Medical Specialties Commons^™

Hearts Hidden Message: Right Ventricular Thrombus Reveals Esophageal Adenocarcinoma, Devika Adusumilli, Seline Haci, Jafri Imran, Arman Vaghefi, Mehdi Khalafi, Ikponmwosa Iyamu, Sarvanan Balamuthusamy

North Texas Research Forum 2025

Introduction Right ventricular thrombi are uncommon, usually found with concurrent pulmonary emboli and associated with significant mortality. They often originate from deep vein thrombi but may also be due to primary intracardiac processes . A right ventricular thrombus can be an unexpected marker for underlying malignancies, including esophageal cancer. This occurs due to the hypercoagulable state often induced by malignancy. Here we report a presentation where the identification of a right ventricular thrombus led to the diagnosis of esophageal cancer. Case Presentation Our patient is a 57-year old male with no past medical history who experienced an episode of dizziness …

When Skin Necrosis Mimics: Diagnostic And Therapeutic Challenges Of Calciphylaxis In A Ckd Patient With A Mechanical Heart Valve, Sienna Luk, Harshil Parekh, Vaishnavi Singh, Darshan Bhatty, Sathish Karmegam

North Texas Research Forum 2025

Calciphylaxis is a rare but serious condition characterized by the calcification and thrombosis of small blood vessels, predominantly affecting patients with end-stage renal disease (ESRD). Diagnosis can be challenging due to overlapping features with other vascular conditions, such as warfarin-induced skin necrosis (WSN). We present a case of a patient with ESRD and typical risk factors—peritoneal dialysis, hyperparathyroidism, and warfarin use—who exhibited classic skin findings suggestive of calciphylaxis. However, two skin biopsies were inconclusive. Management involved addressing the patient's calciphylaxis risk factors, optimizing dialysis, and initiating sodium thiosulfate therapy. The case was further complicated by the need to replace warfarin, …

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 …

Maternal Cardiovascular Risk And Lactation: Disparities And Future Directions, Monica Rodriguez, Michele Mccarroll, Caroline Marrs, Kamala P. Tamirisa

North Texas Research Forum 2025

Pregnancy functions as a cardiopulmonary stress test, unmasking underlying cardiovascular disease (CVD) or heightening the future CVD risk following adverse pregnancy outcomes (APOs). Multiple studies have demonstrated strong associations between APOs, higher mortality rates, and an increased risk of cardiometabolic diseases. Black women, in particular, have a disproportionately higher burden of coronary artery disease related mortality, with an earlier onset compared to women of other racial and ethnic groups. Increasing allostatic load due to both acute and chronic racial discrimination may potentially be a key factor driving poorer pregnancy outcomes. Breastfeeding has a protective effect on allostatic load and is …

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 …

Osteopathic Representation In Orthopedic Literature: A 25-Year Analysis Of Publication Trends Of Former Aoa Residency Programs And Osteopathic Medical Schools, Troy Puga, Ibraheem Qureshi, Hans Drawbert, Michael Muncy, John T. Riehl

North Texas Research Forum 2025

Background Orthopedic surgery remains one of the most competitive specialties. Osteopathic candidates have recently matched at lower rates than allopathic students. One disparity that may exist is research, which has become a critical component of candidate applications. This study aimed to examine the representation of osteopathic-affiliated first authors, senior authors, and overall osteopathic-affiliated authors, in the top 25 leading U.S. orthopedic journals published between 2000 and 2024. Methods A retrospective bibliometric review was conducted on articles published from 2000 to 2024 in orthopedic journals. Journals were selected based on their h-index score. Institutional affiliations were used to identify osteopathic authors. …

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 …

Curtain-Like Vision Loss: A Case Report On Semaglutide And Its Effects On Vision, Sereena Jivraj, Jonathan Eledge, Amenda Khoei, Amnah Andrabi

