Medical Specialties Commons^™

Time To Measure: A Proposed Theoretical Model For Head And Neck Cancer Intervals Of Care, Mary Jue Xu, Hannah Decker, Arianne Abreu, Rolvix H. Patterson, Hirwa Nteyumwete, Pier-Luc Beaudoin, David W. Hamilton, Aslam Nkya, Willybroad Massawe, Nicholas Correia, Furahini Yoram Paulo, Katherine Van Loon, Susan D. Emmett, Christina Reaves, Samuel Okerosi

Otolaryngology (ENT) Resident Research

Head and neck cancer care delays are challenging, given the complexity of cancer care pathways, which leads to delays throughout the patient journey, from the symptom onset to treatment completion. Current models and literature addressing cancer care are limited by heterogeneous definitions of care intervals, a focus on specific aspects of the patient journey instead of the whole care continuum, and limited use of implementation science to target gaps in implementing evidence-based interventions. Here, we propose the Head and Neck Cancer TImely aCess TO Care Model as an approach to conceptualize, measure, and address delays in diverse health systems.

Comparison Of Apixaban And Left Atrial Appendage Exclusion Device (Watchman) In Preventing Stroke And Systemic Embolism In Atrial Fibrillation Patients, Sreeja Konatham

Master's Theses and Doctoral Dissertations

Atrial fibrillation is a cardiac arrhythmia associated with increased risk of stroke and systemic embolism. Apixaban, an oral anticoagulant, and the Watchman, a left atrial appendage closure device, are the currently used therapeutic treatments for the prevention of stroke and systemic embolism in atrial fibrillation patients. However, a direct comparison of these two treatments with respect to safety and effectiveness remains limited. This research evaluates Apixaban and the Watchman device by analysing the clinical trial data and full regulatory approval pathways. Apixaban has been approved through New Drug Application process, and the Watchman device is approved via the premarket approval …

Treatment Of Ovarian Clear Cell Carcinoma: A Case Of Successful Management With Targeted Therapies., Sydney Pence, Kellie Rath, Aine Clements

Women’s Health Articles

No abstract provided.

Multidisciplinary Emergent Control Of Traumatic Neovaginal Bleeding After Foreign-Body Insertion In The Early Postoperative Period After Gender-Affirming Vaginoplasty., Tanisha S Kashikar, Christopher D Mcclung, Michal A Radomski, Anand K Joshi, David C Evans

Trauma and Acute Care Articles

As gender-affirming surgery becomes more widespread, it is important that healthcare providers recognize complications related to gender-affirming surgery. Although rates of postoperative bleeding after gender-affirming vaginoplasty are relatively low, it is imperative that this potentially life-threatening complication is recognized and managed quickly. This case highlights the importance of a multidisciplinary approach to the management of neovaginal bleeding that was unable to be controlled intraoperatively by suture ligation.

Prepared To Protect: Improving Cardiac Emergency Response Through Education And Action Planning In Youth Club Sports, Melissa Garcia

Nursing | Senior Theses

Sudden cardiac arrest (SCA) is the leading cause of death in youth sports, illuminating the essential demand for adequate emergency response, including cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) usage, and comprehensive emergency action plans (EAPs). Research shows that despite the importance of prompt intervention, the majority of youth club sports programs outside of the school setting lack the training and resources needed to respond effectively to SCA incidents. This study will evaluate the effectiveness of an educational seminar that includes CPR/AED training and EAP simulation exercises in improving participants’ knowledge, skills, and confidence in managing cardiac emergencies. A quasi-experimental …

Folliculin (Flcn) In Thyroid Tumors: Incidence, Significance, And Role As A Driver Gene And Secondary Alteration, Faisal Hassan, Camryn Slone, Robert J. Mcdonald, Julie C. Dueber, Adeel M. Ashraf, Melina Windon, Oliver J. Fackelmayer, Cortney Y. Lee, Therese J. Bocklage, Derek B. Allison

