Medical Specialties Commons^™

Implementation Of Viz.Ai Augmented Intelligence Software To Reduce Door To Puncture Times And Patient Outcomes At A Comprehensive Stroke Center, Cody Bryant, Brandon Womack, Mason Patel, Sanjay Sharma

North Texas GME Research Forum 2024

Introduction: Endovascular therapy (EVT) in the form of mechanical thrombectomy is the mainstay of treatment for acute large vessel occlusion (LVO) ischemic stroke, but its efficacy is highly time sensitive. It is crucial that stroke centers continue to implement process improvements that aim to streamline stroke workflow. Viz.AI is a platform that uses artificial intelligence to automatically detect LVOs with computed tomography (CT) imaging. It provides immediate access to the CT images as well as a platform for centralized communication through the mobile application. We sought to determine if the implementation of Viz.AI at our comprehensive stroke center improved stroke …

Comparing Large Language Models Accuracy In Following Interval Surveillance Colonoscopy Guidelines, Olufemi Osikoya, Gregory Brennan

North Texas GME Research Forum 2024

Introduction: Providing pathology results and appropriate recommendations after resection of colon polyps is mandatory. Large language models (LLMs) such as ChatGPT and Google Bard, have shown promise in clinical workflows such as pathology results letters. We tested whether LLMs could provide appropriate surveillance recommendations based on current guidelines from the US multi-society task force for post-colonoscopy follow-up. Methods: Our aim was to compare the accuracy of ChatGPT 3.5, ChatGPT 4, and Google Bard in providing appropriate interval surveillance recommendations. An example prompt being “Write a patient pathology result letter after a colonoscopy with one tubular adenoma polyp (< 10mm) resected. Include recommendations for when the next surveillance colonoscopy should be completed.” Seventeen different post polypectomy surveillance queries and responses were analyzed (correct, partially correct, incorrect) compared to USMSTF guidelines. Results: When …

A Dramatic Case Of Acute Biventricular Failure Secondary To Acute Myocardial Infraction, Heriberto Cantu, Ahmed Mahmood, Luay Alalawi, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

A Case Of Mediastinitis From Esophageal Perforation Presenting As Gastric Volvulus/Para-Esophageal Hernia, Anam Zara, Bushra Bangash, Renu Thomas, Asad Rehman, Karthik Vadamalai, Zuhair Ali, Mishal Mazhar

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

The Ethical Concerns Of Improper Semaglutide Administration After Acquisition From A Compounded Pharmacy, Syed Basit Haider, Renu Thomas, E’Joven Reed, Aneesha Shaju, Bushra Bangash, Jakob Schnell, Edrianna Mae Ablola

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Anomalous Anomaly: A Rare Case Of The Rca Arising From The Mild Lad, Heriberto Cantu, Luay Alalawi, Ahmed Mahmood, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

The Utility Of Cologuard In A Real-World Community Setting, Abhinav K. Rao, Shivam Kalra, Danny Tran, Angeli Patel, Ibrahim Al-Saadi, Levi C. Diggins, Ian Whitaker, Shannon Kang, Kunaal Patel, Eyad Gharaibeh, Ali Khalifa, Don C. Rockey, Brett Van Leer-Greensberg

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Diagnosis Of Intestinal Tuberculosis Mimicking Crohn's Disease, Justin Sanchez, Gabriel Gonzales, Monte Troutman

North Texas GME Research Forum 2024

Intestinal tuberculosis (ITB) is an underrecognized disease that shares many clinical, radiologic, endoscopic, and pathologic features with Crohn's disease, making differentiation difficult. This poses a significant problem as initiation of immunosuppressives for an assumed diagnosis of CD in a patient with ITB can lead to exacerbation of infection and life-threatening consequences. A 30-year-old Nepali man with a medical history only significant for Raynaud disease presented with a febrile illness, right lower quadrant abdominal pain, and productive cough over the course of a month. He immigrated from Nepal 3 years prior to presentation, denying other risk factors or specific symptoms of …

Examining Menstrual Health Experiences In Philadelphia, Pa: A Qualitative Investigation, Allison Casola, Oriana Pando, Lynette Medley, Brianna Kunes, Nya Mcglone, Olivia Rea

Department of Family & Community Medicine Faculty Papers

BACKGROUND: While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators.

