Digital Commons Network^™

Beyond The Assumption: A Comparison Of Resident And Attending Prescribing Errors In Ambulatory Care, Shana-Kay Lambert-Johnson, Megan Wesling, Keneisha Houston, Isabel Vecino, Tasaduq Mir

North Texas GME Research Forum 2026

BACKGROUND: Medication prescribing errors remain a leading cause of preventable patient harm in ambulatory care. This study examined whether the severity, frequency, and distribution of medication prescribing errors differ between residents and attendings in outpatient settings to inform graduate medical education (GME) and system-level medication safety strategies.

METHODS: This retrospective observational study was conducted across a multi-specialty ambulatory care network. Ambulatory medication-related events involving residents and attendings occurring between January 1 and December 31, 2025, were identified through voluntary reporting in a cloud-based risk management system. Events were categorized by prescriber role and classified using the National Coordinating Council for …

From Colonization To Invasion: Risk Factors Of Mrsa Bacteremia Among Hospitalized Patients, Stefan Sarkovich, Spoorthi Lawson, Shaival Thakore, Francia Guerrero

West Florida Division GME Research Day 2026

No abstract provided.

Stewards In The Making: Approaching "Penicillin-Allergies" With Confidence, Trent Percy, Craig Spergel

West Florida Division GME Research Day 2026

No abstract provided.

From Peg To Perfusion: A Case Of Malnutrition Reversed By Mesenteric Revascularization, Sacha Saba, Mahi Basra, Alvin Newman Caro, Vikas Sethi, Marc Kudelko

West Florida Division GME Research Day 2026

No abstract provided.

Impact Of Glp-1a On Clinical Outcomes In Patients With Gp2 Ph: A Real-World Evidence Study, Revanth Reddy Bandaru, Vikramaditya Samala Venkata

West Florida Division GME Research Day 2026

No abstract provided.

Acute Myocardial Infarction In A Patient With Concurrent Atherosclerotic Disease And Significant Myocardial Bridging, Jason Stanberry, Ankith Motkar, Daniela Salazar, Ahmed Tarbay, Kumaraswamy Nutalapati, Sabry Omar

West Florida Division GME Research Day 2026

No abstract provided.

Rare Endometrial Entity: Gastrointestinal-Type Mucinous Adenocarcinoma, Nicholas D'Souza, Vitaly Borodin

West Florida Division GME Research Day 2026

No abstract provided.

Evaluation Of Transthoracic Echocardiography Use In Low-Risk Syncope Patients Utilizing The Canadian Syncope Risk Score: A Qi Analysis, Muhammad Anzar Ullah, Ali Hassan, Ryan Fernandez, Yousuf Qureshi, Areeb Zafar, Farhan Hiya, Huzaifa Hakim, Mohamad Saad, Trushil Patel

West Florida Division GME Research Day 2026

No abstract provided.

Case Report: Unique Presentation Of Mediastinal Mullerian Duct Cyst Developing Alongside Bronchial Cyst, Julia Dane, Stephanie Ngom Morris, Vaughan Marr, Bryan Steinberg

West Florida Division GME Research Day 2026

No abstract provided.

Cauda Equina Syndrome Secondary To Lumbar Stenosis In A Patient With Coexisting Peripheral Arterial Disease, Abboud Batri, Nawras Ibrahim, Hina Mannan

Gulf Coast Division GME Research Day 2026

No abstract provided.

Resurgence Of Liver Cirrhosis And Variceal Hemorrhage Mortality In Us Adults: Trends And Disparities In A 20-Year Analysis, Chandur Bhan, Nimarta Bheesham, Shravya Ginnaram, Gananshree Dharmarpandi, Melvin Joy, Chenyu Sun, Sreekanth Chandrupatla

West Florida Division GME Research Day 2026

No abstract provided.

A Tale Of Two Primaries: Ectopic Papillary Thyroid Carcinoma In A Lung Resection With A Typical Carcinoma, Laura Luu, Laura Glasscock, Christina Maldonado, Vitaly Borodin

West Florida Division GME Research Day 2026

No abstract provided.

Qi Project: Improving Utilization Of Cardiac Monitoring On Inpatients Based On Aha Guidelines, Muhammad Humais, Jorim Parmar, Shakir Al-Ezzi, Florence Murray, David Maldonado, Mohan Sengodan

North Texas GME Research Forum 2026

No abstract provided.

