Medicine and Health Sciences Commons^™

A Residency Wellness Survey: Understanding Baseline Resident Wellness: Developing Residency Program Specific Wellness Interventions, Andrew H. Cushing, Michele Mccarroll

North Texas GME Research Forum 2023

Residency is a demanding period of training that requires long hours and prolonged periods of high mental functioning coupled with an emotionally and physically exhausting work load. Nearly half of all physicians experience burnout. Research has suggested that symptoms of burnout are present even in the earliest parts of physician training and the COVID-19 pandemic presented unique factors to the most recent groups of residents. The various burnout screening tools discussed in literature are limited by barriers of cost and lack of specificity for residency. In response to these findings, program specific resident wellness initiatives are now required for accreditation. …

Capnocytophaga Canimorsus Infection In A Hispanic Male After A Dog Bite, Ahmad Ahsen, Shin Kang, Jack Lee, Jose Sanchez, Fadi Albahra, Stephen Chabot, Tariq Zain, Ranjit Nair

North Texas GME Research Forum 2023

Here we present a unique case of a 38-year-old Hispanic male with a history of alcohol abuse and multiple sexual partners, who presented with fulminant sepsis with shock, multiorgan failure, and livedo racemosa after a dog bite a week prior. Patient was intubated on arrival and started on vasopressors and antibiotics. He later developed gangrene of all of extremities, due to the severity of hypoperfusion and disseminated intravascular coagulation (DIC). Eventually, the patient’s clinical status improved, and he was transferred out of the intensive care unit (ICU). Peripheral blood smear showed gram-negative intracellular rods. Blood cultures tested positive for gram-negative …

Platelets In Preeclamptic Pregnancies Fail To Exhibit The Decrease In Mitochondrial Oxygen Consumption Rate Seen In Normal Pregnancies, Joseph Kim, Andrew Malinow, Rosemary Schuh

North Texas GME Research Forum 2023

Cellular oxygen consumption and lactate production rates have been measured in both placental and myometrial cells to study obstetrics-related disease states such as preeclampsia. Platelet metabolic alterations indicate systemic bioenergetic changes that can be useful as disease biomarkers. We tested the hypothesis that platelet mitochondria display functional alterations in preeclampsia. Platelets were harvested from women in the third trimester of either a healthy, non-preeclamptic or preeclamptic pregnancy, and from healthy, non-pregnant women. Using Seahorse respirometry, we analyzed platelets for oxygen consumption (OCR) and extracellular acidification (ECAR) rates, indicators of mitochondrial electron transport and glucose metabolism, respectively. There was a 37% …

West Nile Virus Encephalitis With Status Epilepticus Treated With High-Dose Steroids: A Case Study, Sherwin Thomas, Sawroop Sandhu

North Texas GME Research Forum 2023

West Nile virus (WNV) is a flavivirus endemic in the United States. WNV infection can present with a variety of non-neurologic and neurologic symptoms. Patients who present with WNV neuroinvasive disease have significant morbidity and mortality, with about 10% of cases resulting in death. There is currently no evidence-based treatment for WNV infection. Management is typically with supportive care. Some limited data shows corticosteroids as a possible treatment for neuroinvasive disease. This case report discusses a 55-year-old female patient who presented with altered mental status. She was found to be septic overnight and was found to be in status epilepticus …

Decreasing Rate Of Clabsi At Medical City North Hills With Implementation Of A “Central Line Cart”, William Mangin, Hong Lou, David Maldonado

North Texas GME Research Forum 2023

Central line associated blood stream infections (CLABSI) impart both a significant increase in mortality but also a substantial financial burden onto hospitals. Several processes have been shown to reduce the rate of CLABSIs, most of which have already been implemented at Medical City North Hills (MCNH) Hospital. Key areas of improvement are in those of compliance; namely, the implementation of a dedicated central line cart and a reminder check list to help staff. The project involved implementation of a dedicated line cart at MCNH Hospital. The cart contains supplies for placement of central lines, including trialysis catheters, and arterial lines. …

