Medicine and Health Sciences Commons^™

Unusual Presentation Of Pulmonary Hypertension From Subacute Hyper Viscosity: A Case Report, Jonathan Martin, Tara Rakiewicz, Ubaldo Martinez-Outshoorn, Adam Binder

Jefferson Hospital Staff Papers and Presentations

No abstract provided.

Midwives' Self-Efficacy In Perimenopause Care: An Educational Intervention, Yinka Sokunbi

Doctor of Midwifery Advances in Midwifery Projects

Study Purpose: This project evaluated the effectiveness of an asynchronous continuing education (CE) webinar in improving midwives’ self-efficacy to provide comprehensive perimenopause care.

Research Questions

1. What is the impact of a targeted CE webinar on midwives’ self-efficacy in providing comprehensive perimenopause care?

2. How do participants perceive the impact and acceptability of a pilot CE webinar?

Significance/Background: Despite midwifery’s defined role in lifespan care, engagement in perimenopause management remains limited. Gaps in formal education and continuing professional development contribute to low confidence in this area. Guided by Social Cognitive Theory, this project targeted self-efficacy as a modifiable factor influencing …

Assessment Of Correctness, Content Omission, And Risk Of Harm In Large Language Model Responses To Ophthalmology Continuing Medical Education Questions, Jacqueline L. Chen, Amanda J. Lu, Rohan Verma, Li Wang, Douglas D. Koch, Allison J. Chen

SKMC Student Presentations and Publications

PURPOSE: To evaluate the accuracy and prose responses of 2 large language models (LLMs) to ophthalmology continuing medical education questions.

DESIGN: Question prompts and multiple choice (MC) answer options were input into the 2 LLMs, and responses were analyzed for accuracy and assessed for evidence of correctness, completeness, bias, and potential harm using a previously reported standardized rubric.

SUBJECTS: Basic and Clinical Science Course questions and MC answer options from the American Academy of Ophthalmology question bank were used as inputs into the 2 LLMs (ChatGPT-4 and Google Vertex's Gemini Pro 1.5).

METHODS: The MC responses were assessed for accuracy …

Seeing Skin, Seeking Evidence: Lessons From A Dermatology Internship, Isabella Floyd

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Indoor tanning exposes individuals to artificial ultraviolet (UV) radiation through devices such as tanning beds and sunlamps, increasing the risk of skin damage and malignancy. Prior research suggests associations between indoor tanning and melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC), with potential variation based on age of initiation and cumulative exposure.

Purpose: The purpose of this literature review was to examine the association between indoor tanning and skin cancer risk, with a focus on age at first exposure, frequency, and duration of tanning bed use across melanoma, BCC, and SCC outcomes.

Methodology: A structured literature review …

Significantly Elevated Procalcitonin In Aki Reliable Or Not Reliable?, Sally Othman, Sujata Kambhatla, Chadi Saad

Conference Presentation Abstracts

Introduction Procalcitonin (PCT) is a biomarker that helps distinguish bacterial infections from other causes of infection or inflammation and can be used as a helpful adjunct to clinical judgment to resolve diagnostic uncertainty. However, the reliability of procalcitonin goes down when a patient has Acute kidney injury (AKI). Yet is there any significance for procalcitonin if it is extremely high, in hundreds, same in our patient, despite the patient in AKI and can PCT still be used to help determine mortality along with all other markers, or independent from other markers. Case report 36 years old male with PMH of …

Device And Patient-Related Complications Of Renal Denervation For Resistant Hypertension: A Post-Marketing Analysis Of The Fda Maude Database, Sai Tharun Reddy Gopannagari, Kesava Manikanta Achuta, Divya Ganisetti, Towfiqul Chowdhury, Chadi Saad

Conference Presentation Abstracts

Background: Renal denervation (RDN) has re-emerged as an adjunctive therapy for resistant hypertension following recent FDA approvals of ultrasound- and radiofrequency-based systems. While contemporary randomized trials report a favorable safety profile, real-world post-marketing data may capture a broader spectrum of complications. Methods: We queried the FDA Manufacturer and User Facility Device Experience (MAUDE) database from inception through December 22, 2025, using product code ‘QYI’ and brand names ‘Paradise’ (Recor Medical) and ‘Symplicity Spyral’ (Medtronic). Reports describing RDN procedures for resistant hypertension were included. Events were manually reviewed and categorized as vascular, device-related, hemodynamic/arrhythmic, neurologic, or other. When multiple events occurred …

