Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Igf-1 As A Biomarker For Symptom Severity In Adult Traumatic Brain Injury: Evidence From An Observational Study, Justin Weppner, Kimberly Rosenthal, Jennifer Bath, Tonja Locklear, Melissa Martinez

Department of Physical Medicine & Rehabilitation Faculty Publications

Traumatic brain injury (TBI)-related growth hormone deficiency is often undertreated, despite documented physical, metabolic, and neuropsychiatric effects. Insulin-like growth factor (IGF-1), with neuroreceptors located in brain regions responsible for learning, memory, and mood, regulates cerebral blood flow, neurogenesis, and neuroplasticity. The aim of this study was to determine associations between IGF-1 levels and post-TBI symptom severity, anxiety, and depression. This retrospective observational study at an Academic Brain Injury Center included participants evaluated 3-12 months post-TBI with available IGF-1 values and complete Rivermead Post-Concussion Symptoms Questionnaire (RPQ-13), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) responses. Patients under 18 or …

Reducing Colonoscopy Cancellations Saves Lives, A Quality Improvement Project, Jennifer L. Brosnan

West Chester University Doctoral Projects

One of Healthy People 2030’s objectives is to increase the proportion of adults screened for colorectal cancer. To address this objective, a quality improvement project was completed within an Ambulatory Surgical Center (ASC). An evidenced-based committee was formed with the primary goal to decrease the number of cancelled colonoscopies. The committee aimed to answer the PICOT question: For patients who cancel their colonoscopy, how does the development and implementation of an evidence-based practice (EBP) committee’s nursing interventions reduce cancelled colonoscopy rates and increase reschedule rates, compared to no implementation of an EBP committee’s nursing interventions, over three months?

Nursing interventions …

Malignant Adenomyoepithelioma Of The Breast, Cole Daisley, Susana Ferra

East Florida Division GME Research Day 2025

No abstract provided.

Mesonephric-Like Carcinoma Of The Endometrium In A 73-Year-Old Female, Cameron Summers-Powell, Carina Ferraris, Zoyla Almeida, Susana Ferra, Mirza Baig

East Florida Division GME Research Day 2025

Introduction: Mesonephric-like carcinoma (MLC) is a newly described malignant tumor that represents 1% of endometrial cancers. The etiology of this disease is currently unknown but immunohistochemical expression with GATA-3, PAX-8 and TTF-1 and lack of ER/PR positivity can aid in correct diagnosis.

Case Summary: A 73-year-old female presented to the hospital with post-menopausal bleeding, an initial hysteroscopy identified a lesion suggestive of endometrial cancer. Ultimately, the patient underwent a hysterectomy and a bilateral salpingectomy/oophorectomy. Chemotherapy ensued due to metastatic disease. At 7 months post-op, the patient appeared to be doing well.

Results: Grossly, the lesion was 5.5 cm and appeared …

Carcinoma With Osteoclast-Like Giant Cells: A Rare Histologic Variant Of Breast Cancer, Robert Bender, Makenna Bowman, Matthew Lee, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: Osteoclast like giant cells (OGCs) can be found in various tissues such as the gallbladder, liver, pancreas, and thyroid. In breast cancer, the presence of OGCs is a rare finding. Currently knowledge of such cases is limited, with approximately 200 reported cases of osteoclast like giant cells (OGCs) among all breast carcinomas. Among the breast cancers that are classified as rare, those with OGCs make up only 0.5-1.2% of cases.

Case Description: An 80+ year-old female presented with a palpable left breast lesion initially suspected by mammography as a benign lesion. She eventually underwent breast core biopsy revealing hormone …

Advantages Of Humeral Stem Retention In Revision Shoulder Arthroplasty: A Retrospective Study, Matthew Mccrosson, Leon Liu, Daniel Deshetler, John Grossi, Devin John, Diego Lima, Howard Routman

East Florida Division GME Research Day 2025

No abstract provided.

​Cd10 Positive Mantle Cell Lymphoma Masquerading As Follicular Lymphoma​, Matthew Lee, Jennifer Barker, Fatemeh Mousavi

East Florida Division GME Research Day 2025

No abstract provided.

Lipoleiomyoma Of The Uterus, A Benign Metastasizing Tumor, Munira Malik, Mohtashim Naeem, Susana Ferra

East Florida Division GME Research Day 2025

No abstract provided.

