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Primary Resection Of Duodenal Neuroendocrine Tumor With Suspected Lymph Node Metastasis: A Case Report, Raleigh Payton, David Bassa, Furrukh Jabbar, Hassan Ahmed Jan 2024

Primary Resection Of Duodenal Neuroendocrine Tumor With Suspected Lymph Node Metastasis: A Case Report, Raleigh Payton, David Bassa, Furrukh Jabbar, Hassan Ahmed

North Texas Research Forum 2024

Introduction: Duodenal neuroendocrine carcinomas are an uncommon variant of Neuroendocrine tumors (NETs) that are typically non-functional with locoregional spread at the time of diagnosis. Management of these tumors is dependent on size, grade, stage, functional status and location. Summary: A 66-year-old male presented with an incidental finding of low grade 3 centimeter duodenal NET on esophagogastroduodenoscopy (EGD) located in the second segment of the duodenum with evidence of lymphadenopathy on staging scans. In patients with suspected lymph node metastases, the first choice for curative intent is a pancreaticoduodenectomy (PD), also known as Whipple Procedure. We achieved surgical resection with free …


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 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 …


Type Ii Diabetes And Keto Diet In Family Medicine Clinic: A Case Report, Dante Paredes, Karos Torres, Joshua Moton Jan 2024

Type Ii Diabetes And Keto Diet In Family Medicine Clinic: A Case Report, Dante Paredes, Karos Torres, Joshua Moton

North Texas Research Forum 2024

The management of patients with high cardiac risk profiles who require insulin therapy for diabetes can be challenging due to the potential adverse effects of insulin on cardiovascular health. In order to achieve remission of type 2 diabetes mellitus (T2DM) and discontinue the need for insulin, weight loss has long been recognized as a valuable approach. The goal for this case was to implement dietary and lifestyle changes in a safe and efficient manner to induce remission of T2DM, without increasing the sympathetic load often associated with fully dosed ketogenic and other fasting strategies. This case report highlights the successful …


Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen Jan 2024

Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen

North Texas Research Forum 2024

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included …


Comparing The Ppv Of At-Home Screening Tests With Chronic Anticoagulant And/Or Antiplatelet Therapies, Bradley Gustafson, Nasima Mehraban, Amjad Awan, Michele Mccarroll Jan 2024

Comparing The Ppv Of At-Home Screening Tests With Chronic Anticoagulant And/Or Antiplatelet Therapies, Bradley Gustafson, Nasima Mehraban, Amjad Awan, Michele Mccarroll

North Texas Research Forum 2024

BACKGROUND: With the rising incidence and mortality of colorectal cancer (CRC), early diagnosis and treatment is imperative. At-home CRC screening kits are a non-invasive Federal Drug Association (FDA) approved designed to detects either hemoglobin or DNA markers associated for CRC and high-grade polyps. Therefore, therapies that have a propensity to increase rates of gastrointestinal bleeding could theoretically lead to higher false positive rates. The goal of this study was to determine the positive predictive value of at-home screening tests when applied to patients on therapies such as antiplatelet, anticoagulant, non-steroidal anti-inflammatory (NSAID), or a combination of the three. METHODS: The …


Case Report: Streptococcus Gallolyticus Prosthetic Joint Infection, Jeffrey Dickerson, Liza Salloum, Amaan Sheikh, Madhukanth Reddy, Bryan Youree Jan 2024

Case Report: Streptococcus Gallolyticus Prosthetic Joint Infection, Jeffrey Dickerson, Liza Salloum, Amaan Sheikh, Madhukanth Reddy, Bryan Youree

North Texas Research Forum 2024

Streptococcus gallolyticus, part of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) formerly known as Group D streptococi, is strongly associated with colorectal cancer and infective endocarditis. Its appearance in septic arthritis is rare, and its role in septic arthritis has not been as thoroughly investigated. We present the case of a 69 year old male with a history of atrial fibrillation and hypertension who was admitted to our hospital after undergoing a right knee replacement in 2023 with a chief complaint of right knee pain, fever, and chills. Arthrocentesis and blood cultures were performed, and the patient was started on …


Horner’S Syndrome, A Rare Complication Of Transcarotid Artery Revascularization, Mollie Ahn, April Miller, Shonda Banegas, Edic Stephanian Jan 2024

Horner’S Syndrome, A Rare Complication Of Transcarotid Artery Revascularization, Mollie Ahn, April Miller, Shonda Banegas, Edic Stephanian

