Medical Specialties Commons^™

A Rare Case Of Epithelioid Hemangioendothelioma In A Teenager, Layal Antoury, Sarah Ferrer Bruker, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2024

No abstract provided.

Improving Depression Screening In Primary Care By Implementing A Systematic Annual Screening Protocol: A Quality Improvement Initiative, Trang Nguyen, Ian Whitaker, Danny Tran, Aidan Lum Kong, Nan Crossley

South Atlantic Division GME Research Day 2024

No abstract provided.

2-Methyl-2-Butanol (2m2b) Ingestion Related Toxicity, Elizabeth Diaz, Darshan B. Bhatty, Ngoc Vu, Sathish Karmegam

North Texas GME Research Forum 2024

2-methyl-2-butanol known as Tert-amyl alcohol (TAA) was previously used in the past for its hypnotic, anticonvulsant, and sedative properties.1 Both ethanol and 2M2B stimulate GABA-A receptors causing similar CNS effects.1 Animal studies have shown that toxicity is greater than 2-pentanol, 3-methyl-1-butanol, and ethanol1. 2M2B is replacing ethanol due to its low cost per dose, high potency, and does not produce a hangover as it is not metabolized to aldehydes.1 This case report describes the clinical course of a patient after intoxication with 2M2B and bringing awareness as it is difficult to confirm diagnosis since there are no specific clinical features …

Multidisciplinary Simulation-Based Trauma Education For General Surgery Interns, Jennifer Austin, April Miller, Jeremiah Avarana, Alicia Lay

North Texas GME Research Forum 2024

Introduction: According to the American Society of Gastroenterology Endoscopy (ASGE), choledocholithiasis is defined as the presence of gallstones in biliary tree. Choledocholithiasis is concomitantly present in approximately 1 to 10 percent of patients with cholelithiasis. Choledocholithiasis can be described as small <15 >mm, large >15 mm, and difficult due to anatomic location, impaction, or unusual hardness/ shape. Choledocholithiasis is managed endoscopically with large balloon papillary dilation, cholangioscopy-guided intraductal laser and electrohydraulic lithotripsy (EHL), and escalation to laparoscopic common bile duct exploration, if endoscopic procedures fail. Thus far, there are sparse studies that show the requirement of choledochotomy in large and …

Case Report: Unilateral Internuclear Ophthalmoplegia As First Manifestation In Multiple Sclerosis, Imaad Zaman, Tyler Adame, Steven Do, Kien Nham, Azeem Muhammad

North Texas GME Research Forum 2024

Multiple Sclerosis is an inflammatory disorder of the central nervous system secondary to myelin degeneration. The disease is mediated by reactive lymphocytes where the spinal cord, brain and optic nerves are attacked. Diagnosis of MS is made clinically and confirmed via MRI with T2 hyperintensities. On presentation, a 26-year-old female with no significant past medical history presented with frequent headaches and blurry vision. There was right eye nystagmus on L lateral gaze with CN III deficits with absent medial rotation. MRI Head presented with a classic presentation of T2 hyperintensities in the subcortical and deep white matter. Further confirmed with …

Early Implementation Of Chf Orders And Physician Education​, Qazi Haider, Tapannita Padhi, Hunter Thornberg, Barry Brown, Alexandra Villacres, Justin Roy P. Sanchez, Ashley Henderson

North Texas GME Research Forum 2024

Each year, 700,000 patients are hospitalized with acute decompensated congestive heart failure. In order to effectively treat these patients, they require delicate management of volume status. Measuring volume status incorporates the following components: recording strict inputs and outputs of urine/fluids, recording daily standing weights and fluid restriction. This project focused on recording daily weights as a measure of accurate volume status and how that affected length of hospital stay. Data will be gathered by patient chart review including patient's admitted from Jan 2023 -Jan 2024 at Medical City Weatherford admitted with a primary/admitting diagnosis of congestive heart failure. Using PDSA …

Increasing Online Reviews And New Patients In Clinic With Qr Codes, Tristan Fun, Danielle Ford

North Texas GME Research Forum 2024

Introduction: Patient census at the Medical City Internal Medicine Grand Prairie clinic has been lower comparatively to other HCA Healthcare clinics. Although the cause can be multifaceted, the clinic’s online presence (e.g. Google Maps) is minimal. One initial issue with the clinic’s online presence was the lack of reviews on the Google page for the clinic. One way to increase online reviews is to provide Quick Response (QR) codes in the clinic for patients to scan on their smartphone. The goal of this project is to increase the number of Google reviews for the clinic through QR codes to at …

Osteopathic Manipulative Treatment (Omt) Utilization In The Primary Care Setting, Ceferino Cruz, Afsha Rais

