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Articles 1 - 30 of 39
Full-Text Articles in Internal Medicine
Case Report Of Neurosyphilis, Caroline Finnerty, Elizabeth Diaz, Teena Mathew
Case Report Of Neurosyphilis, Caroline Finnerty, Elizabeth Diaz, Teena Mathew
North Texas Research Forum 2025
This is the case of a 29 year old female who initially presented with generalized joint aches noted to have neurosyphilis. Because of her delayed treatment, this case presents interesting findings that we classically no longer see in syphilis cases due to early detection and treatment. The case looks at the early symptoms as well as late symptoms if syphilis is left untreated. The patient was ultimately treated with IV penicillin with improvement of her symptoms.
Hearts Hidden Message: Right Ventricular Thrombus Reveals Esophageal Adenocarcinoma, Devika Adusumilli, Seline Haci, Jafri Imran, Arman Vaghefi, Mehdi Khalafi, Ikponmwosa Iyamu, Sarvanan Balamuthusamy
Hearts Hidden Message: Right Ventricular Thrombus Reveals Esophageal Adenocarcinoma, Devika Adusumilli, Seline Haci, Jafri Imran, Arman Vaghefi, Mehdi Khalafi, Ikponmwosa Iyamu, Sarvanan Balamuthusamy
North Texas Research Forum 2025
Introduction Right ventricular thrombi are uncommon, usually found with concurrent pulmonary emboli and associated with significant mortality. They often originate from deep vein thrombi but may also be due to primary intracardiac processes . A right ventricular thrombus can be an unexpected marker for underlying malignancies, including esophageal cancer. This occurs due to the hypercoagulable state often induced by malignancy. Here we report a presentation where the identification of a right ventricular thrombus led to the diagnosis of esophageal cancer. Case Presentation Our patient is a 57-year old male with no past medical history who experienced an episode of dizziness …
When Skin Necrosis Mimics: Diagnostic And Therapeutic Challenges Of Calciphylaxis In A Ckd Patient With A Mechanical Heart Valve, Sienna Luk, Harshil Parekh, Vaishnavi Singh, Darshan Bhatty, Sathish Karmegam
When Skin Necrosis Mimics: Diagnostic And Therapeutic Challenges Of Calciphylaxis In A Ckd Patient With A Mechanical Heart Valve, Sienna Luk, Harshil Parekh, Vaishnavi Singh, Darshan Bhatty, Sathish Karmegam
North Texas Research Forum 2025
Calciphylaxis is a rare but serious condition characterized by the calcification and thrombosis of small blood vessels, predominantly affecting patients with end-stage renal disease (ESRD). Diagnosis can be challenging due to overlapping features with other vascular conditions, such as warfarin-induced skin necrosis (WSN). We present a case of a patient with ESRD and typical risk factors—peritoneal dialysis, hyperparathyroidism, and warfarin use—who exhibited classic skin findings suggestive of calciphylaxis. However, two skin biopsies were inconclusive. Management involved addressing the patient's calciphylaxis risk factors, optimizing dialysis, and initiating sodium thiosulfate therapy. The case was further complicated by the need to replace warfarin, …
Warm Autoimmune Hemolytic Anemia Camouflaged As Persistent Anemia Post-Embolization For Abnormal Uterine Bleeding: A Case Report, Nischal Pokhrel, Sathish Karmegam
Warm Autoimmune Hemolytic Anemia Camouflaged As Persistent Anemia Post-Embolization For Abnormal Uterine Bleeding: A Case Report, Nischal Pokhrel, Sathish Karmegam
North Texas Research Forum 2025
This case report presents a 42-year-old female with heavy menstrual bleeding and syncope, initially diagnosed with AUB due to fibroids. The patient's hemoglobin (Hb) dropped from 11.8 g/dl to 7.3 g/dl within three days, despite multiple PRBC transfusions. Uterine artery embolization (UAE) was performed, but Hb levels continued to decline, prompting further investigation. Additional testing revealed normal iron studies, vitamin B12, and folic acid levels. The peripheral blood smear showed mild anisocytosis, and the ANA screen was negative. However, elevated lactate dehydrogenase (LDH) at 571 U/L, a positive DAT for IgG, and a reticulocyte count of 6.37 were observed. These …
Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr
Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr
North Texas Research Forum 2025
Background Patients with massive/sub-massive pulmonary embolism (PE) and right ventricular strain have a significant risk of hemodynamic collapse. VA ECMO support provides an excellent salvage option for patients with acute/unstable pulmonary embolism with obstructive cardiogenic shock undergoing mechanical thrombectomy. Using VA-ECMO for a “protective PE” procedure allows control of hemodynamics and enables interventionalists to perform the thrombectomy in a more controlled environment. Here, we present our experience. Methods A retrospective data analysis on consecutive VA ECMO patients with cardiogenic shock secondary to pulmonary embolism was abstracted from August 2022 to June 2024. Results Patient characteristics and outcomes are described in …
Effective Communication In The Pronunciation Of Brain Death, Sumanth Reddy, Artur Amirkhanyan, Jeremiah Avarana, Praneetha Arge, Alicia Lay
Effective Communication In The Pronunciation Of Brain Death, Sumanth Reddy, Artur Amirkhanyan, Jeremiah Avarana, Praneetha Arge, Alicia Lay
North Texas Research Forum 2025
Background: Clinical brain death determination requires both technical proficiency and sensitive communication with families. However, residents often report inadequate training and confidence in performing and discussing these examinations. This study evaluated an educational intervention combining didactic training and simulation to improve residents’ competence in brain death protocols and family communication. Methods: A mixed-methods cohort study was conducted with resident physicians. Participants completed a pre-intervention questionnaire assessing baseline knowledge, experience, and confidence in brain death determination and communication. An educational session reviewed clinical criteria, examination protocols, and communication strategies. Residents then engaged in an in-person simulation with standardized actors portraying grieving …
Necrotizing Alternaria Pneumonia In An Immunocompetent Male, Joel Mathews, Jose Aguilar-Martinez, Sean Sojdie, Zain Tariq, Tamer Hudali
Necrotizing Alternaria Pneumonia In An Immunocompetent Male, Joel Mathews, Jose Aguilar-Martinez, Sean Sojdie, Zain Tariq, Tamer Hudali
North Texas Research Forum 2025
Abstract: Alternaria species is a rare cause of invasive fungal pneumonia, typically described as an opportunistic pathogen, usually seen in immunocompromised patients producing virulent forms of sinus, cutaneous, and ocular infections. Alternaria species sparingly affect immunocompetent individuals and are often managed without any medical interventions. We present a case of invasive fungal necrotizing pneumonia caused by Alternaria alternata species in an immunocompetent 28-year-old male with only a past medical history of well-controlled asthma managed with an as-needed albuterol inhaler. His complaints included worsening foul-smelling productive cough with yellow-dark brown sputum along with subjective fevers, chills, chest pain, and dyspnea for …
Curtain-Like Vision Loss: A Case Report On Semaglutide And Its Effects On Vision, Sereena Jivraj, Jonathan Eledge, Amenda Khoei, Amnah Andrabi
Curtain-Like Vision Loss: A Case Report On Semaglutide And Its Effects On Vision, Sereena Jivraj, Jonathan Eledge, Amenda Khoei, Amnah Andrabi
North Texas Research Forum 2025
Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-RA), was introduced and approved by the United States Food and Drug Administration (FDA) for the management of type 2 diabetes in 2017. Since then, the medication has garnered much more attention for its ability to aid with weight loss. Until recently, the most significant side effects of semaglutide noted were mostly gastrointestinal symptoms such as nausea, vomiting, and diarrhea due to the drug’s mechanism of action of delayed gastric emptying. However, a singular cohort study from Harvard Medical School in conjunction with Massachusetts Eye and Ear of 16,827 patients recently suggested a …
Coexisting Type A And B Aortic Dissection With Extension To Carotid Arteries Resulting In Acute Ischemic Stroke, Dung Nguyen, Jilpa Shah, Amnah Andrabi