North Texas Research Forum 2024

Extracranial carotid artery aneurysm is a rare sequela of atherosclerosis, trauma, and conditions of chronic inflammation. Standard treatments include antiplatelet medications, open resection, or endovascular stenting. Transcarotid artery revascularization (TCAR) has become a well-recognized alternative treatment in the past few decades. This case study documents the first reported case of Horner’s syndrome post-TCAR for an internal carotid artery (ICA) aneurysm. A 68 year-old male with intermittent double vision was referred to vascular surgery clinic with brain CT angiography showing a 9mm saccular aneurysm with dissection flap of the right cervical ICA. Prior attempts by neuro-interventional radiology were unsuccessful due to …


Multidisciplinary Management For Large And Difficult Choledocholithiasis: The Role Of Choledochotomy, Jilpa Shah, Balu Chandra Jan 2024

Multidisciplinary Management For Large And Difficult Choledocholithiasis: The Role Of Choledochotomy, Jilpa Shah, Balu Chandra

North Texas Research Forum 2024

Extracranial carotid artery aneurysm is a rare sequela of atherosclerosis, trauma, and conditions of chronic inflammation. Standard treatments include antiplatelet medications, open resection, or endovascular stenting. Transcarotid artery revascularization (TCAR) has become a well-recognized alternative treatment in the past few decades. This case study documents the first reported case of Horner’s syndrome post-TCAR for an internal carotid artery (ICA) aneurysm. A 68 year-old male with intermittent double vision was referred to vascular surgery clinic with brain CT angiography showing a 9mm saccular aneurysm with dissection flap of the right cervical ICA. Prior attempts by neuro-interventional radiology were unsuccessful due to …


Implementing A Standardized Screening Algorithm For Iron Deficiency Anemia In Pregnancy, Ariel Moskowitz, Nicole Tenzel, Joshua Mangels, Lyndsay Millican Jan 2024

Implementing A Standardized Screening Algorithm For Iron Deficiency Anemia In Pregnancy, Ariel Moskowitz, Nicole Tenzel, Joshua Mangels, Lyndsay Millican

North Texas Research Forum 2024

OBJECTIVE: Anemia in pregnancy is a global health problem and complicates >40% of pregnancies. Anemia is associated with significant maternal and fetal complications including low birth weight, preterm delivery, postpartum hemorrhage, ICU admissions, need for blood transfusion, and maternal morbidity. The American College of Obstetricians and Gynecologists (ACOG) and the CDC recommend screening for anemia at the first prenatal visit and again between 24 and 28 weeks gestation. The aim of this quality improvement project is to improve compliance of screening for anemia in pregnancy amongst the providers of Medical City Women's Care. METHODS: Using the Plan-Do-Study-Act (PDSA) quality improvement …


Improving Clostridium Difficile Detection At Medical City Arlington: A Quality Improvement Project, Bremmy Alsbrooks, Nur-Alhuda Shahub, Shabaz Mallick, Jesse Brown Jan 2024

Improving Clostridium Difficile Detection At Medical City Arlington: A Quality Improvement Project, Bremmy Alsbrooks, Nur-Alhuda Shahub, Shabaz Mallick, Jesse Brown

North Texas Research Forum 2024

INTRODUCTION: Hospital acquired Clostridium difficile infection are one of the costliest hospital acquired infections. Over the past year, there were 19 C diff cases. Reasons for this uptick in cases from previous years could be waiting too long for collection (where a patient has C diff on admission, but does not receive testing until several days later), antibiotics, environmental (for example, using the same toilet brush to clean bathrooms on the floor as well as the bathroom in a C diff patient's room, cleaning high touch areas less than two times during the day, etc.), or staff education. From our …


A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai Jan 2024

A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai

North Texas Research Forum 2024

Rheumatoid arthritis (RA) is a chronic multi-system inflammatory disease of which is characterized by articular and extra-articular involvement. Patients with RA have a higher risk of mortality when compared with the general population, which is due predominantly to increased cardiovascular disease. Due to the higher incidence of CVD and MI in RA patients it has been postulated that enhanced systemic inflammation plays an important role in the pathogenesis of CVD in RA patients. Previous studies have shown that ant inflammatory medication such as systemic steroids and immune blockers have been shown to decrease the risk of MI in patients with …


A Challenging Diagnosis Of Intestinal Tuberculosis Mimicking Crohn's Disease, Justin Sanchez, Gabriel Gonzales, Monte Troutman Jan 2024

A Challenging Diagnosis Of Intestinal Tuberculosis Mimicking Crohn's Disease, Justin Sanchez, Gabriel Gonzales, Monte Troutman

North Texas Research Forum 2024

Intestinal tuberculosis (ITB) is an underrecognized disease that shares many clinical, radiologic, endoscopic, and pathologic features with Crohn's disease, making differentiation difficult. This poses a significant problem as initiation of immunosuppressives for an assumed diagnosis of CD in a patient with ITB can lead to exacerbation of infection and life-threatening consequences. A 30-year-old Nepali man with a medical history only significant for Raynaud disease presented with a febrile illness, right lower quadrant abdominal pain, and productive cough over the course of a month. He immigrated from Nepal 3 years prior to presentation, denying other risk factors or specific symptoms of …