When Optimal Therapy Becomes High Risk: A Risk-Benefit Framework For Beta-Lactam Desensitization In Life-Threatening Mssa Infection, Rana Amoush, Aaron Kobernick

Conference Presentation Abstracts

Background Beta-lactam antibiotics are preferred for invasive methicillin-sensitive Staphylococcus aureus (MSSA) infections, especially those involving prosthetic material. Management is challenging in patients with severe beta-lactam hypersensitivity, as alternative agents may be less effective or poorly tolerated. Limited guidance exists on reassessing desensitization risk when second-line therapies become untenable. Purpose To present a case-based risk-benefit framework for evaluating beta-lactam desensitization in medically complex patients with life-threatening MSSA infections. Methods We retrospectively reviewed a patient with recurrent MSSA prosthetic graft infection and severe beta-lactam hypersensitivity. Clinical decision-making was analyzed using a structured risk–benefit framework incorporating infection severity, therapeutic superiority of beta-lactams, tolerance …

Implementation Of A Multi-Institutional Enhanced Recovery After Surgery (Eras) For Elective Spine Surgery: Two-Year Michigan Spine Surgery Improvement Collaborative (Mssic) Experience, Anisse Chaker, Kylie Springer, Kari Jarabek, Michael Melhem, Heegook Yeo, Jian-Hui Hu, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, Victor Chang

Conference Presentation Abstracts

Introduction: Enhanced Recovery After Surgery (ERAS) protocols have been introduced to several surgical specialties with the intention to reduce peri-operative adverse events and improve various health-system quality metrics including length of stay and patient satisfaction. Though this has been studied in the setting of spine surgery, the vast majority are single institution protocols biased toward academic teaching hospitals. There is a paucity of literature studying the utilization of a multi-institutional ERAS protocols that is applicable to community hospitals without associated training programs. We present the Michigan Spine Surgery Improvement Collaborative (MSSIC) two-year experience implementing a multi-institutional ERAS protocol for elective …

Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Though often necessary for adequate analgesia after spine surgery, continued opioid use can lead to chronic dependency. The Michigan Spine Surgery Improvement Collaborative (MSSIC) has demonstrated in prior work the promise of utilizing a multi-institutional morphine milliequivalent (MME) cutoff for elective anterior cervical surgery in the opioid naıve population. However, the effect of this cutoff in patients who were already on opioids pre-operatively have not previously been studied. The goal of this study was to evaluate whether changes in prescribing patterns in the opioid naıve population would also translate to the non-naıve populations, and whether the non-naıve population would …

The Impact Of Covid-19 On Spine Surgery: Temporal Trends In Complications And Patient-Reported Outcomes Across A Statewide Cohort, Ali Mehaidli, Richard Easton, Ahmad Almaat, Gary George, Alqasim Elnaggar, Victor Chang, Doris Tong, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: The COVID-19 pandemic caused major disruptions in elective surgical care, including spine surgery, due to widespread hospital restructuring and resource limitations. Although previous studies have examined surgical volumes and safety during the pandemic, limited data exist on how outcomes varied across multiple phases of the pandemic, especially in real-world, multicenter spine surgery populations. Material and Methods: This retrospective cohort study used data from the Michigan Spine Surgery Improvement Collaborative (MSSIC) to compare outcomes in patients undergoing lumbar or cervical spine surgery across four COVID-19 timeframes: pre-COVID (1/2019-2/2020), onset-COVID (3/2020-9/2020), active-COVID (10/2020-2/2022), and post-COVID (3/2022- 12/2022). Patient demographics, surgical characteristics, …

Pertussis, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Digital Ischemia, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Piloting A Pediatric Screener For Assessing Emergent Literacy With Preschool Children, Nafia Sarhadi

Poster Presentations

From infancy, children develop literacy knowledge, which provides them with the needed skills for reading in primary school (Castillo-Rabanal &Heitmayer, 2025). Before children start to read, they develop skills that involve increasing their rhyming, alphabet, and vocabulary knowledge. Literacy is considered a social determinant of health as it plays a role in one's physical, social, and emotional maturity (Lesauxet. al, 2007). The Bay Area Women Coalition, (BAWC) Inc. has partnered with the Autism, Pediatric Language & Literacy (APLL) Lab to implement PEEL, following modifications identified by the community. The current pre-to-posttest assessment is unsuitable for community participation. An efficient method …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Honors Theses

Medication choice is tightly regulated in most situations, but in the field of obstetric medicine, the American College of Obstetricians and Gynecologists (ACOG) recommends both labetalol and nifedipine as oral treatments for emergent hypertension, with no preference shown between the two. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile. The goals of this study were to determine whether tailoring the oral hypertensive medication to a patient’s hemodynamic profile is associated with better blood pressure control within 72 …

