Medicine and Health Sciences Commons^™

Submental Intubation In Oral Maxillofacial Surgery: A Case Report And Review Of Indications And Complications, Jennifer Inofomoh, Mark Lavering, Ed Wong Alvarado, Diego Aleman

Research Symposium

Introduction/Background: Submental intubation is a valuable alternative airway management technique employed in oral maxillofacial surgery when intraoral or nasal intubation is contraindicated or poses a potential risk (Schütz, 2008). This case report presents a clinical scenario in which a patient underwent oral maxillofacial surgery necessitating submental intubation. Additionally, we review the indications, technique, and potential complications associated with this specialized intubation approach.

Oral maxillofacial surgeries frequently involve complex fractures, extensive soft tissue injuries, or anatomical variations that preclude traditional intraoral or nasal intubation. Submental intubation provides a safe and effective option in such cases, avoiding the need for tracheostomy or …

Wait, Wait, Could It Be Autoimmune Pancreatitis? A Case Of Localized Autoimmune Pancreatitis Mimicking Pancreatic Cancer, Grecia Dominguez Rivera, Hari Movva, Heriberto Cantu, Nabeel Sarhill

Research Symposium

Background: Autoimmune pancreatitis (AIP), an IgG4-related disorder, is a rare condition that typically presents as obstructive jaundice and pancreatic enlargement in older adults mimicking the manifestations of pancreatobiliary malignancies. Although the diagnosis of AIP has improved through growing awareness and proposed diagnostic criteria, differentiating between AIP and pancreatic cancer remains challenging.

Case Presentation: A 69-year-old Hispanic male presented with a 1-month history of nausea, epigastric pain, jaundice, and 20-pound weight loss. His medical history revealed type 2 diabetes. Physical exam showed scleral icterus, and laboratory results demonstrated an ALT of 412, AST 404, alkaline phosphate 501, total bilirubin 7.5, direct …

The Great Mimicker. A Case Of Gastrointestinal Tuberculosis., Grecia Dominguez Rivera, Jose Roberto Flores Gonzalez

Research Symposium

Background: Gastrointestinal (GI) tuberculosis (TB) is rare, accounting for 1-3 % of all TB cases worldwide. Mycobacteria enter the GI tract via hematogenous spread from active pulmonary TB, swallowing infected sputum, or ingesting contaminated food. The ileocecal area is most affected; however, tuberculous enteritis can involve any part of the GI tract. The vague clinical presentation makes the diagnosis challenging and often delayed requiring a high index of suspicion.

Case Presentation: A 28-year-old female who emigrated to the US from Mexico presented to the ED with a 4-month history of abdominal pain, vomiting, diarrhea, anorexia, 40-pound weight loss, intermittent fever, …

Sacral Pain "Recurrence" Not Exactly The Teenage Dream, Evan D. Perez

Research Symposium

Background: This case is a great example of remembering the basics. We teach our medical students, residents and fellows the importance of getting a thorough history and exam. However, this case is a reminder to apply those lessons in the real world.

Case Presentation: 15 yo Female came in complaining of sacral pain. 2 years prior she had a fall causing a coccyx fracture which resolved with conservative treatment. She didn’t have any issues since then until 3 weeks prior to today when she began to have pain in the same area. She denied any new inciting events such as …

Exacerbation Of Acute Angle Closure Glaucoma Symptoms Following Ssri Use, Elizabeth Althaus, Pamela Campos, Shuaibahmed M. Arab, Sidney Selva, Ryan Bialaszewski, Chelsea Chang

Research Symposium

Introduction: General Anxiety Disorder (GAD) is a relatively common disorder in the United States, which affects 6.8 million Americans. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are considered the mainstay of pharmacologic treatment of GAD, along with behavioral modifications, such as Cognitive Behavioral Therapy (CBT). However, these medications may cause harmful side effects in unique individuals. This abstract will discuss the unusual side effect of acute angle closure glaucoma in a male while being treated for GAD with an SSRI.

Case Presentation: The patient is a 60-year-old male with a history of diabetes mellitus, chronic kidney disease, …

Spindle-Cell Mesothelioma Arising From The Right Pleura: A Case Report And Review Of The Literature, Duc Khiem Ngo, Karina Torres, Sobia Hassan Memon, Carlos T. Ramos Jr.