North Texas Research Forum 2025

Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-RA), was introduced and approved by the United States Food and Drug Administration (FDA) for the management of type 2 diabetes in 2017. Since then, the medication has garnered much more attention for its ability to aid with weight loss. Until recently, the most significant side effects of semaglutide noted were mostly gastrointestinal symptoms such as nausea, vomiting, and diarrhea due to the drug’s mechanism of action of delayed gastric emptying. However, a singular cohort study from Harvard Medical School in conjunction with Massachusetts Eye and Ear of 16,827 patients recently suggested a …

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

A Plain Language Summary Of The Final Analysis Of The Griffin Study Of Daratumumab Plus Lenalidomide, Bortezomib, And Dexamethasone For People With Newly Diagnosed Multiple Myeloma., Peter M Voorhees, Douglas W Sborov, Jacob Laubach, Jonathan L Kaufman, Brandi Reeves, Cesar Rodriguez, Rebecca Silbermann, Luciano J Costa, Larry D Anderson, Nitya Nathwani, Nina Shah, Naresh Bumma, Yvonne A Efebera, Sarah A Holstein, Caitlin Costello, Andrzej Jakubowiak, Tanya M Wildes, Robert Z Orlowski, Kenneth H Shain, Andrew J Cowan, Shira Dinner, Katharine S Gries, Huiling Pei, Annelore Cortoos, Sharmila Patel, Thomas S Lin, Saad Z Usmani, Paul G Richardson

Oncology Articles

No abstract provided.

Systemic Challenges In Pediatric Healthcare: Exploring Reimbursement Disparities And Their Impact On Healthcare Equity, Jessica Ford-Davis, Alexandra Gillette

Theses, Dissertations and Capstones

Introduction: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) have provided health coverage for over 135 million Americans, with Medicaid playing a significant role in financing pediatric healthcare. Medicaid covers a wide range of services for children, particularly those from low-income families or with special healthcare needs, including preventive care, immunizations, vision and dental services, and mental health treatments. However, Medicaid reimbursement rates are lower compared to Medicare and private insurance, in some cases 30.6% lower, and have often been insufficient to cover the full cost of care, contributing to financial losses for children's hospitals. Despite these challenges, nearly …

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.

From Dermis To Digestive Tract: When Skin Flaps Do More Than Expected, Supritha Chintamaneni, Bilal Ashraf, Galvin Dhaliwal, Aakriti Soni, Amandeep Kaur

Gulf Coast 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 …

Interprofessional Neonatal Resuscitation Simulations: An In-Situ Assessment Of Pediatric Readiness At A Multi-Site Academic Center, Jessyca C. Gibson, Petru C. Nemes

South Atlantic Division GME Research Day 2025

No abstract provided.

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 …

Exosomes And Encapsulated Exomirs In Breast Cancer: Theragnostic Applications And Clinical Implications, Muhammad Imran Sajid, Shafia Bukhari, Hamid Ilyas, Rubina Malik, Minahil Fatima, Rakesh Kumar Tiwari, Surya M. Nauli, Khawaja Husnain Haider

Pharmacy Faculty Books and Book Chapters

Exosomes, released by cells, are small vesicles that have emerged as critical theranostic tools in breast cancer due to their unique ability to transport diverse biomolecules such as proteins, lipids, and RNAs, including microRNAs (ExomiRs). These vesicles are critical in modulating the tumor microenvironment, driving processes like cancer proliferation, invasion, metastasis, and drug resistance. Exosomal microRNAs such as ExomiR-21, ExomiR-1246, and ExomiR-155, with their profound influence on the gene expressions in the recipient cells, are the unsung heroes in tumor progression and immune modulation. This chapter delves into exosome's dual diagnostic and therapeutic potential in breast cancer. It highlights their …

Species-Specific Discrimination Of Bacterial Biofilms Using A Ratiometric Fluorescence Sensor Array And Machine Learning, Ritika Gupta, Aayushi Laliwala, Elena Muldiiarova, Kenneth W. Bayles, Denis Svechkarev, Marat Sadykov, Aaron M. Mohs