Artificial Intelligence In Cancer-Related Malnutrition And Cachexia: A Transformative Tool In Clinical Nutrition, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

[Introduction] Malnutrition and cachexia are common complications in cancer patients, and they negatively influence prognosis, treatment efficacy, and tolerability as well as quality of life [[1], [2], [3]]. Accurately identifying and effectively managing malnutrition and cachexia in this population remains a clinical challenge. Conventional validated screening tools may lack the sensitivity and specificity required for early detection and personalized intervention in diverse cancer types and treatment settings [4,5]. Over the last decade, the use of artificial intelligence (AI), including machine learning (ML) and deep learning (DL) strategies, has shown promising results in clinical nutrition, with the potential to revolutionize nutritional …

Wrongful Migration: A Hidden Culprit Behind Flank Pain, Ryan Miller, Anjeza Cipi, Emma Pierce

Department of Emergency Medicine Faculty Publications

[Introduction] A 32-year-old woman with no significant past medical history presented to the emergency department with 11 days of fever, fatigue, chills, and new-onset fullness in her left flank. She denied dysuria, abdominal pain, or vaginal bleeding. Vital signs showed fever and mild hypotension, and the physical examination revealed left-sided abdominal distension. Laboratory results demonstrated leukocytosis and a lactate of 3.2 mmol/L. She appeared nontoxic but was persistently febrile despite initial fluids and antibiotics. Computed tomography—shown in Figure 1, and ultrasound—shown in Figure 2, were obtained and revealed the diagnosis.

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

Initiation Of Sterile Vaginal Preps Prior To Cesarean Sections: A Quality Improvement Project, Diane Gilbertson, Timothy Kremer, Kimberly Udell

North Texas Research Forum 2025

OBJECTIVE: Research on patients undergoing routine gynecological procedures with a vaginal preparation has demonstrated a significant reduction in post-operative infections by decreasing the burden of vaginal bacteria. Despite this research, as well as evidence that they reduce postpartum endometritis, especially in labor patients or those with ruptured membranes (Lui), vaginal preparations prior to cesarean section are not standard practice. Prior to the initiation of this quality improvement project, no patients delivering at Medical City Arlington received a vaginal preparation prior to a cesarean delivery. The goal of this quality improvement project is to improve clinical care, patient safety, and healthcare …

Improving Communication And Follow Up For Incidental Findings From Panscan Imaging, Makenzie Morrissey, Kristen Payne, Randall Rittmann, Chris Robert, Joseph Lim, Danielle Pigneri

North Texas Research Forum 2025

OBJECTIVE: Incidental findings in medical imaging pose a significant challenge in healthcare due to the potential for missed follow-ups, which can lead to adverse outcomes for patients. These findings, which are unrelated to the primary purpose of the imaging study, are increasingly common due to advances in imaging technology and its widespread use. The consequences of missed follow-ups can be severe. For instance, the rate of malignancy in incidental pulmonary nodule id about 5% and follow up fails in 30-70% of cases. This means for every 120 CT chest scans ordered, 1 lung cancer is missed (McWilliams et al., 2013). …

The Importance Of Early Source Control: A Case Of Resistant Mrsa, Jack Demirjian, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Not Your Average Syncope: A Case Of Bifascicular Block, Shuchita Jhaveri, Maria Amigo, Zahoor Khan, Marloe Prince

Gulf Coast Division GME Research Day 2025

No abstract provided.

Robotic Whipple Procedure, Chris Robert, Soomal Memon, Umar Butt, Furrukh Jabbar

North Texas Research Forum 2025

Introduction: Pancreatic cancer is an aggressive tumor with surgery being the corner stone of multidisciplinary treatment. Pancreaticoduodenectomy is a technically demanding procedure associated with significant morbidity. Case presentation: 70-year-old man with a past history of hypertension presented with jaundice, dark urine and a total bilirubin of 24. His CT scan showed biliary and pancreatic ducal dilation. An EUS revealed a 2cm pancreatic mass with an intact interface between the mass and splenoportal confluence, the biopsy was suggestive of poorly differentiated adenocarcinoma. We performed a Robotic Whipple procedure. Robotic Whipple surgery is superior in meticulous dissection of the retro pancreatic tunnel. …

Successful Treatment Of Mirizzi Syndrome With Spyglass-Guided Electrohydraulic Lithotripsy, Bushra Bangash, Aakriti Soni, Galvin Dhaliwal, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

Novel Use Of A Biodegradable Endovascular Plug In A Case Of A Ruptured Abdominal Aortic Aneurysm During An Endovascular Aortic Repair, Sophia G. Jimenez, Paul T. Spore, Carolsun S. Rajan, Ryan S. Turley, Bradley Boone

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Unveiling A Rare Pathology: Carcinosarcoma Of The Gallbladder, Gul Emek Wymer, Laci-Rae Pitter, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: Gallbladder carcinosarcoma is a rare and aggressive biliary tract malignancy, constituting approximately 1.7% of gallbladder cancers, with fewer than 100 cases reported in the English literature as of 2023. These tumors, often affecting gynecological organs, feature both carcinomatous and sarcomatous components. They predominantly occur in females, with a mean presentation age of 66 years. Diagnosis is primarily based on pathological analysis, and the mainstay of treatment is surgical excision.