Research Symposium

Background: Spindle cell mesothelioma, or Sarcomatoid mesothelioma, is a rare and insidious type of malignant mesothelioma with a high mortality rate. It arises from mesothelial surfaces of the pleural cavity, peritoneal cavity, tunica vaginalis, or pericardium, and it is usually associated with asbestos exposure. Spindle cell mesothelioma could be challenging to treat because most patients have advanced disease at presentation with an average prognosis of six months. In this case report we present a rare case of spindle-cell mesothelioma arising from the right pleura.

Case presentation: An 82-year-old male with a history of atrial fibrillation and coronary artery disease, status …

Delayed Management Of Pfo After Stroke Presentation In A Healthy Hispanic Female, Diana Othon Martinez, Barbara Malaga-Espinoza, Nestor Gerardo Astorga, Vamsikalayan Borra, Roque Mifuji

Research Symposium

Background: Strokes are a leading cause of long term disability. Around 800,000 people in the USA have a stroke every year. (CDC) 25% of the population have a Patent foramen ovale (PFO). Stroke in the presence of PFO has been described to be found in up to 40% of patients with “embolic stroke of undetermined source”, otherwise known as cryptogenic strokes. Despite the aforementioned prevalence, there is mixed data on PFO management options. Current management guidelines include dual anti-platelet therapy, anticoagulants, and percutaneous transcatheter closure. Some studies suggest that PFO might be an incidental finding in patients with cryptogenic stroke. …

Unmasking The Chameleon: A Rare Case Of Generalized Bullous Fixed Drug Eruption, Christopher Reid-Gordon, Aishwarya Gatiganti, Jose E. Campo Maldonado

Research Symposium

Background: Fixed drug eruption (FDE) is a unique dermatological drug reaction known for its recurrence in identical locations upon re-exposure to the causal drug. Acute FDE typically manifests a single or a small number of dusky red or violaceous plaques that, once resolved, leave post-inflammatory hyperpigmentation.

The case we present involves a patient with maculopapular bullous rash on his back, chest, and extremities. The rash was initially misdiagnosed as Chickenpox, yet a skin biopsy indicated Bullous Drug Eruption as a more likely diagnosis. This case is novel as the patient’s medical history did not reveal any previous intake of drugs …

Dual V2 And V3 Peripheral Pulsed Radiofrequency Ablation For Successful Trigeminal Neuralgia Treatment: A Case Report, Changho Yi, Justin Faye

Research Symposium

Introduction: Radiofrequency ablation is a common treatment for trigeminal neuralgia when medical treatment has failed, as it has been shown to be comparably effective to surgery with a better complication profile¹ . The elderly population, who are at a high risk for surgery, is a good candidate for this treatment. Currently, semilunar ganglion radiofrequency ablation (GRF) is the widely used approach² ; however, recently, peripheral radiofrequency ablation (PRF) of the V2 and V3 branches has been reported with comparable results³.

Objectives: To report a case of trigeminal neuralgia that was successfully treated with dual V2 and …

Spinal Cord Injury After Revisional Placement Of Percutaneous Cervical Spinal Cord Stimulator In The Patient With Cervical Central Canal Stenosis: A Case Study, Changho Yi, Justin Faye

Research Symposium

Summary of background data: Spinal cord injury is a rare but devastating complication of spinal cord stimulator implantation; the incidence has been reported variably, ranging from 0.45 to 2.13% 1.

Objectives: To report a case of spinal cord injury developed postoperatively after revisional spinal cord stimulator placement in a patient with cervical central canal stenosis.

Methods: A case study

Results: Spinal Cord Injury ASIA scale C

Case Description: A 51-year-old female with 5-year chronic neck pain with radiating pain on both upper extremities came with lower extremity weakness and ataxia after revisional cervical spinal cord stimulator placement. In April 2021, …

Navigating The Viral Maze: A Twisted Tale Of Ebv-Induced Autoimmune Hemolytic Anemia With Hepatitis, Blesset Alexander, Mery Bartl, Alfarooq Alshaikhli, Michelle Lopez

Research Symposium

Background: Epstein Barr Virus (EBV) is a widely disseminated virus known to cause infectious mononucleosis and a range of associated conditions. Autoimmune hemolytic anemia (AIHA) is a rare complication of EBV infection, with only a small percentage of cases reported in the literature. We present a unique case of a young female patient with a complex autoimmune pattern, later found to be associated with EBV.

