Digital Commons Network^™

Perforated Congenital Sigmoid Diverticula Of A Pediatric Patient, Tamir Bresler, Ryan Meyer, Kevin Palmer, Philip Frykman

Far West Division GME Research Day 2023

No abstract provided.

Spontaneous Heterotopic Pregnancy: Diagnosis And Management, Katie P. Nguyen, Marlekah Hudspeth, Honey Milestone

Far West Division GME Research Day 2023

No abstract provided.

A Case Of Thrombolytic Associated Ich In The Setting Of Infective Endocarditis, Priscilla Yan, Lama Al-Khoury

Far West Division GME Research Day 2023

No abstract provided.

Fumarate-Hydratase Deficient Leiomyoma – An Opportunity To Intervene, Gul Wymer, Brittany Nagel, Susana Ferra

East Florida Division GME Research Day 2023

No abstract available.

Managing Recurrent Delayed Pleural Effusion Post Rib Fracture In An Elderly Female, Yaseen Ramadan, Fnu Swatisikta, Mushfeka Baker Golawala

East Florida Division GME Research Day 2023

INTRODUCTION Delayed pleural effusion (DPL) post rib fracture is a lesser known and not adequately studied entity. DPL is associated with increased hospital/ICU length of stay (LOS) and poorer disposition at discharge. Some case series have reported incidence as high as 40.8 % making it a clinically significant complication to watch for.

CASE An elderly female presented to the ED after a mechanical fall leading to right side fractured ribs (5th to 9th rib posteriorly) and pneumothorax. Patient was hypoxic in ER and an ICD was placed. Trauma series showed right pulmonary contusion but no hemothorax or any other injury. …

Challenges Of Cerebral Hyperperfusion Syndrome: A Clinical Case Report, Ruth Williams, Ranga Rathakrishnan

East Florida Division GME Research Day 2023

Introduction: Cerebral Hyperperfusion syndrome (CHS) is a clinical syndrome of hypertension, headache, neurological deficits, with or without seizures, following a revascularization procedure. It is characterized by an excessive and sudden increase in cerebral blood flow. The mechanism is largely not understood but theories involve impaired cerebrovascular autoregulation (thought to be mitigated by collateral circulation), free radical damage, and baroreceptor reflex damage, possible from the procedure itself1 . Common presentations include severe ipsilateral headache to the side of the lesion with typical onset within 12 hours to 6 days, but can occur up to one month, after carotid revascularization processes2 . …

Urinary Ascites In A Newborn Male, Amanda Stragnell, Querube Santana-Holcombe, Annette Santiago

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Neonatal ascites is a condition characterized by abdominal distention resulting from the accumulation of fluid within the peritoneal cavity and is life-threatening if not treated appropriately. Genitourinary abnormalities and urinary ascites are important to consider as part of the differential for newborns presenting with abdominal distention and ascites. In male infants with urinary ascites, presence of a posterior ureteral valve is a common etiology, accounting for up to 70% of cases. In this setting, early identification and management of urinary outlet obstruction is essential to prevent progression to autodialysis and uremia. …

A Case Of Transient Left Bundle Branch Block, Taylor Craig, Vincent Grekoski, Kashan Mahmood, Laura Tortora

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Episodic bundle branch blocks are a phenomenon associated with many clinical conditions seen in the emergency department. Intermittent BBBs by definition show both normal conduction and BBB within a single electrocardiographic tracing, where a transient BBB is described as a conduction defect that which then returns to normal. The most common cause of both transient and episodic BBB is rate related however there are many causes.1 Acute LBBB should lead to suspicion of acute coronary syndrome until proven otherwise, however other many other precipitating causes can factor into the overall clinical …

Cardiac Tamponade In The Setting Of Severe Sepsis And Adrenal Insufficiency, Ayesha Choudhry, Matthew Cardeiro, Angelina Hong, Adekunle Bamgboye

East Florida Division GME Research Day 2023

Introduction: Pericardial effusions can have various etiologies, including infectious, autoimmune, drug induced, endocrinologic, among others. Cardiac tamponade occurs when large effusions compress the heart and can lead to obstructive shock.

Case Description: A 48-year-old female with a history of hypothyroidism and pituitary adenoma resection presented with subjective fevers and generalized weakness for the past 5 days. She was lethargic with muffled heart sounds on exam. Vitals showed a heart rate 95 beats per minute, blood pressure 63/51, respiratory rate 18 breaths per minute, with normal temperature. Labs on admission were significant for white blood cell count of 11,500/L, hemoglobin 10.8 …

Surviving The Apprehensive Methicillin-Sensitive Staphylococcus Aureus (Mssa) Bacteremia: A Case Of Bacteremia With An Undetermined Source Of Infection Leading To Suspected Cardioembolic Ischemia And Biochemical Septic Shock, Greisy D. Curbelo Sesin, Eduardo Marino-Urbino, Christopher Fontela, Melanio J. Rodriguez, Jorge A. Diaz, Shivaan C. Oomrigar, Ramon Mendoza Bello, Yoandy Rodriguez Fuentes

East Florida Division GME Research Day 2023

Introduction: This research presents a complex case of a 70-year-old male with acute metabolic encephalopathy and biochemical septic shock, later attributed to cardioembolic ischemia, resulting from Methicillin-Sensitive Staphylococcus Aureus (MSSA) bacteremia with an elusive source of infection.

