Medical Specialties Commons^™

Dilemma In Managing Patients Presenting With Nstemi & Concurrent Gi Bleed, Mehak Sachdeva, Kathleen Mattingly, Franklin Hernandez, Jonathan Grube

North Florida Division GME Research Day 2025

No abstract provided.

Denovo Malignancy After Liver Transplantation In Patients With And Without Hepatocellular Carcinoma, Mohammad Abuassi, Carson Creamer, Harsimran Kalsi, Kobina Essilfie-Quaye, Tony S. Brar, Yaseen Perbtani

North Florida Division GME Research Day 2025

No abstract provided.

Sodium-Glocuse Cotransporter-2 Inhibitor Decreases The Risk Of Heart Failure Hospitalization & Regardless Of Left Ventricular Ejection Fraction, Hussein A. Noureldine, Thais Schwartz, Qusai Alqudah, Maryam Alhousseini, Ann T. Tong

North Florida Division GME Research Day 2025

No abstract provided.

Improving Skin Cancer Screening In A Fm Residency: Dermatoscope Utilization, Aleksandra Radzio, Navina Delight, Aniruddha Logan

North Florida Division GME Research Day 2025

No abstract provided.

Improving Colon & Rectal Cancer Screening At Medical City North Hills Clinic, Basil Nduma, Sharvani Raguthu, Gurunath Subrahmanyam, John Sturgeon

North Texas Research Forum 2025

Introduction: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths globally. Despite its severity, fewer than half of eligible Americans undergo annual screening. The U.S. Preventive Services Task Force (USPSTF) recommends CRC screening from age 45 to 75, with personalized assessments for those aged 76 to 85. The current CRC screening rate at the Medical City North Hills Internal Medicine Residents’ Clinic is 9.3%, significantly below the target rate of over 66%. Objective: This project aimed to increase the CRC screening rate from 9.3% to over 66% at the Medical City North Hills Internal Medicine Residents Clinic, in …

Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan

North Texas Research Forum 2025

INTRODUCTION: When deciding between VA ECMO (veno-arterial ECMO) and VV ECMO (veno-venous ECMO), the primary consideration is the underlying pathology affecting the patient’s heart and lungs. VA ECMO provides support for both the cardiovascular and respiratory systems, making it suitable for patients experiencing cardiogenic shock or combined cardiac and respiratory failure. In contrast, VV ECMO is used exclusively for respiratory failure, offering support to patients with severe lung dysfunction but intact cardiac function. CASE PRESENTATION: 41 year old male with no known past medical history presented s/p cardiac arrest secondary to aspiration pneumonia due to alcohol and opioid intoxication. Chest …

Malignant Phyllodes Tumor With Osteosarcomatous Differentiation, Chris Robert, Kayla Mccarthy, Danielle Pigneri

North Texas Research Forum 2025

Introduction: Phyllodes tumors are fibroepithelial tumors accounting for 1% of primary breast neoplasm with malignant transformations occurring in 10-20% of the tumors. Heterologous osteosarcomatous differentiation is a rare and aggressive variant associated with poor prognosis. Case report: A 38-year-old female presented with a mass that she noticed a month ago with increase in size of mass to 10cm at time of presentation. A biopsy of the mass showed a fibroepithelial lesion with focal areas of stromal overgrowth, accompanied by stromal hypercellularity without evidence of nuclear pleomorphism, mitotic activity, necrosis and heterogenous elements most likely a benign phyllodes tumor. Due to …

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: Management of VA ECMO has substantially evolved over the years. Much literature has been published regarding indications, management, and outcomes; however, limited evidence exists detailing strategies to manage, progress, and wean patients from VA ECMO. We present our experience using a VA ECMO expected progression patient management guideline. METHODS: The VA ECMO Expected Progression Patient Management Guideline, approved on June 1, 2021, consists of six goal-oriented stages with suggestive interventions for managing cardiogenic shock patients undergoing VA ECMO therapy. Patient characteristics and outcomes were collected retrospectively and compared between March 2019 to May 2021 (VA Non-Expected Progression group) and …

Anti-Pd-1 Monoclonal Antibody Induced Diabetic Ketoacidosis In Melanoma, Boney Lapsiwala, Jacqueline Bekhit, Indira Tata, Vibhuti Veeranna