Concurrent Hnf1a (Mody3) And Pdxi (Mody4) Variants In A Young Adult And Critical Therapeutic Implications, Shay-Kay Lambert-Johnson, Matthew Doan, Megan Wesling

North Texas GME Research Forum 2026

BACKGROUND: Monogenic diabetes accounts for approximately 1–5% of diabetes cases and is frequently misclassified. Maturity-onset diabetes of the young (MODY) includes 14 subtypes with distinct pathophysiology and therapeutic implications. Digenic MODY, caused by pathogenic variants in more than one MODY gene, occurs in well under 1% of cases and poses unique diagnostic and management challenges. We report the first known case of concurrent HNF1A (MODY3) and PDX1 (MODY4) mutations, highlighting important clinical and therapeutic considerations.

CASE PRESENTATION: A 19-year-old male with digenic MODY due to MODY3 (HNF1A) and MODY4 (PDX1) mutations presented for team-based adult outpatient diabetes management following transition …

Improving Trauma Resuscitation Through Video Review: A Quality Improvement-Oriented Literature Review, Joshua Smith, Leena Iqbal

North Texas GME Research Forum 2026

Background Trauma resuscitation is a high-acuity, time-critical environment characterized by diagnostic uncertainty, simultaneous interventions, and complex team dynamics. Despite the widespread adoption of standardized trauma frameworks such as Advanced Trauma Life Support (ATLS), deviations from best practice and process variability remain common. Trauma video review (TVR) has emerged as a method to objectively evaluate resuscitation performance beyond traditional documentation.

Methods A narrative literature review was conducted of English-language publications examining the use of video recording and structured video review in trauma resuscitation. Peer-reviewed articles and relevant gray literature were identified through database and citation searches. Included works evaluated TVR for …

Efficacy Of Zuranolone In The Treatment Of Postpartum Depression: An Evidence-Based Review, Shana-Kay Lambert-Johnson, Tasaduq Mir

North Texas GME Research Forum 2026

BACKGROUND: Postpartum depression (PPD) is a common and potentially severe condition frequently managed in primary care, where delayed treatment adversely affects maternal and infant outcomes. Neuroactive steroid therapies targeting γ-aminobutyric acid type A receptors represent a novel therapeutic class. Brexanolone, the first FDA-approved treatment for PPD, required prolonged inpatient administration and was withdrawn from the U.S. market in 2025. Zuranolone is currently the only FDA-approved medication specifically indicated for PPD, offering a short-course oral treatment suitable for outpatient use. This review evaluated the efficacy of zuranolone and its applicability in primary care practice.

METHODS: This evidence-based review was conducted in …

Rethinking Acute Pain Management: Evidence For Suzetrigine As An Opioid-Sparing Strategy In Outpatient Care, Shana-Kay Lambert-Johnson, Tasaduq Mir

North Texas GME Research Forum 2026

BACKGROUND: The ongoing opioid epidemic underscores the urgent need for effective nonopioid options for acute pain management. Suzetrigine, a selective voltage-gated sodium channel NaV1.8 inhibitor, represents a mechanistically novel analgesic targeting peripheral nociception and may reduce reliance on opioid therapy. It received FDA approval on January 30, 2025, for the treatment of moderate-to-severe acute pain in adults. This evidence-based review evaluates the efficacy and safety of suzetrigine as an opioid-sparing option for outpatient acute pain management.

METHODS: A structured literature search of PubMed was conducted from database inception through January 2026 using the terms “suzetrigine” and “NaV1.8.” Eligible studies were …

Case Of Enterococcus Faecalis Infective Endocarditis 6-Weeks Following Post-Partum Hemorrhage, Zohaib Nadeem, Mason Goforth, Yasasvi Sabbineni, Sadia Zahid, Yugandhra Devarapalli, Javed Akram, Veeranna Vibhuti

North Texas GME Research Forum 2026

Peri-partum infective endocarditis (IE) is a rare but serious condition with high maternal and fetal morbidity and mortality. IE is exceedingly uncommon in young healthy patients, especially without any known risk factors such as intravenous (IV) drug use, congenital heart disease, or rheumatic heart disease. IE is estimated to complicate 0.00002% of in-hospital deliveries. Similar to the general population, staphylococcal and streptococcal species remain the most common pathogens in obstetric patients. Enterococcal species make up less than 10% of IE cases in pregnant women. Very few cases of enterococcal IE in the post-partum period are reported in the literature. We …

Drug-Induced Acute Interstitial Nephritis Presenting As Severe Acute Kidney Injury Requiring Temporary Hemodialysis, Nihar Raju, Rohit Nair, Vaishnavi Singh, Veeranna Vibhuti

North Texas GME Research Forum 2026

Background: Acute interstitial nephritis (AIN) is an important but often underrecognized cause of acute kidney injury (AKI), accounting for 2–5% of all kidney biopsies and up to 20% of biopsies performed for AKI. Drug-induced AIN is the most common etiology in developed countries, frequently associated with antibiotics, nonsteroidal anti-inflammatory drugs, and proton pump inhibitors. Classic hypersensitivity features are frequently absent, leading to delayed diagnosis and increased risk of dialysis dependence.