Case Description: The 70-year-old patient, with a medical history of hypertension and aortic valve stenosis status post-Coronary Artery Bypass Grafting and bioprosthetic valve replacement on dual anti-platelet therapy (clopidogrel and aspirin), was admitted following an unwitnessed fall and a day of vomiting and generalized weakness. Upon arrival, the patient exhibited altered mental status, hypotension, and acidosis. Initial diagnostic workup raised suspicion of biochemical …

Invasive Testing For Pre-Operative Localization Of Parathyroid Tumors, Akua Graf, Craig Cochran, Samira Sadowski, Naris Nilubol, William F. Simonds, Lee S. Weinstein, Richard Chang, Smita Jha

East Florida Division GME Research Day 2023

Context: The identification of parathyroid tumor(s) in patients with persistent/recurrent primary hyperparathyroidism (PHPT) is critical for a successful re-operative surgery. If non-invasive studies (ultrasound, CT, MRI, sestamibi) fail to conclusively localize the tumor, invasive procedures (arteriography and selective venous sampling) are performed.

Objective: To describe our experience with invasive studies for parathyroid tumor localization and provide follow-up data on selective arterial hypocalcemic stimulation with central venous sampling, a technique developed at our center.

Methods: We identified patients who underwent preoperative invasive testing for localization of parathyroid tumor from 1991-2020. The result of each invasive localization study (arteriogram, hypocalcemic stimulation and …

Atraumatic Splenic Rupture: An Unaccustomed Complication Of H. Parainfluenzae Endocarditis, Daniel P. High, Jose M. Acosta-Rullan, Danay Herrera, Mauricio Danckers

East Florida Division GME Research Day 2023

No abstract available.

Fatigue More Than Just Anemia: A Case Report Of Undiagnosed Pbc, Sarah Barraza, Payal Passi, George Matus, Michaela Mckissack

Central & West Texas GME Research Day 2023

No abstract provided.

Spontaneous Intercostal Artery Bleeding With Hemothorax, Raafia Sajjad, Legesse Tebeje

Central & West Texas GME Research Day 2023

No abstract provided.

Severe Ivc Thrombosis Presenting As Abdominal Pain In Antiphospholipid Syndrome, Arya Nikjoo, Aswin Srinivasan, Ali Abbasi

Gulf Coast Division GME Research Day 2023

No abstract provided.

Unique Presentation Of Cerebritis: A Case Report, Wajahat Dawood, Kevin Jiang, Bryan Kharbanda

Gulf Coast Division GME Research Day 2023

No abstract provided.

Treatment Options For World Health Organization Hroups 2 And 3 Pulmonary Hypertension: Using Pulmonary Arterial Hypertension Medication, Austin Makadia, Jorge Garza, Arjun Kamath, Ahsan Syed, Vishesh Persaud

Gulf Coast Division GME Research Day 2023

No abstract provided.

Bioprosthetic Valve Endocarditis Causing Non-St Elevation Myocardial Infarction, Cassie Robertson, Lakshmi Tatineni, Talha Qasmi, Sivatej Sarva, Ramesh Kesavan, Michael Daniel

Gulf Coast Division GME Research Day 2023

No abstract provided.

A Rare Case Of Pres In A Patient On Bevacizumab-Awwb Chemotherapy, Alexander Rhodes, John Punla, Aswin Srinivasan, An Dao, Syed Raza

Gulf Coast Division GME Research Day 2023

No abstract provided.

Intestinal Tuberculosis Presenting As Small Bowel Obstruction, Duyen Quach, Jordan Torres, Kayla Nguyen, Kevin Garnepudi, Wenjing Fang, Mike Liang

Gulf Coast Division GME Research Day 2023

No abstract provided.

Kaposi Sacroma In A 27 Year Old Man: A Case Report, Duyen Quach, Kayla Nguyen, Andrew Youssef, Diego Arellano, Jorge Leiva

Gulf Coast Division GME Research Day 2023

No abstract provided.