Case Description: We present a case of an 81-year-old female with no significant medical history, who was admitted after a fall. A CT scan revealed an 18.2 cm gallbladder mass …

Rx On The Rocks: Prescribing Solutions For Alcohol Use Disorder, Arisa Gonzalez, Laura Botero, Adlin Lawrence, Kenneth Jimenez, Eric Chen, Richard Henriquez, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.

Severe Right Ventricular Dilation Due To Selenium Deficiency In A Post Gastric Bypass Patient - A Rare But Life Threatening Complication, Arjun Kamath, Jorge Garza, Ethan Goldberg, A Syed, Deekshita Valiveti, Abhay Vakil, Zuhair Ali, A Ashgar, Luay Alalawi, Heriberto Cantu, Thomas Alexander

Gulf Coast Division GME Research Day 2025

No abstract provided.

Traumatic Aortic Transection, A Case Report, Jared Duval, Ernest Gonzalez

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Comparison Of Fibula Plating Versus Fibula Nailing: A Systematic Review With Meta-Analysis Of All Current Comparative Literature, Troy Puga, Mckenna Box, Charles Marchese, Alan Lam, Sam Stegelmann, John Riehl

North Texas Research Forum 2025

Introduction Ankle fracture surgeries are common orthopaedic procedures. Fibular fixation is often an important component in restoring ankle stability. Fibular intramedullary nailing (fIMN) has gained recent interest as an alternative technique to fibular plating. This systematic review and meta-analysis was performed to compare the outcomes of fibular nailing versus fibular plating for all current available literature. Methods A PRISMA-compliant systematic review was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases for cohort and clinical trial studies comparing outcomes of fibular nailing and fibular plating of ankle fractures. Demographics and results of the studies were extracted from the articles. Outcomes of interest …

Video Games In The Management Of Adhd: A Novel Approach To Adjunct Traditional Treatment, Lekhya Kintada, France Leandre

North Florida Division GME Research Day 2025

No abstract provided.

Femoral Neck Allograft For Glenoid Reconstruction During Revision Reverse Total Shoulder Arthroplasty: A Case Report, Devin Q. John, Leon Z. Liu, Diego J L Lima, Howard D. Routman

East Florida Division GME Research Day 2025

No abstract provided.

Can Residents Cheat The Unknown Slide Sessions By Using The Large Language Models? Which Model Should They Use: Chat-Gpt, Claude, Or Gemini?​, Gul Emek Wymer, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: In recent years, artificial intelligence tools, such as large language models (LLMs) have expanded the potential for diagnostic medicine, including histopathology. This study aims to evaluate the diagnostic ability and utility of the publicly available large language models in predicting the accurate diagnosis of the unknown cases by using the images of the hematoxylin-eosin stained slides taken by a mobile phone and compare their performance with the residents’ performance.

Method: The twenty cases, including a variety of entities, were collected from teaching sets of non-HCA patients and public available domains, which are used for unknown slide sessions for residents. …

Real Time Non-Targeted Renal Biopsy Adequacy Evaluation: A Successful Quality Improvement Activity, Astrid Sacasa, Susana Ferra

East Florida Division GME Research Day 2025

Introduction. Adequate renal biopsies are essential for the diagnosis and treatment of medical renal disease. This process requires a sufficient number of glomeruli for light microscopy, immunofluorescence, and electron microscopy evaluation. On-site microscopic evaluation of kidney biopsy specimens significantly improves sample adequacy and the ability to render a diagnosis, with studies showing a much higher rate of inadequate samples when on-site evaluation is absent. Inadequate biopsies can have a significant negative impact on patient care including delay of adequate diagnoses, worsening of the patients’ condition and complications, and increasing costs due to the need for repeat biopsies. A real time …

Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed

North Texas Research Forum 2025

Introduction: The incidence of concomitant cholelithiasis and choledocholithiasis is 5-20%. Primary choledochlithiasis more than 3 years after cholecystectomy is an even rarer event with only a handful of case reports in the literature. Robot-assisted laparoscopic common bile duct exploration with intraoperative choledochoscopy is a relatively recent development in biliary surgery. In this report, we describe the use of this technique in a patient with rare presentation and surgically challenging anatomy. Objective: To describe a minimally invasive approach for CBD exploration with extraction of choledocholithiasis in a surgically hostile abdomen and Roux-En-Y anatomy. Methods: This report describes the case of a …

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …

Formulation Development Of Dual-Compartment Topical Inserts Combining Tenofovir Alafenamide And Elvitegravir For Flexible On-Demand Hiv Prevention, Vivek Agrahari, M. Melissa Peet, Neelima Chandra, Prakash Ramalingam, Pardeep K. Gupta, Sriramakamal Jonnalagadda, Onkar N. Singh, Timothy J. Mccormick, Gustavo F. Doncel, Meredith R. Clark

Department of Obstetrics & Gynecology Faculty Publications

Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis. Specifically, we describe the lab-scale formulation development, preclinical mucosal safety and pharmacokinetics (PK) testing in rabbits, long-term stability, and scale-up …