Medicine and Health Sciences Commons^™

Case Report: Clonidine Withdrawal-Induced Posterior Reversible Encephalopathy Syndrome (Pres), Aura M. C. Calderon, Francisco Arias, Ivan Mogollon, Luis Salcedo, Hector Arredondo

Research Colloquium

Introduction: Clonidine, an agonist of central α2-adrenergic and imidazoline receptors, possesses the capacity to elicit transient episodes of hypertension succeeded by hypotension and bradycardia. This particular case underscores a rare yet significant complication, Posterior Reversible Encephalopathy Syndrome (PRES), that can occur subsequent to the abrupt cessation of clonidine administration.

Case Presentation: An 18-year-old male with severe asthma and prior ICU admissions presented to the emergency department after two seizures. He had recently been treated for an asthma exacerbation complicated by hypertension, for which clonidine was initiated. He was discharged on clonidine and prednisone but discontinued clonidine the day before admission …

Think Beyond Migraine: A Case Of Transverse Venous Stenosis Masquerading As A Common Headache, Tejaswini Swamy, Aun A. Bangash, Chloe C. Harris, Victoria Parada

Research Colloquium

Introduction: Headache is a common complaint in clinical medicine, but when it is persistent, orthostatic in nature, and unresponsive to conservative therapy, it warrants evaluation for less common etiologies. This case highlights a compelling diagnostic journey involving intracranial hypertension secondary to transverse venous sinus stenosis (TVSS)—a condition that can be under-recognized, especially in patients without classic risk factors or overt imaging abnormalities. Here, a seemingly benign symptom masked a reversible cause of debilitating headaches, unmasked only through careful clinical suspicion and escalation to advanced neuroimaging. Most importantly, it reminds us that in patients with persistent symptoms, we must look beyond …

Norovirus Gastroenteritis Presenting With Intractable Vomiting, Starvation Ketosis, And Hypertensive Emergency: A Case Highlighting Diagnostic And Infection Control Implications, Aun A. Bangash, Blake C. Martin, Stephen M. Garcia, Gesler Madhere, Jose E. Campo Maldonado

Research Colloquium

Background: Norovirus is the most common cause of viral gastroenteritis in adults worldwide, yet its vomiting-dominant presentation is often under-recognized, particularly outside outbreak settings. This case is significant due to both the severity of presentation—including starvation ketosis and hypertensive emergency—and the infection control implications within the healthcare environment. Norovirus’s high transmissibility and environmental resilience necessitate heightened clinical awareness, even in isolated cases.

Case Presentation: A 43-year-old male with peripheral arterial disease, uncontrolled hypertension, and alcohol use disorder presented with over 20 episodes of vomiting, right-sided abdominal pain, and shortness of breath. He denied diarrhea and had a known sick contact …

A Delicate Balance: Antibiotic Allergy, Renal Infection, And Diabetic Ketoacidosis, Aun Ali Bangash, Muhammad Ali Bangash, Ruben Meza Martinez

Research Colloquium

Introduction: Acute pyelonephritis is a bacterial infection of the renal parenchyma and is most commonly caused by Escherichia coli. It presents with systemic and genitourinary symptoms such as fever, flank pain, and urinary abnormalities, which include increased urinary frequency and burning sensation upon urination. Timely antibiotic therapy is necessary to avoid complications like renal abscesses or urosepsis. Empiric treatment often involves third-generation cephalosporins such as ceftriaxone because of their efficacy and renal penetration. However, in patients allergic to ceftriaxone, an allergy seen in approximately 1–2% of cases, alternative regimens need to be brought into the picture. Levofloxacin, a fluoroquinolone, is …

Assessing The Use Of Marker-Less Motion Capture Systems For Neurological Disorders In Indoor Vs Outdoor Settings., Anjana Ganesh, Kelsey Baker

Research Colloquium

Background: Marker-less motion capture systems have improved the assessment of human movement by allowing for a non-invasive, affordable, quantitative data collection useful in clinical settings. However, their use in real-world community care settings is largely underexplored, presenting a unique opportunity to bridge the gap between controlled laboratory environments and the complexity of providing care in diverse, everyday contexts. This systematic review examines the differential use of MMC systems across real-world indoor environments (clinics, homes, living labs) and outdoor settings (public walkways, community spaces), with a focus on their application to neurological disorders such as stroke and neurodegenerative diseases.