Case Presentation: A 22-year-old Hispanic female with no past medical history presented to the Emergency Department with generalized weakness, nausea, left upper quadrant pain, and jaundice progressing for one week. Physical examination revealed scleral icterus, …

Hemophagocytic Syndrome, Radhika Mehta, Bareera Akhtar

Research Symposium

Background: Hemophagocytic syndrome is a rare and potentially fatal disorder characterized by abnormal immune activation leading to multiorgan dysfunction. Although genetic mutation is the most common cause in the pediatric population, adults often present with HPS secondary to infection, autoimmune disease or malignancy. Hodgkin’s lymphoma is a type of lymphoma characterized by Reed Sternberg cells. HL can cause various complications including hemophagocytic syndrome. This is a case of a 22-year-old male with incidental pancytopenia and jaundice, found to have Hodgkin’s lymphoma and hemophagocytic syndrome.

Case Presentation: A 22-year-old male with no significant past medical history presented to the Emergency Department …

Anaphylaxis After Avocado Ingestion In A Patient Located In The Rio Grande Valley, Eric Sanchez, Andreina Baird Borja, David London, Daniela Hernandez, Jose Gomez Casanovas

Research Symposium

Background: The avocado is an integral part of the Tex-Mex cuisine, especially in the Rio Grande Valley. Cases of severe anaphylactic reaction related to avocado mostly occur with previous history of latex-sensitization, also known as "latex-fruit syndrome," rather than caused by avocado alone. One of the major identified avocado allergens is the protein Prs a 1, a chitinase that helps the plant for protection and has cross-reaction with natural rubber latex allergens. According to the most recent national survey done in 2014, the prevalence of anaphylaxis in the United States ranged from 1.6% to 5.1%. Food reactions accounted as the …

Hiding In Plain Sight: Renal Cell Carcinoma Due To Suspected Von Hippel-Lindau Syndrome, Eric Sanchez, Andreina Baird Borja, Jose Gomez Casanovas, Alcibiades Fleires, Daniela Hernandez

Research Symposium

Background: Von Hippel-Lindau (VHL) is a hereditary autosomal dominant disease that affects several organs, characterized by the presence of cysts and tumors, more commonly associated with the central nervous system, eyes, and visceral organs. Prevalence in the US is estimated to be 1 per 30,000.

In this case, we present a 31 year old male from an underserved population in the Rio Grande Valley, presenting with multiple cerebellar and visceral lesions. The rarity of genetic disorders proves to be a diagnostic and management challenge.

Case Presentation: The case is about a 31 year old male with no apparent past medical …

Novel Presentation Of Migrainous Infarction: Alexia Without Agraphia And Right Hemianopsia, Aishwarya Gatiganti, Pamela Davila Siliezar, Noor Laylani, Andrew G. Lee

Research Symposium

Background: As defined by the International Classification of Headache Disorders, a migrainous infarction(MI) is a migraine with aura whose aura symptoms similar to previous attacks persist for at least an hour in duration along with a corresponding ischemic infarction found in neuroimaging. This is a case of a 62 year-old female who suffered an acute ischemic attack that was later found to be a migrainous infarction. Alexia without agraphia and right hemianopsia as a presentation of the MI is exceedingly rare therefore making this case reportable. There are cases reporting alexia without agraphia that was soon revered following a migrainous …

Oncoplastic Nipple Sparing Mastectomy And Immediate Reconstruction In Non-Ideal Candidates, Aaron I. Dadzie, Paul Berry

Research Symposium

Background: Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). In satisfactory surgical candidates, this procedure allows for superior aesthetic outcomes compared to other mastectomy techniques and minimizes the need for additional procedures to reconstruct the nipple. Here, we summarize the established treatment standards and suggest an expansion of the established surgical techniques and selection criteria of NSM …

Ampullary Carcinoma In A Veteran With Exposure To Agent Orange, Eunbee Cho, Shreel Patel, Roy Subash Kondapavuluru

Research Symposium

Introduction: Agent Orange(2,3,7,8-Tetrachlorodibenzo-p-dioxin), also referred to as “dioxin”, is a herbicide, extensively used during the Vietnam War. It is proven to be associated with various types of cancers, including chronic B-cell leukemias, Monoclonal gammopathy of undetermined significance(MGUS), Non-Hodgkin’s and Hodgkin’s lymphoma, as well as diseases such as diabetes mellitus type II and Parkinson’s disease. Primary ampullary carcinoma is a rare cancer of the gastrointestinal tract, with an incidence of 4 to 10 cases per million population. They can occur sporadically or in the setting of a hereditary syndrome. The etiology of sporadic ampullary tumors remains uncertain. Here, we present a …