Choosing Death: The Moral Legitimacy Of Voluntary Active Euthanasia, Emma Rougeou

Honors Theses

During the last three decades, the issue of physician assisted suicide has captivated the interest of private citizens and state legislatures. Thinking about the matter of end-of-life concerns, particularly surrounding euthanasian (practices that hasten the deaths of suffering terminally ill people) have shifted. Views of private citizens and state-level legislation reflects a “slow shift to more permissive attitudes” (Cohen et al., 2012). Meanwhile, as recently as March 2026, state legislators in conjunction with the NY State Governor, passed a bill legalizing medical aid in dying for terminally ill patients. This thesis is intended to thoughtfully contribute to meaningful discourse on …

Spectral Characterization Of Colorectal Cancer Using Excitation-Scanning Hyperspectral Imaging, Natalie Hadad

Honors Theses

Colorectal cancer is one of the most common and deadly cancers worldwide, with a lifetime risk of approximately one in twenty-three for men and one in twenty-five for women. Although early detection significantly improves survival, current diagnostic approaches such as tissue biopsy are invasive, reliant on subjective interpretation, have extended turnaround times, and risk missing flat or depressed lesions that are more difficult to detect than raised polyps. These limitations highlight the need for objective, minimally invasive technologies capable of detecting early tissue changes. This study investigates excitation-scanning hyperspectral imaging (Ex-HSI) as a label-free optical approach for identifying colorectal cancer–associated …

Novel Biomarker Discovery In Multiple Sclerosis, Manisha Gangasani

Honors Theses

Multiple Sclerosis (MS) is a chronic neuroinflammatory disorder affecting the brain, spinal cord, and optic nerve. Patients experience cognitive, motor, autonomic, and emotional symptoms that often overlap with other neurological conditions, making early diagnosis challenging. Current diagnostic criteria require evidence of lesions with dissemination in time and space. Racial disparities in MS outcomes are well documented, with Black individuals often exhibiting greater disease severity, higher relapse rates, and increased disability compared to White individuals. These differences likely reflect a combination of genetic, biological, environmental, and healthcare access factors, underscoring the need to improve early diagnosis and reduce inequities in care. …

Characterization Of Circulating Extracellular Proteome In Plasma Samples Of Triple-Negative Breast Cancer Patients, Brionna Wilson

Honors Theses

Extracellular vesicles (EVs) are membrane-bound vesicles secreted by cells in the body that play an important role in intercellular signaling, immune modulation, and transfer of biomolecules between cells. EV s reflect the physiological state of their cells of origin, so they are being explored as potential noninvasive biomarkers for cancer detection and monitoring. Triple-negative breast cancer (TNBC), an aggressive subtype lacking targeted therapies, is difficult to detect early and currently has no reliable prognostic biomarkers. This study aimed to quantify EV concentrations in the blood serum of TNBC patients (n=40) compared with cancer-free healthy controls (n=35) as well as determine …

Developing A Protocol For Non-Cellular Transplantation Of Donor Mitochondria Into Recipient Cells, Andrew Parton

Honors Theses

Tumor innervation has emerged as a critical feature of cancer progression, with increased nerve density correlating with enhanced aggressiveness, metastatic dissemination, and poor clinical outcome. However, the functional contribution of neurons to tumor biology remains incompletely defined. We recently identified the intercellular transfer of mitochondria from neurons to cancer cells as a mechanism that promotes tumor progression. We therefore hypothesized that disruption of this transfer could attenuate tumor aggressivity. To directly investigate this process, we developed an approach to isolate mitochondria from donor cells and transplant them into recipient cancer cells independently of canonical cell-cell interactions. Transferred mitochondria were tracked …

Global Perspectives On Cns Drug Innovation: Achievements, Barriers, And Priorities For The Next Decade, Hiroyuk Uchida, Gabriella Gobbi, Joseph Zohar, Allan Young, Dan Rujescu, Ming-Chyi Huang, Suresh Sundram, Lukoye Atwoli, Jana Vukovic, Kazutaka Ikeda

Internal Medicine, East Africa

Background Over the past decade, neuropsychopharmacology has shifted from stagnation to momentum, with first-in-class mechanisms and biomarker-enabled trials spanning psychiatry and neurology.

