Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass,
2026
Providence
Hepatic Schistosomiasis: An Unexpected Culprit Behind The Hepatic Mass, Jin Yun Do, Udip Dahal Md, Kenneth Flora, Md
Books, Presentations, Posters, Etc.
Introduction: Schistosomiasis is the second most common parasitic infection worldwide and is associated with significant morbidity and mortality. We present an unusual case of hepatic schistosomiasis presenting as a hepatic mass. Case Description: A 78-year-old male with no prior hepatobiliary disease with an incidental finding of a hepatic lesion on postoperative abdominal CT imaging after an endovascular aneurysm repair. He lived in China until immigrating to the United States over 50 years ago. Previously hospitalized for abdominal pain and diarrhea, at which time he was told he had an infection in his liver. Details of treatment are unknown. He has …
When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism,
2026
Providence
When Common Isn’T Typical: A Diagnostic Twist In Hyperparathyroidism, Connor Shortt, Do*, Laura Loertscher, Md*
Books, Presentations, Posters, Etc.
Introduction: Primary hyperparathyroidism is the third most common endocrine disorder, following diabetes and thyroid disease. It is characterized by excess calcium and inappropriately elevated parathyroid (PTH) levels. Severe disease classically presents with a combination of nephrolithiasis, bone pain, osteoporosis, constipation, abdominal pain, anxiety, depression, or confusion. However, due to the availability of routine labs, most cases now present as asymptomatic hypercalcemia. Case Description: A 60-year-old female was evaluated for falls, generalized weakness, constipation, and brain fog. Her admission labs revealed a calcium of 19.6 mg/dL and subsequent PTH of 1,932 pg/mL. She was treated with intravenous fluids, pamidronate, and cinacalcet, …
Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge,
2026
Providence
Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor
Books, Presentations, Posters, Etc.
Introduction: Eosinophilic fasciitis (EF), or Shulman’s disease, is a rare disorder of unknown etiology and poorly understood pathogenesis. It is characterized by fibroblast activation and interleukin-driven eosinophilia. Early clinical features include limb or trunk erythema, non-pitting edema, and progressive fascial thickening, often producing an “orange peel” appearance. Eosinophilia is a prominent laboratory finding in the early phase, but diagnosis often requires a full-thickness skin-to-muscle biopsy. Systemic corticosteroids are first-line therapy, with methotrexate as the steroid -sparing agent for refractory disease. We present a unique and diagnostically challenging case of EF confirmed by histopathology. Case Presentation: A 56-year-old man presented with …
Closing The Gap: Standardizing Sepsis Management To Address Racial Disparities Across Oregon Providence Hospitals,
2026
Providence
Closing The Gap: Standardizing Sepsis Management To Address Racial Disparities Across Oregon Providence Hospitals, Jennifer Wong, Do, Shelley Schoepflin Sanders, Md, Facp
Books, Presentations, Posters, Etc.
Introduction: Sepsis is a time-sensitive, life-threatening medical emergency affecting approximately 1.7 million adults annually in the United States, contributing to nearly 270,000 deaths and over $24 billion in healthcare expenditures. Delays in recognition and initiation of treatment can significantly increase mortality. Previous studies have identified persistent racial disparities in sepsis care, including lower rates of recognition as the principal diagnosis and delayed antibiotic initiation for Black patients compared with White patients. In alignment with Providence’s mission to provide compassionate, equitable care, Oregon Providence hospitals implemented a standardized “Sepsis Order Set” in all Emergency Departments (ED) to reduce treatment delays and …
Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A,
2026
Providence
Idiopathic Systemic Capillary Leak Syndrome With Shock And Compartment Syndrome Due To Influenza A, Jobe Ashby, Md, Katelyn Bobrowski, Do, Ryan Best, Md
Books, Presentations, Posters, Etc.
INTRODUCTION: Idiopathic systemic capillary leak syndrome (ISCLS) is a rare, poorly understood condition that leads to extreme pathology with severe but predictable complications. First described in 1960, ISCLS has been identified in about 260 case reports and is marked by a triad of hypotension, hypoalbuminemia, and hemoconcentration often preceded by upper respiratory tract infection. It is divided into distinct phases of prodrome, extravasation, and recovery. We present a case of a middle-aged woman who presented with influenza A infection and developed ISCLS needing ICU level care for shock and bilateral upper extremity compartment syndrome. DESCRIPTION: Our patient is a 49-year-old …
Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity,
2026
Providence
Sepsis Transitional Care Management: A Phone Call To Reduce Readmission Health Inequity, Linh Tang Taylor, Md, Erica Leser, Ms, Alyssa Nelson, Michelle Schoepflin Sanders, Md
Books, Presentations, Posters, Etc.
