Nutritional and Metabolic Diseases Commons^™

Scurvy: A Rare Disease Or A Rare Diagnosis?, David F. Gaieski

Department of Emergency Medicine Faculty Papers

Introduction:

Scurvy, the disease state caused by ascorbic acid deficiency, was once an extremely common disease but is now thought to be a rare disease in postmodern societies. Physicians are not trained to consider scurvy as a possible diagnosis in patients at risk; rather, it is considered a rare diagnosis to add to a differential for completeness’s sake.

Methods:

We sought to describe the scorbutic patients seen by one physician during a busy academic emergency medicine career. Case series of patients seen by one physician between 1993 and 2023 at five academic teaching hospitals with Emergency Departments (EDs) in the …

Effects Of Metformin On Glucose Metabolism And Mitochondrial Function In Patients With Obstructive Sleep Apnea: A Pilot Randomized Trial, Elizabeth R.M. Zunica, Elizabeth C. Heintz, Wagner S. Dantas, R. Caitlin Hebert, Ma Kayla Tanksley, Robbie A. Beyl, Edward C. Mader, John P. Kirwan, Christopher L. Axelrod, Prachi Singh

School of Medicine Faculty Publications

Obstructive sleep apnea (OSA) is associated with increased risk for diabetes, and standard treatment with positive airway pressure (PAP) device shows inconsistent effects on glucose metabolism. Metformin is known to treat and prevent diabetes, but its effects on skeletal muscle mitochondrial function are not completely understood. Here, we evaluate the effects of metformin on glucose metabolism and skeletal muscle mitochondrial function in patients with OSA. Sixteen adults with obesity (50.9 ± 6.7 years, BMI: 36.5 ± 2.9 kg/m2) and moderate-to-severe OSA were provided with PAP treatment and randomized to 3 months of placebo (n = 8) or metformin (n = …

Hyperkalemia: Pharmacotherapies And Clinical Considerations, Evan S. Sinnathamby, Kelly T. Banh, William T. Barham, Tyler D. Hernandez, Audrey J. De Witt, Danielle M. Wenger, Vincent G. Klapper, David Mcgregor, Antonella Paladini, Shahab Ahmadzadeh, Sahar Shekoohi, Alan D. Kaye, Giustino Varrassi

School of Medicine Faculty Publications

Hyperkalemia has been defined as a condition where a serum potassium level is > 5.5 mmol/l. It is associated with fatal dysrhythmias and muscular dysfunction. Certain medical conditions, such as chronic kidney disease (CKD), diabetes mellitus, and others, can lead to hyperkalemia. Many of the signs of hyperkalemia are nonspecific. A history and physical examination can be beneficial in the diagnosis of the condition. In this regard, certain characteristic electrocardiogram findings are associated with hyperkalemia along with laboratory potassium levels. In acute and potentially lethal conditions, hyperkalemia treatments include glucose and insulin, bicarbonate, calcium gluconate, beta-2 agonists, hyperventilation, and dialysis. There …

Severe Dysphagia With Eosinophilic Esophagitis Pattern Of Injury Related To Pembrolizumab Therapy, James S Barnett, Kevin K Yu, Xavier Rivera Rivera, Asmeen Bhatt

Faculty, Staff and Student Publications

While immune checkpoint inhibitor (ICI) therapies are effective treatments for many cancers, ICI therapies are associated with immune-related adverse events. We present a 67-year-old man with non-small cell lung carcinoma, who developed severe dysphagia with biopsies from an esophagogastroduodenoscopy showing histopathology consistent with eosinophilic esophagitis while on ICI maintenance therapy with pembrolizumab. The patient's symptoms worsened despite standard therapy. However, he had complete resolution of dysphagia symptoms once pembrolizumab was discontinued. While immune-related adverse events affecting the gastrointestinal system are increasingly recognized, ICI-associated eosinophilic esophagitis is a rare entity.

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Efficacy And Safety Of Once-Weekly Insulin Regimes On Glycemic Control For Type 2 Diabetes: A Systematic Review And Network Meta-Analysis, Peng Wang, Yu Zhang, Wenhao Xu, Liyuan Peng, Ping Xu, Weelic Chong, Yang Hai, Lu Jia, Fang Fang

Student Papers, Posters & Projects

Background

Randomized controlled trials have found that once-weekly insulin resulted in greater glycemic control compared to once-daily insulin in patients with type 2 diabetes. However, no direct comparisons have been made between different types of once-weekly insulin thus far. This systematic review and network meta-analysis aimed to evaluate the effect of the two most advanced once-weekly insulin analogues, namely insulin icodec and insulin Fc, in patients with type 2 diabetes.

