Medicine and Health Sciences Commons^™

Separation Anxiety, Nisha Sidana

Community Reflections

I wrote this poem about a month and a half after we were sent home from SHU. A couple of my friends were talking to me one day, telling me how much they missed their boyfriends/girlfriends, everything they love about them, and their longing to see them, knowing they wouldn't be able to. I took inspiration from this, as well as the feeling of being suddenly separated from the people you love, and wrote it into a poem I titled "Separation Anxiety." I wanted to artistically express the feeling a person gets when they realize how much they have taken …

Evaluating The Effects Of Detergent Concentration On The Reendothelialization And Ultrastructure Of Porcine Internal Thoracic Artery Scaffolds, Jesse Bruce Kooistra

Graduate Theses

Cardiovascular disease exerts a consistent force of morbidity and mortality on the global population. This pressure has created a demand for reliable replacement vascular tissues. Current solutions include synthetic grafts and biological transplant options that are associated with a multitude of complications. Therefore, the continued innovation of vascular tissue replacement solutions is warranted. Decellularized vascular tissues have been previously utilized as scaffolds upon which recellularized tissue engineered vascular solutions are constructed. However the interplay between decellularization agent concentration and effective recellularization has not been well documented. Herein we investigate this relationship through a detail oriented research model that both qualifies …

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice …

The Evil Twin: The Case Of Heterotopic Pregnancy, Rashmi Jadhav, Vegas Brown, Gabriel Cabrera

West Florida Division GME Research Day 2020

• Heterotopic pregnancy occurs in about 1 in 30,000 naturally conceived pregnancies (5). The risk rises 1-3% for pregnancies occurring through assisted reproductive technologies (ART) (1).
• Isolated ectopic pregnancy affects an average of 1 in every 150 live births (1).
• A known pre-existing intrauterine pregnancy (IUP) can be falsely reassuring and delay the diagnosis of a potentially life-threatening concurrent ectopic pregnancy.
• Presentation is vague and 45% of patients have no symptoms (5).
• Differential Diagnoses: endometritis, incomplete miscarriage, ruptured ovarian cyst, non-GYN cause (ie: appendicitis or UTI).
• Risk Factors: Infertility treatment, in vitro fertilization (IVF), prior ectopic, prior tubal surgery, use of …

An Atypical Presentation Of Neuroleptic Malignant Syndrome, Rudy Forte, Shiwani Kamath, Debra Angelo, Johnathan Frunzi

West Florida Division GME Research Day 2020

Neuroleptic Malignant Syndrome (NMS) is a rare, but potentially life threatening condition associated with dopamine blockade, particularly first-generation antipsychotics. The complex pathophysiology of NMS remains somewhat unclear and debatable as the symptoms are not fully explained by dopamine blockade alone.¹ D2 dopamine receptor antagonism remains responsible for most cases of NMS, however a few cases have been reported in which little to no D2 blockade activity was present.¹

This poster is about an atypical presentation of NMS.

Malignant Degeneration Of Spiradenoma Of The Eyebrow, Christopher White, Kristin Witfill, Richard Miller

West Florida Division GME Research Day 2020

Spiradenocarcinoma is a malignancy of eccrine origin, with only 120 reported cases in the literature.¹ Elderly males and females are equally affected.² Benign spiradenomas along with their malignant counterpart are more frequent in patients with Brooke-Spiegler syndrome or familial eccrine spiradenoma, owing to the increased incidence of folliculosebaceous-apocrine tumors seen with these entities.³

Carcinoid Syndrome Arising From The Descending Colon Causing Carcinoid Heart Disease, Julien A. Exposito, Adam Salomon, Oliver Fowler, Christopher Cooke, Joelle Ellis, Patricia Chun, Christiano Caldeira

West Florida Division GME Research Day 2020

No abstract provided.

Pneumonia: An Unexpected Graveyard Visitor?, Daniel A. Casas, Jigar Chauhan, Melanie Williams, Jan Sambataro, David Sukhai, Pablo G. Dubon, Jorge Perez

West Florida Division GME Research Day 2020

Community acquired pneumonia caused by Influenza can present with superinfection. On rare occasions, an unexpected organism is discovered.

