Cocaine Induced Agranulocytosis And Neutropenia, Maria Gomez Alvarez, Ashish Govan, Raymond Larocque

East Florida Division GME Research Day 2025

Introduction: Cocaine use in the United states is seen in many cases within the hospital system. Typically, they present with tachycardia, hypertension, sweating, even heart attack. Due to the uncontrolled sale and distribution of drugs, patients can be exposed to other additives in drugs which can lead to unexpected complications. Cocaine laced with levamisole (an antiparasitic drug used in veterinary medicine) can lead to agranulocytosis and neutropenia. Cocaine being the second most used illegal drug following marijuana it may be much more common than we think. Millions of individuals use cocaine yearly and develop a heavy addiction with use of …

Real Time Non-Targeted Renal Biopsy Adequacy Evaluation: A Successful Quality Improvement Activity, Astrid Sacasa, Susana Ferra

East Florida Division GME Research Day 2025

Introduction. Adequate renal biopsies are essential for the diagnosis and treatment of medical renal disease. This process requires a sufficient number of glomeruli for light microscopy, immunofluorescence, and electron microscopy evaluation. On-site microscopic evaluation of kidney biopsy specimens significantly improves sample adequacy and the ability to render a diagnosis, with studies showing a much higher rate of inadequate samples when on-site evaluation is absent. Inadequate biopsies can have a significant negative impact on patient care including delay of adequate diagnoses, worsening of the patients’ condition and complications, and increasing costs due to the need for repeat biopsies. A real time …

Quality Improvement Project To Increase Compliance With Standard 5.8: A Community Hospital Institutional Experience., Robert Bender, Nicole Sant 'Elia, Susana Ferra

East Florida Division GME Research Day 2025

Background: The Commission on Cancer (CoC) was established by the American College of Surgeons in 1922. In 2020, they launched the Cancer Surgery Standards Program that introduced six operative standards. Standard 5.8 requires curative intent lung resections to include sampling from at least 1 hilar, and at least 3 mediastinal lymph node stations.

Goal: To increase our institution’s compliance with CoC standard 5.8 to greater than 80% overall adherence.

Method: Included in the study were patients undergoing curative intent lung resection for lung cancer. A protocol, including a documentation paper worksheet with metric requirements, was implemented in February 2024. Monthly …

Emerging Role Of Liafensine In The Treatment Of Treatment Resistant Depression: Insights From The Enlighten Trial, Karla Narvaez, Saad Masud, Richard Callahan

East Florida Division GME Research Day 2025

Background: Treatment-resistant depression (TRD) remains a significant unmet need, affecting about one third of patients with major depressive disorder who fail to respond to two or more antidepressant trials. There is a need for new pharmacological approaches. Liafensine (also known as DB104) is a first-in-class triple reuptake inhibitor targeting serotonin, norepinephrine, and dopamine transporters, whose development has recently incorporated a precision medicine approach. Mechanism of Action: Liafensine inhibits reuptake of all three major monoamines (serotonin, norepinephrine, and dopamine) distinguishing it from existing SSRIs, SNRIs, or other agents which typically target one or two systems. A genetic biomarker, ANK3 (also called …

National Outcomes Of Pre-Emptive Tips In Patients With Acute-On-Chronic Liver Failure And Variceal Bleeding, Aya Akhras, Waseem Wahood, Azizullah Beran, Bisher Sawaf, Asad Ur Rahman, David Goldberg, Muhammed U. Shahid

East Florida Division GME Research Day 2025

Background

Pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS), defined as placement within 72 hours of initial endoscopic therapy for an active variceal bleed, has been proposed as a strategy to reduce rebleeding and improve survival in high-risk patients with cirrhosis. We evaluated outcomes of patients with acute-on-chronic liver failure (ACLF) who presented with variceal bleeding and underwent therapeutic endoscopy (EGD) with or without the addition of pre-emptive TIPS.

