Medical Specialties Commons^™

Unveiling A Rare Pathology: Carcinosarcoma Of The Gallbladder, Gul Emek Wymer, Laci-Rae Pitter, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: Gallbladder carcinosarcoma is a rare and aggressive biliary tract malignancy, constituting approximately 1.7% of gallbladder cancers, with fewer than 100 cases reported in the English literature as of 2023. These tumors, often affecting gynecological organs, feature both carcinomatous and sarcomatous components. They predominantly occur in females, with a mean presentation age of 66 years. Diagnosis is primarily based on pathological analysis, and the mainstay of treatment is surgical excision.

Case Description: We present a case of an 81-year-old female with no significant medical history, who was admitted after a fall. A CT scan revealed an 18.2 cm gallbladder mass …

From Deposition To Infection, A Rare Case Of Osteomyelitis In Tumor Calcinosis, Munazzah Kaleem, Alexander Newell, Wendy Phillips, Saravanan Balamuthusamy

North Texas Research Forum 2025

Background/Intro Tumor calcinosis is a rare disease, and its association with greater trochanteric pain syndrome, abscess formation, and Osteomyelitis has not been well studied. Case presentation A 63-year-old woman with a known history of tumor calcinosis presents with right hip pain for 5 days. She woke up with a pain that was constant, alleviated with resting and getting worse with exertion and rolling on that side. She reports a t-max of 101F. Ct scan revealed a 9 x 4 x 11cm rim enhancing right great trochanteric collection and/ or severe bursitis. Orthopedic surgery evaluated the patient and, had low suspicion …

Pacing-Induced Cardiomyopathy After Leadless Pacemaker Placement, Kathleen Mattingly, Ann Opondo, Abdullah Elnaji, Heena Patel, Jonathan Grube, Heather Reed, Justin Reed

North Florida Division GME Research Day 2025

No abstract provided.

Rx On The Rocks: Prescribing Solutions For Alcohol Use Disorder, Arisa Gonzalez, Laura Botero, Adlin Lawrence, Kenneth Jimenez, Eric Chen, Richard Henriquez, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.

Streamlining Stroke Care: Optimizing In-House Stroke Alert Order Set Utilization, Drashti Desai, Joshua Shultz, Yu Ya Nway, Hasib Ibne-Rasa

North Florida Division GME Research Day 2025

No abstract provided.

Phentermine Induced Thrombocytopenia, Claudia Thornton, Jack Demirjian, Jason Pereira, Juan Nunez Rodriguez

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Severe Right Ventricular Dilation Due To Selenium Deficiency In A Post Gastric Bypass Patient - A Rare But Life Threatening Complication, Arjun Kamath, Jorge Garza, Ethan Goldberg, A Syed, Deekshita Valiveti, Abhay Vakil, Zuhair Ali, A Ashgar, Luay Alalawi, Heriberto Cantu, Thomas Alexander

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Vaping Nightmare: Sudden Death Provoked By Vaping In The Setting Of Pectus Excavatum, Anoop Gala, Nga Van, Grace Rustom, Danielle Ford, Phuc Nguyen

North Texas Research Forum 2025

Pectus excavatum (PE), characterized by an inward depression of the sternum, is the most common congenital chest wall abnormality. It has been rarely linked to cardiac abnormalities, such as arrhythmias and sudden cardiac arrest (SCA). In addition, emerging research suggests that vaping is a cardiovascular risk factor that has the potential to destabilize cardiac rhythm and promote arrhythmias. There is a lack of FDA oversight and long-term research on the effects of vaping. The rising popularity of vaping among youth, coupled with misconceptions about its safety, underscores the urgent need to understand the potential interactions vaping has in precipitating fatal …