Hodgkin's Lymphoma-Associated Thoracic Central Venous Obstruction, Eunbee Cho

Research Symposium

Introduction: Hodgkin's lymphoma is a malignancy of the lymphatic system characterized by the presence of Reed-Sternberg cells. B symptoms, lymphadenopathy of the cervical and/or supraclavicular nodes, and mediastinal mass are some common initial clinical manifestations of Hodgkin’s lymphoma. This abstract presents a case study of a 33-year-old man diagnosed with type IV classic type nodular Hodgkin’s lymphoma who presented with brachiocephalic vein compression, resulting in left chest wall edema. This case highlights the importance of recognizing and investigating uncommon presentations of Hodkin's lymphoma to ensure timely diagnosis and management.

Case: A 33-year-old man without significant past medical history presented with …

Hape (High-Altitude Pulmonary Edema) - Hiking Trip From Texas To Colorado Turns Into Nightmare, Eunbee Cho, Jessica Marcela Daza, Shakirat Ganiyu

Research Symposium

Introduction: High-altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that typically occurs in lowlanders who ascend rapidly to altitudes greater than 2,500 meters to 3,000 meters (8,200 feet to 10,000 feet) above sea level. Risk factors for developing HAPE include a history of high altitude illness, rapid ascent without acclimatization, and comorbidities that impair ventilation or respiration. The southern part of Texas is one of the regions with the lowest altitude in the United States. It has proximity to Colorado, well known for its Rocky Mountain National Park, with elevations from 7,890 feet to 14,259 feet. This case presents …

Thinking Outside The Box For Experiential Student Learning: Development Of Remote Experiential Learning And Volunteering During The Pandemic, Amy Christopher

Learning Teaching Forum

In response to the COVID-19 pandemic, experiential learning for health care professional programs struggled to find clinical rotation sites and provide students in the didactic curricular phase opportunities to apply health education outside of the classroom. Many healthcare sites and community health screening events were prohibited during an extended period of time due to pandemic isolation. As a health educator, exploration of remote experiential learning took creative planning to ensure students were able to apply their medical knowledge in real-life situations, give back to their community according to Marianist charisms, and fulfill healthcare-related volunteer service hour requirements.

More information in …

Evaluating Causes Of Sinus Tachycardia In The Pediatrics Population And Managing In A Primary Care Setting, Guillemette Calderwood

Capstone Showcase

This article’s goal is to fill a gap in research that compares causes of tachycardia in children by appropriately addressing epidemiology, what is physiologically happening with tachycardia, symptoms that may be associated with it, as well as a differential diagnosis. This review specifically discusses positional orthostatic tachycardia syndrome, anxiety, hyperthyroidism, as well as infection. This is important and needed in order to help providers in diagnosing the cause for this common arrhythmia.

Basic Principles Of Chronic Wound Care Management, Mahi-Ruhi Ladhani Jain

Capstone Showcase

This CME article aims to address the basics of chronic wound management, especially related to chronic venous insufficiency, peripheral arterial disease, and diabetes. Many providers do not know how to treat or manage chronic wounds and may use outdated methods to treat the wounds. There are many wound care supplies and resources available for providers when it comes to wound care management. However, the information is spread out across different resources. This article aims to create a resource that allows one to have a basic understanding of wounds and the different ways to manage them. In the article, I will …

The Role Of Primary Care Providers In Maintaining Weight Loss By Preventing Behavioral Relapse, Hayden R. Blanchard

Capstone Showcase

Supporting patients in optimizing health by treating obesity remains a relevant goal for primary care providers. While weight loss is frequently achieved with behavioral modification, maintaining weight loss by avoiding behavioral relapse is much more difficult. Patient may lose weight by reducing overall energy intake, incorporating intensive behavior change programs, utilizing pharmacotherapy as needed and, in certain cases, undergoing bariatric surgery. With a focus on behavior change and maintenance, primary care providers can support patients by planning more frequent follow up appointments, at least every one to three months. In these visits, PCPs can: focus on reenforcing lifestyle change principles …

Methods Model For Initiation Of Acute Care Health Promotion Programs Illustrated By Application To Prevention Of Essential Hypertension., Michael A. Metz