Introduction: Sepsis accounts for 52% of hospital admissions in the United States and is the leading cause of death among hospitalized patients1 . However, disparity exists among sepsis survivors with race being reported as a determinant of recovery2 . Such disparity exists in Providence Oregon 8 hospitals: Providence Black patients have higher sepsis readmission rates than White (12.93% vs 11.65%). Using modified community-based participatory research, data analysis, and stakeholder interviews, we identified one potential root cause of the disparity: Black patients being readmitted are not receiving our system's Transitional Care Management (TCM) services. We aim to eliminate the Black/White sepsis …
Pulmonary Prelude: Ild As The Only Manifestation Of Rheumatoid Arthritis,
2026
Providence
Pulmonary Prelude: Ild As The Only Manifestation Of Rheumatoid Arthritis, Matthew Moritz, Md, Benjamin Hackett
Books, Presentations, Posters, Etc.
Abstract: Rheumatoid arthritis (RA), a systemic autoimmune disorder, classically presents with joint pain and prolonged morning stiffness. Extra-articular pulmonary manifestations are frequently observed but can be the primary initial presentation. We present a case of a women with chronic RA in remission who presented with shortness of breath and was found to have new RA-associated interstitial lung disease (RA-ILD). A 74-year-old female with a history of rheumatoid arthritis in remission, chronic obstructive pulmonary disease, and recent admission for septic shock presented with progressive dyspnea and hypoxia. Initial vitals noted an oxygen saturation in the low 80s. CT pulmonary angiography excluded …
Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient,
2026
Providence
Ofatumumab Associated Legionella Pneumonia In A Young Multiple Sclerosis Patient, Jobe Ashby, Omar Panhair
Books, Presentations, Posters, Etc.
Ofatumumab is the only anti-CD20 IgG1κ human monoclonal antibody therapy for relapsing forms of multiple sclerosis (MS) that patients can self-administer subcutaneously. Anti-CD20 agents are biologic therapies that carry an increased risk of serious infections, but rarely Legionellosis. We present the case of a young man taking ofatumumab for his MS who developed Legionella pneumoniae pneumonia. A 30-year-old man with MS diagnosed two years prior, stable on ofatumumab, presented with fevers, cough, and hemoptysis. A week earlier, he developed fevers and myalgias after administering ofatumumab, but these symptoms persisted longer than usual. Though initial vital signs were normal, he appeared …
The Power Of Two Questions: A Simplified Approach To Delirium Detection,
2026
Providence
The Power Of Two Questions: A Simplified Approach To Delirium Detection, Dalton Vanderpol, Md, Laura Perry, Shelley Schoepflin Sanders
Books, Presentations, Posters, Etc.
Background: Delirium affects one-third of general medical patients aged 70 or older. Patients with older age, preexisting dementia, or cognitive impairment are at increased risk of developing delirium. Delirium is associated with increased length of stay, mortality, transfer to skilled nursing facilities, and costs. Although the Confusion Assessment Method (CAM) is a validated tool for delirium, its sensitivity can be low when administered by nurses because of its subjective nature and the need for formal training. The Ultra Brief Confusion Assessment Method (UB-CAM) is an objective, two-question test administered in 30-35 seconds compared to 5-10 minutes for CAM. The objective …
Extracorporeal Membrane Oxygenation (Ecmo) In Acute Chest Syndrome,
2026
Providence
Extracorporeal Membrane Oxygenation (Ecmo) In Acute Chest Syndrome, Natalie Bolton, Md, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Acute chest syndrome (ACS) is a severe complication of sickle cell disease. Rarely, it may progress to acute respiratory distress syndrome (ARDS). Inability to oxygenate despite mechanical ventilation necessitates consideration of extracorporeal membrane oxygenation (ECMO). Case Summary: A 31-year-old man with sickle cell disease presented with low back pain similar to prior pain crises. Vital signs were normal, and his hemoglobin level was 10.2 g/dL, with a reticulocyte index of 0.05. He was admitted for pain control and rehydration. That night, he developed fever, tachypnea, and hypoxemia with imaging showing a right lower lobe infiltrate, consistent with ACS. He …
Spur Cell Anemia: A Crucial Unanticipated Anemia In Critical Care,
2026
Providence
Spur Cell Anemia: A Crucial Unanticipated Anemia In Critical Care, Jobe Ashby
Books, Presentations, Posters, Etc.