Coexisting Type A And B Aortic Dissection With Extension To Carotid Arteries Resulting In Acute Ischemic Stroke, Dung Nguyen, Jilpa Shah, Amnah Andrabi
North Texas Research Forum 2025
Coexisting Type A and B aortic dissection with extension to carotid arteries resulting in acute ischemic stroke Abstract Background: Acute aortic dissection (AAD) is a rare cause of ischemic stroke. Additionally, it is even rarer to have a combined type A and type B aortic dissection. ADD is a high-mortality disease that can lead to immediate decompensation and can be masked by stroke-like symptoms, which can result in delayed or missed diagnosis. We report a patient with acute ischemic stroke (AIS) with subsequent combined type A and type B aortic dissection. Case Report: A 47-year-old man was admitted to the …
Hydralazine Induced Anca Vasculitis, Justin Huang, Yasasvi Sabbineni, Sumanth Reddy, Hani Khair
Hydralazine Induced Anca Vasculitis, Justin Huang, Yasasvi Sabbineni, Sumanth Reddy, Hani Khair
North Texas Research Forum 2025
Hydralazine is a vasodilator commonly used for hypertension. Hydrazine is commonly used in patients who can not tolerate ACEs and ARBs, resistant hypertension, and during pregnancy. Hydralazine has also been implicated in ANCA-associated vasculitis and drug-induced lupus erythematosus. Vasculitis is the presence of inflammatory leukocytes in vessel walls, inflammation can cause loss of vessel integrity which can lead to bleeding and downstream tissue ischemia and necrosis. Antineutrophil cytoplasmic antibody (AΝCΑ)-associated vаsсulitiѕ (ΑΑV) is a necrotizing vаsсսlitis that does not substantially involve the deposition of immune complexes. AΑV predominantly affects small vessels and is associated with ANСΑ specific for myeloperoxidase (MPO-ΑNCΑ) …
Severe Hypokalemic Paralysis Following Rituximab Infusion In A Patient With Type I Rta, Ayham Alsaab, Yousuf Sherwani, Emily Devine, Sarah Faheem, Vikas Gullapalli, Mohan Sengodan
Severe Hypokalemic Paralysis Following Rituximab Infusion In A Patient With Type I Rta, Ayham Alsaab, Yousuf Sherwani, Emily Devine, Sarah Faheem, Vikas Gullapalli, Mohan Sengodan
North Texas Research Forum 2025
Rituximab is a CD-20 monoclonal antibody used in the treatment of _. Rituximab is a steroid-sparing agent that can be used to control a variety of diseases. (find sources but I found several possible uses). As with any therapy, there are side effects. One potential side effect of Rituximab that has only been described a few times in the literature is hypokalemia. One such report is a case report from 2020 that describes symptomatic hypokalemia in an 18-year-old female with steroid-dependent nephrotic syndrome after her 6th rituximab infusion, with K dropping from 4.0 prior to infusion to 2.3 at the …
Out Of Left Field Lv Thrombus: Incidental Finding In Patient Presenting With Abdominal Pain, Chak Lam Yeung, Shivani Gandi, Shakir Al-Ezzi, Nicole Huang, Adhikari Pragyan
Out Of Left Field Lv Thrombus: Incidental Finding In Patient Presenting With Abdominal Pain, Chak Lam Yeung, Shivani Gandi, Shakir Al-Ezzi, Nicole Huang, Adhikari Pragyan
North Texas Research Forum 2025
Introduction: Left Ventricular thrombus (LVT) is one of the most feared complications post myocardial infarction due to the high incidence of embolization. LVT typically form after myocardial infarction and the presence of low ejection fraction (EF), both of which contribute to Virchow’s triad for thrombus formation. LVT are less common in the absence of these risk factors or pre-existing cardiovascular disease. This case report explores the incidental discovery of LVT in a patient, without any known cardiovascular disease, who presented for treatment of acute pancreatitis. Case Presentation: 42-year-old male with past medical history of alcohol use disorder and recurrent pancreatitis …
Current Trends In School Nursing For Diabetes & Dermatology, Ali Al-Nahi, Jeffrey Dickerson, Enith Espinosa Palmett, Shterna Frand, Garrett Furth, Matthew Gutzmer, Marshall Hall, Sana Khan, Shana-Kay Lambert-Johnson, Henry Lim, Kelly Mofor, Lakshmi Morla, Ali Nazim, Rui Zhang, Christian Scheufele, Zara Soomro, Michele Mccarroll, Taylor Pickering, Jasmine Silva, Brina Gonzalez, Devika Adusumilli, Sherri Morgan, Nischal Pokhrel