Methods

The Nationwide Readmissions Database (2010–2022) was queried for patients with ACLF using previously validated algorithms admitted with variceal upper GI bleeding who received endoscopic intervention. Patients were stratified into two groups: therapeutic …

The Role Of Bandemia In Clinical Outcomes Of Critically Ill Septic Patients., Yerandi Gil, Grettel Gonzalez Garcia, Ambar Sekulis, Rafael Miret, Siddarth Kathuria, Mauricio Danckers, Daniel Heller

East Florida Division GME Research Day 2025

Rationale: Bandemia, defined as the presence of immature neutrophils in circulation, is commonly used as an early marker of systemic inflammation and infection. 1 However, its prognostic significance in sepsis, severe sepsis, and septic shock remains uncertain. 1-2 This study aimed to determine whether bandemia is associated with adverse clinical outcomes and increased intensive care unit (ICU) resource utilization among critically ill septic patients admitted from the emergency department (ED).

Methods: A retrospective analysis was conducted using de-identified data from the HCA Healthcare database. Adult patients (aged 18–90 years) admitted to the ICU at HCA Florida Aventura Hospital from the …

Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed

North Texas Research Forum 2025

Introduction: The incidence of concomitant cholelithiasis and choledocholithiasis is 5-20%. Primary choledochlithiasis more than 3 years after cholecystectomy is an even rarer event with only a handful of case reports in the literature. Robot-assisted laparoscopic common bile duct exploration with intraoperative choledochoscopy is a relatively recent development in biliary surgery. In this report, we describe the use of this technique in a patient with rare presentation and surgically challenging anatomy. Objective: To describe a minimally invasive approach for CBD exploration with extraction of choledocholithiasis in a surgically hostile abdomen and Roux-En-Y anatomy. Methods: This report describes the case of a …

An Unexpected Source Of Gi Bleeding: Enteric Muco-Submucosal Elongated Polyp In The Proximal Jejunum With Literature Review, Galvin Dhaliwal, Dev Patel, Ashvin Singh Dhaliwal, Aakriti Soni, Bilal Ashraf, Shane Sweeney, Sushovan Guha, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

Turmeric, Red Yeast Paste, And Statins: A Recipe For Dili, John V. Nahas, Sinay Ceballos, Franklin Kasmin

East Florida Division GME Research Day 2025

Introduction Drug induced liver injury (DILI) contributes to a significant portion of acute liver injuries and acute liver failure in the west. DILI accounts for approximately 11% of acute liver failure cases in the US according to ACG. Insulting agents are numerous and well documented in the NIH LiverTox database, however the rarity and complexity of individual agents is a matter of ongoing study. Case Description/Methods A 52 year old man with PMH of HTN and HLD presents for a 2 week history of abdominal swelling, bilateral lower extremity swelling, decreased appetite, and positional shortness of breath. He endorses occasionally …

An Evaluation Of The Decline In Primary Care Physician Visits, 2010 To 2021, Anuradha Jetty, Marie Ezran, Alison Huffstetler, Yalda Jabbarpour

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.

METHODS: The Medical Expenditure Panel Survey data (2010-2021) …

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

Adenomatoid Tumor Of The Testis: A Report Of Two Cases And Literature Review, Amadadin Alhlib, Trudea Juma, Shahin Sayed

General Surgery, East Africa

Testicular adenomatoid tumor is a rare benign condition that can resemble testicular malignancies in its clinical presentation, potentially leading to overtreatment, such as radical orchidectomy. In our two case reports, we aim to better understand the behavior of this disease by examining its clinical presentation, as well as radiological, intraoperative, and pathological findings.

The Association Between Obstetric Violence And Postpartum Depression Among Latina Women In The United States: An Integrative Review, Natalia Alameda

Scripps Senior Theses

Obstetric violence, a structural form of gender-based violence, involves abuse, mistreatment, or neglect by healthcare providers during obstetric care. It is often associated with childbirth trauma and may result in physical and psychological harm to mothers and children, including postpartum depression. Postpartum depression is a major depressive episode occurring during pregnancy or within four weeks following delivery. While these concepts are often studied independently, few studies examine their intersection, particularly among Latina women in the United States. To address this gap, an integrative literature review was conducted to explore the association between obstetric violence and postpartum depression among Latina women. …