Managing Kaposi Sarcoma In Controlled Hiv: A Case Study On Cutaneous Manifestations And Multidisciplinary Care, Rafael Do Valle, Reem Ayoub, Henry Lim, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Kaposi Sarcoma (KS) is a soft tissue sarcoma that affects the linings of blood and lymphatic vessels. It occurs, primarily in immunocompromised individuals. It is caused by the Human Herpesvirus 8. There are four recognized forms of KS: AIDS-related, iatrogenic, classic, and endemic. Each form varies in demographics and manifestation. AIDS-related KS occurs in HIV-positive individuals, while iatrogenic KS develops in transplant patients undergoing immunosuppressive therapy. Classic KS is typically seen in elderly males from specific geographic regions, and endemic KS affects young individuals in certain areas of Africa. Clinical manifestations of KS include red, purple, or brown papules …

Traumatic Aortic Transection, A Case Report, Jared Duval, Ernest Gonzalez

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Bradycardia In A Renal Transplant Patient Receiving Rabbit Antithymocyte Globulin, John Mathew, Victor Delprincipe, Seline Haci, Karthik Anand, Rangina Farhad

North Texas Research Forum 2025

Rabbit antithymocyte globulin (rATG) is widely used for induction and treatment of acute T-cell mediated rejection in renal transplant patients. Bradycardia is reported as a rare side effect of this medication (citation). With the increasing number of transplanted kidneys in today's world, there is greater need to understand the adverse effects of these drugs in transplant recipients.. Here we report a case of symptomatic bradycardia in a renal transplant patient receiving rATG for acute T-cell mediated rejection.

Improving Patients’ Postpartum Contraception Plans And Access To Postpartum Contraception, Rebecca Johnson, Timothy Kremer, Nicole Tenzel

North Texas Research Forum 2025

Introduction: ACOG recommends prenatal discussions with patients regarding their lifetime reproductive plans and postpartum contraception. Up to 40% of patients are not seen for postpartum visits and this rate is highest amongst populations with limited resources (ACOG Practice Bulletin: Optimizing Postpartum Care). By having consistent documentation amongst our clinic providers we aim to maximize patient education and choice in their postpartum contraception. Methods: The providers at our clinic were educated on where to document postpartum contraception discussions on the obstetric flow sheet under the “problems” tab. Providers were to document the discussion even if the patient declined postpartum contraception. Every …

Streptococcus Intermedius In The Setting Of Adalimumab Use, Gerardo Martinez Arroyo, Amelia Mellor, Joseph Prokop, Oscar Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Exploring The Link Between Covid-19 And Transverse Myelitis: A Case Report, Sara Sanghera, Trivianne Franklin, Veeranna Vibhuti, Danielle Ford

North Texas Research Forum 2025

Transverse myelitis (TM) is a rare inflammatory syndrome of the spinal cord that is often attributed to immune-mediated responses which lead to demyelination and the resultant varying degrees of motor, sensory, and autonomic dysfunction. While COVID-19 virus itself is known to present with anosmia, ageusia and Guillian Barre syndrome, a few rare cases of COVID-virus related TM have been reported. This case presents a 61-year-old female experiencing bilateral lower extremity weakness with brisk to absent reflexes. Onset of the symptoms was of 3 days origin, and she was tested positive for COVID-19. Patient did not have upper extremity symptoms but …

Comparison Of Fibula Plating Versus Fibula Nailing: A Systematic Review With Meta-Analysis Of All Current Comparative Literature, Troy Puga, Mckenna Box, Charles Marchese, Alan Lam, Sam Stegelmann, John Riehl

North Texas Research Forum 2025

Introduction Ankle fracture surgeries are common orthopaedic procedures. Fibular fixation is often an important component in restoring ankle stability. Fibular intramedullary nailing (fIMN) has gained recent interest as an alternative technique to fibular plating. This systematic review and meta-analysis was performed to compare the outcomes of fibular nailing versus fibular plating for all current available literature. Methods A PRISMA-compliant systematic review was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases for cohort and clinical trial studies comparing outcomes of fibular nailing and fibular plating of ankle fractures. Demographics and results of the studies were extracted from the articles. Outcomes of interest …

Hematometra In A Pre-Menopausal Patient: A Case Report Of Idiopathic Cervical Occlusion, Sandra Zhi, Claire Middleton, Chrystal Stallworth, Mindy Beth Luck, Nicole Tenzel