Journal Articles: Pathology and Microbiology

Biofilms are intricate bacterial communities encased in a self-produced extracellular matrix (ECM) of DNA, lipids, proteins, and polysaccharides. The diverse ECM composition across bacterial species significantly influences the progression of biofilm-associated infections, making precise identification crucial for effective treatment. Traditional methods such as biochemical assays, MALDI-TOF mass spectrometry, DNA sequencing and culturing provide valuable insights but have notable drawbacks, including time-consuming procedures, high costs, and the need for specialized equipment and trained personnel. These limitations hinder the rapid and widespread adoption of biofilm identification in clinical settings, underscoring the need for more streamlined, accurate, and accessible methods. In this study, …

Efficacy Of Pharmacotherapy Vs Psychotherapy For Insomnia: A Clinical Review, Logan Lovell

The PA Department Journal of Medical Science

Introduction: Insomnia is a widespread sleep disorder with significant impacts on public health, economics, and vulnerable populations including the elderly and those with chronic health conditions. This review examines current literature comparing pharmacologic and non-pharmacologic treatments for insomnia.

Methods: A comprehensive literature search was conducted via PubMed using the keywords “insomnia,” “cognitive behavioral therapy,” and “pharmacotherapeutics” which was refined using MeSH terms, Boolean operators, and specific parameters (English, free full-text, published between 2019 and 2024). Six articles were selected for an in-depth review of pharmacotherapeutic and psychotherapeutic treatments for insomnia.

Results: The selected articles from the PubMed search were …

Semaglutide Vs Liraglutide For Weight Loss In Adults With Obesity, Orian Bar

The PA Department Journal of Medical Science

Introduction: Obesity is a growing chronic condition worldwide with limited effective and safe treatment options. Semaglutide and liraglutide are two GLP-1a medications with encouraging outcomes for the treatment of obesity. The purpose of this paper is to compare semaglutide to liraglutide for weight loss and obesity

Methods: Pubmed was searched for randomized controlled trials, systematic reviews, and meta- analyses from 2019 to 2024 to assess efficacy of semaglutide and liraglutide. Five articles were selected for clinical review.

Results: In 4 out of the 5 studies there was a greater reduction in weight in patients receiving semaglutide compared to liraglutide. Statistically …

Reduced Set-Shifting Processing Speed In Male Rats Following Low Dose (10 Cgy) Proton Exposure, Hui Ho Vanessa Chang, Gyutae Kim, Kyu-Sung Kim, Richard A. Britten

Center for Integrative Neuroscience and Inflammatory Diseases (CINID) Faculty Publications

Space radiation (SR) exposure poses significant biomedical risks, including effects on the central nervous system (CNS). These risks are particularly relevant to cognitive function during long-duration space missions. One critical cognitive skill is decision-making, which requires attentional set-shifting (ATSET)—the ability to quickly assess problems, evaluate options, and select the best actions. Previous studies have shown that exposure to However, the impact of low LET (< 1 keV/μm) protons, which significantly contribute to the total radiation flux astronauts encounter within spacecraft, on ATSET performance is unknown. To address this gap, we evaluated the effects of cranial irradiation with 10 cGy of 100 MeV/n protons (LET = 0.732 keV/μm) on ATSET performance in male Sprague-Dawley rats. We also investigated whether concurrent exposure to variable gravity (hypergravity step-up, step down, purported to have the same effect as exposure to microgravity (another major spaceflight stressor) exacerbated SR-induced cognitive deficits. Our findings indicate that proton exposure alone significantly impaired ATSET performance, as evidenced by decreased processing speed while performing compound discrimination reversal and extra-dimensional shifting. Notably, no additive or synergistic effects were observed when hypergravity was combined with proton exposure. The impact that low-dose proton exposure has on CNS functionality, particularly in reducing processing speed during complex tasks, warrant further investigation. If similar cognitive deficits were to occur in astronauts exposed to galactic cosmic rays, mission success and safety could be significantly compromised.