Capstone Showcase

Background and Purpose: Physical therapists (PTs) have a responsibility to assume their role in health promotion. A model program adaptable to setting and participant readiness could facilitate compliance to address modifiable behavioral risk factors and reduce the disabling cardiovascular consequences of hypertension. The purpose of this methods model report is to catalyze the development of hospital-based primary care physical therapy programs for patients with hypertension, encapsulating the PT’s niche in preventative care. Method/Model Description and Evaluation: This proposal began with compilation of causative and biometric factors for hypertension and relevant hospital-based referral sources. One PT received nutritional certification. An acronym …

Emerging Unconventional Therapies For Glioblastoma Multiforme, Danielle Morang

Capstone Showcase

Glioblastoma multiforme (GBM) is the most prevalent and aggressive primary malignant brain tumor occurring in adults with a median survival of less than two years. It is a highly invasive tumor characterized by genetic heterogeneity, angiogenesis, and rapid proliferation. Patients undergo a multimodal treatment regimen consisting of surgical resection and chemoradiation therapy, yet GBM tumors almost always recur with a worsening prognosis. The molecular and genetic complexities of GBM pose a significant challenge for developing effective therapeutics. Thus, it is imperative to identify new therapeutic targets and explore novel treatment strategies to improve patients’ overall survival time and quality of …

Impact Of Sleep Deprivation On Stress And Performance In Students: Best Interventions, Brianna Crowley

Capstone Showcase

Sleep is an essential part of physical and mental well-being, yet, many individuals underestimate its importance.^1,2,4 Sleep deprivation can lead to a variety of detriments including memory loss, disorganized thinking, and mood changes.^3,6,7 Because of this, academic performance can be directly impaired as well, which further perpetuates a vicious cycle of sleep deprivation and increasing stress.⁸ Interventions to help improve sleep include adequate sleep hygiene, appropriate physical exercise, lifestyle changes, practicing mindfulness, and using pharmaceutical aids. Providers must continue to address this common issue among patients as it truly impacts various aspects of life and follow good …

Examining The Efficacy Of Treatments For Complex Regional Pain Syndrome, Michael Podcasy

Capstone Showcase

Complex Regional Pain Syndrome (CRPS) is a disease that affects the sensory, motor, sudomotor, vasomotor and trophic systems of patients. The pathophysiology is currently unknown and the diagnostic criteria that is used, the Budapest criteria, has its own shortcomings. This had led to hurdles in the research of the disease and well as a lack of high-quality studies on the efficacy of the many treatments currently being used to treat CRPS today. This poster explores those concepts.

Early Onset Colorectal Cancer: Research, Trends & Challenges, Sarah E. Smith

Capstone Showcase

Early onset colorectal cancer (EOCRC) incidence and mortality are rising in a global trend, contrasting with improvements seen in late-onset colorectal cancer (LOCRC). EOCRC appears to differ in presentation, histology, and pathology from LOCRC painting concerns of a more aggressive tumor profile. With incidence steadily climbing, there is still lacking awareness and guidance on screening for EOCRC. This article aims to provide background on EOCRC including epidemiology, risk factors, and traits, as well as to explore methods for adjusting provider screening criteria to combat this concerning trend.

A Thoughtful Approach To Weight Loss Management, Zachary Brock

Capstone Showcase

As a student preparing to graduate PA school, one of the areas I hope to improve upon is my ability to educate patients in a comfortable, caring, encouraging, and effective manner. In my experience, the topic of weight-loss is often handled in ways that are insensitive, making patients feel shameful about their condition and less inspired to change. The goal of this article will be to address the current literature on how to medically manage obesity in patients and combine resources that offer more effective, encouraging, and subtle approaches that will help lead to a more effective, shame-free treatment of …

Migraine Treatment In Primary Care, Vivian Tran

Capstone Showcase

Migraines are a common problem that medical providers encounter, especially in primary care, neurology, and the emergency department. Given that 15% of the population suffers from migraines annually, it is important for providers to know how to diagnose migraines. Migraines may also present as a symptom of another disorder, so being able to recognize whether symptoms are alarming is crucial to start the correct workup. The mainstay abortive therapy for migraines is ibuprofen, and for prophylactic therapy is topiramate. However, CGRP targeted medications like gepants and CGRP mAbs may be the new treatment of choice for abortive and prophylactic treatment …