Internal Medicine Commons^™

Successful Treatment Of Mirizzi Syndrome With Spyglass-Guided Electrohydraulic Lithotripsy, Bushra Bangash, Aakriti Soni, Galvin Dhaliwal, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Rare Case Of Right Sided May-Thurner Syndrome Diagnosis And Treatment, Sania Moonnumackel, Akhil Gade, Anand Karthik, Machaiah Madhrira

North Texas Research Forum 2025

Introduction: May-Thurner Syndrome (MTS) is a phenomenon commonly described as acquired stenosis of the left common iliac vein secondary to compression by the right common iliac artery. Right sided MTS is a rare syndrome that can happen due to a left sided inferior vena cava (IVC) and abdominal aorta with a high bifurcation which results in the right common iliac vein being compressed by the left internal iliac artery. It is a rare presentation of this condition which can commonly be missed and management guidelines are less defined compared to classic MTS. Case Report: A 63-year- old female with past …

An Atypical Presentation Of Pheochromocytoma, Ali Asghar, Neil Maithel, Ibrahim Musa, Hasnan Ijaz, Thomas Alexander

Gulf Coast Division GME Research Day 2025

No abstract provided.

An Atypical Presentation Of Anti-Caspr2 Autoimmune Encephalomyelitis, Aaron De La Cruz, Sarita Thanedar, Shao-Ting Min, Prabhdeep Singh, Hitesh Gidwani

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

A Rare Case Of Pseudo-Pseudo Meigs Syndrome With Systemic Lupus Erythematosus, Rabia Mahfooz, Grant Patterson, Neil Maithel, Daniel Kim

Gulf Coast Division GME Research Day 2025

No abstract provided.

Anomalous Aortic Origin Of Right Coronary Artery With Malignant Course Presenting As Non-St Elevation Myocardial Infarction (Nstemi) In A Middle-Aged Female, Ahmad Karzoun, Hamza Alkowatli, Mir Hussaini, Ahmad Ghafoor, Muhammad Faiz

West Florida Division GME Research Day 2025

No abstract provided.

Two Is Not Always Better Than One: An Intersting Case Of Inflammatory Myositis With Dual Myositis Specific Antibodies, Neil Maithel, Rabia Mahfooz, Ali Asghar, Paul S. Bongat

Gulf Coast Division GME Research Day 2025

No abstract provided.

Too Rash To Rule Out The Rash, Fnu Swatisikta, Chinar Singh

East Florida Division GME Research Day 2025

No abstract provided.

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.

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.

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 …

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.

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 …

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 …

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.

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. …

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 …

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 …

Recombinant Factor Viia: New Insights Into The Mechanism Of Action Through Product Innovation, Miguel A Escobar, Maureane Hoffman, Giancarlo Castaman, Cedric Hermans, Johnny Mahlangu, Johannes Oldenburg, Charles L Percy, Mark T Reding, Amy D Shapiro, Steven W Pipe

Faculty, Staff and Student Publications

Management of bleeding in persons with hemophilia and inhibitors involves treatment with bypassing agents, including recombinant activated factor VII (rFVIIa). Two rFVIIa products are commercially approved for use in the United States and the European Union. Eptacog alfa and eptacog beta share the same amino acid sequence but differ in posttranslational modifications. Although rFVIIa has been used to manage bleeding in persons with hemophilia and inhibitors for over 30 years, its mechanisms of action is still being studied. In vitro and in vivo studies have suggested that rFVIIa could promote hemostasis by (1) increasing tissue factor-dependent activation of factor (F)X …

Key Considerations For Combination Therapy In Alzheimer’S Clinical Trials: Perspectives From An Expert Advisory Board Convened By The Alzheimer’S Drug Discovery Foundation, Jeffrey Cummings, Michael Gold, Mark Mintun, Michael Irizarry, Andrew Von Eschenbach, Suzanne Hendrix, Donald Berry, Cristina Sampaio, Kaycee Sink, Jaren Landen, Miia Kivipelto, Michael Grundman, Steven E Arnold, Allan Green, Katherine Partrick, Laura Nisenbaum, Aaron Burstein, Howard Fillit

Faculty, Staff and Student Publications

There is growing consensus in the Alzheimer's community that combination therapy will be needed to maximize therapeutic benefits through the course of the disease. However, combination therapy raises complex questions and decisions for study sponsors, from preclinical research through clinical trial design to regulatory, statistical, and operational considerations. In January 2024, the Alzheimer's Drug Discovery Foundation convened an expert advisory board to discuss the key considerations in each of these areas. Experts agreed on the need to prioritize a combination therapy approach that encompasses a wide range of targets associated with aging and the underlying biology of Alzheimer's disease. Progress …

Unintentional Lead Dislodgement In Twiddler’S Syndrome, Howard Tan, Ashok Chaudhary, Nishant Nerella, Suman Pasupuleti

West Florida Division GME Research Day 2025

No abstract provided.

Development Of Intra-Hospital Ceftriaxone Resistance Of Serratia Marcescens Endocarditis, Mahyar Doraji, Michael Denney, Adeel Malik, Praveen Chekka, Nishant K. Nerella

West Florida Division GME Research Day 2025

No abstract provided.

Metastatic Cardiac Tumor: New Onset Cardiac Tamponade And Atrial Fibrillation, Maheen N. Mirza, Aixa M. Rivera Rodriguez, Antonio J. Santiago Rodriguez, Adeel Malik, Matthew Vincent Tavares

West Florida Division GME Research Day 2025

No abstract provided.

Pancytopenia, A Rare Case Associated With Influenza A, Aida Sarita Gonzalez, Ajith Vivek, Gabriela Salazar, Joseph Maslak

West Florida Division GME Research Day 2025

No abstract provided.

A Case Report: Cardiac Tamponade Secondary To Myelofibrosis Induced Extramedullary Hematopoiesis In Pericardium, Jaafar A. Hamdan, Mustafa Tahir, Ahmed Taha, Chrissy Sharma, Amrita Randhawa

West Florida Division GME Research Day 2025

No abstract provided.

Hemoptysis In A Previously Healthy Hispanic Male: A Case Of Anca Vasculitis Diagnosis, Muhammad Anzar Ullah, Angel Pacheco-Rueda, Marwa Hegagi

West Florida Division GME Research Day 2025

No abstract provided.