OBJECTIVES: The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia.

DESIGN: This project was a qualitative research study.

METHODS: We used a collaborative, community-based participatory research approach with No More …

Epidemiologic Profile And Treatment Analysis Of Cervicalgia In Patients With Migraine Vs. Tension-Type Headaches From A Multicenter Electronic Medical Record Database (Trinetx), Ethan J. Le, Victor S. Wang, Md, Hsiangkuo Yuan, Md, Phd

Alpha Omega Alpha Research Symposium Posters

BACKGROUND

• Cervicalgia, or chronic neck pain, remains an understudied and undertreated comorbid condition in patients with headache disorders that benefits from both pharmacologic and non-pharmacologic treatment profiles.

• Cervicogenic headaches present a significant global healthcare burden, with estimates projecting up to 4.1% of the global population and 20% of headache complaints are attributed to cervicalgia (Fernandez et al. 2020).

• What is the global demographic, treatment, and migraine preventive profile of cervicalgia in patients with either concurrent migraine (CM) or tension-type (CT) headaches?

Preoperative Predictors Of Arthroscopic Partial Meniscectomy Outcomes: The Apm Index Score, Natalie Lowenstein, Yuchiao Chang, Hanna Mass, Angela M. Mercurio, Chierika Ukogu, Jeffrey N. Katz, Elizabeth G. Matzkin

Alpha Omega Alpha Research Symposium Posters

Problem Statement:

- Arthroscopic partial meniscectomy (APM) has been shown to be the most common meniscal surgical treatment in the United States

- Pre-op risk factors known to contribute to poor outcomes after APM:

• Symptom duration and radiographic OA at baseline

• Baseline knee functional score, location of meniscal tear, BMI, activity level, age, sex, and chondral damage on MRI

Project AIM:

To create an index score using easily available preoperative risk factors such as Kellgren-Lawrence (KL) grade, age, duration of symptoms, BMI, activity level, and preoperative outcome scores to predict the …

Determining Effective Treatment Regimens For Breast Cancer Using Combined Immunotherapy And Chemotherapy In Vivo, Akhila Kunuthuru

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Breast cancer has the highest incidence rate of all cancers globally in women, and those of African descent, especially West African females, face higher rates of triple-negative breast cancer (TNBC), a more aggressive form of breast cancer. Immunotherapy for breast cancer is a relatively new treatment option, and research is ongoing to identify the best combination treatments for increasing survival of those diagnosed with TNBC. Eganelisib (IPI-549: a PI3K-gamma inhibitor that works to shift M2 macrophages to M1 to augment T cell function) with other combinatory treatments has shown promising results in reducing tumor growth and increasing survival in mice. …

Informing A Care Plan For Hepatitis C Treatment On The Street, Claire Campbell

Scripps Senior Theses

This thesis aims to use community knowledge to inform clinical street treatment of Hepatitis C and to unpack the intersections of social systems within the realms of Street Medicine and healthcare for the unsheltered unhoused population. During the summer of 2023, 15 qualitative interviews were conducted with patients of the USC Keck School of Medicine Department of Street Medicine who received treatment for Hepatitis C infections. Using grounded theory analysis, participant responses were analyzed to identify key concepts and ideas from interview transcripts. Core themes fell into the following categories: how treatment affected patients’ lives, facilitators and barriers to treatment, …

The Efficacy Of Botulinum Toxin Use In Service Members And Veterans With Migraine And Post-Traumatic Headache Disorders: A Scoping Review, Qing Zhao Ruan, Daniel J Pak, David E Reece, Rohan Jotwani, Sean Li, Moises Dominguez, Alan David Kaye, R Jason Yong, Abdulrazaq Albilali, Sadiq Bhayani, Jamal Hasoon, Michael E Schatman, Jun Beom Ku, Thomas T Simopoulos, Sait Ashina, Christopher L Robinson

Faculty, Staff and Student Publications

Objective: To delineate the trend of use of botulinum toxin, including onabotulinum toxinA (OTA), in active military personnel and veterans with the diagnoses of migraine and post-traumatic headache (PTH) and describe the efficacy of botulinum toxin administration.

