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When Appendiceal Obstruction Looks Metallic: An Unusual Radiologic Presentation Of Appendicitis, Nathan Cohen, Gary Padilla-Maldonado 2025 HCA Healthcare

When Appendiceal Obstruction Looks Metallic: An Unusual Radiologic Presentation Of Appendicitis, Nathan Cohen, Gary Padilla-Maldonado

East Florida Division GME Research Day 2025

Introduction: Right lower quadrant pain is a common presentation of acute appendicitis, but presentations in elderly patients may be subtle. Appendiceal obstruction is frequently caused by fecaliths; however, not all radiopaque findings in the appendix represent fecaliths. Rarely, these obstructions can mimic metallic foreign bodies on imaging, complicating interpretation and management. This case highlights an unusual radiologic presentation of appendiceal obstruction with metallic appearance, underscoring the importance of careful image analysis in atypical cases of appendicitis.

Case Description: An elderly man presented to the emergency department with a three-day history of constant right lower quadrant abdominal pain. He denied associated …


​Comparison Of Diagnostic Accuracy Of Ct And Spect-Ct In Pseudarthrosis Detection: A Systematic Review And Meta-Analysis​, Nicholas Schiller, Miguel Cartagena-Reyes, Elyette Lugo, Diego Lopes de Lima, Brett Schlifka, Milad Alam 2025 HCA Healthcare

​Comparison Of Diagnostic Accuracy Of Ct And Spect-Ct In Pseudarthrosis Detection: A Systematic Review And Meta-Analysis​, Nicholas Schiller, Miguel Cartagena-Reyes, Elyette Lugo, Diego Lopes De Lima, Brett Schlifka, Milad Alam

East Florida Division GME Research Day 2025

No abstract provided.


Performance In Grading Of Well Differentiated Pancreatic Neuroendocrine Tumors (Wdpannet) Using The 2019 World Health Organization (Who) Classification Of Tumors Of The Digestive System. Experience Of A Community Teaching Hospital., Astrid Sacasa, Gul Emek Wymer, Susana Ferra 2025 HCA Healthcare

Performance In Grading Of Well Differentiated Pancreatic Neuroendocrine Tumors (Wdpannet) Using The 2019 World Health Organization (Who) Classification Of Tumors Of The Digestive System. Experience Of A Community Teaching Hospital., Astrid Sacasa, Gul Emek Wymer, Susana Ferra

East Florida Division GME Research Day 2025

CONTEXT: The WHO Classification of Tumors of the Digestive System (2019) categorizes WDPanNETs as grade 1 (G1), grade 2 (G2) or grade 3 (G3) by mitotic count and proliferative index (KI67). We examined the performance of pathologists and pathology trainees in grading WDPanNET according to the 2019 WHO Classification.

DESIGN: One H&E and KI-67 slides of eleven WDPanNET cases from our 2023 archives (7 G1, 1 G2 and 3 G3) were blindly evaluated by 2 junior residents (PGY-1), 2 senior residents (PGY-3), 2 pathologists without formal gastrointestinal training (NOGIP) and 2 pathologists with formal gastrointestinal training (GIP), provided with the …


Percutaneous Levoatrial Cardinal Vein Closure For Stroke Prevention, Chee Spencer, Amir Hasani, Alexander Ellis, David Adler 2025 Macon & Joan Brock Virginia Health Sciences at Old Dominion University

Percutaneous Levoatrial Cardinal Vein Closure For Stroke Prevention, Chee Spencer, Amir Hasani, Alexander Ellis, David Adler

Department of Medicine Faculty Publications

We report 2 cases of cerebral embolism related to congenital levoatrial cardinal vein anomalies. Both patients had positive echocardiographic agitated saline studies but intact interatrial septum on transesophageal echocardiography. Levoatrial cardinal vein was diagnosed using computed tomography angiography. A novel technique for percutaneous levoatrial cardinal vein closure using vascular plug devices was successful in both patients.


Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison 2025 Marshall University

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …


Heterotopic Ossification (Ho) Prophylaxis In Total Hip Arthroplasty (Tha): A Systematic Review Of Level I And Level Ii Evidence Since 2000, Troy Puga, McKenna Box, Vincent Dieu, Charles Marchese, John T. Riehl 2025 HCA Healthcare

Heterotopic Ossification (Ho) Prophylaxis In Total Hip Arthroplasty (Tha): A Systematic Review Of Level I And Level Ii Evidence Since 2000, Troy Puga, Mckenna Box, Vincent Dieu, Charles Marchese, John T. Riehl

North Texas Research Forum 2025

Introduction: Heterotopic ossification (HO) is a somewhat common occurrence after total hip arthroplasty (THA), particularly with certain approaches. This complication can be detrimental to the success of the surgical outcome. Indomethacin and radiotherapy remain common treatment modalities; however, no true gold-standard treatment is universally agreed upon. This study aims to evaluate Level I and Level II evidence for treatment practices of HO prophylaxis since 2000. Methods: To evaluate HO prophylaxis in total hip arthroplasty, a search was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases using keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for …


Facial Hair And Infection: A Beardly Question With A Bald Spot In The Literature, Kyle O'Connor, Samuel Stegelmann, Hans Drawbert, Edwin Dudoussat, John T. Riehl 2025 HCA Healthcare

Facial Hair And Infection: A Beardly Question With A Bald Spot In The Literature, Kyle O'Connor, Samuel Stegelmann, Hans Drawbert, Edwin Dudoussat, John T. Riehl

North Texas Research Forum 2025

Background: Upholding a sterile environment in orthopedic surgery is vital to minimize surgical site infections (SSIs). Among personal protective equipment, beard covers for surgical staff with facial hair have been recommended as a measure to prevent contamination. However, their effectiveness in reducing SSIs remains uncertain, especially in orthopedic procedures that often involve high-risk implants and extended exposure of surgical fields. This systematic review assesses the current evidence on the role of beard covers in infection prevention during surgery. Methods: Using PRISMA guidelines, databases were searched for studies investigating facial hair, beard covers, and infection risk. Eligible studies included comparative studies, …


The Impact Of Early Vs. Late Intubation On Morality Among Obese Patients With Idiopathic Pulmonary Fibrosis, Peter Holleb, Enkhbileg Batbileg, Brandon Chong, Jameel Osborne 2025 HCA Healthcare

The Impact Of Early Vs. Late Intubation On Morality Among Obese Patients With Idiopathic Pulmonary Fibrosis, Peter Holleb, Enkhbileg Batbileg, Brandon Chong, Jameel Osborne

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.


The Hungriest Of Bones, Srinidhi Shyamkumar, Syed Raza, Eric Riha, Zuhair Ali 2025 HCA Healthcare

The Hungriest Of Bones, Srinidhi Shyamkumar, Syed Raza, Eric Riha, Zuhair Ali

Gulf Coast Division GME Research Day 2025

No abstract provided.


Optimizing Fluid Resuscitation: Balancing Access Efficiency And Infusion Speed In Trauma Care, Chris Robert, Enoch Wong, David Bassa, Danielle Pigneri, Paul Granet 2025 HCA Healthcare

Optimizing Fluid Resuscitation: Balancing Access Efficiency And Infusion Speed In Trauma Care, Chris Robert, Enoch Wong, David Bassa, Danielle Pigneri, Paul Granet

North Texas Research Forum 2025

Study Objective: Time is a critical resource during the initial treatment of an injured patient. Fluid resuscitation is also a critical component of trauma care. Clinicians are faced with the need to actively resuscitate an injured patient while simultaneously working to provide them operative or procedural hemorrhage control as quickly as possible. In these circumstances, physicians must balance perceived flow efficiency with time required to place certain types of access devices, though little data exists to guide this decision process. This study aims to evaluate the infusion times of different sizes of peripheral and central venous catheters to optimize fluid …


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 2025 HCA Healthcare

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. …


Streamlining Bubble Study Requests In Echo Orders: A Qi Initiative, Vineeth Lekkala, Sharvani Raguthu, Taher Yusufali, Mahmood Ahmad, Mohan Sengodan 2025 HCA Healthcare

