Medical Specialties Commons^™

Implementing Intermittent Fasting Education For Improved A1c Control In Type 2 Diabetes Patients, Dakota Dalton, Elizabeth White, Malinda Hansen, Tasaduq Mir

North Texas Research Forum 2025

Background: Management of Type 2 Diabetes Mellitus (T2DM) in the UNTHSC Family Medicine clinic varies among residents, with some advocating robust lifestyle counseling and others relying more on medical management. This leads to inconsistencies in patient education and treatment strategies. Lifestyle interventions such as dietary modifications, are unfortunately too often underutilized in the clinic and in primary care in general, despite strong evidence supporting their efficacy in control of both A1C measurements and random fasting blood sugar, and improved prognosis of diabetes. To address this, we have designed and introduced an intermittent fasting (IF) handout as a supplemental standardized educational …

Warm Autoimmune Hemolytic Anemia Camouflaged As Persistent Anemia Post-Embolization For Abnormal Uterine Bleeding: A Case Report, Nischal Pokhrel, Sathish Karmegam

North Texas Research Forum 2025

This case report presents a 42-year-old female with heavy menstrual bleeding and syncope, initially diagnosed with AUB due to fibroids. The patient's hemoglobin (Hb) dropped from 11.8 g/dl to 7.3 g/dl within three days, despite multiple PRBC transfusions. Uterine artery embolization (UAE) was performed, but Hb levels continued to decline, prompting further investigation. Additional testing revealed normal iron studies, vitamin B12, and folic acid levels. The peripheral blood smear showed mild anisocytosis, and the ANA screen was negative. However, elevated lactate dehydrogenase (LDH) at 571 U/L, a positive DAT for IgG, and a reticulocyte count of 6.37 were observed. These …

Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr

North Texas Research Forum 2025

Background Patients with massive/sub-massive pulmonary embolism (PE) and right ventricular strain have a significant risk of hemodynamic collapse. VA ECMO support provides an excellent salvage option for patients with acute/unstable pulmonary embolism with obstructive cardiogenic shock undergoing mechanical thrombectomy. Using VA-ECMO for a “protective PE” procedure allows control of hemodynamics and enables interventionalists to perform the thrombectomy in a more controlled environment. Here, we present our experience. Methods A retrospective data analysis on consecutive VA ECMO patients with cardiogenic shock secondary to pulmonary embolism was abstracted from August 2022 to June 2024. Results Patient characteristics and outcomes are described in …

Effective Communication In The Pronunciation Of Brain Death, Sumanth Reddy, Artur Amirkhanyan, Jeremiah Avarana, Praneetha Arge, Alicia Lay

North Texas Research Forum 2025

Background: Clinical brain death determination requires both technical proficiency and sensitive communication with families. However, residents often report inadequate training and confidence in performing and discussing these examinations. This study evaluated an educational intervention combining didactic training and simulation to improve residents’ competence in brain death protocols and family communication. Methods: A mixed-methods cohort study was conducted with resident physicians. Participants completed a pre-intervention questionnaire assessing baseline knowledge, experience, and confidence in brain death determination and communication. An educational session reviewed clinical criteria, examination protocols, and communication strategies. Residents then engaged in an in-person simulation with standardized actors portraying grieving …

Use Of Intraoperative Vancomycin Powder And Its Effects On The Incidence Of Surgical Site Infection In Orthopaedic Trauma: A Systematic Review And Meta-Analysis, Troy Puga, Mckenna Box, Alan Lam, Claire Ferguson, Mason Poffenbarger, Cornelis Potgieter, John Riel

North Texas Research Forum 2025

Introduction Surgical site infection (SSI) in orthopaedic trauma can have devastating consequences for patients. Many risk factors for SSI exist and many strategies are employed to prevent SSI. The use of intraoperative powdered vancomycin is one such strategy used in orthopaedic trauma surgery, however, evidence and guidelines remain unclear. The aim of this systematic review is to evaluate the evidence for the use of powdered vancomycin in orthopaedic trauma surgery for the prevention of SSI. Methods A search was conducted across Pubmed/Medline, Cochrane, and Embase databases to evaluate for the use of powdered vancomycin in orthopaedic trauma surgery for the …