Idiopathic Chylopericardium: A Rare Entity, Seema Jaga, Joseph Namey, Christiano Caldeira, Salah Al-Andary

West Florida Division GME Research Day 2020

• Idiopathic chylopericardiumis a rare entity in which the acculumation of chylousfluid surrounds the pericardial space.
• Herein, we present a case of a 50 year old healthy female patient with no known past medical history that was diagnosed with idiopathic chylopericardiumand was successfully treated using a pleurXcatheter drainage for two and a half weeks and a low fat diet.

Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, William R. Judson, John D. Murphy, Phillip H. Sussman, John N. Harker

West Florida Division GME Research Day 2020

• Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.^{1, 2}
• Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.¹ The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.^{3, 4}
• Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy. …

Giant Splenic Artery Pseudoaneurysm Rupture Presenting As Hemorrhagic Shock, Jaya Sanapati, Parth R. Desai, Locke W. Barber, Johnathan Frunzi, Timothy Lee

West Florida Division GME Research Day 2020

A 56-year-old Asian male was brought to the emergency department by first responders after he developed severe, sudden-onset headache and chest pain at his home. Past medical history was insignificant. On arrival to the emergency department, the patient was in respiratory distress. Vital signs revealed temperature of 36.0°C, blood pressure of 71/44, heart rate of 90 beats per minute, respiratory rate of 18 breaths per minute, and oxygen saturation of 95% with delivery of oxygen at 2 liters per minute via nasal cannula. Examination of the abdomen revealed diffuse tenderness. Laboratory findings and arterial blood gas analysis revealed normocytic anemia …

My Thoughts On Covid-19, Patrick Ferraro

Community Reflections

I feel deeply sorry for the loved ones that were lost from the SHU community directly from COVID-19. The tragedy of death can feel even worse in a time like this where it’s almost as if we can feel it through all of the fear we are presented with.

Coronavirus Update 5-1-2020, The Coronavirus Planning Team

University Briefings & Virtual Events

Our plan to offer a full on-campus program for both residential and commuter students (for the fall semeser) will not come without temporary changes to our typical way of campus life.

Experience During Covid-19, Anonymous

Community Reflections

This submission from Professor James Bartley was a class assignment from a student who maintained a journal describing her experience working at a hospital during the pandemic.

Cervical Cancer Recurrence In The Colon, Samantha A. Erb, Shreyash Pandya, Johnny Johnson

West Florida Division GME Research Day 2020

Cervical cancer is the fourth leading cancer worldwide in women, ranking only after breast cancer, colorectal cancer, and lung cancer. Because it is typically diagnosed at a younger age compared to other major cancer types, it leads to a proportionally greater loss in life-years. Most cancers occur in squamo-columnar junction, the transition point between squamous and columnar cells; squamous cell carcinoma accounts for approximately 70% of cervical cancer cases. Treatment options vary depending on the stage at diagnosis and include surgery (conization or hysterectomy), radiation, chemotherapy, targeted therapy, and immunotherapy. Prognosis is affected by stage, tumor volume, age and performance …

Iatrogenic Pneumothorax With Subsequent Subcutaneous Emphysema, George Michael, Eric Yuschak, My Myers

West Florida Division GME Research Day 2020

Lung cancer is the leading cause of cancer-related death in the United States, accounting for 13% of all new cancer diagnoses and 24% of all cancer deaths.1 Transthoracic CT-guided biopsy (CTGB) is commonly used as a diagnostic tool for lung cancer, with high diagnostic accuracy, sensitivity, and specificity. 2 This procedure, however, is not without its risks which include pulmonary hemorrhage and iatrogenic pneumothorax (IPNX). Emergent chest tube placement is standard care of treatment for massive or symptomatic IPNX, commonly with the use of smaller caliber chest tubes. 2 There is, however, a growing discussion over use of larger caliber …

New Onset Psychosis Secondary To Neurosyphilis, Samantha Linda Jane Vu, Lauren Angela Demarco, Francis Butler, Nihal Shah

West Florida Division GME Research Day 2020

Syphilis is a highly contagious sexually transmitted infection (STI) caused by the spirochetal bacterium Treponema pallidum. Transmission occurs through direct contact of painless ulcerative lesions, chancres, located on the genitalia (penis, labia) and oral mucosa. Neurosyphilis is any involvement of the central nervous systems (brain, meninges, or spinal cord) by the bacterium.