North Texas Research Forum 2025

Introduction: Hematometra is a blood collection caused by a structural blockage of the vagina or cervix. Most cases of hematometra and/or hematocolpos occur in a relatively rare condition of imperforate hymen or Mullerian anomalies in children or adolescent patients. Case: We present a case of a 46 year old G2P2002 with a past surgical history of two C-sections with increasingly severe pelvic pain and abnormal uterine bleeding for the prior five years since her last Cesarean delivery. A large hematometra was found on CT imaging. Pelvic exam showed no vaginal abnormalities and a discolored, pale cervix. Digital pressure led to …

Telestration With Augmented Reality In Surgery: A Comprehensive Systematic Review And Meta-Analysis, Hannan A. Maqsood, Minaam Farooq, Laiba Sarfraz, Michael Truitt

North Texas Research Forum 2025

Objective: Augmented reality (AR) telestration has the potential to completely transform surgical teaching and training. In contrast to traditional telestration and telestration without AR, this systematic review and meta-analysis attempted to thoroughly assess the effect of telestration with AR on a variety of performance metrics, including task completion time, error rates, GOALS task-specific scores, OSATS task-specific scores, and GOALS Global scores. Methods: Six relevant publications were included after a thorough literature search was carried out to March 2024 across relevant databases. To evaluate the impact of telestration with AR on performance indicators, meta-analyses were carried out, and statistical analysis produced …

Hypothyroidism Associated Hyponatremia, A Complicated Presentation, Gary Lee, Spencer Steinberg, Samiuallh Shahid, Evangelista Ezenduka, Edgardo Flores

North Texas Research Forum 2025

Introduction: Hypothyroidism is a well known text-book cause of euvolumic hyponatremia that is a rare occurrence in clinical practice in the absence of other potential etiologies of hyponatremia. We review a case of a 48 year old female presenting with profound generalized weakness found to have severe hyponatremia, later found to have severe hypothyroidism during admission. We review the potential mechanisms whereby hypothyroidism results in hyponatremia and whether or not hypothyroidism-induced hyponatremia truly exists and the current evidence supporting these views Case Presentation: 48 year old female with history of hypothyroidism, breast cancer post right lumpectomy and radiation presented for …

Treatment Of Starvation Ketoacidosis In The Third Trimester Of Pregnancy: A Case Report, Christine Le, Charmaine Oladell, Nicole Tenzel

North Texas Research Forum 2025

INTRODUCTION: Starvation ketoacidosis represents a rare but complicated maternal morbidity that primarily occurs in the third trimester of pregnancy. With increased insulin resistance and metabolism manifesting in pregnancy, prompt care is required to diagnose and treat starvation ketoacidosis as it appears at an accelerated rate. However, despite the severity of maternal and fetal complications arising from this condition, standardized treatment protocols have not been elucidated. CASE PRESENTATION: In this case report, a 33-year-old gravida 3 para 0-2-0-2 at 31 weeks and 5 days gestational age was admitted to antepartum services for intractable nausea, vomiting, and anuria and transferred to the …

Video Games In The Management Of Adhd: A Novel Approach To Adjunct Traditional Treatment, Lekhya Kintada, France Leandre

North Florida Division GME Research Day 2025

No abstract provided.

Has The Elimination Of Mandatory Buprenorphine X-Waiver Increased Presciptions Of This Medication Upon Discharge From The Hospital?, Kendall Moore, Robyn Meadows, Robyn Hoelle, Matthew Calestino

North Florida Division GME Research Day 2025

No abstract provided.

Adverse Bleeding Events In Patients Taking Verapamil With Apixaban Or Rivaroxaban, Heena Patel, Franklin Hernandez, Kathleen Mattingly, Seth Sukriti, Chandan Mitra

North Florida Division GME Research Day 2025

No abstract provided.

Association Of Glp-1 Receptor Agonist With Risk Of Hepatocellular Carcinoma, Joane Titus, Vinay Katukuri, Moheb Boktor, Ishak Mansi

North Florida Division GME Research Day 2025

No abstract provided.