Challenges In Public Health: The Diagnosis And Treatment Of Crusted Scabies, Marshall Hall, Alyssa Forsyth, Wenquin Du, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Common scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of common scabies is crusted scabies, formerly known as Norwegian scabies. While infection with common scabies typically involves 10 to 20 mites, individuals with crusted scabies are burdened with thousands to millions of mites. Crusted scabies is characterized clinically by hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case presentations: We present 4 cases of crusted scabies. An 89-year-old male …

Necrotizing Alternaria Pneumonia In An Immunocompetent Male, Joel Mathews, Jose Aguilar-Martinez, Sean Sojdie, Zain Tariq, Tamer Hudali

North Texas Research Forum 2025

Abstract: Alternaria species is a rare cause of invasive fungal pneumonia, typically described as an opportunistic pathogen, usually seen in immunocompromised patients producing virulent forms of sinus, cutaneous, and ocular infections. Alternaria species sparingly affect immunocompetent individuals and are often managed without any medical interventions. We present a case of invasive fungal necrotizing pneumonia caused by Alternaria alternata species in an immunocompetent 28-year-old male with only a past medical history of well-controlled asthma managed with an as-needed albuterol inhaler. His complaints included worsening foul-smelling productive cough with yellow-dark brown sputum along with subjective fevers, chills, chest pain, and dyspnea for …

Efficacy Of Pegloticase In Combination With Methotrexate In Tophaceous Gout: Case Report, Rabia S. Mahfooz, Amita J. Dsouza, Neil Maithel, Naser Elkhalili

Gulf Coast Division GME Research Day 2025

No abstract provided.

Atypical Hemorrhoid Or Hidden Malignancy? Anal Melanoma And Palliative Strategies, Osamuyi Asemota, Kayla Brown, Megan Turley

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

Is There An Association Between Living In A Rural Area And The Incidence Of Postoperative Complications Or Hospital Readmissions Following Left Ventricular Assist Device (Lvad) Implantation, Compared To Urban Lvad Recipients? A Systematic Review., Samrat Gollapudi, Abhiram Gollapudi, Sri Banala, Sheraj Singh, Kiran Tadi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can enhance survival rates and quality of life, the procedure has its risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

METHODS: A comprehensive literature review examined studies that compared postoperative outcomes between rural and urban LVAD recipients. Data on adverse events, hospitalizations, and mortality rates were extracted, focusing …

Vonoprazan Vs. Lansoprazole In The Healing & Maintenance Phase Of Erosive Esophagitis, Sushil Rayamajhi, Syed Hasham Ali, Hareesha Bharadwaj, Ali Tariq

North Florida Division GME Research Day 2025

No abstract provided.

Drug Induced Sweet's Syndrome Secondary To Pegfilgrastim: A Rare Case, Renuka Mahatara, Abhi Rao, Ian Whitaker, Bradley Saylors, Charles Holladay

South Atlantic Division GME Research Day 2025

No abstract provided.

Coexisting Type A And B Aortic Dissection With Extension To Carotid Arteries Resulting In Acute Ischemic Stroke, Dung Nguyen, Jilpa Shah, Amnah Andrabi

North Texas Research Forum 2025

Coexisting Type A and B aortic dissection with extension to carotid arteries resulting in acute ischemic stroke Abstract Background: Acute aortic dissection (AAD) is a rare cause of ischemic stroke. Additionally, it is even rarer to have a combined type A and type B aortic dissection. ADD is a high-mortality disease that can lead to immediate decompensation and can be masked by stroke-like symptoms, which can result in delayed or missed diagnosis. We report a patient with acute ischemic stroke (AIS) with subsequent combined type A and type B aortic dissection. Case Report: A 47-year-old man was admitted to the …

Bucks Traction In The Emergency Departments (Ed) In North Texas Division (Ntxd), Mason Poffenbarger, Neil Werthmann, Cody Beltran, Hannah Affleck, Kristen Payne, Caleb Shin, Hans Drawbert, Hayley Buehler, James Drinan, Sanjay Sharma, Diona Johnson, John T. Riehl, Adam Green

