Internal Medicine Commons^™

Artificial Intelligence In Colonoscopy In A Community Setting, Kunaal Patel, Brett Vanleer-Greenberg

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of An African American Female Presenting With Idiopathic Granulomatous Lobular Mastitis, Wendy Timirau, Esra Sari, Maham Shahid, Nilmarie Guzman, Augusto Villegas

South Atlantic Division GME Research Day 2023

No abstract provided.

Under Pressure: A Case Of Acute Compartment Syndrome/Vitt After The Covid-19 Vaccine, Thashali Anthony, Brittany Lyons

South Atlantic Division GME Research Day 2023

No abstract provided.

Disseminated Miliary Tuberculosis And Intestinal Tuberculosis Mimicking Ibd, Danny Tran, Kunaal Patel, Areeba Asfaq, Brittany Lyons

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of Type 1 Cryoglobulinemia With Waldenstrom’S Macroglobulinemia/Lymphoplasmocytic Lymphoma And Dry Gangrene, Abhinav Rao, Diego Garrido, Fahim Syed, Kody Dhaliwal, Charles Holladay, Julia Saylors, Matthew Madden, Jason Clark

South Atlantic Division GME Research Day 2023

No abstract provided.

Effect Of High Sensitivity Troponin Assay On Hospital Resources And Emergency Department Discharges In Patients Presenting With Symptoms Concerning For Myocardial Infarction, Hans Koop, Keysha N. Gonzalez, Madalyn Nygren, Andrea Deneen, Jennifer Chapman

South Atlantic Division GME Research Day 2023

No abstract provided.

Case Report: Right Ventricular Free Wall Rupture Due To Displaced Aicd Lead, Abhinav Rao, Angeli Patel, Kunaal Patel, Craig Herrforth, Fahim Syed, Brittany Lyons, E Maci

South Atlantic Division GME Research Day 2023

No abstract provided.

Metformin Discontinuation In Acute Heart Failure, Curtis Wong, Erica Junqueira, Nayda Parisio-Poldiak, Nancy Crossley, Shantae Jenkins

South Atlantic Division GME Research Day 2023

No abstract provided.

Haemorrhoidal Artery Ligation Compared To Alternative Surgical Techniques For The Treatment Of Grade Ii-Iv Haemorrhoids: A Systematic Review, Dayna Van De Hoef, Aisling Hogan

Journal of Mind and Medical Sciences

Background. Haemorrhoidal disease is a common disorder in the Western World that commonly requires surgical treatment, but original open techniques were associated with significant complications and pain. Haemorrhoidal Arterial Ligation (HAL) has gained popularity for relatively low complication and postoperative pain rates. This review assesses clinical outcomes of this technique in comparison to alternative modern techniques. Methods. The literature was searched on MEDLINE, EMBASE, Google Scholar, and Cochrane Library databases. Search terms: dearterialization, artery ligation, mucopexy, recto-anal repair. Inclusion criteria: RCTs, original publications, grade II, III and/or grade IV haemorrhoids, elective procedures. Exclusion criteria: non-English, non-adults, published pre-2016. Results. 14 …

Impact Of Risk Factors On The Evolution Of Severe Acute Pancreatitis, Andra Maria Trotea, Raluca Grigorescu, Dragos Serban, Radu Palade, Simona Balasescu, Cristian Mihai Branescu, Daniel Radu, Corneliu Tudor, Tiberiu Alexandru Trotea

Journal of Mind and Medical Sciences

Introduction. Severe acute pancreatitis (SAP) is an acute inflammatory condition of the pancreas with increasing incidence and mortality rates in recent years. The aim of this study was to evaluate the impact of age, comorbidities, and different scoring systems on the complications and outcomes of SAP. Materials and Methods. A retrospective study was conducted on 161 patients diagnosed and treated for SAP at the Bucharest University Hospital in the intensive care unit (ICU), in the period 2014-2021. The impact of risk factors for the development of SAP, occurrence of complications (respiratory, cardiac, etc.), length of hospital stays and mortality was …

A Rare Case Of Autopsy Proven Achromobacter Xylosoxidans Endocarditis Involving Tricuspid Valve: A Case Report, Chaitra Janga, Mackenzie Kramer, Ifrah Naeem, Lucy Checchio, Md, Zahra Qamar