Sex Differences In Brain Iron Deposition And Microglial Ferritin In Alzheimer’S Disease, Syed Mushfiqur Rahman, Chunfeng Tan, Akiyoshi Kakita, Jose Felix Moruno-Manchon

Faculty, Staff and Student Publications

Objective

Iron is the most abundant metal in the human brain, and plays a crucial role in many biological processes. However, disruptions in brain iron metabolism can lead to iron buildup, which occurs with aging and is linked to several brain disorders, including Alzheimer's disease. Microglia, the brain's resident immune cells, have the highest capacity to store iron, which is stored intracellularly within ferritin complexes. Importantly, women are at a higher risk of developing Alzheimer's disease and experience faster disease progression compared to men.

Methods

We used postmortem brain samples from patients with Alzheimer's disease and small vessel disease patients …

A Vision Transformer Based Assistive System For Dermatological Diagnosis In Systemic Lupus Erythematosus, Syeda Lamima Farhat

All Graduate Theses, Dissertations, and Other Capstone Projects

Systemic Lupus Erythematosus (SLE) is a complex and often underdiagnosed autoimmune disease that affects multiple organs and presents with a wide range of symptoms-ranging from fatigue and joint pain to life-threatening organ damage. One of its most visible and diagnostically significant indicators is the Butterfly Malar Rash (BMR), a distinctive facial rash that often resembles other common dermatological conditions like rosacea, acne, eczema, and fifth disease. This overlap can lead to misdiagnosis or delayed detection, especially in busy clinical environments. To assist dermatologists in distinguishing BMR from similar facial rashes, this study explores the development of an AI-powered image classification …

Early Tissue Changes Linked To Diabetes: Insights From A Preclinical Model, Bryan Liu, Ramiro Cisneros, Estephania Garcia, Jimena Mora, Sumedha Guha, Evelin Rios, Krishna Prajapati, Danieli Rodrigues, Bhuvana Lakkasetter Chandrashekar, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: The aim of this study is to compare soft tissue morphology and fibrosis pathology of different organs between diabetic and non-diabetic rats. Type 2 diabetes causes soft tissue remodeling in organ systems including heart, kidney, spleen, and pancreas. Fibrotic remodeling is a common pathological mechanism seen in diabetes-related organ dysfunction. By understanding fibrotic pathology in rats, it serves as a foundation to develop lower limb models applicable to podiatry. These systemic changes caused by diabetes may also play a role in lower limb changes such as diabetic ulcers and delayed wound healing.

Methodology: Male Lewis rats (6 …

Quantitative Preventive Approaches To Diabetes: Mathematical Modeling And Analysis, Rushi P. Bhatt

Theses, Dissertations and Culminating Projects

The rising prevalence of diabetes presents a pressing global health concern, necessitating effective control strategies. This study aims to construct a mathematical model to analyze the influence of diverse factors on blood sugar levels, with a focus on identifying optimal methods for maintaining healthy glucose levels. Employing ordinary differential equations (ODE), the model investigates variables including leptin resistance, fat mass, glucose, insulin resistance, beta cell mass, daily physical activity, and dietary intake. Utilizing parameter estimates from existing literature, the model’s framework is established, and simulation results elucidate the intricate interplay between lifestyle choices and blood glucose dynamics. Furthermore, the model …

Formulation Development Of Dual-Compartment Topical Inserts Combining Tenofovir Alafenamide And Elvitegravir For Flexible On-Demand Hiv Prevention, Vivek Agrahari, M. Melissa Peet, Neelima Chandra, Prakash Ramalingam, Pardeep K. Gupta, Sriramakamal Jonnalagadda, Onkar N. Singh, Timothy J. Mccormick, Gustavo F. Doncel, Meredith R. Clark

Department of Obstetrics & Gynecology Faculty Publications

Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis. Specifically, we describe the lab-scale formulation development, preclinical mucosal safety and pharmacokinetics (PK) testing in rabbits, long-term stability, and scale-up …