Background: Service members and veterans represent a unique population in the medical management of headache disorders, particularly migraine. They exhibit higher susceptibility to pain of greater intensity and longer durations, possibly due to their history of exposure to combat, trauma, and the associated psychological stresses. Given the burden and morbid nature of these headache disorders, prophylactic measures to reduce migraine attacks and disability …

Phase 1 Trial Of Tpi 287, A Microtubule Stabilizing Agent, In Combination With Bevacizumab In Adults With Recurrent Glioblastoma, Samuel A Goldlust, Louis B Nabors, Sigmund Hsu, Nimish Mohile, Paul J Duic, Tara Benkers, Samuel Singer, Mayank Rao, Lori Cappello, Sandra L Silberman, George Farmer

Faculty, Staff and Student Publications

BACKGROUND: Recurrent glioblastoma (rGBM) has limited treatment options. This phase 1 protocol was designed to study the safety and preliminary efficacy of TPI 287, a central nervous system penetrant microtubule stabilizer, in combination with bevacizumab (BEV) for the treatment of rGBM.

METHODS: GBM patients with up to 2 prior relapses without prior exposure to anti-angiogenic therapy were eligible. A standard 3 + 3 design was utilized to determine the maximum tolerated dose (MTD) of TPI 287. Cohorts received TPI 287 at 140-220 mg/m

RESULTS: Twenty-four patients were enrolled at 6 centers. Treatment was generally well tolerated. Fatigue, myelosuppression, and peripheral …

Alternatives To The Squad Car: A Strategy Providing Hope For People With Mental Illness, Judy Ann Clausen, Joanmarie I. Davoli

UF Law Faculty Publications

Frontline healthcare providers and first responders have had enough of mental health care policy rooted in ideology and utopian visions instead of the practical realities of the nature of Serious Mental Illnesses (SMI). The current system of a severe shortage of mental health beds and strict criteria for administering mental health treatment in contravention of illness-induced treatment refusals has caused the real-world preventable tragedies of mass shootings, incarceration, homelessness, victimization, and death of people suffering from untreated SMI. Innovative programs and long-established protocols have been profiled by the media and examined by scholars. Momentum is brewing. Across the country, creative …

Elucidating The Role Of Fatty Acid Synthase In Apc-Driven Colorectal Cancer, Courtney O. Kelson

Theses and Dissertations--Toxicology and Cancer Biology

Globally, colorectal cancer (CRC) is the second leading cause of cancer related deaths. Currently, there is a growing incidence rate for individuals aged 20-49 years. Genetic and environmental factors contribute to the risk of this cancer. Early detection of CRC allows for the most effective treatment option in which surgical resection of the primary tumor occurs along with adjuvant chemotherapy. This therapeutic approach contributes to 5-year survival rate of 91%. However, surgical procedures and chemotherapy struggles against metastatic and relapsed CRC resulting in 5-year survival rate of 14%. Inefficacious treatments for relapsed and metastatic diseases emphasizes the need for more …

The Impact Of Workplace Stressors On Anxiety Levels And Mental Health Among Pediatric Intensive Care Nurses, Kelsey Ericah Ang

Nursing | Student Research Posters

Background: Pediatric Intensive Care Unit (PICU) nurses work in a high-stress environment where they are exposed daily to traumatic situations. The demanding emotional and physical challenges contribute to significant psychological burdens, including increased stress and anxiety. Purpose: The current paper proposes a research design to examine the outcomes of stress, anxiety levels, and mental well-being on PICU nurses when workplace support and structured debriefing sessions take place following a traumatic event. Methods: Participants will be recruited from PICU hospitals in Northern California. Participation will be voluntary, and informed consent will be obtained prior to the study. The selection criteria will …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Effects Of Menopause On Coronary Artery Disease, Angelica Gonzales

Nursing | Senior Theses

Menopausal women, 40 to 60 years old, have an increased risk of developing coronary artery disease (CAD) when they experience hormonal changes. Which then can lead to unwanted cardiac events. Within the literature review of this paper, it was found that there are factors of menopause that may further increase the risk of coronary artery disease in menopausal women. Such factors include whether a woman underwent surgical or natural menopause and the timing when menopause began. Additionally, within the review, hormone replacement therapy (HRT) was explored to determine whether the possible intervention can decrease the progression and risk of developing …