Abington Jefferson Health Papers

Infective endocarditis refers to infection of one or more valves of the heart, with Achromobacter xylosoxidans (A. xylosoxidans) being a rare cause. So far, 24 cases of A. xylosoxidans endocarditis were reported, with only one case describing tricuspid valvular involvement. Despite the rarity of A. xylosoxidans endocarditis, it is important for clinicians to be aware of atypical presentation and the high mortality associated with it. We present an autopsy-proven case of tricuspid valve endocarditis in the setting of A. xylosoxidans bacteremia in a 43-year-old female.

Rapid Escape Of New Sars-Cov-2 Omicron Variants From Ba2-Directed Antibody Responses, Aiste Dijokaite-Guraliuc, Raksha Das, Daming Zhou, Helen M Ginn, Chang Liu, Helen M E Duyvesteyn, Jiandong Huo, Rungtiwa Nutalai, Piyada Supasa, Muneeswaran Selvaraj, Thushan I De Silva, Megan Plowright, Thomas A H Newman, Hailey Hornsby, Alexander J Mentzer, Donal Skelly, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Eleanor Barnes, Susanna J Dunachie, Optic Consortium, Cornelius Roemer, Thomas P Peacock, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

In November 2021, Omicron BA.1, containing a raft of new spike mutations, emerged and quickly spread globally. Intense selection pressure to escape the antibody response produced by vaccines or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection then led to a rapid succession of Omicron sub-lineages with waves of BA.2 and then BA.4/5 infection. Recently, many variants have emerged such as BQ.1 and XBB, which carry up to 8 additional receptor-binding domain (RBD) amino acid substitutions compared with BA.2. We describe a panel of 25 potent monoclonal antibodies (mAbs) generated from vaccinees suffering BA.2 breakthrough infections. Epitope mapping shows potent …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey

Evidence-Based Practice Project Reports

Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …

Loss-Of-Function Variants In Mycbp2 Cause Neurobehavioural Phenotypes And Corpus Callosum Defects, Lama Alabdi, Muriel Desbois, Domniţa-Valeria Rusnac, Raashda A Sulaiman, Jill A Rosenfeld, Seema Lalani, David R Murdock, Lindsay C Burrage, Ping Yee Billie Au, Shelley Towner, William G Wilson, Lawrence Wong, Theresa Brunet, Gertrud Strobl-Wildemann, Jennifer E Burton, George Hoganson, Kirsty Mcwalter, Amber Begtrup, Yuri A Zarate, Elyse L Christensen, Karla J Opperman, Andrew C Giles, Rana Helaby, Artur Kania, Ning Zheng, Brock Grill, Fowzan S Alkuraya

Faculty, Staff and Student Publications

The corpus callosum is a bundle of axon fibres that connects the two hemispheres of the brain. Neurodevelopmental disorders that feature dysgenesis of the corpus callosum as a core phenotype offer a valuable window into pathology derived from abnormal axon development. Here, we describe a cohort of eight patients with a neurodevelopmental disorder characterized by a range of deficits including corpus callosum abnormalities, developmental delay, intellectual disability, epilepsy and autistic features. Each patient harboured a distinct de novo variant in MYCBP2, a gene encoding an atypical really interesting new gene (RING) ubiquitin ligase and signalling hub with evolutionarily conserved functions …

Redox And Nucleophilic Reactions Of Naphthoquinones With Small Thiols And Their Effects On Oxidization Of H2s To Inorganic And Organic Hydropolysulfides And Thiosulfate, Kenneth R Olson, Kasey J Clear, Yan Gao, Zhilin Ma, Nathaniel M Cieplik, Alyssa R Fiume, Dominic J Gaziano, Stephen M Kasko, Jennifer Luu, Ella Pfaff, Anthony Travlos, Cecilia Velander, Katherine J Wilson, Elizabeth D Edwards, Karl D Straub, Gang Wu