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, …


Denovo Malignancy After Liver Transplantation In Patients With And Without Hepatocellular Carcinoma, Mohammad Abuassi, Carson Creamer, Harsimran Kalsi, Kobina Essilfie-Quaye, Tony S. Brar, Yaseen Perbtani 2025 HCA Healthcare

Denovo Malignancy After Liver Transplantation In Patients With And Without Hepatocellular Carcinoma, Mohammad Abuassi, Carson Creamer, Harsimran Kalsi, Kobina Essilfie-Quaye, Tony S. Brar, Yaseen Perbtani

North Florida Division GME Research Day 2025

No abstract provided.


Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan 2025 HCA Healthcare

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 2025 HCA Healthcare

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 …


The Use Of Coronary Sinus Diameter Measurements To Distinguish Atrioventricular Nodal Reentrant Tachycardia From Atrioventricular Reentrant Tachycardia, Mohamed Ibrahim Ataalla Khalil, Sherif Abd El Salam Sakr, Hany Mahmoud Abd Elshakour, Hoda Mohamed Sobh 2025 resident of cardiology, Mansoura university, Egypt.

The Use Of Coronary Sinus Diameter Measurements To Distinguish Atrioventricular Nodal Reentrant Tachycardia From Atrioventricular Reentrant Tachycardia, Mohamed Ibrahim Ataalla Khalil, Sherif Abd El Salam Sakr, Hany Mahmoud Abd Elshakour, Hoda Mohamed Sobh

Mansoura Medical Journal

Background: Supraventricular tachycardia (SVT) is a common clinical arrhythmia, with atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) being the most frequent subtypes. Distinguishing between these arrhythmias is crucial for determining the appropriate treatment strategy. Aim: To evaluate the clinical utility of echocardiographic measurement of coronary sinus (CS) diameter in distinguishing AVNRT from AVRT. Methods: This prospective descriptive study included 54 patients with narrow complex tachycardia who underwent echocardiography then electrophysiology study (EPS). CS diameter was measured at the ostium and 1 cm distal using 2D echocardiography then CS ostium area by 4D echocardiography was measured. Results: Patients …


Skin Grafting After Reconstruction For Head And Neck Cancer: Does Thickness Matter?, P Larson Miller, Nicholas Hrdlicka, Eric Shaw, Robert Liebman, Matthew Ochsner 2025 HCA Healthcare

Skin Grafting After Reconstruction For Head And Neck Cancer: Does Thickness Matter?, P Larson Miller, Nicholas Hrdlicka, Eric Shaw, Robert Liebman, Matthew Ochsner

South Atlantic Division GME Research Day 2025

No abstract provided.


A Case Of Dress Syndrome Following Recurrent Hardware-Related Knee Infection: Diagnosis, Management, And Recovery, Cooper Alden Josephs, Himani Patel, James Everhart 2025 HCA Healthcare

A Case Of Dress Syndrome Following Recurrent Hardware-Related Knee Infection: Diagnosis, Management, And Recovery, Cooper Alden Josephs, Himani Patel, James Everhart

South Atlantic Division GME Research Day 2025

No abstract provided.


A Rare Case Of Vulvar Endometriosis, Taylor Penny, Shelby Freeberg, Brittany Stofko 2025 HCA Healthcare

A Rare Case Of Vulvar Endometriosis, Taylor Penny, Shelby Freeberg, Brittany Stofko

South Atlantic Division GME Research Day 2025

No abstract provided.


Ballistics Gel Model To Teach Ultrasound Guided Pericapsular Nerve Group (Peng) Block, Nicholas Murphy, Matthew Carr, Taryn Hoffman, Leily Naraghi 2025 HCA Healthcare

Ballistics Gel Model To Teach Ultrasound Guided Pericapsular Nerve Group (Peng) Block, Nicholas Murphy, Matthew Carr, Taryn Hoffman, Leily Naraghi

South Atlantic Division GME Research Day 2025

No abstract provided.


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