North Texas GME Research Forum 2024

INTRODUCTION: Osteopathic Manipulative Treatment (OMT) is a skillset used to help diagnose and treat patients with a wide range of musculoskeletal complaints and can also be used as adjunctive treatment modalities for other organ systems. The project is designed to increase OMT usage across 3 clinical sites in our residency program to improve the quality of care provided to our patients. OBJECTIVES: Integrate OMT review into longitudinal clinical education. Address the shortage of faculty members that can precept OMT across all three sites. METHODS: The metrics being tracked are various OMT CPT codes ranging from 98925 to 98929 …

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Timothy Kremer

North Texas GME Research Forum 2024

Introduction: Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was found to have neither infectious nor malignant cause for such finding. Case Presentation: Patient is a 56 year old postmenopausal female who presenting with “hip pain” and was found to have incidental intrauterine gas on pelvic CT. She underwent in office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign and …

Type Ii Diabetes And Keto Diet In Family Medicine Clinic: A Case Report, Dante Paredes, Karos Torres, Joshua Moton

North Texas GME Research Forum 2024

The management of patients with high cardiac risk profiles who require insulin therapy for diabetes can be challenging due to the potential adverse effects of insulin on cardiovascular health. In order to achieve remission of type 2 diabetes mellitus (T2DM) and discontinue the need for insulin, weight loss has long been recognized as a valuable approach. The goal for this case was to implement dietary and lifestyle changes in a safe and efficient manner to induce remission of T2DM, without increasing the sympathetic load often associated with fully dosed ketogenic and other fasting strategies. This case report highlights the successful …

Heart Of Medicine: Simulation To Educate Pre-Clinical Med Students In Basic Life Support (Bls) And Advanced Cardiac Life Support (Acls), Taylor Cesarz, Rachel Shi, Adrien Thokalath, Madison Morris, Shayne Gue, Noe Navarro, Rebecca Beiler, Stephanie Cohen

North Florida Division GME Research Day 2024

No abstract provided.

An Open Source Guide To Off Service Rotations May Enhance Intern Learning And Wellbeing, Thomas Alterman, Michael Cho, Emily Macauley, Rohan Wanchu, Brian Tan, Morgan Killian, Farah Khan

North Florida Division GME Research Day 2024

No abstract provided.

Comparing The Ppv Of At-Home Screening Tests With Chronic Anticoagulant And/Or Antiplatelet Therapies, Bradley Gustafson, Nasima Mehraban, Amjad Awan, Michele Mccarroll

North Texas GME Research Forum 2024

BACKGROUND: With the rising incidence and mortality of colorectal cancer (CRC), early diagnosis and treatment is imperative. At-home CRC screening kits are a non-invasive Federal Drug Association (FDA) approved designed to detects either hemoglobin or DNA markers associated for CRC and high-grade polyps. Therefore, therapies that have a propensity to increase rates of gastrointestinal bleeding could theoretically lead to higher false positive rates. The goal of this study was to determine the positive predictive value of at-home screening tests when applied to patients on therapies such as antiplatelet, anticoagulant, non-steroidal anti-inflammatory (NSAID), or a combination of the three. METHODS: The …

Ascending Paralysis: A Case Of West Nile Virus, Samantha Rudy, Claire Levinson, Lauren Gilbert, Michaela Snow, Robyn Kramer

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Clinical Outcomes Following Interventions By Different Modalities Of Percutaneous Coronary Intervention (Pci): An Updated Systematic Review And Network Meta-Analysis, Hamza Naveed, Mary Adnan, Mohammad Hamza, Mahboob Alam

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Doxazosin Immediate Release As A Novel Treatment For Nightmares In Posttraumatic Stress Disorder., Danyaal Khan, Christie Richardson, Martin Forsberg

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Nightmares and flashbacks are common debilitating symptoms of posttraumatic stress disorder (PTSD) that can disrupt daily functioning. Prazosin, an alpha-1 adrenergic antagonist, has been commonly used off-label for the treatment of these intrusion symptoms, although its short half-life makes it so that often multiple doses are needed. Doxazosin, another alpha-1 antagonist, is starting to be investigated in the treatment of PTSD-related nightmares due to its lesser side effect profile and longer half-life. In our case series, we present three cases of patients with PTSD-related nightmares who were successfully treated with doxazosin following a relapse of symptoms after discontinuation of prazosin …

Potential Prognostic Determinants For Fet::Creb Fusion-Positive Intracranial Mesenchymal Tumor, Frank M. Mezzacappa, Frankie K. Smith, Weiwei Zhang, Andrew Gard, Fatmagul Kusku Cabuk, Ignancio Gonzalez-Gomez, Hector L. Monforte, Jiancong Liang, Omkar Singh, Martha M. Quezado, Kenneth D. Aldape, Murat Gokden, Julia A. Bridge, Jie Chen