Current Trends In School Nursing For Diabetes & Dermatology, Ali Al-Nahi, Jeffrey Dickerson, Enith Espinosa Palmett, Shterna Frand, Garrett Furth, Matthew Gutzmer, Marshall Hall, Sana Khan, Shana-Kay Lambert-Johnson, Henry Lim, Kelly Mofor, Lakshmi Morla, Ali Nazim, Rui Zhang, Christian Scheufele, Zara Soomro, Michele Mccarroll, Taylor Pickering, Jasmine Silva, Brina Gonzalez, Devika Adusumilli, Sherri Morgan, Nischal Pokhrel
North Texas Research Forum 2025
Background: School nurses are on the front lines of assessing, identifying and treating school-age children with a number of health complications. Implementing nursing services in schools has previously demonstrated improved medical care costs for students, less productivity loss for parents, and less productivity loss for teachers. As a result, nursing services in schools provide a cost-beneficial investment of public money, and warrant both financial support from policy makers as well as educational support from local healthcare services. Aim Statement: This quality improvement project addressed the targeted continuing education gap topics of Dermatology and Diabetes management in school age children. Methods: …
Mimicking Malignancy: A Case Of Non-Traumatic Myositis Ossificans In The Calf, Fatima Safi, Artur Amirkhanyan, Amnah Andrabi, Madeline Doucet
Mimicking Malignancy: A Case Of Non-Traumatic Myositis Ossificans In The Calf, Fatima Safi, Artur Amirkhanyan, Amnah Andrabi, Madeline Doucet
North Texas Research Forum 2025
Objective: This case report highlights the diagnostic challenges of non-traumatic myositis ossificans (MO), a rare benign heterotopic ossifying lesion, and emphasizes its potential to mimic malignancy. Case Presentation: An 18-year-old female with no trauma history presented with a one-month history of progressive right calf pain, ankle weakness (4/5 strength), and difficulty ambulating. Initial ultrasound suggested a hematoma, but the persistence of symptoms prompted advanced imaging. CTA revealed arterial extravasation, while MRI identified a heterogeneously enhancing soleus muscle mass, raising suspicion for sarcoma. Core biopsy demonstrated focal bone formation, mitotically active stroma, and a "zone phenomenon" (central cellularity with peripheral osteoid …
The Intersection Of Hypophysitis And Central Diabetes Insipidus: A Clinical Case Report, Sanjana Kesireddy, Brina Gonzalez, Mohan Sengodan
The Intersection Of Hypophysitis And Central Diabetes Insipidus: A Clinical Case Report, Sanjana Kesireddy, Brina Gonzalez, Mohan Sengodan
North Texas Research Forum 2025
INTRODUCTION: Hypophysitis can cause damage to the posterior pituitary, which in turn impairs the production or release of ADH, leading to the symptoms of central diabetes insipidus. Without enough ADH, the kidneys cannot concentrate urine, resulting in the symptoms of excessive thirst and urination seen in central diabetes insidious. CASE PRESENTATION: 27 year old female presents with excessive thirst, headache, nausea and vomiting. Patient had increased urine output since endoscopic trans sphenoidal resection of pituatary mass. She was started on desmpressin 0.2mg orally three times a day. Based on urine specific gravity and urine output per hour, IV desmopressin was …
Cannabis Induced 2nd Degree Av Block, Shivani Gandhi, Vineeth Lekkala, Muhammad Suleman, Anvitha Manduva
Cannabis Induced 2nd Degree Av Block, Shivani Gandhi, Vineeth Lekkala, Muhammad Suleman, Anvitha Manduva
North Texas Research Forum 2025
Cannabis use, both medical and non-medical, has seen a marked increase following the growing trend of legalization. While the immediate effects of cannabis on mental and physiological states are well-documented, its potential impact on the cardiovascular system remains an area of growing concern. Cannabis-induced arrhythmias, particularly atrioventricular (AV) block, are rare but potentially life-threatening events that can present in young, otherwise healthy individuals (Heckle et al., 2018). This case highlights the importance of recognizing cannabis as a potential contributing factor in the development of AV block.