INTRODUCTION: Spur Cell Anemia (SCA) is a rare underrecognized non-autoimmune hemolytic anemia occurring in severe liver disease with prognostic implications. Since the 1980s there have been only a few dozen case reports and clinical images concerning SCA. We present a case of a young man managed in the ICU with multiorgan failure and a masked diagnosis of SCA. DESCRIPTION: A 33-year-old man was found down and presented to the ICU with hematemesis and hemorrhagic shock. He required massive transfusion for bleeding esophageal varices that were later banded and an expanding thigh hematoma. He was diagnosed with alcohol induced liver cirrhosis …
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates,
2026
Providence
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley
Books, Presentations, Posters, Etc.
Abstract: In June 2024, Providence St Joseph Health updated the standard gentamicin dose in the Pediatric and Neonatal Aminoglycoside protocol from 4 mg/kg to 5 mg/kg every 24 hours for late preterm and term neonates. This project aims to evaluate late preterm and term neonatal patients who received gentamicin for empiric sepsis coverage within the first seven days of life, at 4 mg/kg/dose or 5 mg/kg/dose, to assess the safety of the standardized 5 mg/kg dosing for late preterm and term neonates after the protocol change. This study is a multicenter retrospective pre-/post-intervention analysis at a multistate health system spanning …
Looking Past The Portal: A Hidden Origin Of Ascites,
2026
Providence
Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md
Books, Presentations, Posters, Etc.
Introduction: The most common cause of ascites is portal hypertension secondary to cirrhosis and accounts for nearly 75% of cases. In contrast, pancreatic ascites is a rare presentation of ascites and occurs in less than 1% of patients. Because of its low prevalence, pancreatic ascites is often excluded from the initial differential diagnosis and rarely assessed in ascitic fluid analysis. This is a case in which pancreatic ascites was considered and ultimately confirmed based on the overall clinical picture, challenging the initial assumption of portal hypertension and cirrhosis. Case Presentation: A 47-year-old man with ongoing alcohol use disorder presented to …
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program,
2026
Providence
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program, Vanoosheh Ferdousian, M.A., Teresa Davigo, Luke Dowling
Books, Presentations, Posters, Etc.
Interrater reliability (IRR) is an important component of evaluation processes that involve subjective judgments, as it reflects the degree of consistency among multiple raters. In training and hiring contexts, establishing adequate IRR helps ensure that applicant evaluations are fair, systematic, and minimally influenced by individual bias. The present program evaluation examines the interrater reliability of the intern selection process at the Providence Medical Group Psychology Training Program. Specifically, this project evaluates the consistency of raters’ scores assigned to internship applicants using the program’s standardized application rating forms. Numerical ratings from multiple reviewers were collected for each applicant and analyzed using …
Beyond The Negative Serologies: A Case Of Fulminant Vasculitis, Multiorgan Dysfunction, And An Uncharacteristic Infection,
2026
Providence
Beyond The Negative Serologies: A Case Of Fulminant Vasculitis, Multiorgan Dysfunction, And An Uncharacteristic Infection, Guo Hui (Greyson) Gan, Do
Books, Presentations, Posters, Etc.
Case Presentation: 70-year-old male presented with one week of fever and a painful right lower extremity purpuric rash that rapidly evolved into fullthickness desquamation and necrosis. Concurrent multiorgan dysfunction: respiratory failure, renal failure with nephritic proteinuria, and severe thrombocytopenia refractory to high dose steroids. Extensive serologic workup for viral, autoimmune, vascular, and hematologic etiologies were pan-negative, including serum cryoglobulins twice repeated (QR code for table of workup). A PET scan for a broad evaluation found a hypermetabolic right inguinal lymph node. Discussion: Unique features of this case: His hematologic workup was convincingly negative in setting of having type 1 CryoGN. …
Enhancing Gestational Diabetes Screening,
2026
Providence
Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Gestational diabetes mellitus (GDM) screening is recommended between 24–28 weeks of gestation to allow timely diagnosis and treatment and reduce adverse maternal and neonatal outcomes. The two-step glucose tolerance testing method is supported by ACOG, though completion can be delayed due to the need for multiple tests. In 2024 at Providence Milwaukie Family Medicine Clinic, incomplete GDM screening occurred in 23.1% of patients, and incomplete two-step screening occurred in 33.3%, with an average completion time of 12 days. Objective: To increase completion rates of two-step GDM screening and reduce time between abnormal 1-hour and diagnostic 3-hour glucose tolerance tests …
Acquired Amegakaryocytic Thrombocytopenia And Pure Red Cell Aplasia As Initial Presentation Of Thymoma,
2026
Providence
Acquired Amegakaryocytic Thrombocytopenia And Pure Red Cell Aplasia As Initial Presentation Of Thymoma, Nidhi Patel, Md, Natasha Edwin, Md
Books, Presentations, Posters, Etc.