Methods We narratively synthesized advances from 2013 to 2026 across central nervous system (CNS) discovery and development, including pivotal trials, regulatory actions, digital/real-world evidence, genetics, artificial intelligence (AI), and implementation/global-access themes that are endorsed by international societies.

Results Therapeutic gains include rapid-acting drugs for treatment-resistant depression (intranasal esketamine); psychedelic-assisted therapy for posttraumatic stress disorder and depression; neuroactive steroid γ-aminobutyric acid-A receptor positive allosteric modulators (brexanolone, zuranolone) for postpartum depression; non-dopaminergic muscarinic agonists (xanomeline–trospium) for schizophrenia; orexin receptor antagonists …

Beyond The Cycle: How Menstruation Influences Gender Identity And Well-Being In Binary And Non-Binary Adults, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased …

Consensus Guidelines On Inferior Petrosal Sinus Sampling: A Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Farhan Siddiq, Hunter Brooks, Esra Demirtas, Ibrahim Ahmad Bhatti, Sami Al Kasab, Adam De Havenon, Robin Novakovic, Ossama Y. Mansour, Cynthia L. Kenmuir, Ameer E. Hassan

School of Medicine Publications

Background: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard test to distinguish Cushing disease (CD) from ectopic adrenocorticotropic hormone (ACTH) secretion when biochemistry confirms ACTH-dependent Cushing syndrome and pituitary magnetic resonance imaging is equivocal. However, practice varies widely between centers, leading to false negatives, misinterpretation, sampling errors, and avoidable risk. Neurointerventionalists performing BIPSS have lacked dedicated, procedure-focused guidance.

Methods: Using the Society of Vascular and Interventional Neurology Guidelines and Practice Standards framework, a multidisciplinary panel (endocrinology, interventional neuroradiology, and endovascular neurosurgery) performed a systematic review through August 2025 and developed recommendations graded by class of recommendation and level of …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski, Dustin Wallace Phd, Cara M. Hoffart, Jenny Scheurich Phd

Posters

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: …

Recognizing What Matters Most: Using Safety-Critical Tasks To Strengthen Central Line-Associated Bloodstream Infection (Clabsi) Prevention Rounds, Lacey Bergerhofer, Christian Anthony Schneider, Emily Evans

Posters

Background: Our CLABSI improvement team developed high-risk rounding processes on the Hematology/Oncology unit. Expanding this model to additional Med/Surg units was challenging due to limited staffing and time-intensive tasks required during rounds. Concurrently, CLABSI rates across other Med/Surg units increased, necessitating a scalable approach. Objectives: Apparent Cause Analysis (ACA) review in Med/Surg units identified an opportunity to strengthen surveillance by engaging Vascular Access subject-matter experts. Our proactive high-risk rounds pilot led to CLABSI rate reduction. The objective was to expand service coverage without compromising established high-risk rounding quality standards. Our goal is to assess > 90% of central lines in Med/Surg …

Aspirin And Preterm Birth Among Pregnant People With Increased Heat Exposure: Secondary Analysis Of A Randomized Clinical Trial, Gabriella Meltzer, Luke Duttweiler, Sarah Saleem, Kartik Shankar, Manolo Mazariegos, Antoinette Tshefu, Jackie Patterson, Elwyn Chomba, Waldemar Carlo, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia Hibberd, Edward Liechty, Fabian Essamai, Edwin Asturias, Denise Babineau, Janet Moore, Cascade Tuholske, Andrew Zimmer, Brent Coull, Elizabeth Mcclure, Robert Goldenberg, Nancy Krebs, Matthew Hoffman, Blair Wylie

Global Health Articles

IMPORTANCE: Scalable interventions are urgently needed to mitigate the adverse effects of heat on pregnancy and newborn health.

OBJECTIVE: To evaluate whether low-dose aspirin modifies the association between heat exposure and preterm birth.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the Global Network for Women's and Children's Health Research Aspirin Supplementation for Pregnancy Indicated Risk Reduction in Nulliparas (ASPIRIN) randomized, double-blinded, placebo-controlled clinical trial was conducted from March 2016 to June 2018. Statistical analyses were performed from June 2024 to June 2025. The study settings included the Democratic Republic of Congo, Zambia, Kenya, Guatemala, Pakistan, and Belagavi and Nagpur, …