Faculty, Staff and Student Publications

Naphthoquinone (1,4-NQ) and its derivatives (NQs, juglone, plumbagin, 2-methoxy-1,4-NQ, and menadione) have a variety of therapeutic applications, many of which are attributed to redox cycling and the production of reactive oxygen species (ROS). We previously demonstrated that NQs also oxidize hydrogen sulfide (H2S) to reactive sulfur species (RSS), potentially conveying identical benefits. Here we use RSS-specific fluorophores, mass spectroscopy, EPR and UV-Vis spectrometry, and oxygen-sensitive optodes to examine the effects of thiols and thiol-NQ adducts on H2S-NQ reactions. In the presence of glutathione (GSH) and cysteine (Cys), 1,4-NQ oxidizes H2S to both inorganic and organic hydroper-/hydropolysulfides (R2Sn, R=H, Cys, GSH; …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

Extended Analysis Of Hiv Infection In Cisgender Men And Transgender Women Who Have Sex With Men Receiving Injectable Cabotegravir For Hiv Prevention: Hptn 083, Mark A Marzinke, Jessica M Fogel, Zhe Wang, Estelle Piwowar-Manning, Ryan Kofron, Amber Moser, Pradip Bhandari, Ryann Gollings, Lane R Bushman, Lei Weng, Elias K Halvas, John Mellors, Peter L Anderson, Deborah Persaud, Craig W Hendrix, Marybeth Mccauley, Alex R Rinehart, Marty St Clair, Susan L Ford, James F Rooney, Adeola Adeyeye, Suwat Chariyalertsak, Kenneth Mayer, Roberto C Arduino, Myron S Cohen, Beatriz Grinsztejn, Brett Hanscom, Raphael J Landovitz, Susan H Eshleman

Faculty, Staff and Student Publications

HPTN 083 demonstrated that injectable cabotegravir (CAB) was superior to oral tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) for HIV prevention in cisgender men and transgender women who have sex with men. We previously analyzed 58 infections in the blinded phase of HPTN 083 (16 in the CAB arm and 42 in the TDF-FTC arm). This report describes 52 additional infections that occurred up to 1 year after study unblinding (18 in the CAB arm and 34 in the TDF-FTC arm). Retrospective testing included HIV testing, viral load testing, quantification of study drug concentrations, and drug resistance testing. The new CAB arm infections …

Neurofibroma Of The Internal Carotid Artery Cavernous Sympathetic Plexus: Illustrative Case, Duncan J Trimble, Bryden H Dawes, Hussein A Zeineddine, Katie B Guttenberg, William C Yao, Meenakshi Bhattacharjee, Spiros L Blackburn

Faculty, Staff and Student Publications

BACKGROUND: Intracranial carotid sympathetic plexus (CSP) nerve sheath tumors have rarely been reported in the literature. This study describes the first reported case of a CSP neurofibroma and the first case of a CSP nerve sheath tumor treated via an endoscopic endonasal approach followed by adjuvant radiosurgery.

OBSERVATIONS: A 53-year-old man presented with 3 days of headaches and diplopia and was found to have a complete left abducens nerve palsy. Computed tomography (CT) revealed a smoothly dilated left carotid canal, CT angiography revealed a superiorly displaced left internal carotid artery (ICA), and magnetic resonance imaging revealed a T2-hyperintense and avidly …

Stranger Things: New Roles And Opportunities For Androgen Receptor In Oncology Beyond Prostate Cancer, Javier Leo, Eleonora Dondossola, Kaitlin J Basham, Nathaniel R Wilson, Omar Alhalabi, Jianjun Gao, Katherine C Kurnit, Michael G White, Jennifer L Mcquade, Shannon N Westin, Elizabeth A Wellberg, Daniel E Frigo

Faculty, Staff and Student Publications

The androgen receptor (AR) is one of the oldest therapeutic targets in oncology and continues to dominate the treatment landscape for advanced prostate cancer, where nearly all treatment regimens include some form of AR modulation. In this regard, AR remains the central driver of prostate cancer cell biology. Emerging preclinical and clinical data implicate key roles for AR in additional cancer types, thereby expanding the importance of this drug target beyond prostate cancer. In this mini-review, new roles for AR in other cancer types are discussed as well as their potential for treatment with AR-targeted agents. Our understanding of these …