Retrospective Review Of Adverse Events After Treatment Of Non-Melanoma Skin Cancer With Image-Guided Superficial Radiation Therapy, Marshall Hall, Henry Lim, Jason Pham, Alyssa Forsyth, Wenqin Du Jan 2024

Retrospective Review Of Adverse Events After Treatment Of Non-Melanoma Skin Cancer With Image-Guided Superficial Radiation Therapy, Marshall Hall, Henry Lim, Jason Pham, Alyssa Forsyth, Wenqin Du

North Texas Research Forum 2024

No abstract provided.


Crusted Scabies: A Case Report, Marshall Hall, Philip Oh, Michael Carletti, Stephen E. Weis Jan 2024

Crusted Scabies: A Case Report, Marshall Hall, Philip Oh, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2024

Introduction: Scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of scabies is crusted scabies, formerly known as Norwegian scabies. Crusted scabies presents with hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case presentation: Case 1: An 89-year-old male with a history of dementia, anxiety, and benign prostatic hyperplasia presented with a 2-month history of a generalized pruritic rash. He lived in a memory care center. The physical exam showed an …


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 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 …


The Role Of Ercp In Post Covid-19 Cholangiopathy: A Systemic Review Of Published Case Reports, Olufemi Osikoya, Gregory Brennan Jan 2024

The Role Of Ercp In Post Covid-19 Cholangiopathy: A Systemic Review Of Published Case Reports, Olufemi Osikoya, Gregory Brennan

North Texas Research Forum 2024

Introduction: Post COVID-19 cholangiopathy (CC) is a rare complication of COVID-19 infection. It is characterized by abnormal elevation of serum alkaline phosphatase, with evidence of bile duct injury (via imaging or biopsy) in the absence of other causes. Not much is known regarding the role of ERCP in post COVID-19 cholangiopathy. We sought to better understand the findings, interventions and outcomes in patients with CC undergoing ERCP. Methods: We searched Pubmed, Scopus and Embase from December 2019 to present. Search words included "post-Covid-19 cholangiopathy," and “ERCP.” Data on patient characteristics, COVID-19 infection, imaging, ERCP fluoroscopic findings, ERCP interventions, …


Mcs Assisted High Risk Multi-Vessel Percutaneous Intervention In Cardiogenic Shock Patient With Lv Thrombus, Amanpreet Kaur, Akhil Gade, Srinivasan Rajaganapathy, Ruben Abreu, Victor Delprincipe Jan 2024

Mcs Assisted High Risk Multi-Vessel Percutaneous Intervention In Cardiogenic Shock Patient With Lv Thrombus, Amanpreet Kaur, Akhil Gade, Srinivasan Rajaganapathy, Ruben Abreu, Victor Delprincipe

North Texas Research Forum 2024

Background: Acute coronary syndrome patients presenting with Cardiogenic shock carry a very high mortality risk >70% without appropriate intervention in a timely fashion. Here we present a patient requiring an axial pump mechanical circulatory support despite having an apical thrombus. Case report: 55-year-old male with past medical history of type 2 diabetes mellitus and medication noncompliance was transferred from outside facility for high risk ACS with EKG showing ST segment elevation in inferior and anterolateral leads. Lab showed hsTroponin more than 125K, BG 556, HCO3 17, and Beta hydroxybutyrate of 41.87 indicating DKA. Emergent coronary angiography showed mid LAD artery …


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 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 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 …


Ulcerating Plaques Of The Lower Extremities Of A 23-Year-Old Female, Robyn O. Okereke, Christian J. Scheufele, Michael Carletti, Stephen E. Weis Jan 2024

Ulcerating Plaques Of The Lower Extremities Of A 23-Year-Old Female, Robyn O. Okereke, Christian J. Scheufele, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2024

INTRODUCTION: What should come to mind when any physician sees dark red spots on the legs? If you answered vasculitis, then you are on the right track. Leukocytoclastic vasculitis (LCV) is defined as small vessel inflammation of the dermal capillaries and venules. The clinical hallmark finding of LCV is palpable purpura (raised, round, purple plaques) on the lower extremities. LCV is confirmed by histopathology showing neutrophilic infiltration in the walls of dermal vasculature. Though LCV is the most common cause of clinical vasculitis, the annual incidence of biopsy-proven LCV is approximately 30-45 per million individuals. LCV typically occurs in adults …


Disseminated Coccidioidomycosis Discovered Through Skin Biopsy In A Pregnant Patient From Mexico, Henry Lim, Christina Guo, Marshall Hall, Christian Scheufele, Christopher M. Wong Jan 2024