A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti

Conference Presentation Abstracts

Introduction Thymomas are rare epithelial tumors of the anterior mediastinum, accounting for < 1% of adult malignancies, with an estimated annual incidence of approximately 0.15 cases per 100,000 persons. Although often indolent, thymomas are malignant by definition and may invade locally, recur, and, less commonly, disseminate. They are classically associated with autoimmune conditions, most notably myasthenia gravis, yet their relationship with hereditary cancer syndromes remains poorly defined. Germline BRCA2 mutations are well established in the pathogenesis of breast, ovarian, pancreatic, prostate, and other malignancies through impaired homologous recombination DNA repair. However, an association between BRCA2 mutations and thymic epithelial tumors has rarely been reported. We describe an unusual case of invasive malignant thymoma with pericardial invasion in a BRCA2 mutation carrier, discovered concurrently with a synchronous FDG-avid breast mass suspicious for malignancy. Case Presentation An 85-year-old man with a history of CAD, hypertension, GERD, and prior radical prostatectomy presented with several months of unintentional weight loss and chronic diarrhea. During evaluation for recurrent appendicitis, imaging incidentally revealed a large anterior mediastinal mass measuring up to 7.9 cm with irregular margins. FDG-PET demonstrated moderate metabolic activity within the mass (SUVmax 3.8). CT-guided biopsy revealed a thymic epithelial neoplasm consistent with thymoma. There was no clinical evidence of myasthenia gravis. He subsequently underwent partial sternotomy with thymectomy. Pathology demonstrated a 6-cm type B2 thymoma with direct pericardial invasion, positive surgical margins (R1), and no regional lymph node involvement (pN0), consistent with pT2 stage III disease by the Masaoka–Koga system. Given high-risk features, adjuvant radiation therapy was initiated, with planned surveillance using PET imaging and circulating tumor DNA monitoring. Concurrent PET imaging identified a palpable FDG-avid right breast mass. Genetic testing revealed a pathogenic germline BRCA2 mutation. The breast lesion is currently undergoing diagnostic biopsy and surgical evaluation. Discussion Thymomas are malignant neoplasms with a predilection for local invasion. Type B2 thymomas carry a higher risk of recurrence, particularly in the presence of pericardial invasion or incomplete resection. Complete surgical excision remains the cornerstone of management, while postoperative radiotherapy is recommended in invasive or R1 disease to reduce locoregional recurrence. The coexistence of invasive thymoma and a germline BRCA2 mutation is exceedingly rare and raises questions regarding shared oncogenic mechanisms. While thymic epithelial tumors are not classically associated with BRCA mutations, DNA repair defects may contribute to tumorigenesis in rare malignancies. The presence of a synchronous FDG-avid breast mass in a male BRCA2 carrier further underscores the importance of comprehensive oncologic and genetic evaluation and highlights the need for multidisciplinary management in complex hereditary cancer presentations. Conclusion We report a rare case of malignant type B2 thymoma with pericardial invasion in a BRCA2 mutation carrier, identified alongside a synchronous breast mass suspicious for malignancy. This case highlights the potential intersection between thymic epithelial tumors and hereditary cancer syndromes, reinforces the importance of genetic evaluation in patients with multiple malignancies, and underscores the need for long‑term multidisciplinary surveillance. Further investigation is warranted to elucidate any causal relationship between BRCA‑mediated DNA repair dysfunction and thymoma development.

Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka

Conference Presentation Abstracts

Background: Nonclassic congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is generally a milder variant of congenital adrenal hyperplasia characterized by partial enzyme activity and variable increases in adrenal androgen levels. Patients presenting with such a condition may present in adolescence or adulthood with symptoms such as acne, hirsutism, irregular menses, and infertility. These symptoms often overlap with those of Polycystic Ovary Syndrome (PCOS), creating challenges in differentiation and management. It is critical to differentiate between PCOS and NCCAH in females of reproductive age, as hyperandrogenism treatment depends on the underlying cause, such as adrenal, ovarian, or a combination of …

The First Cut Is The Deepest: Understanding Learner Trauma In The Emergency Medicine Clerkship, Dimitrios Papanagnou, Leela Raj, Karen E. Watkins, Xiao C. Zhang, Andres Fernandez, Md, Victoria J. Marsick

Department of Emergency Medicine Faculty Papers

BACKGROUND: As third-year medical students transition into high-stakes, high-stress clinical environments like the emergency department (ED), they may experience significant personal trauma. However, little is known about how this trauma is experienced early in their training - specifically during the transition from preclinical to clinical learning environments. This study addresses that gap by exploring third-year medical students' experiences of trauma during the emergency medicine (EM) clerkship through the lens of Trauma-Informed Care (TIC) and identifies workplace factors and intersectional demographics influencing these experiences.

METHODS: This qualitative study used the critical incident technique to explore emotionally-significant events encountered by third-year medical …