Fair Domestic Allocation Of Monkeypox Virus Countermeasures, Govind C. Persad, R. J. Leland, Trygve Ottersen, Henry S. Richardson, Carla Saenz, G. Owen Schaefer, Ezekiel J. Emanuel

Sturm College of Law: Faculty Scholarship

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; …

Mpox (Formally Known As Monkeypox), Molly O'Neill, Tricia Lepage, Vanessa Bester, Henry Yoon, Frederick Browne, Eric C. Nemec

Physician Assistant Studies Student Publications

Mpox originates from the Mpox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family.1, 2, 3 Other Orthopoxvirus species include the variola virus (the now eradicated smallpox virus), vaccinia virus (a virus used in the creation of the smallpox vaccine), and cowpox virus.1, 2, 3 The identified clades consist of the West African clade and the Congo Basin clade, each with varying fatality rates of 1% and 10%, respectively.1, 2, 3, 4 Since the eradication of smallpox in 1980, the Mpox virus has emerged as the most relevant Orthopoxvirus infection in humans.

Bundle Up To Improve Cauti, Jennifer Anderson, Valorie Dearmon

DNP Manuscripts

Catheter Associated Urinary Tract Infections (CAUTIs) are a leading cause of healthcare acquired infections. Strong evidence for CAUTI best practices exists, however, the struggle to translate best practice evidence into everyday practice remains a challenge. Catheter associated urinary tract infection rates continue to be a problem despite organizational efforts to implement best practice guidelines; the challenge is to effectively translate and embed best practices into everyday practice. The Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for expenses associated with hospital acquired CAUTI; moreover, hospitals are subject to penalties for high rates of hospital acquired CAUTIs. …

The Treatment Of Rem Sleep Disorder Using Neuromodulation: A Literature Review, Aaron Marbin, Shane Ragland, Orestes Hadjistamoulou, Clara Alvarez Villalba, Samuel Neuhut

East Florida Division GME Research Day 2023

No abstract available.

The Treatment Of Depression In Alzheimer's Disease Using Neuromodulation: A Literature Review, Aaron Marbn, Shane Ragland, Thalia Adrian, Clara Alvarez Villalba, Samuel Neuhut

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

INTRODUCTION: An estimated 44 million individuals live with Alzheimer's Dementia globally, a number expected to triple by 2050.1 Depression is a commonly observed comorbidity in individuals with Alzheimer's disease. Traditional antidepressant medications often pose challenges due to their side effects and limited efficacy in this population. As a result, alternative therapeutic approaches are being explored, with Transcranial Magnetic Stimulation (TMS) emerging as a promising intervention for treating depression in Alzheimer's patients. TMS is a non-invasive brain stimulation technique that utilizes magnetic fields to modulate neural activity in targeted brain regions …

Elucidating The Impact Of Western Diet On Bone Marrow Cytokine Signatures: Understanding Poor Outcomes In Susceptibility To Infection And Progression Of Cancer, Lahari Kondeti

Theses, Dissertations and Capstones

Among other disease outcomes, obesity is associated with 1) reduction in long-lasting immune protection and 2) acquisition of cancer. Given our interest in hematopoietic stem and progenitor cell (HSPC) dynamics, we questioned if similar mechanisms in the bone marrow microenvironment contribute to obesity-induced HSPC alterations responsible for 1) decreased immune protection and 2) transformation of HSPCs in the pathogenesis of hematologic malignancies. The negative effects of obesity on immune protection are most notably established in influenza models. Influenza infection susceptibility is increased and influenza vaccine-induced immunity wains in obese individuals. Ongoing studies aim to define mechanisms for waning immunity at …

Mesenchymal Stem Cell Use In The Treatment Of Osteoarthritis: A Literature Review, Samantha Arrizon, Nolan Barnes, Teresa Del Toro, Lei Wena Herme, Vanessa Mendoza, Thi Tran, Reeta Zamro

Physician Assistant Studies | Student Literature Reviews

Mesenchymal stem cell (MSC) therapies have been growing in popularity in research due to their anti-inflammatory, immunomodulatory, and regenerative properties. Many ongoing clinical trials are investigating the safety and efficacy of MSC therapies to treat osteoarthritis, also known as “wear and tear” arthritis. As the average life expectancy increases, with age people are more prone to developing this disease, therefore, increasing its prevalence. This condition is progressive and will lead to functional decline, decreased quality of life, and increased medical costs. Our focus is to discuss the efficacy of mesenchymal stem cell injections in alleviating pain, improving functionality, and slowing …

Complications Of Colonscopies: Splenic Injury Following Routine Screening For Colorectal Cancer, Elisabeth Barrar, Ainsley Freshour

South Atlantic Division GME Research Day 2023

No abstract provided.

Shells On 90yttrium Microspheres To Improve Radiopacity And Imaging Detection, Colin Woolard, Nicole Levi, Brian Kouri

South Atlantic Division GME Research Day 2023

No abstract provided.