Medicine and Health Sciences Commons^™

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 …

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 …

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

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 …

Tips For Teaching Ebm In The Busy Clinical Setting, Sonam Kiwalkar, Basil Verghese

Faculty Development Lunch and Learn

Tips for Teaching EBM in the Busy Clinical Setting. Sonam Kiwalkar, MD, FACP, Associate Program Director, Legacy Salmon Creek IMRP; Basil George Verghese, MD, FACP, FHM, Associate Program Director, Rochester General Hospital IMRP

Discussion:

• What is evidence-based medicine?
• What are the steps to evidence-based medicine?
• Why is it important to teach evidence-based medicine?
• How to teach evidence-based medicine in the busy clinical setting?

2024 January 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Comparing Cognitive Tests And Smartphone-Based Assessment In 2 Us Community-Based Cohorts., Ileana De Anda-Duran, Preeti Sunderaraman, Edward Searls, Shirine Moukaled, Xuanyi Jin, Zachary Popp, Cody Karjadi, Phillip H Hwang, Huitong Ding, Sherral Devine, Ludy C Shih, Spencer Low, Honghuang Lin, Vijaya B Kolachalama, Lydia Bazzano, David J Libon, Rhoda Au

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Smartphone-based cognitive assessments have emerged as promising tools, bridging gaps in accessibility and reducing bias in Alzheimer disease and related dementia research. However, their congruence with traditional neuropsychological tests and usefulness in diverse cohorts remain underexplored.

METHODS AND RESULTS: A total of 406 FHS (Framingham Heart Study) and 59 BHS (Bogalusa Heart Study) participants with traditional neuropsychological tests and digital assessments using the Defense Automated Neurocognitive Assessment (DANA) smartphone protocol were included. Regression models investigated associations between DANA task digital measures and a neuropsychological global cognitive

CONCLUSIONS: Our findings demonstrate that smartphone-based cognitive assessments exhibit concurrent validity with a …