North Texas Research Forum 2025

Implementing Buck’s traction for elderly hip fracture patients in the emergency department (ED) is often inefficient, leading to prolonged setup times, increased staff workload, and delays in patient care, ultimately impacting ED length of stay (LOS). This quality improvement project aims to streamline the process by establishing a standardized storage system for traction equipment, optimizing bed compatibility, developing a clear workflow flowchart, and providing targeted staff training. By improving organization and efficiency, we anticipate a reduction in setup time, enhanced workflow, and decreased ED LOS for hip fracture patients. Measuring pre- and post-intervention times will ensure continuous refinement, ultimately leading …

Zinc Promotes Mitochondrial Health Through Pgc-1alpha Enhancing Bacterial Clearance In Macrophages Infected With Mycobacterium Avium Complex, Ruxana Sadikot, Prabagaran Narayanasamy, Zhihong Yuan, Deandra R. Smith, Daren L. Knoell

Journal Articles: Pulmonary & Critical Care Med

Mitochondria are increasingly recognized as important contributors to immune function, in addition to energy production. They exert this influence through modulation of various signaling pathways that regulate cellular metabolism and immune function in response to pathogens. Peroxisome proliferator-activated receptor (PPAR) coactivator 1 alpha (PGC-1α) is the primary transcription factor and regulator involved in mitochondrial biogenesis. Long known to be involved in immune function, zinc (Zn) is also required for proper mitochondrial function. It is increasingly recognized that many cellular immunometabolic activities are also Zn-dependent. Taken together, we investigated the role of Zn deficiency, both dietary and genetically induced, and Zn …

A Look Into Postpartum T2dm Screening In Patients Diagnosed With Gdm, David Vincent Ream, Joshua Ferrell, Ashlee Nichole Tillery

South Atlantic Division GME Research Day 2025

No abstract provided.

Sle And Aps Synergy: Aortic Dissection, Neil Maithel, Ali Asghar, Rabia Mahfooz, Ibrahim Musa, Hasnan Ijaz, Thomas Alexander

Gulf Coast Division GME Research Day 2025

No abstract provided.

Atypical Presentation Of Moyamoya Disease Presenting With Severe Headache: A Case Report, Nilay Bhatt, Tirth Vyas

Gulf Coast Division GME Research Day 2025

No abstract provided.

Research Priotitization In Hernia Surgery: A Modified Delphi Achqc And Vhoc Expert Consensus, Rachel Wright, Daphne Remulla, Mazen R. Al-Mansour, Christopher Schneider, Sharon Phillips, William W. Hope

Gulf Coast Division GME Research Day 2025

No abstract provided.

The Gut Feeling: Diagnosing The Unexpected Ogilvie’S Syndrome, Sakina Haider, Jenny Cherenfant, Supritha Chintamaneni, Rama Laxman

Gulf Coast Division GME Research Day 2025

No abstract provided.

Micra-Scopic Hero: Rare Unroofed Cornoary Sinus Complicating Pacemaker Placement, Suhas Tatapudi, E Castillo, Jeby Kalathoor, Zuhair Ali, Hytham Rashid, R Cargioli

Gulf Coast Division GME Research Day 2025

No abstract provided.

Incidental Discovery Of Bilateral Pheochromocytoma In A Patient With Lifelong Hypertension, Umema Irfan, Sara Shahid, Anam Zara

Gulf Coast Division GME Research Day 2025

No abstract provided.