Disseminated Coccidioidomycosis Discovered Through Skin Biopsy In A Pregnant Patient From Mexico, Henry Lim, Christina Guo, Marshall Hall, Christian Scheufele, Christopher M. Wong

North Texas Research Forum 2024

Introduction: Coccidioidomycosis is an infection caused by the organism Coccidioides immitis, a fungus endemic to the southwestern United States, Mexico, Central and South America. The presentation of coccidioidomycosis can range from symptoms resembling a simple upper respiratory infection, such as cough, to more severe systemic symptoms including fever, malaise, and chills. Cutaneous lesions of coccidioidomycosis demonstrate a large heterogeneity of clinical manifestations but are significant as they may be the presenting sign of disseminated disease. While usually confined to the lungs, extrapulmonary coccidioidomycosis can occur in about 1 in 200 patients, most commonly associated with immunocompromised status. Pregnancy is an …


A Unique Case Of Spontaneous Pectoral Abscess, Martin Sentmanat, Zachary Shields, David Ross Jan 2024

A Unique Case Of Spontaneous Pectoral Abscess, Martin Sentmanat, Zachary Shields, David Ross

North Texas Research Forum 2024

Pyomyositis is a rare disease that is often misdiagnosed. Formerly more common in tropic areas, it has been more prevalent in temperate climates in the past couple of decades. Most cases of pyomyositis have a known cause or the patient is immunocompromised, but there are a few documented cases of spontaneous pyomyositis in an otherwise healthy patient. Our case describes a 35-year-old male with no past medical history or history of IV drug use who presented to the emergency department with right sided chest pain. The patient was initially seen and diagnosed with a pectoral muscle strain and fever. He …


Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Navya Peddireddy, Braden Van Alfen, Christian Scheufele, Marshall Hall, Christopher M. Wong Jan 2024

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Navya Peddireddy, Braden Van Alfen, Christian Scheufele, Marshall Hall, Christopher M. Wong

North Texas Research Forum 2024

Introduction: Tinea corporis, a superficial fungal skin infection, typically manifests as pruritic annular erythematous scaly plaques with central clearing. This condition can involve every body region. Here we present tinea corporis across various skin pigmentations. The goal of this presentation is to highlight distinctions and similarities in light, medium, and dark skin tones, using the Fitzpatrick scale for stratification of skin types. We hope this can aid primary care clinicians in early recognition of this common condition. Case Presentation: We present a series of cases illustrating the diverse manifestations of tinea corporis across different Fitzpatrick skin types. In Figure 2, …


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 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 …


A Rare Case Of Invasive Adenocarcinoma Of The Duodenum And A Bovel Biliary Stent: A Case Report, Sabastiana Sanz, Nasima Mehraban, Bradley Gustafson, Amjad Awan Jan 2024

A Rare Case Of Invasive Adenocarcinoma Of The Duodenum And A Bovel Biliary Stent: A Case Report, Sabastiana Sanz, Nasima Mehraban, Bradley Gustafson, Amjad Awan

North Texas Research Forum 2024

Adenocarcinoma of the duodenum is a rare but aggressive malignancy making up less than 0.5% of gastrointestinal cancer cases (Tuan et al., 2023), (Cloyd, 2016). We present a rare case of invasive adenocarcinoma of the first part of the duodenum and major papilla that required complex biliary stenting. A 72-year-old male was admitted to our hospital for further workup of gastrointestinal bleeding and 30-pound weight loss. Through imaging it was noted he had lymphadenopathy and biliary dilation. Patient underwent multiple gastrointestinal procedures and was endoscopically found to have a circumferential mass within the ampulla. After unsuccessful cannulation during endoscopic retrograde …


Bilateral Spontaneous Osteonecrosis Of The Knee (Sponk) In Young Male: A Case Report, Hans Drawbert, Mason Poffenbarger, Joshua Payne Jan 2024

Bilateral Spontaneous Osteonecrosis Of The Knee (Sponk) In Young Male: A Case Report, Hans Drawbert, Mason Poffenbarger, Joshua Payne

North Texas Research Forum 2024

Introduction: Spontaneous osteonecrosis of the knee (SPONK) is a relatively uncommon disease consisting of a focal, subchondral lesion thought to be a subchondral insufficiency fracture that has progressed to collapse and may lead to end-stage osteoarthritis of the knee. There are several treatment options, including nonsurgical and surgical measures but almost 80% of cases end up requiring surgery, usually consisting of unicompartmental or total knee arthroplasty. However, despite these treatment options, there remains no good option for young patients who present with SPONK in large areas of their distal femur or disease in both medial and lateral condyles. Case …


Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen Jan 2024

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen

North Texas Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …


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 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 …


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 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, …


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 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 …