Introduction: Pure Red Cell Aplasia (PRCA) is a common feature of thymomas, but it rarely presents with acquired amegakaryocytic thrombocytopenia (AAMT). Here, we present a case of a 59-year-old male with fatigue found to have severe anemia and thrombocytopenia, who was eventually diagnosed with a thymoma Case Presentation: Found to have Hg of 6.1 g/dL and platelet count of 33 k/uL; Reticulocyte count was 0.0068. CT chest showed an anterior mediastinal mass measuring 4.5 x 6.6 cm. Mass biopsy showed thymoma. Bone marrow biopsy showed 50% cellularity with absence of erythroid and megakaryocyte precursors compatible with AAMT and PRCA. At …
Addition Of Gitr Agonist To A Dark Matter Cancer Vaccine And Anti-Pd-1 Increases Regulatory T Cell Numbers Without Appearing To Impact Therapeutic Efficacy, Rom S. Leidner1, Guo Hui Gan1, Christopher C. Paustian, Shawn M. Jensen
Books, Presentations, Posters, Etc.
Background: DPV-001 is an off-the-shelf cancer vaccine containing tumor associated proteins commonly overexpressed in adenocarcinoma and squamous cell carcinoma. It is enriched for short-lived proteins (SLiPs) and defective ribosomal products (DRiPs), including both canonical and non-canonical (or “dark matter”) antigens —comprising over 100 identified non-canonical microproteins. These antigens are delivered in spectrin-coated microvesicles that contain 5 TLR/ NOD agonists and 15DAMPs/molecular chaperones, and target CLEC9A+ conventional dendritic cells (cDCs). Preclinical models showed enhanced antitumor responses when the murine analog of DPV-001 (DRibbles) was combined with co -stimulatory agonists. Additional studies showed enhanced antitumor responses when co-stimulatory agonists were combined with …
Acute Pancreatitis Outcomes In Native Americans In Northern Arizona,
2026
Providence
Acute Pancreatitis Outcomes In Native Americans In Northern Arizona, Jin Yun Do1, Afsheen Moshtaghi Do2, Hamza Khan, Md2, Hady Shahbaz Bs2, Yoshinobu Koguchi, Tarsem L. Moudgil, Noah D. Simons, Venkatesh Rajamanickam
Books, Presentations, Posters, Etc.
Background and Aims: Prior studies have shown the impact of racial and ethnic disparities in outcomes of acute pancreatitis (AP). Data remains sparse for Native American populations, who may be uniquely affected by socioeconomic and geographic factors. This retrospective study aimed to evaluate the disproportionate outcomes of AP in Native Americans compared to the general population in Northern Arizona. Methods: A retrospective cohort study of hospitalized patients with AP at two community hospitals in Northern Arizona. A total of 1,113 patients between Jan and Aug 2024 were included, comprising 413 Native American patients and 700 patients of other racial backgrounds. …
Ceftriaxone-Induced Thrombocytopenia: An Atypical Presentation Of A Commonly Used Antibiotic,
2026
Providence
Ceftriaxone-Induced Thrombocytopenia: An Atypical Presentation Of A Commonly Used Antibiotic, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
INTRODUCTION: Drug-induced thrombocytopenia (DITP) is rare and impacts roughly ten persons per million people annually (1). Over one-hundred medications have been identified as possible offenders, with immune response occurring within one to two weeks of drug exposure (2). Here we present a case of ceftriaxone as cause of DITP, an extremely rare complication of a commonly used antibiotic. CASE PRESENTATION: A fifty-year-old male with diabetes and depression initially presented after attempted suicide by hanging. He was intubated in the field and admitted directly to the intensive care unit (ICU). He remained in the ICU due to persistent encephalopathy which was …
