kenneth Krell, Sreenidhi Chintalapani, Kevin Trappett

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.


Flash Pulmonary Edema Secondary To Persistent Left Superior Vena Cava, Jack Demirjian, Rohan Divecha, Emmanuel Garrastegui-Mercado, Oscar Garcia Jan 2024

Flash Pulmonary Edema Secondary To Persistent Left Superior Vena Cava, Jack Demirjian, Rohan Divecha, Emmanuel Garrastegui-Mercado, Oscar Garcia

Central & West Texas GME Research Day 2024

No abstract provided.


A Rare Case Of Rapidly Progressive Glomerulonephritis During Chronic Immunosuppression With Mycophenolate, Elizabeth O. Uba, Ryan Knight, Trevi Mancilla, Tarek Barbar Jan 2024

A Rare Case Of Rapidly Progressive Glomerulonephritis During Chronic Immunosuppression With Mycophenolate, Elizabeth O. Uba, Ryan Knight, Trevi Mancilla, Tarek Barbar

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.


Pantoprazole Induced Pancytopenia In A Post-Chemotherapy Patient: A Case Report, Rohan Divecha, Caleb Nieves, Paul Mathew Jan 2024

Pantoprazole Induced Pancytopenia In A Post-Chemotherapy Patient: A Case Report, Rohan Divecha, Caleb Nieves, Paul Mathew

Central & West Texas GME Research Day 2024

No abstract provided.


Cutaneous Leishmaniasis In The Setting Of Syphilis On The Us-Mx Border, Jourdan Harper, Enkhbileg Batbileg, Andrew Bush, Cesar Calianga, Hector Zepeda Jan 2024

Cutaneous Leishmaniasis In The Setting Of Syphilis On The Us-Mx Border, Jourdan Harper, Enkhbileg Batbileg, Andrew Bush, Cesar Calianga, Hector Zepeda

Central & West Texas GME Research Day 2024

No abstract provided.


Mycobacterium Flavescens Infection: An Unusual Case Of Prosthetic Joint Infection, Peter Holleb, Suresh Antony Jan 2024

Mycobacterium Flavescens Infection: An Unusual Case Of Prosthetic Joint Infection, Peter Holleb, Suresh Antony

Central & West Texas GME Research Day 2024

No abstract provided.


Acute Calcific Tendinitis Of The Longus Colli: A Rare Cause Of Acute Neck Pain, Walker Pride, Kevin Tragesser, Patrick Oshakuade, Elizabeth Hicks Jan 2024

Acute Calcific Tendinitis Of The Longus Colli: A Rare Cause Of Acute Neck Pain, Walker Pride, Kevin Tragesser, Patrick Oshakuade, Elizabeth Hicks

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.