Methods: …

Clinical Considerations For Spinal Fusion In Adolescents On Puberty Blockers: Hormonal And Surgical Implications, Anesu K. Murambadoro, Rebekah Julie Park, Sonya Bhatia, Shaunte Hadnot, Model Zerfu, Kathryn Horton

Research Colloquium

Background: Spinal fusion is a common intervention for adolescent scoliosis, particularly during periods of rapid skeletal growth in patients with progressive curves or those who do not meet criteria for non-operative management. Adolescents receiving puberty suppression with gonadotropin-releasing hormone (GnRH) analogs as part of gender-affirming care present unique clinical challenges due to altered bone metabolism and delayed physeal (growth plate) maturation.

Methods: We conducted a narrative review of the current literature evaluating the effects of puberty blockers and gender-affirming hormone therapy (GAHT) on bone metabolism, skeletal development, and outcomes related to spinal fusion in adolescents.

Results: GnRH analogs are associated …

Examining Domain-Specific Neuropsychological Differences Across Cognitive Status Groups In Utrgv South Texas Alzheimer’S Disease Research Center Cohort, Andrea Ramirez, Estrella Palomo, Rosa Pirela, Hector Rodriguez, Roberto Reyes, Eron Manusov, Ney Alliey-Rodriguez, Jesus D. Melgarejo, Gladys E. Maestre, Silvia Mejia-Arango

Research Colloquium

Background: The Uniform Data Set 3.0 Neuropsychological Battery (UDS3NB) is a standardized tool for assessing cognitive function in aging populations. Factor analytic studies on the UDS 3 have shown that performance across cognitive domains, such as memory, attention, executive function, language, and visuospatial abilities, can differentiate between cognitive status groups, cognitively normal (CN), mild cognitive impairment (MCI), and dementia. Understanding how specific cognitive domains relate to diagnostic categories, CN, MCI, and dementia, is essential for early identification. Additionally, socioeconomic and health factors may influence cognitive outcomes and should be considered alongside cognitive performance. The aims of this study are to: …

Systemic Vascular Dysregulation And Retinal Microvascular Alterations In Glaucoma, Amin Ibrahim, Tori Sayers, Alexa Nichols, Igor Zwir, Andrew Tsin, Lorena Flores-Hernandez, Gladys E. Maestre, Jesus D. Melgarejo

Research Colloquium

Background: Glaucoma is a multifactorial, progressive optic neuropathy, for which both mechanical and vascular mechanisms of pathogenesis have been proposed. Optical coherence tomography angiography (OCTA) enables noninvasive visualization of the choroidal and retinal vasculature and may be used to quantify vascular changes associated with glaucoma. Systemic risk factors, including variations in blood pressure (BP), whether low or elevated, have been associated with the vascular pathogenesis of glaucoma. This systematic review aims to synthesize the current evidence on the relationship between systemic vascular dysregulation and OCTA-derived retinal vascular markers in glaucomatous eyes.

Methods: Following PRISMA guidelines, we conducted a systematic search …

Treatment Evolution In Paroxysmal Nocturnal Hemoglobinuria: A Case Series Of Sequential Treatment Versus Early Iptacopan Use, Alyssa L. Sepulveda, Ronald Shaju, Yolanda Gutierrez, Francisco Arias Reyes, Daniela Hernandez