Bilateral Sporotrichoid Cutaneous Atypical Mycobacterial Infection Due To Primary Inoculation, Erin Lowe, Alexa Broderick, Richard Miller

West Florida Division GME Research Day 2020

The group of mycobacterial species that excludes Mycobacteria tuberculosis and Mycobacteria leprae is known as nontuberculosis or atypical mycobacteria. Nearly all atypical mycobacteria species can cause cutaneous infection. The diagnosis is challenging as disease may take months to become clinically apparent, morphology is non-specific, routine culture has a low sensitivity, and organisms can be sparse on histopathologic examination. Antibiotic resistance and further complicates management. The Gulf Coast is the highest incidence region of cutaneous atypical mycobacterial infections. Here we present a challenging case of bilateral sporotrichoid atypical mycobacterial infection due to primary inoculation.

Acral Lentiginous Melanoma: A Rare Variant With Unique Diagnostic Challenges, Taylor Gray, Brett Brazen, Maheera Farsi, Richard Miller

West Florida Division GME Research Day 2020

Acral lentiginous melanoma (ALM), named for its location and histological growth pattern, is a rare variant of melanoma. ALM presents on palms, soles, or in association with the nail unit.1 While ALM accounts for approximately 5% of melanomas diagnosed each year, it is the most commonly diagnosed subtype of melanoma in non-Caucasian patients.

Evaluating Awareness Of Low-Dose Computerized Tomography For Lung Cancer Screening, Roshni Leboutillier, Bansi Savla, Vincent Wu, Zia Khan, Erick Mejia, Leah Tehranchi, My Myers, Khine Min, Jennifer Broyles, Stacy Chase

West Florida Division GME Research Day 2020

In the U.S., excluding melanoma, lung cancer is the leading cause of cancer-related deaths.¹
Cigarette smoking is the number one risk factor and is linked to 80-90% of lung cancer deaths.²
Low-dose Computerized Tomography has been shown to reduce lung cancer deaths by 20% in randomized control trials and observational studies.⁴
The U.S. Preventative Task Force recommends annual screening for lung cancer with low-dose computerized tomography (LDCT) in adults ages 55-80 years of age who:

• Have a 30 pack-year smoking history and
• Currently smoke or
• Have quit within the past 15 years.

Vitamin D Deficiency And Perceived Pain, Theodore Korty, Adam Grunbaum, Ken Baxa, Olu Oyesanmi

West Florida Division GME Research Day 2020

Vitamin D deficiency has been shown to contribute to the onset of musculoskeletal pain, headaches, and fatigue (1, 2). Deficient levels of calcium phosphate have been linked to musculoskeletal pain associated with vitamin D deficiency (3). Low levels of calcium phosphate may result in an inadequately mineralized bone matrix, and normalization of vitamin D levels should help to diminish symptoms of pain by correcting suboptimal mineralization of bone matrix (3). One prior study of patients who underwent orthopedic procedures (including treatment of vertebral compression fractures, Colle’s fractures, hip & knee arthroplasty, ligament repair, and meniscal repair), showed that 44% (n …

Evolving De Winter Presentation Of Acute Myocardial Infarction, Caroline Shepherd, Anthony Furiato

West Florida Division GME Research Day 2020

de Winter ECG pattern first detailed in 2008 in a case series Diagnostic criteria

• Tall, prominent, symmetric T waves in the precordial leads
• Upsloping ST segment depression >1mm at the J-point in the precordial leads
• Absence of ST elevation in the precordial leads
• ST segment elevation (0.5mm-1mm) in aVR

Strongly correlated with acute LAD occlusion

Acute Hypoxic Respiratory Failure Due To Organizing Pneumonia With Lipoid/Cholesterol Component Caused By Thc Vaping With E-Cigarette, Jinal K. Patel, Kiran Tirumalasetty, Jessica Khabra, Imran Khan, Johnathan Frunzi