Pathology and Laboratory Medicine Faculty Publications

Thyroid carcinomas are driven by diverse molecular alterations, but the tumor suppressor gene folliculin (FLCN), best known for its role in Birt–Hogg–Dubé (BHD) syndrome, has received limited attention in thyroid tumors. Here, we describe two thyroid tumors with pathogenic FLCN alterations—one germline and one somatic—and analyze the broader prevalence and significance of FLCN in thyroid carcinomas using multiple large sequencing datasets, including ORIEN-AVATAR. Patient 1, with a germline FLCN mutation and a history of BHD syndrome, presented with a well-circumscribed oncocytic adenoma. Molecular testing confirmed biallelic FLCN inactivation, but no additional mutations or aggressive features were observed, and the patient …

Distinguishing Narcolepsy Hallucinations From Drug-Induced Hallucinations In An Adolescent With Comorbidities, Avidor Gerstenfeld, Biwy Emmanuella Cadet, Salma Alkhatib, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Comparing Efficacy Of Psychotropic Classes To Control Aggression Among Pediatric Patients Hospitalized With Oppositional Defiant Disorder, Orestes Hadjistamoulou, Sindhura Kompella, Melissa Ricardo, Samuel Neuhut

East Florida Division GME Research Day 2025

No abstract provided.

Malignant Adenomyoepithelioma Of The Breast, Cole Daisley, Susana Ferra

East Florida Division GME Research Day 2025

No abstract provided.

Life Over Limb: A Case Of Rapidly Rrogressive Necrotizing Fasciitis, Olesya A. Balashova, Adam Lerchenfeld, Rahul Ramakrishnan, Ashley Diaz, Anna Felizcek, Daniel Heller

East Florida Division GME Research Day 2025

No abstract provided.

Platypnea-Orthodeoxia Syndrome In A Case Of Septal Occlusion Device Migration, Bike Ozkan, Richard Shalmiyev, Adam Devine, Michael Pelekhach, Siddarth Kathuria, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction

Platypnea-orthodeoxia syndrome (POS) is defined by dyspnea and hypoxemia in the upright position, which improves upon recumbency. While often linked with hepatopulmonary syndrome, intracardiac etiologies, particularly a patent foramen ovale (PFO), may also be responsible. PFOs are typically managed with device closure, and while rare, device migration can occur unbeknownst to the patient with resultant critical sequelae.

Methods

Here, we present the case of an 89-year-old female with a medical history of hypertension, diabetes, and coronary artery disease status post PCI, who arrived with severe dyspnea and was subsequently intubated for profound hypoxia. A chest CT angiogram ruled out …

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 …

Oil And Air Don’T Mix: Vitamin E Acetate In Evali, Angelo Lopez-Lacayo, Jordan Taylor-Bentley, Josef Masseli, Michelle Silva, Christy Diaz, Daniel Zapata

East Florida Division GME Research Day 2025

Introduction: Electronic cigarette or vaping-associated lung injury (EVALI) is an acute or subacute condition characterized by acute respiratory symptoms and bilateral pulmonary infiltrates seen in patients who are exposed to electronic cigarettes or vapes. The condition has been strongly linked to inhalation of aerosolized vitamin E acetate, particularly in THC-containing e-cigarette products. Despite regulation of vitamin E acetate in the production of electronic vapes, it continues to be a byproduct of EVALI due to counterfeit electronic vapes. Clinically, patients with EVALI present in various ways but are not limited to fever, shortness of breath, cough, chills, body aches, pleuritic chest …

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.

Lactate/Albumin And Rdw/Albumin Ratios For Mortality And Readmission In Post-Mi Heart Failure, Amogh Killedar, Hamza Khan, Henry Cusnir

East Florida Division GME Research Day 2025

BACKGROUND Robust biomarkers that capture the combined effects of inflammation and tissue hypoperfusion, are needed to refine post–acute myocardial infarction (AMI) risk stratification—especially in the large subset that develops congestive heart failure (CHF). Two emerging candidates are the lactate/albumin ratio (LAR) and the red-cell-distribution-width/albumin ratio (RAR). Separate studies have linked each ratio to short- and long-term mortality in critical illness, AMI, and heart failure, yet no work has directly compared their performance together. We addressed this evidence gap in a large, multi-hospital dataset.