Development Of A Continous Renal Replacement Therapy Protocol For A Midsize Community Hospital, Srinidhi Shyamkumar, Eric Riha, Crystal Ike, Rachel Wright, D Villareal, Justin Shanks, Damon Cao

Gulf Coast Division GME Research Day 2025

No abstract provided.

Femoral Neck Allograft For Glenoid Reconstruction During Revision Reverse Total Shoulder Arthroplasty: A Case Report, Devin Q. John, Leon Z. Liu, Diego J L Lima, Howard D. Routman

East Florida Division GME Research Day 2025

No abstract provided.

Fatal Overlapping Cns Infections: Radiologic Correlates Of Ventriculitis, Encephalitis, And Meningitis​, Jesse F. Simon, Sara Darwish, Stephanie Nagy, Richard Shalmiyev, David Kosoy, Bryan Rubio, Gustavo Pantol, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: This case study explores an uncommon triad of encephalitis, ventriculitis, and meningitis complicated by ischemic strokes and seizures in a COVID-19-positive patient. Prior studies suggest that bacterial meningitis and encephalitis can lead to cerebral infarctions due to inflammation and vascular injury.1,2,5 Ventriculitis, in particular, is rarely observed and typically is seen as a severe complication of meningitis, and can be managed with neurosurgical interventions such as CSF shunt placement, ventricular drains, or other intracranial devices.3,4 The simultaneous presentation of all three conditions in a single patient is rare and poses significant challenges from a diagnostic and management standpoint.

Case …

Can Residents Cheat The Unknown Slide Sessions By Using The Large Language Models? Which Model Should They Use: Chat-Gpt, Claude, Or Gemini?​, Gul Emek Wymer, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: In recent years, artificial intelligence tools, such as large language models (LLMs) have expanded the potential for diagnostic medicine, including histopathology. This study aims to evaluate the diagnostic ability and utility of the publicly available large language models in predicting the accurate diagnosis of the unknown cases by using the images of the hematoxylin-eosin stained slides taken by a mobile phone and compare their performance with the residents’ performance.

Method: The twenty cases, including a variety of entities, were collected from teaching sets of non-HCA patients and public available domains, which are used for unknown slide sessions for residents. …

Comparing Chatgpt And Deepseek For Deprescription Support In Geriatric And Palliative Care: An Exploratory Study Using Clinical Vignettes, Gokhan Demir, Angel Sanchez, Sanaz Kashan

East Florida Division GME Research Day 2025

Background: Polypharmacy is common in older adults and increases risks of adverse drug events, falls, and hospitalizations. Deprescription can mitigate these harms but is often hindered by time constraints, fragmented guidelines, and complex comorbidities. Artificial intelligence (AI) large language models (LLMs) may provide decision-support for deprescription in geriatric and palliative care.

Objective: To compare ChatGPT and DeepSeek in their deprescription recommendations across standardized polypharmacy vignettes.

Methods: Three validated clinical vignettes, varied by activities of daily living (ADL) status and cardiovascular disease (CVD) history, were presented to ChatGPT (GPT-4/5) and DeepSeek (2024 version). Each vignette was tested in three replicates per …

Variability In Emergency Medicine Provider Practices For Recommending Days Off From Work Or School By Chief Complaint​, Jaime Said, Dennis Cardriche

East Florida Division GME Research Day 2025

No abstract provided.

A Case Of Gastric Outlet Obstruction Secondary To A Gallstone, Mahesh Tummala, Adam Devine, Akash Tummala, Livasky Concepcion-Perez

East Florida Division GME Research Day 2025

Introduction: Bouveret syndrome is characterized by a gallstone passing through a bilioenteric fistula causing gastric outlet obstruction and represents 1-3% of gallstone obstructions. Fistualization occurs when chronic inflammation from the gallstone on the gallbladder wall leads to ischemia and perforates into the bowel. Over 60% of patients with cholelithiasis are asymptomatic. Biliary colic is the most common presentation in symptomatic patients. A biliary fistula occurs in 3-5% of cases and just 7-10% of these cases lead to gallstone ileus. The highest prevalence is among women of advanced age. Typical presentation is with general symptoms of nausea/vomiting and vague abdominal pain. …