A Case Of Severe Synodic Stenosis In A Patient With Granalomatosis With Polyangitis Requiring Tracheostomy, Yousuf Sherwani, Mohan Sengodan
A Case Of Severe Synodic Stenosis In A Patient With Granalomatosis With Polyangitis Requiring Tracheostomy, Yousuf Sherwani, Mohan Sengodan
North Texas Research Forum 2025
Granulomatosis with polyangiitis (GPA) is characterized by vasculitis of small and medium sized blood vessels and granulomatous lesions of the upper respiratory tract. A rare condition associated with GPA, subglottic stenosis, presents in about 20% of cases on inpatient GPA. Symptoms such as stridor, hoarseness, dyspnea and dysphagia are hall marks of subglottic stenosis. Here we present the case of a male patient with life threatening subglottic stenosis that required tracheostomy.
Albuterol: An Often-Forgotten Cause Of Lactic Acidosis, Sania Moonnumackel, Sameera Muqueet, Machaiah Madhrira
Albuterol: An Often-Forgotten Cause Of Lactic Acidosis, Sania Moonnumackel, Sameera Muqueet, Machaiah Madhrira
North Texas Research Forum 2025
Introduction Lactic acid (LA) is a commonly used biomarker and is often indicative of severity of disease in critically ill patients. Lactic acidosis which is defined as LA > 4.0 can be divided into two categories: Type A which is the more common type is caused by systemic tissue hypoperfusion most likely due to shock and Type B which is caused by impairment of cellular metabolism and or decreased clearance of LA. An important cause of Type B lactic acidosis is medications including acetaminophen, anti-retroviral drugs, antibiotics and beta-adrenergic agonists including albuterol. Often patients with severe lactic acidosis are given fluid …
Culture Negative Endocarditis Masquerading As Idiopathic Leukocytoclastic Vasculitis, Sania Moonnumackel, Manish Pandey, Randy Nguyen, Reuben Abreu, Seline Haci, Neelima Paladugu, Machaiah Madhrira
Culture Negative Endocarditis Masquerading As Idiopathic Leukocytoclastic Vasculitis, Sania Moonnumackel, Manish Pandey, Randy Nguyen, Reuben Abreu, Seline Haci, Neelima Paladugu, Machaiah Madhrira
North Texas Research Forum 2025
Background: Infective endocarditis (IE) is a challenging disease to diagnose often presenting with heterogeneous features. Blood cultures are the gold standard for diagnosing endocarditis, but it is important to know that up to 20 % of cases of infective endocarditis have negative blood cultures. Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis and is idiopathic in 50% of cases. LCV is a rare but possible presentation of Infective endocarditis. Hence IE should be part of the differential diagnosis when LCV is diagnosed. Case summary: A 53-year-old male patient presenting right lower extremity pain and vesiculobullous lesions over bilateral upper and …
Case Report: Left Internal Mammary Artery (Lima)/Coronary Steal Syndrome (Css) In Severe Coronary Artery Disease And End-Stage Renal Disease, Fahed Alsayed, Muhannad Badran, Sara Khasawneh, Mohan Sengodan
Case Report: Left Internal Mammary Artery (Lima)/Coronary Steal Syndrome (Css) In Severe Coronary Artery Disease And End-Stage Renal Disease, Fahed Alsayed, Muhannad Badran, Sara Khasawneh, Mohan Sengodan
North Texas Research Forum 2025
Background: LIMA/coronary steal syndrome is a rare but significant complication in patients with severe coronary artery disease (CAD) who have undergone coronary artery bypass grafting (CABG) and concurrently have high-flow arteriovenous (AV) fistulas for hemodialysis. The left internal mammary artery (LIMA) is a preferred conduit for CABG due to its long-term patency and ability to sustain myocardial perfusion. However, in patients with end-stage renal disease (ESRD) requiring hemodialysis, excessive AV fistula flow can divert blood away from the LIMA graft, leading to myocardial ischemia despite graft patency. Early recognition and appropriate intervention are essential to prevent further deterioration of cardiac …
A Match Made In Heaven: The Heart And The Kidney, A Case Report On Uremic Pericardial Effusion With Complete Resolution Post Transplant, Sania Moonnumackel, Victor Delprincipe, Vivek Bhupathi, Srinivasan Rajaganapathy, Anand Karthik, Machaiah Madhrira
A Match Made In Heaven: The Heart And The Kidney, A Case Report On Uremic Pericardial Effusion With Complete Resolution Post Transplant, Sania Moonnumackel, Victor Delprincipe, Vivek Bhupathi, Srinivasan Rajaganapathy, Anand Karthik, Machaiah Madhrira
North Texas Research Forum 2025
Introduction: Pericardial effusion resulting from uremic pericarditis is a complication associated with chronic kidney disease (CKD). In patients with advanced CKD or End Stage renal disease (ESRD) renal transplant is the definitive treatment to improve long term outcomes. However, the presence of a large pericardial effusion poses a risk of hemodynamic compromise during transplant surgery. Options of stabilizing the patient with aggressive dialysis, pericardiocentesis or pericardial window can be considered. Here we present a case of a patient with advanced CKD who underwent pre-emptive kidney transplant and in three months had complete resolution of a large pericardial effusion noted pre-operatively. …
Todd's Paralysis: Sharpnel-Induce Seizure, Kenny Tran, Alain Folefack
Todd's Paralysis: Sharpnel-Induce Seizure, Kenny Tran, Alain Folefack
North Texas Research Forum 2025
When evaluating seizure in war veterans, distinguishing new-onset hemiparesis with aphasia from stroke can be challenging due to prior brain injury and anticonvulsant therapy. This case involves a patient with a shrapnel injury displaying stroke-symptoms after a seizure highlights the differences between stroke and seizure-related deficits in this population. Careful consideration of imaging, history and clinical presentation are essential for accurate diagnosis and management.