METHODS We performed a retrospective analysis of 8 115 encounters drawn from the HCA Healthcare database (2016-2024). …

Closing The Communication Gap: A Quality Improvement Approach To Safer Shift Changes And Transfers, Stephanie O'Kresik Jewette, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Perceptions Of Presyncope Versus Syncope: A Comparative Survey Of Emergency Medicine And Hospitalist Providers​, Jaime Said, Dennis Cardriche

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.

Of Bugs And Bruton's: Infection Risks In Btki Therapy, Musa Kiyani, Owen Clanahan

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.

Seizure Action Plan, Ian Holt, Sy Jama

East Florida Division GME Research Day 2025

No abstract provided.

A Case Of Recurrent Pleural Effusion Secondary To Thoracic Endometriosis Syndrome After Discontinuation Of Oral Contraceptives, Kevin Gopala-Rao, Luis Santiesteban, Carmen Tormo Carrillo, Christian Almanzar Zorilla, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: Thoracic endometriosis syndrome (TES) is a rare condition in which functional endometrial tissue spreads to the thoracic cavity. Manifestations of TES include catamenial hemoptysis, pneumothorax, and pleural effusions along with symptoms of dyspnea, cough, and pleuritic chest pain.1 Approximately 6 to 10% of women of reproductive-age women develop TES with concurrent pelvic endometriosis in 80% of patients.2 Treatment of TES includes medical management with progesterone-based oral contraceptive pills (OCPs) and surgical management involving cardiothoracic surgery. We present a case of recurrent pleural effusions in a patient who was non-compliant with medical management of TES. Methods: Data was collected during …

Characterizing And Targeting The Non-Catalytic Functions Of Phosphatase Of Regenerating Liver 3 (Prl-3) In Oncogenesis And Cancer Progression, Jeffery T. Jolly

Theses and Dissertations--Molecular and Cellular Biochemistry

Phosphatase of Regenerating Liver 3 (PRL-3) is frequently upregulated in various cancers and is associated with poor patient prognosis. Although traditionally studied for its phosphatase activity, PRL-3 also interacts with the CNNM family of magnesium transporters through its catalytic site, and these two functions are mutually exclusive at any given time. Most previous studies relied on a commonly used PRL-3 mutation that disrupts both phosphatase activity and CNNM binding, making it challenging to determine which function drives its oncogenic effects. To address this gap in the field, I utilized a panel of PRL-3 mutants that selectively disrupt either phosphatase activity …

Complete High Thoracic Spinal Cord Injury Causes Bowel Dysfunction In Mice, Olivia Wireman, Ellie L. Sams, Lynnet E. Richey, Gabrielle V. Hammers, Andrew N. Stewart, William M. Bailey, Samir P. Patel, John C. Gensel

Spinal Cord and Brain Injury Research Center Faculty Publications

Bowel dysfunction, is a prevalent and life-impacting comorbidity of spinal cord injury (SCI) with no long-term treatment available. SCI-induced colon changes including motility and fibrosis are understudied as are strategies to address SCI bowel dysfunction. This need remains partly due to the lack of a mouse model that recapitulates the human condition. We hypothesized that a high thoracic spinal transection in mice would trigger bowel dysfunction with coincident colon pathology similar to humans and rats after SCI. We observed bowel dysfunction as increased fecal pellet numbers within the colon, smaller pellet size, and decreased motility. Fecal pellets numbers in the …

Igg N-Glycosylation Contributes To Different Severities Of Insulin Resistance: Implications For 3p Medical Approaches, Xiaohong Chen, Lois Balmer, Kun Lin, Weijie Cao, Ziyu Huang, Xiang Chen, Manshu Song, Yongsong Chen