Case Presentation: A 74-year-old male with a history of prostate cancer, type 2 diabetes mellitus, and hypertension presented with progressive exertional dyspnea and was found to have severe AKI without …

Acute Gastrointestinal Bleeding Associated With Cowden Syndrome: A Case Report, Gennipher A. Smith, Robert Keller

North Texas GME Research Forum 2026

No abstract provided.

Negative Imaging, Ongoing Hemorrhage: An Ulcerated Jejunal Avm Requiring Advanced Endoscopic Intervention, Joel Mathews, Trina Lewis, John Mathew, Long Hoang

North Texas GME Research Forum 2026

Small bowel bleeding is relatively uncommon, accounting for less than 10% of all gastrointestinal (GI) bleeds. Small bowel angiodysplasias are the most common cause of small bowel bleeding. These lesions can often be difficult to identify on radiographic imaging or endoscopy and tend to rebleed after intervention. Our case centers on an 86-year-old patient who presented with an acute GI bleed from an obscure ulcerated jejunal arteriovenous malformation (AVM); his past medical history includes an undisclosed prior upper GI bleed treated with endoscopic clipping, paroxysmal atrial fibrillation, type 2 diabetes, prostate cancer with prostatectomy, and other chronic conditions. He presented …

A New Conceptual Framework For The Approach To The Emergency Department Patient, Christopher Houston

North Texas GME Research Forum 2026

Background

The Emergency Department (ED) is an often chaotic environment where you have little information, little time, and must evaluate for multiple serious conditions. This can be overwhelming for trainees and young physicians. Having a thought process specifically tailored to the ED could be helpful organizing priorities and diagnostic pathways. There are several disease specific core measures that are time sensitive in the ED. Specifically; STEMI, stroke, sepsis, and trauma. Each of these conditions must be rapidly identified, and appropriate pathways initiated.

Trainees are traditionally taught to approach a patient with a wide differential diagnosis for each chief complaint and …

The Rapid Case Of Anoxic Brain Injury Secondary To Hyperammonemia, Jacqueline Bekhit, Ngoc Vu, Jiaming Xue, Gabriella David, Qasim Sajawal

North Texas GME Research Forum 2026

Background: Acute hyperammonemia presents as a toxic state with the clinical presentation as altered consciousness, seizures, and coma. Hyperammonemia disrupts astrocytes osmotic balance via glutamine accumulation, triggering brain edema, inflammation, and apoptosis whom mechanism is closely parallel to hypoxic ischemic injury. This overlap necessitates differentiating metabolic causes from hypoxic etiologies, as timely ammonia clearance therapies can prevent catastrophic outcomes. This case underscores the need for close clinical vigilance and early recognition of severe hyperammonemia

Case Presentation: A 65-year-old woman with metabolic dysfunction-associated steatotic liver disease related cirrhosis complicated by recurrent ascites requiring bimonthly paracentesis presented with abdominal distension and pain. …

An Unusual Source Of A Lethal Pathogen: Paeniclostridium Sordellii Bacteremia In Acute Cholecystitis, Myrna Garcia, Leena Algarin, Olutoyin Abitoye, Rachel Gnanaprakasam

North Texas GME Research Forum 2026

Paeniclostridium sordellii is a spore-forming, gram-positive, anaerobic bacilli known for its highly virulent toxin production, often leading to fulminant sepsis and shock. It is most commonly associated with gynecologic infections and necrotizing soft tissue infections associated with intravenous drug use. However, reports of P. sordellii bacteremia in the setting of gall bladder infections are quite rare. This case report highlights an unusual presentation of P. sordellii infection with bloodstream infection originating from acute cholecystitis, demonstrating a non-fulminant clinical course and successful treatment with ceftriaxone.

Ashwagandha-Associated Liver Injury: A Systematic Literature Review, David Teplitsky, Jacob Sebaugh, Danielle Ford, Rashid Syed

North Texas GME Research Forum 2026

Background: Ashwagandha (Withania somnifera), an herb with origins in Ayurvedic medicine, has recently grown in global popularity due to its reported stress- and anxiety-relieving properties. While generally regarded as safe, emerging cases in medical literature have raised concern for its ability to cause drug- or herb-induced liver injury (DILI/HILI). As use of this supplement rises, it is particularly important to characterize ashwagandha’s potential hepatotoxicity.