Journal Articles: Pathology and Microbiology

Intracranial mesenchymal tumor (IMT), FET::CREB fusion-positive is a provisional tumor type in the 2021 WHO classification of central nervous system tumors with limited information available. Herein, we describe five new IMT cases from four females and one male with three harboring an EWSR1::CREM fusion and two featuring an EWSR1::ATF1 fusion. Uniform manifold approximation and projection of DNA methylation array data placed two cases to the methylation class "IMT, subclass B", one to "meningioma-benign" and one to "meningioma-intermediate". A literature review identified 74 cases of IMTs (current five cases included) with a median age of 23 years (range 4-79 years) and …

Pharmacokinetic-Pharmacodynamic Evidence From A Phase 3 Trial To Support Flat-Dosing Of Rifampicin For Tuberculosis, Huy X. Ngo, Ava Y. Xu, Gustavo E. Velásquez, Nan Zhang, Vincent K. Chang, Ekaterina V. Kurbatova, William C. Whitworth, Erin Sizemore, Kia Bryant, Wendy Carr, Marc Weiner, Kelly E. Dooley, Melissa Engle, Susan E. Dorman, Payam Nahid, Susan Swindells, Richard E. Chaisson, Pheona Nsubuga, Madeleine Lourens, Rodney Dawson, Radojka M. Savic

Journal Articles: Infectious Diseases

BACKGROUND: The optimal dosing strategy for rifampicin in treating drug-susceptible tuberculosis (TB) is still highly debated. In the phase 3 clinical trial Study 31/ACTG 5349 (NCT02410772), all participants in the control regimen arm received 600 mg rifampicin daily as a flat dose. Here, we evaluated relationships between rifampicin exposure and efficacy and safety outcomes.

METHODS: We analyzed rifampicin concentration time profiles using population nonlinear mixed-effects models. We compared simulated rifampicin exposure from flat- and weight-banded dosing. We evaluated the effect of rifampicin exposure on stable culture conversion at 6 months; TB-related unfavorable outcomes at 9, 12, and 18 months using …

Pyrazinamide Safety, Efficacy, And Dosing For Treating Drug-Susceptible Pulmonary Tuberculosis: A Phase 3, Randomized Controlled Clinical Trial, Ava Y. Xu, Gustavo E. Velásquez, Nan Zhang, Vincent K. Chang, Patrick P. J. Phillips, Payam Nahid, Susan E. Dorman, Ekaterina V. Kurbatova, William C. Whitworth, Erin Sizemore, Kia Bryant, Wendy Carr, Nicole E. Brown, Melissa L. Engle, Nguyen Viet Nhung, Pheona Nsubuga, Andreas Diacon, Kelly E. Dooley, Richard E. Chaisson, Susan Swindells, Radojka M. Savic

Journal Articles: Infectious Diseases

Optimizing pyrazinamide dosing is critical to improve treatment efficacy while minimizing toxicity during tuberculosis treatment. Study 31/AIDS Clinical Trials Group A5349 represents the largest phase 3 randomized controlled therapeutic trial to date for such an investigation. Objectives: We sought to report pyrazinamide pharmacokinetic parameters, risk factors for lower pyrazinamide exposure, and relationships between pyrazinamide exposure and efficacy and safety outcomes. We aimed to determine pyrazinamide dosing strategies that optimize risks and benefits. Methods: We analyzed pyrazinamide steady-state pharmacokinetic data using population nonlinear mixed-effects models. We evaluated the contribution of pyrazinamide exposure to long-term efficacy using parametric time-to-event models and safety …

The Impact Of Telestroke Services On Diagnosis, Patient Outcomes, And Treatment, Dustin Baum

Theses, Dissertations and Capstones

Introduction: In 2011, an estimated 20% of U.S. residents lacked timely access to stroke care. As of 2019, that number plummeted to 4% of patients. A reason for this improved access was the implementation of telestroke services. Telestroke services have utilized remote stroke specialists to help guide local emergency department physicians in reviewing imaging, diagnosing, treating, or transferring patients appropriately.