Research outputs 2022 to 2026

Background: Reliable biomarkers capturing immunometabolic processes in insulin resistance (IR) remain limited. IgG N-glycosylation modulates immune responses and reflects metabolic disorders, yet its role in IR remains unclear. This study investigated its potential for early detection, risk stratification, and targeted prevention within the framework of predictive, preventive, and personalised medicine (PPPM/3PM). Methods: A total of 313 participants were categorized into three groups based on the homeostatic model assessment for insulin resistance (HOMA-IR): insulin-sensitive (HOMA-IR < 2.69 without diabetes, n = 75), mild IR (HOMA-IR ≥ 2.69 without diabetes, n = 155), and severe IR (HOMA-IR ≥ 2.69 with type 2 diabetes, n = 83). Canonical correlation analysis was conducted to explore the overall relationship between IgG N-glycosylation and IR-related inflammation, indicated by tumour necrosis factor-α, interleukin- 6, C-reactive protein, and adiponectin. Mediation analysis was performed to evaluate the effect of IgG N-glycans on IR. Ordinal logistic regression was used to assess the association between IgG N-glycans and IR severity, with discriminative power evaluated using receiver operating characteristic curves. Results: Pro-inflammatory IgG N-glycoforms, characterized by reduced sialylation and galactosylation, along with increased bisecting N-acetylglucosamine, were observed as IR severity increased. IgG N-glycosylation significantly correlated with inflammatory markers in the insulin-sensitive (r = 0.599, p < 0.05), mild (r = 0.461, p < 0.05), and severe (r = 0.666, p < 0.01) IR groups. IgG N-glycosylation significantly influenced IR (β = 0.406) partially via modulation of inflammation. Increased glycoforms FA2[6]G1 (OR: 0.86, 95% CI: 0.78–0.96) and A2G2S2 (OR: 0.88, 95% CI: 0.82–0.94) were associated with a lower IR risk, with respective area under the curves (AUCs) of 0.752, 0.683, and 0.764 for the insulin sensitive, mild, and severe IR groups. Conclusions: IgG N-glycosylation contributes to IR by modulating inflammatory responses. Glycoforms FA2[6]G1 and A2G2S2 emerge as protective biomarkers, offering potential for predicting and preventing IR through primary prevention strategies within the PPPM framework.

The Remote Supervision Road To Registrar Training In Australia - Paving The Path With Pixels And Phones (A Narrative Review)., Nicholas Coburn, Kylie Fitzgerald, Brett Vaughan

Health Professions Education

Purpose: Specialist medical training in rural or remote Australia is limited due to current requirements of specialist medical colleges to supervise and train registrars onsite. Remote supervision, where the registrar is supervised via telephone and videoconferencing technology remotely, offers a solution that allows doctors to train in rural or remote areas. This review describes the opportunities, challenges, and recommendations to pave the path for a best practice model of remote supervision for private practice focused registrar training in Australia which may offer insights for other countries with rural and remote medical workforces.

Methods: Ovid Medline and Ovid Embase were …

The Short And Sweet On Sodium-Glucose Cotransporter Inhibitors And Glucagon-Like Peptide-1 Receptor Agonists In Heart Failure, Jose L. Batista, Tracy Makuvire, Jonathan D. Davis, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Heart failure (HF) affects 6 million people in the US, and type 2 diabetes (T2D) is a significant risk factor for HF. Since 2008, regulatory agencies have required cardiovascular safety trials for new T2D therapies, and these have consistently demonstrated the cardiovascular benefits of glucose-lowering drugs. Sodium-glucose cotransporter inhibitors (SGLTi) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs)/glucose-dependent insulinotropic polypeptide (GIP) reduce major adverse cardiovascular events and deaths, regardless of diabetes status, and improve cardiorespiratory fitness. SGLTis, such as dapagliflozin and empagliflozin, benefit patients with reduced and preserved ejection fraction, significantly reducing HF hospitalizations and cardiovascular deaths. The DAPA-HF and EMPEROR-Reduced …

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 …

Establishing The Philippine Cancer Center National Cancer Research Agenda 2024-2028: Insights And Future Directions, Frederic Ivan L. Ting, Edward Christopher Dee, Ma Katrina Domenica R. Ting, Abigail R. Tud, Erin Jay G. Feliciano, Erika P. Ong, Carol V. Narra

Ateneo School of Medicine and Public Health Publications

No abstract provided.