Methods

We conducted a thorough search in the databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The search included articles published from the beginning to October 10, …

A Mindfulness Approach To Regulate Depressive-Associated Emotional Eating, Jillian G. Montefusco

Doctor of Nursing Practice Scholarly Projects

Background: Depression affects 350 to 500 million people globally, with depressive-associated emotional eating (DAEE) impacting approximately 43.5% of these individuals. Depressive-associated emotional eating contributes to obesity through poor dietary choices and weight gain, leading to the projection that by 2048 all United States citizens will be overweight or obese.

Local Problem: At a Chicago weight loss center, the Emotional Appetite Questionnaire screened 75 patients, revealing that 56% (N = 42) ate more during sadness, boredom, and loneliness, and 50.7% (N = 38) ate more during depression, indicating significant DAEE.

Methods: This quasi-experimental quality improvement project uses a pre- and post-evaluation …

Vitamin D Deficiency Leading To Renal Tubular Acidosis, Christopher Jacob Reguyal, Jake Francisco

South Atlantic Division GME Research Day 2024

No abstract provided.

An Interesting Case Of Modern Day Scurvy, Petar Jen, Jessica Cook, Elise Clark, Laurence Dubensky

East Florida Division GME Research Day 2024

No abstract provided.

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 …

Mcardle Disease Rhabdomyolysis Precipitated By Acetazolamide For Idiopathic Intracranial Hypertension, Shahin Cyrus Owji, Vivian Paraskevi Douglas, Mohammad Pakravan, Chaow Charoenkijkajorn, Andrew G. Lee

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Full Plate Living-Teaching Kitchen: A Sustainable Approach To Employee Health, Amy M. Daniel

Doctor of Nursing Practice Scholarly Projects

Abstract

Insufficient fiber intake is a key contributor to diet-related chronic diseases (DRCD) such as obesity, hypertension, and diabetes. This evidence-based health promotion program evaluated integrating a teaching kitchen with the Full Plate Living Plan (FPL-TK) to increase daily fiber intake. Grounded in the Social Cognitive Theory, the 8-week employee health promotion program included hands-on culinary demonstrations, a structured FPL nutrition curriculum, and fiber tracking tools to help participants engage and participate in weekly health and wellness changes. The program successfully achieved high engagement rates, with 80% of participants reporting high satisfaction with the program and 100% of participants stating …

Devastating Cerebral Injury Prior To Dka Therapy -Case Report, Brittany Bare, Chandler Sapp, Evelyn Fagan, Sunil Keshwah

South Atlantic Division GME Research Day 2024

No abstract provided.

To Have And To Not Hold: Long-Acting Insulin For Npo Patients With Diabetes, William Hicks, Cindy Iwuagwu, Suzan Khalil, Juan Pablo Meruvia Garron, Cynthia Schwartz, Carlos Botero Suarez, Ashwini Komarla, Mustafa Kinaan

North Florida Division GME Research Day 2024

No abstract provided.

Retrospective Study: Adverse Effects Of Hyperglycemia In Nondiabetic Critically Ill Patients With Myocardial Infarction, Enkhbileg Batbileg, Jourdan Harper, Daniel Moore, Carol Wang, Sarah Barraza

Central & West Texas GME Research Day 2024

No abstract provided.

Improvement Of Diabetes Mellitus Management In A Resident-Run Clinic By Using Continuous Glucose Monitoring (Cgm), Janet Tam, Nathan Holt, Rakahn Haddadin, Ranier Rivera, Yasra Badi, Esar Dini, Andrey E. Manov

Far West Division GME Research Day 2024

No abstract provided.

Case Report: Special Considerations When Initiating Insulin In A Non-English-Speaking Patient With Diabetes: A Social Guide For New Insulin-Prescribing Residents, Jacob Uskavitch, Seth Barker

TriStar Division GME Research Day 2024

No abstract provided.

A Case Report In Hyponatremia As The First Presentation Of Stage Iv Lymphoma; An Opportunity For Earlier Diagnosis, Kathleen Rowe

TriStar Division GME Research Day 2024

No abstract provided.

Pregnancy Outcome In Assisted Reproductive Technology Pregnancy Complicated By 46 Day Preterm Prelabor Rupture Of Membranes, Type 2 Diabetes Mellitus And Severe Preeclampsia, A Case Report, Dana Rei Cassab, Alexis O'Connell, Maral Darya

East Florida Division GME Research Day 2024

No abstract provided.

Risks And Benefits Of Continuing Metformin During Hospitalization, Joel Speir, Sean Shearan, Kevin Trappett, Elizabeth Uba, Kenneth Krell

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.