Methods: Cases of ashwagandha-induced liver injury were collected by accessing PubMed, Europe PMC, Google Scholar, and the HCA Healthcare Library and searching combinations of the terms “liver” or “hepatic” and one of the following names for …

Massive Subcutaneous Emphysema Following Robot-Assisted Total Laparoscopic Hysterectomy: A Case Report, Alia Valdez, Isabella Sciacca, Charmaine Oladell

North Texas GME Research Forum 2026

Background Subcutaneous emphysema is the presence of air within subcutaneous tissues, often presenting as swelling and palpable crepitus. Air may spread along fascial planes and arise from traumatic, iatrogenic, infectious, or spontaneous sources. In laparoscopic surgery, it is most commonly related to carbon dioxide insufflation. Reported incidence following laparoscopic procedures ranges from 2% to 24%, depending on procedure type, surgical duration, insufflation pressure, and patient factors. In gynecologic laparoscopy, incidence has been reported as low as 2.3% in some studies, with rates up to 10–15% in others, particularly with higher intraabdominal pressures. Although often benign, extensive subcutaneous emphysema may lead …

Salvage Percutaneous Spyglass-Assisted Lithotripsy Via A Cholecystostomy Tract After Failed Ercp: A Case Report, Nicholas Gerden, Tiffany Hong, Asad Rehman, Long Hoang

North Texas GME Research Forum 2026

IR-driven percutaneous cholangioscopy with SpyGlass-assisted lithotripsy is an emerging salvage technique for biliary stone disease in patients with failed or contraindicated endoscopic retrograde cholangiopancreatography (ERCP) due to complex anatomy. We report an 85-year-old patient with an indwelling cholecystostomy tube and biliary stent who presented with recurrent obstructive jaundice, with cholangiography demonstrating occlusion of the common bile duct stent due to choledocholithiasis. Conventional ERCP was unsuccessful because of complex biliary and gastrointestinal anatomy. A multidisciplinary interventional radiology–gastroenterology approach was therefore pursued, utilizing antegrade percutaneous choledochoscopy through an existing cholecystostomy tract with SpyGlass-assisted lithotripsy, followed by cholecystostomy tube exchange. The procedure resulted …

Cocaine Kicks Mitral Valve In The Pap- A Rare Case Of Papillary Muscle Rupture Secondary To Cocaine-Induced Ischemia Mimicking A Tumor Vs Vegetation, Greeshma Molugu, Seline Haci, Mehdi Khalafi, Amir Z. Malik, Machaiah Madhrira

North Texas GME Research Forum 2026

Background: Cocaine is known to have many cardiotoxic effects, specifically secondary to increased sympathetic output from the increased catecholamines, calcium modulation, and increased platelet aggregation. This can cumulatively cause suppression of myocardial contractility and decreased coronary blood flow, resulting in arrhythmias, myocardial ischemia, or even infarction. Papillary muscle rupture, already a rare complication of myocardial infarction (MI), is exceedingly rarely associated with cocaine toxicity in the absence of MI. Also, acute mitral regurgitation(MR) due to papillary muscle rupture from cocaine-induced ischemia remains exceedingly rare. We present a second-ever reported case of papillary muscle rupture secondary to cocaine-induced ischemia in the …

Hemoptysis And Shock From A Proximal Bronchial Artery Aneurysm Successfully Treated With Endovascular Embolization, Gautham Raghuthaman, Charmi Mehta, Tamer Hudali

North Texas GME Research Forum 2026

Background: Bronchial artery aneurysm (BAA) is a rare vascular abnormality and an uncommon cause of hemoptysis. Although many BAAs are asymptomatic, rupture can result in life-threatening hemorrhage and shock. Proximal BAAs arising near the bronchial artery origin are particularly rare and may be underrecognized due to nonspecific clinical and radiographic findings.

Case Presentation: Patient is a 49-year-old male with a history of pituitary tumor resection complicated by secondary adrenal insufficiency and hypothyroidism presented with three days of cough, fatigue, and hemoptysis. He was hypotensive and hypoxic on arrival and required vasopressor support with stress-dose corticosteroids. Computed tomography angiography (CTA) of …

Challenges Of Thrombectomy In Submassive Pulmonary Embolism With Patent Foramen Ovale, Sana Khan, Syed Ahmed, Muhammad T. Siddique, Edic Stephanian

North Texas GME Research Forum 2026

BACKGROUND/ INTRODUCTION: Submassive, or intermediate-risk, pulmonary embolism (PE) is defined by preserved systemic blood pressure with evidence of right ventricular (RV) strain. The presence of a patent foramen ovale (PFO) in this setting significantly increases the risk of hypoxemia, paradoxical embolization, and procedural complications during catheter-based interventions. Mechanical thrombectomy has become an important treatment option for selected patients with intermediate- to high-risk PE; however, experience in patients with concomitant large PFOs remains limited.

CASE PRESENTATION: A 78-year-old woman presented with acute dyspnea, hypoxemia, and chest pain and was found to have a saddle PE with severe RV dilation and biomarker …