Exposure To Phthalates And Replacements During Pregnancy In Association With Gestational Blood Pressure And Hypertensive Disorders Of Pregnancy, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Emma M. Rosenthal, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Exposure to endocrine-disrupting chemicals such as phthalates may increase risk of hypertensive disorders of pregnancy (HDP). Prior studies lack investigation of chemical mixtures, phthalate replacements, or key periods of susceptibility including early pregnancy. In the present study, we used a longitudinal approach to evaluate gestational exposure to phthalates and replacements, as both single-pollutants and mixtures, in association with blood pressure and diagnosis of preeclampsia or any HDP. The Human Placenta and Phthalates prospective pregnancy cohort includes 291 participants recruited from two U.S. clinics. Urinary metabolites of ten phthalates and replacements were quantified at up to 8 time points per individual …

Association Between Adverse Pregnancy Outcomes And Awareness Of Cardiovascular Risk Factors: A Numom2b-Hhs Secondary Analysis, Elizabeth M. Wendl, Amanda A. Allshouse, Ashley Goodwin, Bri Hobbs, Philip Greenland, Lisa Levine, William Grobman, George R. Saade, Natalie Cameron, C. Noel Bairey Merz, Caroline Rouse, Sarah Rogan, Judith H. Chung, Lauren H. Theilen, National Heart, Lung, And Blood Institute Numom2b Heart Health Study Network

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure …

A New Risk Assessment Scale For Pressure Injuries In The Icu: The M.D.R. Scale, Ann Murdock, Andrea Daily, Deb Reilly, Shih-Ting Chiu

Articles, Abstracts, and Reports

No abstract provided.

Inpatient Utilization Among Medicaid Members With Substance Use And Serious Mental Illness In Oregon, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Oregon Doula Workforce Analysis, Aisha K Gilmore, Apoorva Somayazulu, Lindsay Dickey, Rosemelty Jimenez Medal

Articles, Abstracts, and Reports

No abstract provided.

Early Palliative Care In Heart Failure, Meadow Stempek, Beverly Balfe, Jennifer Tantarelli

Articles, Abstracts, and Reports

No abstract provided.

Editing Approaches To Treat Alpha-1 Antitrypsin Deficiency, Derek M. Erion, Leah Y. Liu, Christopher R. Brown, Stephen I. Rennard, Humam Farah

Journal Articles: Pulmonary & Critical Care Med

TOPIC IMPORTANCE: Alpha-1 antitrypsin (AAT) deficiency is a genetic disorder most commonly due to a single G to A point mutation (E342K), leading to debilitating lung and/or liver disorders and is associated with increased mortality. The E342K point mutation causes a conformational change of the AAT protein resulting in its retention in liver hepatocytes. This reduces AAT secretion into the serum resulting in higher protease activities due to the lack of inhibition from AAT, causing damage to healthy lung tissue. The current standard of care for lung manifestations involves weekly IV augmentation therapy and is considered suboptimal for these patients. …

Tryptophan Kynurenine Pathway-Based Imaging Agents For Brain Disorders And Oncology-From Bench To Bedside, Erik Stauff, Wenqi Xu, Heidi H. Kecskemethy, Sigrid A. Langhans, Vinay V. R. Kandula, Lauren W. Averill, Xuyi Yue

Jefferson Hospital Staff Papers and Presentations

Tryptophan (Trp)-based radiotracers have excellent potential for imaging many different types of brain pathology because of their involvement with both the serotonergic and kynurenine (KYN) pathways. However, radiotracers specific to the kynurenine metabolism pathway are limited. In addition, historically Trp-based radiopharmaceuticals were synthesized with the short-lived isotope carbon-11. A newer generation of Trp-based imaging agents using the longer half-lived and commercially available isotopes, such as fluorine-18 and iodine-124, are being developed. The newly developed amino acid-based tracers have been demonstrated to have favorable radiochemical and imaging characteristics in pre-clinical studies. However, many barriers still exist in the clinical translation of …

Medical-Grade Honey And Standard Dressings In Burn Wound Care: Evaluating Effectiveness, Cost, And Patient Outcomes, Chloe Shin, Andrew Golonka