Gallium Β-Cyclodextrin Nanoparticles Containing Both Gallium Protoporphyrin And Gallium Nitrate Exhibit Antimicrobial Activity Against Nontuberculous Mycobacteria In Vitro And In Vivo, Seoung-Ryoung Choi, Bradley E. Britigan, Prabagaran Narayanasamy

Journal Articles: Pulmonary & Critical Care Med

Effective and safe antibiotics active against pathogenic mycobacterial species are needed. Iron is an essential element for bacterial survival. Ga(NO₃)₃ (GN) and Ga protoporphyrin (GP) as iron mimetics have each been shown to inhibit the iron metabolism and growth of various mycobacterial species. In this study, the dual cyclodextrin nanoparticle (CDGPGN) is prepared that carries GP and GN using a sonication homogenization technique to increase the efficacy of the combination therapy. CDGPGN shows a long-acting antimicrobial activity against Mycobacteroides abscessus residing in monocyte-derived macrophages (MDM). A murine pulmonary study showed that the CDGPGN also inhibited the growth …

Enhancing Patient-Centered Efficiency: Reducing Cardiology Clinic No-Shows Using Technology, Pre-Visit Planning & Patient Resources, Pat Shirey

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Cardiovascular disease (CVD) affects 48% of U.S. adults, requiring regular cardiology visits to manage risk factors and the early detection of complications (American Heart Association, 2019). No-shows disrupt continuity of care, worsen health outcomes (Choi et al., 2020), and decrease clinic efficiency (Goossens et al., 2022). A North Texas cardiology clinic reported a 31.9% overall no-show rate and a 42.1% no-show rate for new patients, costing $1.3 million annually.

Purpose: This quality improvement project aimed to reduce no-show rates through a patient-centered cardiology appointment bundle to improve continuity, patient outcomes, and efficiency.

Methods: This eight-week project utilized the Plan-Do-Study-Act …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

Mycosis Fungoides: A Mimicker Of Atopic Dermatitis, Christian Scheufele, Paige Loux, Henry Lim, Garrett Furth, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction Cutaneous T cell lymphoma (CTCL) is a rare, cutaneous, malignant neoplasm of the resident T cell lymphocytes within the skin. CTCL encompasses a spectrum of morphologically and prognostically distinct entities, the most common of which is mycosis fungoides (MF). The incidence of mycosis fungoides is about 6 cases per million per year in the United States and Europe. MF is notoriously difficult to diagnose clinically. It can masquerade as several common dermatologic conditions and may be treated as such for years until a biopsy reveals the correct diagnosis. One of the most common diseases that MF mimics is atopic …

A Standardized Surgical Protocol For Placenta Accreta Spectrum Disorder At An Accreta Center Of Excellence, Ana Adams, Monica Rodriguez, Kate Hansen, Aysu Erdemir, Robert Cohen

North Texas Research Forum 2025

Introduction Placenta Accreta Spectrum Disorder (PASD) refers to a spectrum of abnormal invasion of the placenta into the uterus during pregnancy. PASD ranges in severity from involvement through the endometrial layer of the uterus to complete invasion involving other pelvic structures. This abnormal invasion can result in significant postpartum hemorrhage, often requiring large-volume transfusions, about six units of packed red blood cells on average. The maternal mortality rate associated with PASD is approximately 4-7%. The Society for Maternal-Fetal Medicine (SMFM) recommends that pregnancies complicated by PASD be delivered in hospitals with dedicated interdisciplinary teams, referred to as “Accreta Centers of …

Hydralazine Induced Anca Vasculitis, Justin Huang, Yasasvi Sabbineni, Sumanth Reddy, Hani Khair

North Texas Research Forum 2025

Hydralazine is a vasodilator commonly used for hypertension. Hydrazine is commonly used in patients who can not tolerate ACEs and ARBs, resistant hypertension, and during pregnancy. Hydralazine has also been implicated in ANCA-associated vasculitis and drug-induced lupus erythematosus. Vasculitis is the presence of inflammatory leukocytes in vessel walls, inflammation can cause loss of vessel integrity which can lead to bleeding and downstream tissue ischemia and necrosis. Antineutrophil cytoplasmic antibody (AΝCΑ)-associated vаsсulitiѕ (ΑΑV) is a necrotizing vаsсսlitis that does not substantially involve the deposition of immune complexes. AΑV predominantly affects small vessels and is associated with ANСΑ specific for myeloperoxidase (MPO-ΑNCΑ) …

Managing Thyroid Storm In A 40 Year Old Male Patient: A Case Report, Mark Barkat

Gulf Coast Division GME Research Day 2025

No abstract provided.