Unleashing Wellness: Exploring The Impact Of Pet Therapy On Anxiety Reduction, Quality Of Life, And Treatment Adherence In Pediatric Oncology Patients, Karina Brouwer

Nursing | Senior Theses

Pet therapy is a complementary intervention that involves the interaction between a person and animal, with the focus of improving psychological well-being within diverse populations. In particular, children with oncological disorders have increases in anxiety and stress levels, therefore it is imperative to study the impact of animal interventions within this population. This literature critique explores the impact of pet therapy interventions on anxiety, stress, and quality of life perceptions in pediatric oncology patients. This research proposal will investigate how animal therapy interactions within pediatric oncology patients influence their anxiety levels and perceptions of quality of life and how these …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Robotic-Assistance In Total Hip Arthroplasty Is Associated With Decreased Dislocation Rates, Gabrielle N. Swartz, Sandeep S. Bains, Jeremy A. Dubin, Reza Katanbaf, Hunter Hayes, James Nace, Michael A. Mont, Ronald E. Delanois

Orthopedic Surgery Resident Research

Background

As the use of robotics in total hip arthroplasty (THA) continues to gain popularity, differences in clinical outcomes when compared to manual techniques have remained unclear. This study aimed to compare postoperative complications between patients undergoing robotic-assisted techniques and manual THA for primary osteoarthritis at 90 days, 1 year, and 2 years.

Methods

Using an all-payer national database, we identified 405,048 patients who underwent either robotic-assisted or manual THA for primary osteoarthritis. A propensity match was performed for age, sex, a comorbidity index, chronic kidney disease, obesity, and diabetes, resulting in 7652 patients in each cohort. We assessed postoperative …

In Vivo Scanning Laser Fundus And High-Resolution Oct Imaging Of Retinal Ganglion Cell Injury In A Non-Human Primate Model With An Activatable Fluorescent-Labeled Tat Peptide Probe, Xudong Qiu, Seth T Gammon, Carol Rasmussen, Federica Pisaneschi, Charlene B Y Kim, James Ver Hoeve, Steven W Millward, Edward M Barnett, T Michael Nork, Paul L Kaufman, David Piwnica-Worms

Faculty, Staff and Student Publications

The optical imaging agent TcapQ488 has enabled imaging of retinal ganglion cell (RGC) injury in vivo in rodents and has potential as an effective diagnostic probe for early detection and intervention monitoring in glaucoma patients. In the present study, we investigated TcapQ488 in non-human primates (NHPs) to identify labeling efficacy and early signals of injured RGC, to determine species-dependent changes in RGC probe uptake and clearance, and to determine dose-limiting toxicities. Doses of 3, 6, and 12 nmol of TcapQ488 were delivered intravitreally to normal healthy NHP eyes and eyes that had undergone hemiretinal endodiathermy axotomy (HEA) in the inferior …

Case Report: Nocturnal Low-Frequency Stimulation Of The Centromedian Thalamic Nucleus Improves Sleep Quality And Seizure Control, Surya Suresh, Ganne Chaitanya, Ajay Deep Kachhvah, Vladimir Vashin, Manojkumar Saranathan, Sandipan Pati

Faculty, Staff and Student Publications

Sleep disturbances and drug-resistant seizures significantly impact people with idiopathic generalized epilepsy (IGE). Thalamic deep brain stimulation (DBS) offers potential treatment, but its effect on sleep and seizure control needs clarification. In this study, we combined wearable sleep monitoring with electroencephalogram (EEG) confirmation to investigate the impact of nocturnal centromedian nucleus (CM) DBS parameters in a patient with drug-resistant IGE. We found that high-frequency (125 Hz) CM stimulation during sleep severely disrupted sleep macro architecture and exacerbated seizures. Conversely, switching to low-frequency (10 Hz) stimulation enhanced both sleep quality and seizure control. This study underscores the critical need to personalize …

Use Of A Borate-Based Bioactive Glass Martix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi V. Dove, Connor Krolikowski

School of Podiatric Medicine Publications

Hardware exposure is a challenging complication following foot and ankle surgery due to the high risk of infection, biofilm formation, and delayed healing. In two consecutive cases, the bioactive glass matrix combined with particulate micromatrix successfully eradicated the wound infection and biofilm, resulting in full granulation of the wound and successful wound closure. Here we present a novel bioactive glass matrix that successfully managed exposed hardware in an infected foot, providing a promising treatment strategy for managing these complications and preventing further morbidity.