Nursing | Student Research Posters

Background: Burn injuries burden the healthcare system globally as silver sulfadiazine (SSD) is the standard treatment even though it delays healing and is highly costly. Medical-grade honey (MGH) demonstrates superior antimicrobial and anti-inflammatory properties, however, there are still evidence gaps when comparing effectiveness, cost efficiency, and patient centered outcomes. Purpose: This study aims to compare MGH and SSD amongst these gaps to inform evidence based burn care. Methods: A randomized controlled trial will enroll 100 people between 25-50 years of age with first and second degree burns, < 20% total body surface area within two hospital burn units. Participants will be assigned to either MGH or SSD treatment. The study will be a single blind design where dermatologists evaluating the wound photographs will not know the treatment given. Primary outcomes include wound healing time, infection rates, and patient reported pain scores. Secondary outcomes will focus on cost effectiveness analyses and patient quality of life. Standardized protocols will be implemented for data collection, wound assessment, and safety monitoring. Results: We anticipate that MGH will have lower infection rates, promote faster wound healing, improved outcomes from patient reports, and better cost effectiveness through shorter hospital stays and reduced medical treatments compared to SSD. Conclusion: This study will provide evidence comparing MGH and SSD across economic, clinical, and patient centered outcomes. If our hypothesis aligns with the results, MGH could be a new evidence based standard in burn care as it offers many advantages over SSD in patient comfort, healing efficiency, and medical costs. The findings will provide areas for future research, especially long term outcome and a bigger patient population.

The Sound Of Survival: The Effect Of Personalized Music Selection On Cpr Performance And Anxiety Levels, Carmin A. Dotario

Nursing | Senior Theses

The connection between music and CPR has gained attention in recent media, yet there is limited research examining its effects on CPR performance, particularly with regard to anxiety levels. This study aims to evaluate the impact of personalized music selection on CPR performance and anxiety levels among first-time trainees. Specifically, the study will assess whether personalizing CPR training with music that aligns with the optimal chest compression rate enhances overall compression quality while simultaneously reducing anxiety in the rescuer. Using a randomized controlled trial design, CPR quality (rate, depth, and consistency) and anxiety levels will be measured. The sample will …

Medical-Grade Honey And Standard Dressings In Burn Wound Care: Evaluating Effectiveness, Cost, And Patient Outcomes, Andrew Golonka, Chloe Shin

Nursing | Senior Theses

Background: Burn injuries burden the healthcare system globally as silver sulfadiazine (SSD) is the standard treatment even though it delays healing and is highly costly. Medical-grade honey (MGH) demonstrates superior antimicrobial and anti-inflammatory properties, however, there are still evidence gaps when comparing effectiveness, cost efficiency, and patient centered outcomes. Purpose: This study aims to compare MGH and SSD amongst these gaps to inform evidence based burn care. Methods:A randomized controlled trial will enroll 100 people between 25-50 years of age with first and second degree burns, < 20% total body surface area within two hospital burn units. Participants will be assigned to either MGH or SSD treatment. The study will be a single blind design where dermatologists evaluating the wound photographs will not know the treatment given. Primary outcomes include wound healing time, infection rates, and patient reported pain scores. Secondary outcomes will focus on cost effectiveness analyses and patient quality of life. Standardized protocols will be implemented for data collection, wound assessment, and safety monitoring. Results: We anticipate that MGH will have lower infection rates, promote faster wound …

Nursing Students’ Attitudes And Preparedness For Maid, Kristal Candray

Nursing | Senior Theses

Medical assistance in dying (MAiD) also known as physician-assisted suicide in addition to euthanasia is on the rise with an increase in decriminalization of the practice(s) and enactment of practice-protected policies in many countries. Ethics and morals on the subject continue to be controversial in healthcare. As student nurses enter the field as clinicians, they may encounter a patient requesting MAiD. Studies from students in other countries where MAiD and/or euthanasia is practiced found that student nurses do not feel adequately prepared to navigate such situations. However, although MAiD has been legalized in a handful of states within the United …