Streamlining Bubble Study Requests In Echo Orders: A Qi Initiative, Vineeth Lekkala, Sharvani Raguthu, Taher Yusufali, Mahmood Ahmad, Mohan Sengodan
Streamlining Bubble Study Requests In Echo Orders: A Qi Initiative, Vineeth Lekkala, Sharvani Raguthu, Taher Yusufali, Mahmood Ahmad, Mohan Sengodan
North Texas Research Forum 2025
Introduction: This quality improvement project centers around the implementation of a dedicated mechanism for ordering bubble studies in echocardiograms at Medical City North Hills Hospital. Drawing inspiration from successful implementations observed at Medical City Denton Hospital, the project aims to address existing challenges, standardize practices, and improve overall efficiency in the echocardiogram ordering workflow. Background: The echocardiogram ordering process at Medical City North Hills Hospital currently faces challenges, specifically the absence of a dedicated mechanism for ordering bubble studies. This deficiency introduces the risk of oversights, particularly in cases of syncope and stroke, thereby compromising diagnostic precision. Acknowledging these challenges, …
Improving Annual Wellness Visit Documentation In Clinic, Chak Lam Yeung, Gurunath Subramanyam, Krishna Ramesh, Mohammad Nadim, Jasmyne Bowser, John Sturgeon
Improving Annual Wellness Visit Documentation In Clinic, Chak Lam Yeung, Gurunath Subramanyam, Krishna Ramesh, Mohammad Nadim, Jasmyne Bowser, John Sturgeon
North Texas Research Forum 2025
Introduction: Medicare beneficiaries who received an annual wellness visit (AWV) were noted to have reduced Medicare spending. Review of Medical City North Hills Internal Medicine Clinic data showed that 44% of eligible patients received an AWV. Improper documentation and coding were the primary reasons eligible AWVs were not accounted for even though they were performed. Majority of incomplete documentation was missing information regarding patient’s functional ability, level of safety, home safety, and activities of daily living. The information is normally obtained from a questionnaire completed by the patient prior to the visit. Questionnaire was noted by residents to be unorganized …
Improving Colon & Rectal Cancer Screening At Medical City North Hills Clinic, Basil Nduma, Sharvani Raguthu, Gurunath Subrahmanyam, John Sturgeon
Improving Colon & Rectal Cancer Screening At Medical City North Hills Clinic, Basil Nduma, Sharvani Raguthu, Gurunath Subrahmanyam, John Sturgeon
North Texas Research Forum 2025
Introduction: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths globally. Despite its severity, fewer than half of eligible Americans undergo annual screening. The U.S. Preventive Services Task Force (USPSTF) recommends CRC screening from age 45 to 75, with personalized assessments for those aged 76 to 85. The current CRC screening rate at the Medical City North Hills Internal Medicine Residents’ Clinic is 9.3%, significantly below the target rate of over 66%. Objective: This project aimed to increase the CRC screening rate from 9.3% to over 66% at the Medical City North Hills Internal Medicine Residents Clinic, in …
Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan
Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan
North Texas Research Forum 2025
INTRODUCTION: When deciding between VA ECMO (veno-arterial ECMO) and VV ECMO (veno-venous ECMO), the primary consideration is the underlying pathology affecting the patient’s heart and lungs. VA ECMO provides support for both the cardiovascular and respiratory systems, making it suitable for patients experiencing cardiogenic shock or combined cardiac and respiratory failure. In contrast, VV ECMO is used exclusively for respiratory failure, offering support to patients with severe lung dysfunction but intact cardiac function. CASE PRESENTATION: 41 year old male with no known past medical history presented s/p cardiac arrest secondary to aspiration pneumonia due to alcohol and opioid intoxication. Chest …
Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr
Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr
North Texas Research Forum 2025
BACKGROUND: Management of VA ECMO has substantially evolved over the years. Much literature has been published regarding indications, management, and outcomes; however, limited evidence exists detailing strategies to manage, progress, and wean patients from VA ECMO. We present our experience using a VA ECMO expected progression patient management guideline. METHODS: The VA ECMO Expected Progression Patient Management Guideline, approved on June 1, 2021, consists of six goal-oriented stages with suggestive interventions for managing cardiogenic shock patients undergoing VA ECMO therapy. Patient characteristics and outcomes were collected retrospectively and compared between March 2019 to May 2021 (VA Non-Expected Progression group) and …
Anti-Pd-1 Monoclonal Antibody Induced Diabetic Ketoacidosis In Melanoma, Boney Lapsiwala, Jacqueline Bekhit, Indira Tata, Vibhuti Veeranna
Anti-Pd-1 Monoclonal Antibody Induced Diabetic Ketoacidosis In Melanoma, Boney Lapsiwala, Jacqueline Bekhit, Indira Tata, Vibhuti Veeranna
North Texas Research Forum 2025
Background: Immune checkpoint inhibitors (ICIs), including pembrolizumab, are increasingly used in cancer therapy, particularly for melanoma. While effective, these agents are associated with various immune-related adverse events (IRAEs), including endocrine disorders like diabetic ketoacidosis (DKA). This report aims to contribute to the understanding of pembrolizumab-induced DKA, especially in patients with pre-existing prediabetes. Case Presentation: A 78-year-old male with a history of melanoma, prediabetes, and other comorbidities developed DKA after 1.5 years of pembrolizumab treatment. He presented with symptoms of weakness, thirst, dry mouth, and diarrhea, alongside severe hyperglycemia and metabolic acidosis. Diagnostic workup confirmed DKA, and his clinical improvement followed …
Assessing The Effectiveness Of A Rapid Response Training Course, Nasima Mehraban, Caroline Brooke, Vivek Punjabi, Veeranna Vibhuti
Assessing The Effectiveness Of A Rapid Response Training Course, Nasima Mehraban, Caroline Brooke, Vivek Punjabi, Veeranna Vibhuti
North Texas Research Forum 2025
Introduction: Rapid response teams are crucial in healthcare settings for managing clinical emergencies. To enhance the preparedness of interns in handling such situations, we developed a rapid response training course. This study aimed to evaluate the course's effectiveness by examining changes in residents' self-reported confidence levels before and after completing the training. Methods: A group of interns participated in five simulated rapid response scenarios. Before the training, participants rated their confidence level on a scale from 1 (not confident in running a rapid response) to 10 (very confident). Following the training, they reassessed their confidence level. Pre- and post-training ratings …
Cryptococcal Meningitis In A Patient With Multiple Sclerosis On Fingolimod, Syed Hassan Amir, Teena Mathew
Cryptococcal Meningitis In A Patient With Multiple Sclerosis On Fingolimod, Syed Hassan Amir, Teena Mathew
North Texas Research Forum 2025
Background: There are a host of pathogens that thrive only when the host is weakened enough to be susceptible – Cryptococcus is one such organism that causes fatal meningitis, primarily in HIV patients. Those immunocompromised by other means are also susceptible. Among them, patients with multiple sclerosis (MS) pose a significant challenge as what may initially be considered an MS flare could mask a serious underlying infection. Objective: This case study discusses an MS patient on Fingolimod, an immunosuppressant, that likely made them vulnerable to cryptococcal meningitis. Pathogenesis: Cryptococci are encapsulated yeast that enter the body via inhalation of spores …