North Texas Research Forum 2025

Background: Immune checkpoint inhibitors (ICIs), including pembrolizumab, are increasingly used in cancer therapy, particularly for melanoma. While effective, these agents are associated with various immune-related adverse events (IRAEs), including endocrine disorders like diabetic ketoacidosis (DKA). This report aims to contribute to the understanding of pembrolizumab-induced DKA, especially in patients with pre-existing prediabetes. Case Presentation: A 78-year-old male with a history of melanoma, prediabetes, and other comorbidities developed DKA after 1.5 years of pembrolizumab treatment. He presented with symptoms of weakness, thirst, dry mouth, and diarrhea, alongside severe hyperglycemia and metabolic acidosis. Diagnostic workup confirmed DKA, and his clinical improvement followed …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keloids, Marshall Hall, Alyssa Forsyth, Paige Loux, Henry Lim, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Keloids are benign, firm nodules resulting from excessive scar formation, typically following trauma, but they can also arise spontaneously. They commonly affect areas like the chest, shoulders, back, cheeks, and earlobes. Their growth exceeds the boundaries of the original injury. Keloids can cause discomfort, pruritus, or cosmetic concerns. While they are more prevalent in individuals with darker skin tones, they occur across all age groups and skin types. Differentiating keloids from conditions such as hypertrophic scars, dermatofibromas, acrochordons, inflamed nevi, cysts, and lipomas i s crucial for proper diagnosis and management. This review highlights the diverse clinical presentations of …

Gastrografin Enema To The Rescue Of The Glorious Cecal Bascule, Dominique Pean, Bushra Bangash, Guntash Khasria, Ismail Hader

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Rare Case Of Brucellosis Relapse, Rabia Mahfooz, Grant Patterson, Annmary Behanan, Babivigasan Gunasegaran

Gulf Coast Division GME Research Day 2025

No abstract provided.

Recurrent Syncope In A Young Adult With Postural Orthostatictachycardia Syndrome (Pots): A Diagnostic And Therapeutic Challenge, Syed Raza, Shuchita Jhaveri, Neethu George, Julian Nguyen

Gulf Coast Division GME Research Day 2025

No abstract provided.

Planned Out Of Hospital Birth Maternal And Neonatal Outcomes In A Single Institution, Priyanka Vuppala, Juhi Singhal, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Incarcerated Gravid Uterus, Adelene Morrow, Aaron Poole

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Management Of Placenta Accreta Spectrum Disorder Diagnosed Prior To Viability, Anjali Patel, Virginia Lowe, Linda Haddox

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Immune Related Cardiac Cardiac Tamponade Triggered By Pd-L1 Blockade In Breast Cancer: A Case Report, Luis Salcedo, Ivan Mogollon, Francisco Arias, Jose Donis, Michelle Lopez

Gulf Coast Division GME Research Day 2025

No abstract provided.

Atn Masquerading Rapidly Progressive Glomerulonephritis: Atypical Presentation Of P-Anca Associated Vasculitis With Rpgn, Nimmy Joy, Anabel Al Abdallah, Andrea Francis, Saurabh Pande

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Optimizing Opioid Selection For Vaso-Occlusive Crisis: Identifying The Best Option To Reduce Hospital Length Of Stay, Benjamin H. Bridges, Laura Strom, Eric Belcher, Winston Daniels, Ansley Connelly, Joshua Ferrell

South Atlantic Division GME Research Day 2025

No abstract provided.

Skin Grafting After Reconstruction For Head And Neck Cancer: Does Thickness Matter?, P Larson Miller, Nicholas Hrdlicka, Eric Shaw, Robert Liebman, Matthew Ochsner

South Atlantic Division GME Research Day 2025

No abstract provided.

Abnormal Pap Smears In Pregnancy And The Potential For Fulminant Cervical Cancer: A Case Report And Review Of Staging And Contemporary Treatment, Aliya Nurani, Claud Crosby, Ashley Valenzuela, Meenah Dhir, Mikalah Maury, Stephen Salmieri, Anthony Royek

South Atlantic Division GME Research Day 2025

No abstract provided.

Occlusive Thrombosis Of Superior Mesenteric And Portal Veins, Radhika Mohan, Genevieve Mccloskey, Curtis Wong, Hedaya Othman, Valerie Sinkler

South Atlantic Division GME Research Day 2025

No abstract provided.