Purpose: The purpose of this research was to analyze the impact of telestroke implementation in the hospital setting. The study hypothesized the implementation of telestroke services in the hospital setting maintained an accurate stroke diagnosis, decreased inappropriate hospital transfers, reduced …

Bridging The Gap: Evaluating The Impact Of Buprenorphine-Based Prenatal Care On Neonatal Abstinence Syndrome And Maternal Health, Whitney-Lanae Crofcheck-Glenn, Jennifer Nethercutt

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome (NAS), now known as Neonatal Opioid Withdrawal Syndrome (NOWS) by government authorities, is a severe postnatal withdrawal condition caused by opioid exposure during pregnancy. NAS is diagnosed every 25 minutes in the United States. Medication-assisted treatment (MAT) with buprenorphine was used to treat opioid use disorder (OUD) and NAS. The MOTHER trial found that utilizing buprenorphine to treat mother OUD during pregnancy led to significant decreases in LOS and length of therapy.

Purpose of the Study: The purpose of this study is to evaluate the effectiveness of a prenatal care program that integrates buprenorphine-based Medication-Assisted Treatment …

Burnout For General Surgeons, Luke Edwards, Lindsay Mckelvey

Theses, Dissertations and Capstones

Introduction: In the healthcare sector, burnout among surgeons has emerged as a critical issue, impacting both the well-being of medical professionals and the quality outcomes of patient care. Research has consistently shown that long hours, high workloads, demanding results, and mental fatigue make physicians more vulnerable to experiencing burnout than others. Studies have revealed alarming statistical rates, with a significant percentage of surgeons reporting physical exhaustion and mental health repercussions. This trend is further enhanced by the demanding nature of the medical environment, where work-related stress and burnout have become common concerns.

Purpose of the Study: The negative effects of …

The Benefits Of Medical Tetrahydrocannabinol On Glaucoma, Hunter Kane

Theses, Dissertations and Capstones

Introduction: This paper explores the potential therapeutic benefits of medical Tetrahydrocannabinol (THC) on glaucoma management, particularly in terms of intraocular pressure (IOP) reduction, ocular blood flow, and symptom management. Glaucoma, characterized by increased IOP and progressive optic nerve damage, is a leading cause of irreversible blindness. Current treatments focus on IOP control but may have inadequate efficacy or intolerable side effects, necessitating alternative approaches such as medical THC.

Methods: The study hypothesis posited that medical THC could significantly reduce IOP, enhance ocular blood flow, and improve symptom management in glaucoma patients. To test this hypothesis, a literature review supplemented by …

The Measure Of Efficiency And Effectiveness When Using Artificial Intelligence (Ai) In Radiology, Jordan Watts

Theses, Dissertations and Capstones

Introduction: The use of artificial intelligence in radiology has helped radiologists identify patterns and abnormalities in medical images to diagnose and treat patients. Deep learning and machine learning algorithms have been used to assist physicians in detecting features that are not noticeable to the human eye. The FDA has approved almost 400 AI algorithms for radiology and estimated that the market for AI in medical imaging would grow from $21.48 billion in 2018 to $264.85 billion in 2028.

Purpose of the Study: The purpose of this research was to evaluate the use of artificial intelligence in radiology to determine its …

Hypothyroid: New Insights On An Old Disease, Sara Ward

Graduate Research Projects

No abstract provided.

Cycle Synced Fitness: The Impact Of Menstrual Cycle Phases On Women's Exercise Performance And Health, Sabrina Galindo

Graduate Research Projects

No abstract provided.

Digital Clock Drawing As An Alzheimer's Disease Susceptibility Biomarker: Associations With Genetic Risk Score And Apoe In Older Adults, L I Thompson, M Cummings, S Emrani, David J. Libon, A Ang, C Karjadi, R Au, C Liu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Alzheimer's disease (AD) is the leading cause of dementia in older adults, but most people are not diagnosed until significant neuronal loss has likely occurred along with a decline in cognition. Non-invasive and cost-effective digital biomarkers for AD have the potential to improve early detection.

OBJECTIVE: We examined the validity of DCTclockTM (a digitized clock drawing task) as an AD susceptibility biomarker.

DESIGN: We used two primary independent variables, Apolipoprotein E (APOE) ε4 allele carrier status and polygenic risk score (PRS). We examined APOE and PRS associations with DCTclockTM composite scores as dependent measures.

SETTING: We used existing data …

A Puzzling Case: Complete Regression Of Pituitary Macroadenoma, Nebyat Mazeniga Md, Deepak R. Vangipuram, Sachin Majumdar

Posters

We present a case of pituitary macroadenoma regression following childbirth and two months of cabergoline treatment.

Reactive Infectious Mucocutaneous Eruption Secondary To Mycoplasma Pneumoniae, Final Patel, Michael Bossak, Natalie Hogan

South Atlantic Division GME Research Day 2024

No abstract provided.

Retrospective Analysis For Incidence Of Takotsubo Cardiomyopathy Compared Against Insurance Coverage Type, Kevyn Niu, Iftekhar Baig

West Florida Division GME Research Day 2024

No abstract provided.