Research Colloquium

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired hematopoietic stem cell disorder characterized by complement-mediated intravascular hemolysis, bone marrow failure, and a heightened risk of thrombosis. Prior to targeted therapies, management of PNH was largely supportive, focusing on transfusions, anticoagulation, and bone marrow transplantation. Thromboembolic events were the leading cause of mortality, accounting for approximately 40-67% of deaths prior to the introduction of complement inhibitors such as eculizumab, a monoclonal antibody targeting terminal complement protein C5. In December 2023, iptacopan, an oral factor B inhibitor that targets the alternative complement pathway, was approved for PNH, offering improved patient compliance …

Efficacy Of Psychedelics Therapy Across Psychiatric Disorders: An Umbrella Review Of Meta-Analyses, Alissa A. Lopez, Ihsan Salloum, Juan C. Lopez-Alvarenga

Research Colloquium

Background: Psychedelics are gaining renewed scientific interest as a treatment for mental health conditions such as major depression, post-traumatic stress disorder (PTSD), anxiety, and addiction. Numerous clinical trials and meta-analyses suggest these substances may produce significant therapeutic effects. However, there is currently no high-level synthesis comparing how different psychedelic compounds perform across a range of psychiatric conditions. A quantitative umbrella review is needed to clarify whether psychedelics broadly improve mental health outcomes, and whether certain compounds are more effective for specific diagnoses.

Methods: The aim of this study is to conduct an umbrella review (meta-analysis of meta-analyses) to assess the …

Anemia Is Never The Diagnosis: Autoimmune Hemolytic Anemia As A Herald Of Late-Onset Systemic Lupus Erythematosus, Alhasan Asaad, Dixie Duran, Cristina Duran-Nesovic, Jose E. Campo Maldonado

Research Colloquium

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by multisystem involvement and a highly variable clinical presentation. It predominantly affects women of childbearing age and arises from complex interactions between genetic, environmental, and hormonal factors, resulting in immune dysregulation and widespread inflammation. The disease can manifest in nearly any organ system, with common presentations including skin rashes, arthritis, renal dysfunction, and hematologic abnormalities. Despite advances in understanding its pathogenesis and management, SLE remains a diagnostic and therapeutic challenge due to its heterogeneous nature and potential for severe complications. This case report highlights a unique presentation of SLE, …

Retinal Vessel Density And Diameter Changes In Alzheimer’S Disease: A Systematic Review, Alexa E. Nichols, Tori Sayers, Amin Ibrahim, Jorge Zwir, Andrew Tsin, Lorena Flores-Hernandez, Gladys Maestre, Jesus Melgarejo

Research Colloquium

Background: Alzheimer’s disease (AD) is characterized by cerebral microvascular dysfunction, which may be mirrored in the retina due to shared embryological origins and common risk factors such as hypertension.1 Optical coherence tomography angiography (OCTA) offers a noninvasive approach to quantify retinal microvascular changes associated with AD.2 This systematic review evaluated retinal vessel density and diameter changes in relation to AD and related disorders, including mild cognitive impairment.

Methods: A systematic search of PubMed and Scopus was conducted following PRISMA guidelines.3 Eligible studies included peer-reviewed human research using OCTA to assess retinal vessel density and/or diameter in mild cognitive impairment, AD, …

Etomidate Vs Ketamine In Rapid Sequence Intubation: A Comparative Review Of Clinical Efficacy And Safety, Abelardo Rodriguez, Cesar Ortega, Jessica Daza

Research Colloquium

Background: Rapid Sequence Intubation (RSI) is a critical procedure in emergency and critical care settings, and the choice of induction agent can significantly affect patient outcomes. Etomidate and Ketamine are two widely used agents with distinct pharmacologic profiles. Understanding their comparative efficacy and safety across clinical contexts is essential for optimizing care in high-acuity environments.

Objective: To compare Etomidate and Ketamine as induction agents for RSI, focusing on their mechanisms of action, hemodynamic effects, and clinical outcomes in various patient populations.

Methods: A literature-based review was conducted using key databases including PubMed, Cochrane, and clinical guidelines. Studies examining the use …

Refractory Neutropenic Fevers In Aml: Unmasking Voriconazole-Resistant Invasive Aspergillosis, Abdel Martinez Borrego, Sahir Bhatti, Cesar Gutierrez

Research Colloquium

Background: Persistent fever in neutropenic patients with acute myeloid leukemia (AML) often raises concern for invasive fungal infections (IFIs), especially when unresponsive to broad-spectrum antibiotics and first-line antifungal agents like voriconazole. Invasive aspergillosis (IA), primarily caused by Aspergillus fumigatus, is a major cause of morbidity and mortality in this population, with mortality rates exceeding 50% in refractory cases. The emergence of azole-resistant Aspergillus, now reported in up to 10–15% of isolates in some regions, has complicated management. Patients may present with nonspecific symptoms such as persistent fevers, as well as concerning findings like cutaneous lesions—a clue to hematogenous spread—and …

Information & Schedule Flyer, Macon & Joan Brock Virginia Health Sciences At Old Dominion University

Cardiovascular Research Symposium

Information and schedule for Cardiovascular Research Symposium: Bridging Gaps and Advancing Care.

The Role Of Ceramides As Biomarkers And Therapeutic Targets For Cardiometabolic Disease And Its Intersection With Cellular Aging, Youssef Moustafa Shalaby

Thesis/ Dissertation Defenses

Ceramides (Cer), a subclass of sphingolipids with potent bioactive properties, have gained recognition as key players in the pathogenesis of cardiometabolic diseases (CMD). They modulate critical cellular functions such as apoptosis, inflammation, insulin signaling, and oxidative stress. This dissertation explores the dual role of Cer as both early diagnostic markers and therapeutic targets, bridging clinical insights with mechanistic understanding through a combination of human and experimental studies.

A highly sensitive liquid chromatography–tandem mass spectrometry (LC-MS/MS) method was developed and validated to quantify intracellular levels of specific Cer species, including CerC16:0, CerC18:0, CerC22:0, CerC24:0, and CerC24:1. This method was translated into …

Novel Percutaneous Repair Of Femoral Pseudoaneurysms Using Perclose Proglide™: A Case Series, Ryan Mancoll, Emily Burnett, Nicholas Bandy, Benjamin Samberg, Thomas Cook, Jacob Hoffman, Christopher Murter, Matthew Rossi, David Dexter, Hosam El Sayed, Animesh Rathore Md

Cardiovascular Research Symposium

BACKGROUND - This case series details the novel use of the Perclose ProGlide closure device to successfully repair three separate cases of iatrogenic femoral pseudoaneurysms (PSAs) without attempting other modalities first. Conventional treatment methods of ultrasound-guided compression, duplex-directed thrombin injection (DDTI), or open surgical repair were contraindicated in these patients due to unique anatomy or advanced comorbidities.

METHODS – Details were gathered via a retrospective chart review.

RESULTS - In the first case, a 73-year-old female had an access site PSA off the superficial femoral artery (SFA) with concomitant arteriovenous fistula (AVF) and advanced cardiac disease. The ProGlide device was …

A Diagnostic Dilemma Due To A Large Chiari Network, Kyle Admire, Xian Qiao

Cardiovascular Research Symposium

INTRODUCTION: Chiari networks are reticulated networks of fibers that result from incomplete reabsorption of the right valve of the sinus venosus. While the true clinical significance of these is currently unknown, there are associations with dysrhythmias, paradoxical emboli, and thrombi formation. Here, we describe a large, incidentally found Chiari network which encompasses most of the right atrium.

CASE: A 42-year-old female with a past medical history of obesity (BMI 58) and well-controlled asthma presented to the emergency department in respiratory distress with hypercapnia and hypoxemia. Computed tomography (CT) with angiography of the chest was performed and did not show a …

Challenging Case: Acute Type A Aortic Dissection With Multi-Organ Malperfusion, Rishab Agarwal, Allebelle Bradshaw Md, Jennifer S. Lawton Md

Cardiovascular Research Symposium

Description of case: A 57-year-old male with hypertension and obesity presented with acute, severe chest pain. He developed a cold, numb right leg with motor deficits. He was hypotensive with a lactate of 7.4. CT imaging revealed an acute Type A aortic dissection (TAAD) with malperfusion involving the right internal carotid, right subclavian, and right coronary arteries, as well as the superior mesenteric artery, and right iliac artery (Fig 1A/B). He was transferred to our tertiary center for emergent surgery.

Five hours after presentation, he underwent emergent ascending aortic replacement, deep hypothermic circulatory arrest, and retrograde cerebral perfusion. The …

Emergent Aorto-Bi-Iliac Bypass For Collapsed Gore Excluder Endograft, Ryan Mancoll, Khushie Martharoo, Emidio Germano Md, David Dexter Md, Animesh Rathore Md

Cardiovascular Research Symposium

No abstract provided.

Peri-Graft Sheath Anchor Technique For Target Vessel Cannulation In Fenestrated Aortic Repair, Ryan Mancoll, Khushie Martharoo, Emidio Germano Md, David Dexter Md, Animesh Rathore Md

Cardiovascular Research Symposium

No abstract provided.

Association Between Cardiovascular Risk And Kidney Function In A Real-World Peruvian Cohort, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Cardiovascular risk and kidney function are interrelated, with variations by sex and age. Middle-aged women often have slightly lower kidney function than men, increasing susceptibility to early renal effects of elevated cardiovascular risk, but data from Latin America remain limited.

Methods: Cross-sectional study of adults aged 40-79 years evaluated at a tertiary hospital in Peru between January and June 2024. We excluded individuals with established cardiovascular disease, statin use, LDL >190 mg/dL, or incomplete ASCVD risk data. Ten-year ASCVD risk was estimated using the 2013 Pooled Cohort Equations with race set as “Other” and classified as low, borderline, intermediate, …

Six-Year Survival Following Liver Transplant In Val30met Hereditary Transthyretin Amyloidosis, Juan Munoz-Moreno, Johanna Contreras

Cardiovascular Research Symposium

Background: Hereditary transthyretin amyloidosis (ATTRv) is a progressive, multisystem disorder caused by pathogenic TTR mutations affecting the heart and peripheral nerves. While disease-modifying agents such as tafamidis are available, liver transplantation (LTx) remains an option in selected genotypes, with over 50% of Val30Met carriers surviving up to 20 years post-transplant.

Case: A 53-year-old male with a permanent pacemaker for complete atrioventricular block presented with NYHA class II dyspnea, syncope, and lower extremity paresthesias. ECG showed atrial fibrillation. Transthoracic echocardiography revealed preserved ejection fraction, biventricular wall thickening with granular appearance, moderate left atrial dilation, and moderate mitral regurgitation. Speckle-tracking echocardiography demonstrated …

Mechanical Circulatory Support As A Bridge To Early Recovery Of Left Ventricular Function In Fulminant Myocarditis, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Fulminant myocarditis (FM) is a rare cause of acute heart failure that can lead to a rapid left ventricular ejection fraction (LVEF) decline within four weeks. With in-hospital mortality up to 18.2%, timely mechanical circulatory support (MCS) is essential to stabilize hemodynamics and bridge to recovery or transplantation.

Case: A 49-year-old Japanese man with hypertension and diabetes presented with two weeks of dyspnea and angina after a flu-like illness. On admission, he developed ventricular fibrillation requiring advanced CPR. Physical exam revealed pulmonary congestion. ECG showed repolarization abnormalities. TTE demonstrated severe biventricular dysfunction (LVEF 9%, RVFAC 9%). Labs showed elevated …

Inferior Vena Cava Thrombosis In Nephrotic Syndrome: Two Cases Managed With Endovascular Thrombectomy, Rishab Agarwal, Benjamin Samberg, David Dexter Md

Cardiovascular Research Symposium

Background: Nephrotic syndrome (NS) confers a hypercoagulable state that can precipitate venous thromboembolism (VTE), rarely involving the inferior vena cava (IVC).

Cases: We describe two patients with NS who developed IVC thrombosis. One underwent mechanical thrombectomy using the ClotTriever®/Protrieve™ system (Inari Medical, Irvine, CA, USA); the other underwent aspiration thrombectomy using the AngioVac® system (AngioDynamics, Latham, NY, USA), with adjunct balloon maneuvers for renal vein thrombus.

Outcomes: Both patients achieved immediate IVC recanalization with symptom improvement and patent IVC on short‑term duplex follow‑up.

Conclusions: In NS‑associated IVC thrombosis, device‑based endovascular thrombectomy can be performed safely with restoration of caval patency. …

Cardiopulmonary Bypass Facilitates Emergent Tavr And Bifurcation Pci In A Highly Comorbid 72-Year-Old Female With Acute Valvular Shock, Omar Sale Bs, Nicholas Valle Do, Matthew Rossi Md, Joshua Cohen Md, Paul Lavigne Md, Matthew Summers Md

Cardiovascular Research Symposium

Title:

Cardiopulmonary Bypass Facilitates Emergent TAVR and Bifurcation PCI in a Highly Comorbid 72-year-old Female with Acute Valvular Shock

Introduction:

Transcatheter aortic valve replacement (TAVR) has emerged as a critical minimally invasive option for patients with severe AS who present in valvular shock, particularly those at prohibitive surgical risk. Multicenter registry data demonstrate that emergent TAVR in this population is associated with promising procedural success, significant improvements in functional status, and lower short- and long-term mortality compared to medical management or balloon aortic valvuloplasty, with outcomes approaching those of surgical aortic valve replacement in selected patients [1] [2]. We present …

Acute Valve Syndrome And 1-Year All-Cause Mortality Post-Avr: A Retrospective Cohort Study, Omar Sale Bs, Nicholas Valle Do, Israa Saleh, Omar Jafar Md, Matthew Summers Md

Cardiovascular Research Symposium

Background: Acute Valve Syndrome (AVS) identifies a high-risk cohort of aortic stenosis (AS) patients with poor outcomes following aortic valve replacement (AVR), but the spectrum of risk within this group has yet to be fully explored. We sought to evaluate whether admission markers facilitated risk stratification of 1-year mortality in an AVS cohort.

Methods: In a retrospective cohort study (MIMIC-IV v3.1), we identified 2,380 adults who underwent AVR between 2008–2019. Patients were classified as AVS or progressive valvular disease (PVD). AVS was defined by criteria of acute decompensation, including advanced heart failure symptoms, cardiogenic shock, or significant hyperlactatemia. The AVS …

Advanced Database Searching, Sandra Y. Desjardins

Library Class: Lunch & Learn

Master the art of finding relevant research articles. This 30-minute class focuses on building strong search strategies using Medline, Web of Science, and Embase. Develop essential skills in concept building to uncover critical information for your research project.

Investigating Extracellualr Vesicles Role In The Pathogenesis Of Acute Lung Injury, Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Tierney Day, Anca Dobrian, John D. Catravas

Cardiovascular Research Symposium

Background: Extracellular vesicles (EVs) are small lipid-bound particles containing proteins and RNAs, whose role in intercellular communication and signaling is critical for homeostasis or inflammatory responses. Patients with acute lung injury display changes in EVs number, cargo content and signature compared to healthy individuals.

Hypothesis: We have hypothesized that EVs may play a role in the pathogenesis of acute lung, by transferring harmful mediators of inflammation and disrupting recipient cells homeostasis.

Methods: C57BL/6j mice (8-10 weeks old, 25g BW) were intratracheally instilled with 50µL of 5*1010- 11 EVs isolated from Human Lung Microvascular Endothelial cells (HLMVEC) exposed to 1 µg …

Characteristics And Outcomes Of Axillary And Subclavian Artery Injuries, Benjamin Samberg, Nicholas Bandy, Michael Martyak

Cardiovascular Research Symposium

INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.

METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.

RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; …