A Complex Case Of Invasive Ductal Carcinoma In A Patient With Multisystem Complications Leading To Acute Cerebral Infarctions And Debility, Genevieve Mccloskey, Radhika Mohan, Michael A. Smith

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of Dress Syndrome Following Recurrent Hardware-Related Knee Infection: Diagnosis, Management, And Recovery, Cooper Alden Josephs, Himani Patel, James Everhart

South Atlantic Division GME Research Day 2025

No abstract provided.

A Rare Case Of Vulvar Endometriosis, Taylor Penny, Shelby Freeberg, Brittany Stofko

South Atlantic Division GME Research Day 2025

No abstract provided.

Impact Of Fluid Balance On Clinical Outcomes In Icu Patients W. Pulmonary Arterial Hypertension, Geran Maule, John Rickards, Abdallah Rayyan, Moh'd Alamin Daise, Kobina Essilfie-Quaye, Peters Okonoboh

North Florida Division GME Research Day 2025

No abstract provided.

A Rare Case Of Cutaneous Vulvar Leiomyoma Complicated By Postoperative Hematoma Formation, Ariel Moskowitz, Kimberly Udell

North Texas Research Forum 2025

Leiomyomas are benign, well-circumscribed, monoclonal smooth muscle tumors. While leiomyoma of the uterus are exceedingly common, soft tissue leiomyomas are rare and often misdiagnosed. While excisional therapy is the mainstay of treatment, wide vulvar excisions can cause significant discomfort and disfigurement of the vulva. Here we present a unique case of a vulvar hematoma excision complicated by hematoma formation. A 39-year-old female presented to the ambulatory gynecology clinic with a 4-month history of an enlarging vulvar mass. On exam, a 4-cm mass was seen arising from the right upper labium. Office biopsy showed a well-circumscribed spindle cell lesion without nuclear …

Hemifacial Spasm Due To Dolichoectasia Of Vertebral And Basilar Arteries, Meena Iyer, Shasthara Paneyala Dr.

Digital Journal of Clinical Medicine

Dolichoectasia refers to the non-focal dilatation and tortuosity of arteries, primarily affecting the vertebral and basilar arteries due to severe tunica intima degeneration. It is associated with genetic predisposition and atherosclerosis, leading to vessel wall weakening. Patients may remain asymptomatic or develop neurological deficits due to mass effect. We report a case of a 60-year-old male presenting with hemifacial spasm secondary to vertebral artery dolichoectasia. Magnetic Resonance Angiography (MRA) revealed ectatic and tortuous basilar and vertebral arteries, with the left vertebral artery compressing the left facial nerve complex. Using Smoker’s criteria, a diagnosis of dolichoectasia was confirmed. Dolichoectasia-induced hemifacial spasm …

Comparison Of The Effectiveness Of Preoperative Dexmedetomidine Nebulization Versus Lignocaine Nebulization In Attenuation Of Stress Response During Direct Laryngoscopy And Endotracheal Intubation In Elective Surgeries Under General Anaesthesia: A Randomised Control Study At A Tertiary Care Hospital, Mandya, Sumayya E., Kiran A V., Santhosh M C B., Shivakumar G

Digital Journal of Clinical Medicine

Introduction: Direct laryngoscopy and tracheal intubation are known to provoke harmful stimuli that can lead to transient, unpredictable, and variable hemodynamic alterations, primarily due to heightened sympathoadrenal activity.¹ Various pharmacological agents have been explored to mitigate this stress response; however, none have emerged as optimal.²

Aim: This study aims to compare the effects of nebulized dexmedetomidine in comparison to nebulized lignocaine on the hemodynamic stress response during direct laryngoscopy and tracheal intubation, including any adverse effects in patients undergoing general endotracheal anesthesia.

Materials and Methods: Informed consent was obtained from 60 patients aged 18 to …

Lymphoma Chronicles: Insights From A Distinct Hodgkin's Lymphoma Case Report, Srirangam Shankaralingam, Vibha Nagaragatta

Digital Journal of Clinical Medicine

Hodgkin lymphoma (HL) is a kind of lymphatic malignancy distinguished by the presence of Reed-Sternberg cells. It often manifests as painless lymphadenopathy and systemic symptoms (B symptoms and can affect a variety of lymphoid tissues. The causes of HL are complicated and include genetic predisposition, environmental conditions and viral infections, particularly the Epstein-Barr virus (EBV). The diagnosis is primarily based on histological evaluation of lymph node samples, with immunophenotyping assisting classification. Herein, we report a case of classical Hodgkin’s lymphoma (HL) in an otherwise healthy 31-year-old male who had a mass per abdomen for a year and recently noticed a …