Phq -9 Utilization In The Primary Care Setting, Michael Armstrong, Ramisa Rahman, Ceferino Cruz Iv, Afsha Rais Kaisani

North Texas GME Research Forum 2023

INTRODUCTION: The Patient Health Questionnaire-9 (PHQ-9) is a tool used to help diagnose depression and assess a patient’s response to treatment. Quality metric (QM) 371 is a measure of PHQ-9 utilization in patients with depression, and Medical City Family Medicine tracks QM 371 in order to improve the quality of care provided to our patients. This project sought to assess utilization of the PHQ-9 in our clinical practice. At the time of this QI project’s inception, QM 371 was reporting at 0%.

METHODS: Our intervention was to give an educational presentation regarding depression, the PHQ-9, as well as how to …

A Rare Case Of Gigantic Ascending Aortic Arch Thrombus, Srujana Dasari, Akhil R. Gade, Nethuja Salagundla, Chandralekha Ashangari, Rashonda Carlisle

North Texas GME Research Forum 2023

An ascending aortic arch thrombus (ACT) is a rare finding in an anatomically normal aorta. It can be seen with aortic dissection or aneurysm. Complications of large thrombus like stroke or systemic emboli are less likely when found in normal aorta. Even with the low risk embolic events, it is even less likely if patients are on therapeutic anticoagulation. Here we discuss this rare case in detail. 49 y/o with PMHx of HTN, HLD, COVID19, DVT s/p thrombectomy, noncompliant with warfarin, ICH from fall presents with left-sided weakness and blurry vision. MRI head showed scattered acute infarction along right PCA …

Early Diagnosis Of Purulent Pericarditis Secondary To Methicillin-Sensitive Staphylococcus Aureus In An End-Stage Renal Disease Patient, Stephen Shey, Alejandro Espinosa-Tello, Amnah Andrabi

North Texas GME Research Forum 2023

Introduction Purulent pericarditis is a rare illness in the modern age of medicine due to the increased usage of antibiotics. Unfortunately, diagnosis of this disease is often delayed due to its nonspecific symptoms. Without treatment, the mortality is nearly one hundred percent due to major complications such as cardiac tamponade and constrictive pericarditis. As a result, most cases of purulent pericarditis are discovered post-mortem. This case report details an early diagnosis of purulent pericarditis secondary to methicillin-sensitive Staphylococcus aureus (MSSA) in an end-stage renal disease (ESRD) patient. Case Presentation A 66-year-old female with past medical history of ESRD initially presented …

When We Pause: On The Discontinuation Of Enteral Feeding In Head And Neck Cancer A Case Report, Kyle Fisk, Ana Sanchez

South Atlantic Division GME Research Day 2023

No abstract provided.

Great Expectations: A Multi-Site Randomized Controlled Trial Of A Novel Patient Expectations Communication Tool In The Emergency Department, Martin Wegman, Jennifer Chapman, Michael Wakely, Hayley Williams, Kelsey Leonard, Elizabeth Piwowarski, Penelope Cote

South Atlantic Division GME Research Day 2023

No abstract provided.

Cerebal Venous Sinus Thrombosis In A Patient With Smith-Magenis Syndrome, Hovra Zahoor, Ameer Hamza, Daniel Vather-Wu, Nilmarie Guzman

South Atlantic Division GME Research Day 2023

No abstract provided.

Acute Thalamic Stroke In A Covid Positive Adult: A Case Report, Norberto Escobales, Daniel Kiehl, Michelle Militello, Aleger Vorbes

South Atlantic Division GME Research Day 2023

No abstract provided.

Quality Improvement: Improving Discussion And Documentation Of Advance Directives In An Outpatient Setting, Amanda Brenner, Elizabeth J. Bogaty, Anjan Parghi

South Atlantic Division GME Research Day 2023

No abstract provided.

Glaucoma Associated With Sinusitis: A Case Report, Nawzad Jacksi, Jennifer Chapman, Martin Wegman

South Atlantic Division GME Research Day 2023

No abstract provided.

Artificial Intelligence In Colonoscopy In A Community Setting, Kunaal Patel, Brett Vanleer-Greenberg

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of An African American Female Presenting With Idiopathic Granulomatous Lobular Mastitis, Wendy Timirau, Esra Sari, Maham Shahid, Nilmarie Guzman, Augusto Villegas

South Atlantic Division GME Research Day 2023

No abstract provided.

Intraoperative Management Of Vasa Previa During Cesarean Delivery, Nicholas Sheets

South Atlantic Division GME Research Day 2023

No abstract provided.

Blastic Plasmacytoid Dendritic Cell Neoplasm, Jacquelyn Medina, Adam Chahine, Courtney Bernett, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of Aquagenic And Cholinergic Urticaria, Marilian A. Canals Rivera, Kyle Rauch, Amanda Brenner, Victoria Charry

South Atlantic Division GME Research Day 2023

No abstract provided.

A Challenging Mimicker: Uncovering Hypopigmented Mycosis Fungoides From Common Benign Dermatoses, Paola Torres-Laboy, Rachel Dykes, Michelle Foley, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2023

No abstract provided.

Under Pressure: A Case Of Acute Compartment Syndrome/Vitt After The Covid-19 Vaccine, Thashali Anthony, Brittany Lyons

South Atlantic Division GME Research Day 2023

No abstract provided.

Disseminated Miliary Tuberculosis And Intestinal Tuberculosis Mimicking Ibd, Danny Tran, Kunaal Patel, Areeba Asfaq, Brittany Lyons

South Atlantic Division GME Research Day 2023

No abstract provided.

Right Atrial Malignant Multi-Focal High-Grade Angiosarcoma With Pulmonary Metastasis, Ly Tran, Jomel Jacinto, Christopher Blakely, Ibrahim Fahdi

South Atlantic Division GME Research Day 2023

No abstract provided.

Clinical Decision Making In A Challenging Case: A Case Of Anomalous Origin Of The Right Coronary Artery With Interarterial Course Presents With Sudden Cardiac Death, Israa Al-Gburi, Amid Bitar, Reem Alqader

South Atlantic Division GME Research Day 2023

No abstract provided.

Timing Of Dual Antiplatelet Therapy (Dapt) Initiation Post Mechanical Thrombectomy With Stent Placement In Acute Ischemic Sroke, Mallory R. Stringer, Eric Shaw, Osman Perez, Emily G. Bowers

South Atlantic Division GME Research Day 2023

No abstract provided.

Hepatitis B Virus Screening In Asian Immigrants: Community-Based Campaign To Increase Screening And Linkage To Care, Aziza Win

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of Type 1 Cryoglobulinemia With Waldenstrom’S Macroglobulinemia/Lymphoplasmocytic Lymphoma And Dry Gangrene, Abhinav Rao, Diego Garrido, Fahim Syed, Kody Dhaliwal, Charles Holladay, Julia Saylors, Matthew Madden, Jason Clark

South Atlantic Division GME Research Day 2023

No abstract provided.

Effect Of High Sensitivity Troponin Assay On Hospital Resources And Emergency Department Discharges In Patients Presenting With Symptoms Concerning For Myocardial Infarction, Hans Koop, Keysha N. Gonzalez, Madalyn Nygren, Andrea Deneen, Jennifer Chapman

South Atlantic Division GME Research Day 2023

No abstract provided.

Non-Nec Pneumatosis And Pneumoperitoneum, Arham Aslam, Alexander Soutter

South Atlantic Division GME Research Day 2023

No abstract provided.

Case Report: Right Ventricular Free Wall Rupture Due To Displaced Aicd Lead, Abhinav Rao, Angeli Patel, Kunaal Patel, Craig Herrforth, Fahim Syed, Brittany Lyons, E Maci

South Atlantic Division GME Research Day 2023

No abstract provided.