Cancer-Associated Mdm2 W329g Mutant Attenuates Ribosomal Stress-Mediated P53 Responses To Promote Cell Survival And Glycolysis, Sally Lien, Thomas P Whitbread, Shiva O Shastri, Jamie A Contreras, Ruiying Zhao, Yan Zhu

Faculty, Staff and Student Publications

Although amplification/overexpression is the predominant mechanism for the oncogenic properties of MDM2, an increasing number of MDM2 somatic missense mutations were identified in cancer patients with the recent advances in sequencing technology. Here, we characterized an MDM2 cancer-associated mutant variant W329G identified from a patient sample that contains a wild-type p53 gene. Trp329 is one of residues that were reported to be critical to MDM2's binding to ribosomal protein L11 (RPL11). We found that the MDM2 W329G mutant was resistant to the inhibitory effect of RPL11 on MDM2-mediated p53 ubiquitination and degradation, in line with its defect on RPL11 binding. …

Spinal Cord Evaluation In Multiple Sclerosis: Clinical And Radiological Associations, Present And Future, B Mark Keegan, Martina Absinta, Julien Cohen-Adad, Eoin P Flanagan, Roland G Henry, Eric C Klawiter, Shannon Kolind, Stephen Krieger, Cornelia Laule, John A Lincoln, Steven Messina, Jiwon Oh, Nico Papinutto, Seth Aaron Smith, Anthony Traboulsee

Faculty, Staff and Student Publications

Spinal cord disease is important in most people with multiple sclerosis, but assessment remains less emphasized in patient care, basic and clinical research and therapeutic trials. The North American Imaging in Multiple Sclerosis Spinal Cord Interest Group was formed to determine and present the contemporary landscape of multiple sclerosis spinal cord evaluation, further existing and advanced spinal cord imaging techniques, and foster collaborative work. Important themes arose: (i) multiple sclerosis spinal cord lesions (differential diagnosis, association with clinical course); (ii) spinal cord radiological-pathological associations; (iii) 'critical' spinal cord lesions; (iv) multiple sclerosis topographical model; (v) spinal cord atrophy; and (vi) …

Immunomodulatory Effects Of Modified Colostrum, Whey, And Their Combination With Other Natural Products: Effects On Natural Killer Cells, Xuesheng Han, David Vollmer, Xuefei Yan, Yahong Zhang, Mingfa Zang, Chenfei Zhang, Catherine M.T. Sherwin, Elena Y. Enioutina

Pediatrics Faculty Publications

Objectives Natural killer (NK) cells are important immune system effector cells providing innate defenses against intracellular infections, including viral infections, immune surveillance, and cancer immunoediting. The primary purpose of this study was to investigate whether modified ultra-filtrated colostrum (UC) and hydrolyzed whey (W) products or their combinations with other natural products with reported immunomodulatory properties will stimulate NK cell cytotoxic activity by activation of granzyme B and IFN-γ production. Methods The ability of study products to stimulate the cytotoxic activity of human-purified CD56+ NK cells and the production of granzyme B and IFN-γ by activated NK cells was evaluated in …

Aligning Eye Care Provider Beliefs With Behaviors: Exploring And Improving Ocular Surface Disease Decision-Making In A Cataract Surgery Clinic, Amy Hellem

Communication (PhD) Dissertations

Millions of cataract surgeries are performed every year in the United States, yet both surgeon reports and patient reports indicate that practices are not utilizing the diagnostic tests and treatments that are advocated in the medical literature to identify and manage ocular surface disease prior to surgery. As a result, patients risk suffering several significant consequences with regard to their vision, comfort and safety. Personal observations from my 25 years of experience working with ophthalmologists and optometrists led to curiosity regarding the root cause of undertreatment of ocular surface disease. Specifically, I had the impression that eye care providers held …