West Florida Division GME Research Day 2020

Vaping has been the new and deemed “safer” way to inhale addictive chemicals such as nicotine and tetrahydrocannabinol (THC), but it does not encompass the detrimental effects of other ingredients in these vaping cartridges that can cause lung injury[1,2]. Similar studies with dabbing (heating THC wax concentrate at high temperatures with butane) showcase rapidly progressing lung injury with massive consolidation and lasting effects on lung parenchyma over a period of time [3]. This case report aims to educate people, especially the younger generation, of the dangers of newer ways of combustible alternatives that have been marketed as a “safer” way …

Hailey-Hailey Disease Successfully Treated With Low-Dose Naltrexone, John Moesch, Richard Miller

West Florida Division GME Research Day 2020

Hailey-Hailey disease (HHD) is an uncommon autosomal dominant disorder resulting from a mutation in the ATP2C1 gene resulting in dysfunction of the Golgi apparatus calcium-associated ATPase, thus interfering with intercellular calcium signaling.

HHD presents clinically as flaccid blisters and erosions in intertriginous areas, especially the axillae and groin.

The major histologic finding is acantholysis throughout the spinous layer of the epidermis, commonly referred to as a “dilapidated brick wall” appearance.

The initial lesions and associated symptoms usually develop during the second or third decade of life.

Complications of HHD include infections (bacterial, fungal, and viral), and malignant transformation (cutaneous squamous …

Progressive Collateral Stenosis Leading To Symptomatic Chronic Total Occlusion, Farhan Shah, Andrew Maiolo

Capital Division GME Virtual Research Day 2020

Chronic total occlusion is defined as the complete obstruction of a coronary artery, with TIMI 0 or TIMI 1 flow, and an occlusion duration of greater than 3 months. We present a case of symptomatic chronic total occlusion in a functional 79 year old female with no past history of coronary artery disease, previously asymptomatic due to robust collateral circulation.

Segmental Neurofibromatosis: Isolated Eruption Of Neurofibromas On The Scapula In A Middle-Aged Man, Christopher White, Brett Brazen, Richard Miller

West Florida Division GME Research Day 2020

No abstract provided.

A Rare Case Of Primary Cutaneous Mucoepidermoid Carcinoma, Hassie Cooper, Maheera Farsi, Richard Miller, Pay Kamrani, Dudith Pierre Victor

West Florida Division GME Research Day 2020

Mucoepidermoid carcinoma (MEC) is a well-documented malignant tumor commonly found in the salivary glands. Cutaneous involvement is very rare, especially when presenting as a primary cutaneous neoplasm. Gallagher first described primary cutaneous MEC in 1959 and since then, to the best of our knowledge, there have been approximately 20 reports published in the literature. Here we present a very rare case of primary cutaneous mucoepidermoid carcinoma.

Novel Inference Methods For Generalized Linear Models Using Shrinkage Priors And Data Augmentation., Arinjita Bhattacharyya

Electronic Theses and Dissertations

Generalized linear models have broad applications in biostatistics and sociology. In a regression setup, the main target is to find a relevant set of predictors out of a large collection of covariates. Sparsity is the assumption that only a few of these covariates in a regression setup have a meaningful correlation with an outcome variate of interest. Sparsity is incorporated by regularizing the irrelevant slopes towards zero without changing the relevant predictors and keeping the resulting inferences intact. Frequentist variable selection and sparsity are addressed by popular techniques like Lasso, Elastic Net. Bayesian penalized regression can tackle the curse of …

Polycystic Ovary Syndrome, Subfertility And Vitamin D Deficiency, Arfa Azhar, Fatima Abid, Rehana Rehman

Department of Biological & Biomedical Sciences

Polycystic ovarian syndrome (PCOS) is the most common endocrine female disorder, affecting 4-18% women of reproductive age. The prevalence of PCOS in South Asian women, especially in Pakistani women, is much higher (52%) as compared to white population (20 - 25% in UK). In Pakistan, vitamin D status displays 31.2% vitamin D insufficiency, 53.5% vitamin D deficiency, and 15.3% normal vitamin D values. Vitamin D deficiency, though very common in the general population, is even more prevalent in PCOS patients, seen in approximately 67-85%, which further correlates to their related comorbidities. A lot of researches have to be directed to …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …