Medicine and Health Sciences Commons^™

The Impact Of Alcoholism In Depression, Anjali Sharma, Pooja Chawla

Research Symposium

Depression is a common mental health condition characterized by lack of passion or enjoyment in activities as well as persistent emotions of sadness and hopelessness. Excessive alcohol consumption is a chronic issue on nationwide and presents a significant public health concern. Consuming alcohol is linked to worse outcomes in terms of how depression develops it happens when the untreated alcoholism intensifies, it leads to depressive states, decreases responsiveness to conventional therapeutics as well as increases the likelihood of suicide, suicide attempts and other self-destructive behavior. Major depressive episodes and excessive alcohol use have long been thought to be related clinically …

Alcoholism And Psychiatric Comorbidity: A Complex Relationship, Aniket Saini, Pooja Chawla

Research Symposium

Alcoholism, also known as alcohol use disorder (AUD), is a chronic and relapsing condition characterized by the excessive and compulsive consumption of alcohol which leads to negative effects on the physical as well as mental health. Heavy drinking associated with alcoholism can coexist with or contribute to several different psychiatric disorders like depression, bipolar disorder, anxiety disorder, antisocial personality disorder, and schizophrenia. In patients with AUD, around 80% of cases suffer from a social anxiety disorder, 27% -40% of cases are diagnosed with major depressive disorder, 19%-26% of young adults suffer from attention-deficient hyperactivity disorder, 21% of patients with AUD …

Fibromyxoid Sarcoma Of The Breast: An Atypical Presentation Of A Rare Mesenchymal Tumor, Aaron I. Dadzie, Yossef Alsabawi, Lois C. Akpati, Valentine S. Alia, Roger Galindo

Research Symposium

Background: Low-grade Fibromyxoid Sarcoma (LGFMS) is a rare soft-tissue sarcoma with an incidence rate of 0.18 per million, first introduced into the literature by Harry L. Evans in 1987 [1]. This tumor, of mesenchymal origin, has a predilection for young adults and is most commonly found in the upper and lower extremities of deep soft tissues [1,2,3,4,5]. LGFMS has been described as having multiple variants, often presenting histologically as alternating fibrous and myxoid areas containing bland spindle and stellate cells arranged in a swirling, whorled appearance [6]. The predominant chromosomal abnormality of LGFMS has a FUS-CREB3L2 fusion gene with a …

Small Cell Carcinoma Of The Bladder: A Rare Case, Simita Gaglani, James Sander

Research Symposium

In this case report, we explore a case of small cell bladder carcinoma in a 75-year-old man with a history of smoking. This is a unique, aggressive subtype of bladder cancer which, in this patient, presented with gross hematuria. Workup included cystoscopy and transurethral resection of the bladder tumor, and pathological confirmation of the diagnosis elicited a referral to oncology for staging CT and potential chemotherapeutic measures. While the small cell carcinoma was successfully identified, it had already invaded the detrusor muscle on presentation, prompting the question of how to go about diagnosing and treating this subtype of bladder cancer …

Rare Presentation Of Oral Squamous Cell Carcinoma Of The Tongue With Ectopic Β-Hcg Secretion: A Case Report And Literature Review, Taha Al Hassan, Rachel A. Giese

Research Symposium

Background: Oral squamous cell carcinoma is the most common form of cancer in the oral cavity and pharynx, comprising more than 90% of all cases, with approximately half presenting with regional lymph node spread at the time of diagnosis. Pathogenesis includes various stages of progression encompassing multiple genetic and cellular events that ultimately lead to the malignant transformation of the squamous cells and invasion into surrounding tissues. Given the multistep nature of disease progression, recent studies have investigated potential prognostic indicators and screening markers through immunohistochemical staining and few studies suggest that human chorionic gonadotropin may be one marker that …

The Difficulty In The Diagnosis And Management Of Antidepressant Discontinuation Syndrome, Sidney Charm D. Reyes

Research Symposium

Background: Antidepressant discontinuation syndrome (ADS) is a condition that occurs in about 20% of patients following the abrupt reduction/stoppage of any antidepressant medication that has been taken continuously for at least 1 month. The difficulty of diagnosing ADS lies in the fact that the symptoms tend to be mistaken for other illnesses. Symptoms are commonly variable per individual, and the staggered presentation of symptoms can contribute to the difficulty in diagnosing ADS.

Case Presentation: We present a 36-year-old Hispanic woman who comes for evaluation of worsening, generalized body aches for the past 3 days. Associated signs and symptoms included rhinorrhea, …

Cost Effective Treatment Options For Uninsured Patients With Diabetes, Sidney Selva, Ryan Bialaszewski, Elizabeth Althaus, Pamela Campos, Shuaibahmed M. Arab, Chelsea Chang

Research Symposium

Background: Approximately 37.3 million people in the United States have diabetes, accounting for 14.7% of the US population. Additionally, an estimated 2 million adults with diabetes have no health insurance coverage, which can contribute to chronic co-morbidities and increase all-cause mortality. Given the economic challenges these uninsured patients may face, it is important for healthcare providers to understand the cost-effective treatment options available to improve long-term outcomes. Therefore, this abstract aims to provide a cost-effective treatment algorithm for uninsured patients with diabetes.

Case Presentation: Our patient was a 47-year-old uninsured Hispanic female with uncontrolled type 2 diabetes mellitus. The …

Case Report: Kidney Transplant Pyelonephritis, Shuchita Jhaveri, Ruayda Bouls, Duc Khiem Ngo, Laura E. Garcia

Research Symposium

Background: Individuals with end-stage kidney disease (ESKD), and especially those who have received kidney transplants, are at an increased risk of developing urinary tract infection (UTI). UTI, especially recurrent UTI, is a common problem occurring in >75% of kidney transplant (KTX) recipients. Progression of infection can have significant consequences on the functioning of the transplanted kidney. It may be challenging to distinguish complicated UTI from acute or chronic rejection when patients present with fever and abdominal pain at the transplanted location. In this case study, we present the clinical scenario of a patient with a history of hypertension and ESKD …

Exploration Of Treatment Options For A Hispanic Patient With Obesity Class Iii And Multiple Comorbidities, Shuaibahmed M. Arab, Elizabeth Althaus, Pamela Campos, Sidney Selva, Ryan Bialaszewski, Chelsea Chang

Research Symposium

Introduction: The prevalence of obesity has reached epidemic proportions worldwide, presenting a significant challenge to public health systems and clinicians alike. The CDC published new statistics for the prevalence of obesity in the United States, with numbers reaching 41.9% from 2017-2020. Morbid obesity, indicated by a body mass index (BMI) of 40 kg/m² or higher, is associated with an increased risk of numerous comorbidities, including cardiovascular disease, type 2 diabetes, hypertension, and musculoskeletal disorders. This case report aims to explore the available treatment options for a Hispanic female with Obesity Class III and multiple comorbidities while keeping insurance coverage and …

Simultaneous Brachial Artery Injury And Ulnar Nerve Palsy: A Case Study Of An Atv Accident Survivor, Ryan Bialaszewski, Sidney Selva, Shuaibahmed M. Arab, Pamela Campos, Elizabeth Althaus, Chelsea Chang

Research Symposium

Background: All-terrain vehicle (ATV) accidents are a common cause of traumatic elbow injuries due to outstretched arms accepting contact at greater forces. However, their complexity and clinical significance often go unrecognized upon initial evaluation, especially in patients without acute fractures. Sequelae of such injuries can include neurovascular deficits, leading to chronic pain, limb ischemia, and paresthesias. This article aims to present a case study detailing a post-traumatic elbow injury with chronic neurovascular deficits following an ATV accident. Additionally, we address common clinical findings in post-traumatic concomitant brachial artery and ulnar nerve injuries, their evaluation, and respective management plans.

Case Presentation: …

Mycotic Aneurysms In Fungal Meningitis: The Management In A Case Of Fusarium Solani Meningitis, Ruayda Bouls, Duc Khiem Ngo, Jose E. Campo Maldonado

Research Symposium

Introduction:

We present a 31 y.o previously healthy woman who developed Fusarium solani fungal meningitis after undergoing cosmetic surgeries in Mexico. Fungal meningitis and particularly F. solani meningitis is very rare, and little is known about the extent and frequency of neurovascular complications in patients with this condition. To our knowledge, previous reports of fungal meningitis don’t recognize or emphasize enough the importance and extension of neurovascular complications noticed in our patient.

Case Presentation: A 31-year-old female presented with severe headaches and intermittent fever, two weeks after receiving epidural anesthesia during cosmetic surgery near the Texas-Mexico border. Lab results showed …

Avoiding A Perfect Storm: Delving Into The Consequences Of A Complex Case Of Superimposed Cellulitis After A Herpes Zoster Infection, Ruayda Bouls, Ed Wong Alvarado, Daniel Ibarias Paz, Yuri Cuellar De La Cruz

Research Symposium

Introduction: Cellulitis is an acute bacterial infection causing inflammation affecting the deep dermis layer as well as the surrounding subcutaneous tissue that does not contain an abscess. In this case study we aim to describe the clinical presentation of a middle aged Hispanic woman who developed a superimposed cellulitis infection following a flare-up of a zoster infection. Herpes Zoster is typically considered a typically benign infection but in immunocompromised individuals severe complications of the infection include bacterial superinfections, coagulopathies including disseminated intravascular coagulation, and central nervous system manifestations including encephalopathy with long term detrimental outcomes [1]. Management of Herpes Zoster …

Comatose Deception, Benzodiazepine Masquerade Of Myxedema Coma, Roy Subash Kondapavuluru, Sabhi Gull, Hemaswini Kakarla, Reshmanth Prathipati, Andres Suarez Parraga

Research Symposium

Introduction: Myxedema coma is a life:-threatening condition due to severe hypothyroidism or long-standing untreated hypothyroidism. This condition can be triggered by factors such as infection, exposure to certain medications, or other stressors on the body. Symptoms of myxedema coma include hypothermia, altered mental status, and fluid accumulation. This condition can be life threatening and requires immediate medical attention.

Benzodiazepines are often prescribed to address various conditions such as anxiety, sedation, and seizures. However, they have significant side effects including drowsiness, sedation, low blood pressure, and slow heart rate. These side effects can mimic symptoms of other conditions such as myxedema …

When Medications Collide: Demystifying Drug-Induced Hyponatremia In A Complex Medical Case, Roy Kondapavuluru, Jian Garcia Cruz, Manaswini Kakarla, Ram Maganti, Akshay Pingilati, Andres Suarez Parraga

Research Symposium

Introduction: Hyponatremia, defined as serum sodium below 135mEq/L( normal range:136-145mEq/l), is a medical emergency associated with various complications. Sodium is an important electrolyte that helps regulate fluid balance and nerve/muscle function. Severe hyponatremia may not show obvious symptoms initially but can eventually manifest as nausea, vomiting, fatigue, impaired movement, and in extreme cases, seizures, coma, respiratory failure, or even death.

Thiazide diuretics have been associated with hyponatremia with a sodium level as low as 99mEq/L. In our case, the patient was on bumetanide, a loop diuretic and she developed hyponatremia which worsened with additional metolazone treatment to a sodium level …

“Blood, Blood Everywhere”: A Case Of Buried Bumper Syndrome Presenting As Melena And Hematochezia, Roy Subash Kondapavuluru, Baron S. Ekeledo, Jian Garcia Cruz, Eunbee Cho, Balakrishna Ravella, Sudheer K. Kanumari

Research Symposium

Gastrostomy tubes are frequently placed for a variety of conditions that cause interference with oral intake or gastric decompression and are used for enteral feeding, hydration, and medication administration in patients who are likely to have prolonged inadequate oral intake. Buried bumper syndrome is an extremely rare, but major complication of gastrostomy tubes which results due to tight apposition of the external bumper against the abdominal wall and erosion of the internal bumper of the gastrostomy tube against the gastric wall. The overall incidence has been reported to be 0.3 to 2.6 % of all patients with gastrostomy tubes. We …

Tick-Borne Illness In A Guatemalan Migrant, Radhika Mehta, Bareera Akhtar

Research Symposium

Abstract: Migration is a complex phenomenon that involves numerous physical and psychological challenges, particularly for individuals undertaking long and arduous journeys. In the case of this 39 year old Guatemalan man, his perilous 25-day journey crossing forests to reach the United States resulted in severe health consequences, including dehydration, acute kidney injury and a possible tick-borne illness. This case report aims to shed light on the healthcare needs of migrants and emphasizing the importance of providing comprehensive care.

A 39 year old male from Guatemala presented to the emergency department with diffuse abdominal pain associated with nausea, vomiting and a …

Clinical Management Of Larsen Syndrome In Inpatient Rehabilitation: A Case Report, Philippe J. Dentino

Research Symposium

Background: Larsen Syndrome is a rare osteochondrodysplasic disorder associated with Filamin 1 (FLN) gene mutations and clinically presents with frequent large joint dislocations, osseous disturbances, and craniofacial abnormalities. To date, no studies have assessed the medical and rehabilitative management of an individual living with Larsen Syndrome in an inpatient rehabilitation care setting.

Case Presentation: A 30 year-old biological female presented to the emergency department after developing worsening right-sided low back pain while bending forward. The patient’s past medical and surgical history was significant for Larsen Syndrome complicated by chronic hip, knee, and back pain, Celiac disease, major depressive disorder, post-traumatic …

Mystery Case: An Effort To Diagnose A Patient With A Decade Of Relapsing And Remitting Neurologic Symptoms With A Comprehensive Medical Approach, Pamela Campos, Sidney Selva, Ryan Bialaszewski, Elizabeth Althaus, Shuaibahmed M. Arab, Chelsea Chang

Research Symposium

Background: Muscle weakness and numbness are prevalent complaints amongst patients and can have a varying range of diagnoses from benign inconsequential to life-threatening causes. The pattern and intensity of weakness, accompanying symptoms, medication use, and family history assist the physician in determining if a patient's presentation is caused by infectious, neurologic, metabolic, inflammatory, psychiatric, or drug-induced condition.

Case Presentation: Our patient is a 37-year-old female who presents to the clinic for a follow-up. The patient has a past medical history of Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and an undiagnosed neuromuscular weakness for approximately 10 years. The weakness …

New Onset Bilateral Pleural Effusion: An Uncommon Presentation Of Subclinical Hypothyroidism Or A Premature Closure Diagnosis Error?, Molly Chapman, Andrea Soto Abarca, Duc Khiem Ngo, Carlos T. Ramos

Research Symposium

Background: Subclinical hypothyroidism is biochemically defined with normal serum-free T4 in the presence of an elevated serum TSH. Common symptoms of an underactive thyroid can include fatigue, weakness, cold intolerance, weight gain despite poor appetite, hair loss, constipation, and depression. Pleural effusions have also been recognized as a clinical sequelae in the literature, where up to 25% of patients can develop a pleural fluid collection in the setting of hypothyroidism. Although not well understood, a mechanism includes an increased capillary permeability that leads to the retention of fluid in pleural cavities and other tissues.

Case presenting: A 66-year-old woman …

A Rare Case Of Acute Pancreatitis Associated With Cannabinoids Consumption, Mays Abdulazeez, Michael Perez, Alejandro Hidalgo Parada, Rani Rabah, Greity Dominguez, Rowel Perez Vargas, Jose Cano, Jesus Garza-Tamez, Sunand Kallumadanda

Research Symposium

Introduction: Acute pancreatitis is an inflammatory condition of the pancreas characterized by abdominal pain and elevated levels of pancreatic enzymes in the blood. Acute pancreatitis is a leading gastrointestinal cause of hospitalization in the United States. Several conditions are associated with acute pancreatitis, of which gallstones and chronic alcohol use disorder account for approximately two-thirds of the cases. Others, including smoking, hypertriglyceridemia, infections, trauma, drugs, malignancy, scorpion stings, hypercalcemia, endoscopic retrograde cholangiopancreatography (ERCP), opioids, angiotensin-converting enzyme (ACE) inhibitors, macrolides, diuretics, statins, and cannabis have also been associated with acute pancreatitis. Cannabis is the most widely used recreational drug worldwide, with …

From Carious To Salivarius: A Case Of Streptococcus Salivarius Infective Endocarditis, Maria E. Torres Perez, Ed Wong Alvarado, Cecilia Salinas Domene, Jennifer Rojas Huen, Sara G. Mojica, C. Garza, Usman Sheriff

Research Symposium

Background: Streptococcus salivarius forms part of the Viridans family which accounts for almost 40% of all endocarditis cases. However, S.salivarius is only attributed to 2% of those cases. In the most common setting, S.salivarius is a commensal bacterium of both the oral mucosa and the gut, but it has proven to have infective potential. S.salivarius accounts as an easily missed and commonly misdiagnosed Viridians strep species, but has been implicated as a rare cause of infective endocarditis.

Case presentation: We present the case of a 43-year-old male who presented with worsening fatigue, chest pain, shortness of breath, and subjective fever. …

Sudden Cardiac Death Due To Pharmacological Cardioversion Of Atrial Fibrillation, Manlio F. Lara Duck, Juan Rosales-Martínez, Netzahualcoyotl Mayek Pérez

Research Symposium

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia. The global prevalence of AF is 0.51% of the world population (37.5 million people) and has increased 33% in the last 20 years. AF may be associated with increased risk of sudden cardiac death (SCD); as well as ischemic stroke or coagulopathies. Coronary heart disease and heart failure are the two most common substrates of SCD. Therefore, the relationship between AF and SCD is particularly difficult to address. AF may have a shared molecular basis with ventricular fibrillation (VF; the most common arrhythmia underlying SCD), as both involve cellular …

Use Of Translational Science, Continuous Glucose Monitoring In The Primary Care Setting For Management Of Nesidioblastosis. A Case Report, Karuna Manandhar, Othman Farahneh, Gerardo Munoz-Monaco

Research Symposium

Background: Nesidioblastosis is a term used to describe histologic changes in the pancreatic cell defined by beta cell hypertrophy and formation of ductoinsular complexes. It is a disease previously most extensively identified in neonates and is a rare cause of endogenous hypoglycemia in the adult population. However, with increasing numbers of gastric bypass surgeries for management of obesity in recent years, there has been a growing number of populations with post gastric bypass surgery related nesidioblastosis.

Case Description: Our case report follows a 60-year-old female with previous history of Roux-en-Y gastric bypass surgery who initially presented to an acute-care hospital …

Asymptomatic Spontaneous Pneumopericardium In A Young Post-Covid-19 Patient: A Case Report, Jose Gomez Casanovas, Andreina Baird Borja, Eric Sanchez, Alcibiades Fleires, Daniela Hernandez

Research Symposium

Background: Pneumopericardium is a rare clinical condition which is defined as the presence of air or gas in the pericardial cavity. Although uncommon to see, it can present after chest trauma, barotrauma, fistula between the pericardium and surrounding structures, gas producing microorganisms and iatrogenic causes. But spontaneous presentations are even more uncommon. Coronavirus Disease 2019 (COVID 19) infection became a large global epidemic and in addition to respiratory symptoms, involvement of other organs such as pericardium was also reported. We here present a young patient post COVID 19 infection with isolated spontaneous pneumopericardium.

Case Presentation: A 19 year old patient …

A Case Of Recently Diagnosed Uncontrolled Hyperthyroidism Associated With Bilateral Pulmonary Embolism, Jose Gomez Casanovas, Mery Bartl, Lina Pedraza Sanchez, Alcibiades Fleires, Andres Suarez Parraga

Research Symposium

Background: Pulmonary embolism (PE) is a relatively common acute cardiovascular disorder with considerable mortality, despite advances in diagnosis and treatment. In 25 to 50% of first-time cases, no readily identifiable risk factor can be found. Several studies have suggested hyperthyroidism to be a potential hypercoagulable and hypofibrinolytic state. In this case, we present a patient with uncontrolled hyperthyroidism with incidental bilateral PE.

Case Presentation: A 47-year-old Hispanic lady with past medical history of recently diagnosed hyperthyroidism who was not compliant with medical therapy, presented to the emergency department with 4-hour history of chest pain. She described it as sudden onset, …

Transient Sinus Node Dysfunction In A Postpartum Female With Sinus Bradycardia: A Case Report, Jose Gomez Casanovas, Andreina Baird Borja, Laura Rincon-Rueda, Mery Bartl, Daniela Hernandez

Research Symposium

Background: Conduction disorders are common cardiac complications during pregnancy in women with and without structural heart disease. Sinus bradycardia has been described in few case reports secondary to increased vagal tone. Prevalence of newly acquired sinus node dysfunction without structural heart disease is unknown. In this case, we present a post-partum female with symptomatic acquired sinus node dysfunction who presented with severe sinus bradycardia.

Case Presentation: A 32-year-old Hispanic lady with a past medical history of obesity and obstetric formula of G4P4, who recently delivered her 4th child via C-section 4 weeks prior, presented to the Women´s Hospital as a …

Enterococcus Avium Peritonitis, Jian Garcia Cruz, Johanne Chaglasian, Oliverio Abarca Guzman

Research Symposium

Introduction: Enterococcus spp. are part of normal human GI tract flora which has been known to cause community acquired UTI, bacteremia, and nosocomial infections. Enterococcus faecalis and faecium are the most commonly isolated pathogens within enterococcus family although there have been few to no cases reported of peritonitis secondary to enterococcus avium in the setting of recent paracentesis and end-stage-liver disease. The incidence of peritonitis from rare organisms is increasing because of improved microbiological identification techniques. This case is relevant because it shows us that enterococcus avium even if it is not common show be considered when choosing antibiotics coverage …

Spontaneous Iliopsoas Hematoma Secondary To Warfarin Toxicity, Jian Garcia Cruz, Julio Perez Rodriguez, Roy Subash Kondapavuluru, Oliverio Abarca Guzman, Johanne Chaglasian, Jonathan Yaw Gyebi-Agyepong

Research Symposium

Abstract: Warfarin is a commonly prescribed anticoagulant with a narrow therapeutic window. The prevalence of retroperitoneal hematoma in the general population is not well documented, but it is estimated to be less than 1%. However, the incidence is higher in patients taking anticoagulants such as warfarin, with some studies reporting an incidence as high as 3-6%. Iliopsoas hematoma is reported in literature with frequent non-specific symptoms ranging from abdominal, leg and thigh pain. It is important to recognize them due to the high mortality. This paper aims to demonstrate that patients on warfarin with low hemoglobin and purplish bruises of …

Syncope As A Presentation Of Waldenstrom Macroglobulinemia, Jian Garcia Cruz, Julio Perez Rodriguez, Roy Subash Kondapavuluru, Eunbee Cho

Research Symposium

Abstract: Syncope as defined by ACC/AHA is defined as a symptom that presents with an abrupt, transient, complete loss of consciousness, associated with inability to maintain postural tone, with rapid and spontaneous recovery without clinical features of other non-syncope causes of loss of consciousness, such as seizure, antecedent head trauma, or apparent loss of consciousness. Syncope is a common complaint treated in the emergency department and a major reason for hospital admissions. Identification of the etiology of syncope is important for diagnostic and therapeutic purposes. Syncope is a symptom as a presentation with multiple differential diagnosis listed and clearly explained …

Grey Turner's Sign Unveiling A Rare Case Of Neuroendocrine Tumor In The Tail Of The Pancreas: A Reminder To Expand The Differential In Young Patients With Chronic Back Pain, Jennifer Rojas Huen, Gilbert Flores Jr., Ismael Pavel Polo Pérez, Nabeel Sarhill

Research Symposium

Background: Pancreatic cancer is often difficult to diagnose due to its asymptomatic nature, silent progression or symptoms overlapping with more common benign conditions. We present a case of a 30-year-old male with chronic worsening back pain, weight loss, and Grey Turner's sign, ultimately leading to the diagnosis of a neuroendocrine tumor in the tail of the pancreas. The rarity of this diagnosis in a young patient with atypical symptoms emphasizes the importance of considering uncommon diagnoses and expanding differentials, even when presented with seemingly typical symptoms, to enable early detection and intervention.

Case Presentation: 30-year-old male past medical history of …