Medicine and Health Sciences Commons^™

Bridging Bone Health: Osteoporosis Disparities In The Rio Grande Valley, Ryan P. Bialaszewski, John M. Gaddis, Blake Martin, Philippe J. Dentino, John Ronnau

School of Medicine Publications and Presentations

Introduction: Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine …

Cognitive Decline Associated With Longitudinal Changes In 24-H Ambulatory Blood Pressure Variability, Jesus D. Melgarejo, Kristina P. Vatcheva, Luis J. Mena, Carlos A. Chavez, Egle Silva, Gustavo E. Calmon, Rosa P. Mavarez, Joseph H. Lee, Joseph D. Terwilliger, Gladys E. Maestre

School of Medicine Publications and Presentations

Background: Cognitive decline has been associated with variability in blood pressure (BP). However, whether the increment of the BP variability during follow-up precedes cognitive decline remains undocumented. We aimed this study to investigate cognitive decline in relation to longitudinal changes in 24-h reading-to-reading BP variability.

Methods: We conducted an observational longitudinal study that included 717 dementia-free participants from the Maracaibo Aging Study who underwent follow-up assessment in both 24-h ambulatory BP monitoring and cognitive tests between 1998 and 2015. Cognitive domains consisted of selective reminding tests (total, long-term, short-term, and recognition memory) and the Mini-Mental State Examination (MMSE). …

Community Exercise Program Participation And Mental Well-Being In The U.S. Texas-Mexico Border Region, Alma G. Ochoa Del-Toro, Lisa A. Mitchell-Bennett, Michael Machiorlatti, Candace A. Robledo, Amanda C. Davé, Rebecca N. Lozoya, Belinda M. Reininger

School of Medicine Publications and Presentations

Hispanics are disproportionately affected by low rates of physical activity and high rates of chronic diseases. Hispanics generally and Mexican Americans specifically are underrepresented in research on physical activity and its impact on mental well-being. Some community-based interventions have been effective in increasing physical activity among Hispanics. This study examined data from a sample of low-income Hispanic participants in free community exercise classes to characterize the association between self-reported frequency of exercise class attendance, intensity of physical activity, and participant well-being. As part of two cross-sectional samples recruited from a stratified random sample of community exercise classes, 302 participants completed …

Tuberculosis Presentation And Outcomes In Older Hispanic Adults From Tamaulipas, Mexico, Belinda Medrano, Miryoung Lee, Gretchen L. Gemeinhardt, Javier E. Rodríguez-Herrera, Moncerrato García-Viveros, Blanca I. Restrepo

School of Medicine Publications and Presentations

Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006–2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18–39 years) and middle-aged adults (40–64 years). We found that the OA had features associated with a less complicated TB (e.g., lower …

Addressing Cervical Cancer Disparities In Texas: Expansion Of A Community-Based Prevention Initiative For Medically Underserved Populations, Samantha H. Batman, Melissa L. Varon, Maria Daheri, Tony Ogburn, Saul D. Rivas, Laura Guerra, Paul Toscano, Monica Gasca, Lori Campos, Savanah Foster

School of Medicine Publications and Presentations

Although cervical cancer is preventable, significant disparities exist in access to screening and prevention services. In medically underserved areas (MUAs) of Texas, these rates are 55% higher compared to the remainder of the US. In 2019, we expanded a multicomponent, comprehensive program to improve cervical cancer prevention in partnership with 13 clinics and mobile vans in MUAs of Texas. Our multicomponent intervention program consists of community education and patient navigation coupled with a training/mentoring program for local medical providers to perform diagnostic procedures and treatment for patients with abnormal screening results. Hands-on training courses to learn these skills are coupled …

Symptoms Of Depression And Anxiety And Subsequent Use Of Nicotine And Thc In Electronic Cigarettes, Stephanie Clendennen, Jacob Smith, Aslesha Sumbe, Baojiang Chen, Anna Wilkinson

School of Medicine Publications and Presentations

Background: This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes.

Methods: Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, …

Adiposity And Sex Influence On Sars-Cov-2 Antibody Response In University Students. An Esfuerso Cross-Sectional Study, Adriana L. Perales-Torres, Lucia M. Perez-Navarro, Esperanza M. Garcia-Oropeza, Alvaro Diaz-Badillo, Yoscelina Estrella Martinez-Lopez, Marisol Rosas-Diaz, Octelina Castillo-Ruiz, Laura Yanneth Ramirez-Quintanilla, Leonel Vela, Beatriz Tapia, Juan Carlos Lopez-Alvarenga

School of Medicine Publications and Presentations

Introduction: Prior studies have identified various determinants of differential immune responses to COVID-19. This investigation delves into the Ig-G anti-RBD marker, scrutinizing its potential correlations with sex, vaccine type, body fat percentage, metabolic risk, perceived stress, and previous COVID-19 exposure.

Methods: In this study, data were obtained from 116 participants from the ESFUERSO cohort, who completed questionnaires detailing their COVID-19 experiences and stress levels assessed through the SISCO scale. Quantification of Ig-G anti-RBD concentrations was executed using an ELISA assay developed by UNAM. Multiple regression analysis was adeptly employed to control for covariates, including sex, age, body fat percentage, BMI, …

Factors Associated With Meeting Physical Activity Guidelines During The Covid-19 Pandemic, Natalia I. Heredia, Michael Machiorlatti, Belinda M. Reininger, Candace Robledo

School of Medicine Publications and Presentations

Introduction: The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.

Methods: Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin …

Covid-19 And Vaccination: Myths Vs Science, Vivek P. Chavda, Yangmin Chen, Jayant Dave, Zhe-Sheng Chen, Subhash C. Chauhan, Murali M. Yallapu, Vladimir N. Uversky, Rajashri Bezbaruah, Sandip Patel, Vasso Apostolopoulos

School of Medicine Publications and Presentations

Introduction: Several vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed since the inception of the coronavirus disease 2019 (COVID-19) in December 2019, at unprecedented speed. However, these rapidly developed vaccines raised many questions related to the efficacy and safety of vaccines in different communities across the globe. Various hypotheses regarding COVID-19 and its vaccines were generated, and many of them have also been answered with scientific evidence. Still, there are many myths/misinformation related to COVID-19 and its vaccines, which create hesitancy for COVID-19 vaccination, and must be addressed critically to achieve success in the battle against …

Covid-19 Vaccination Drive In A Low-Volume Primary Care Clinic: Challenges & Lessons Learned In Using Homegrown Self-Scheduling Web-Based Mobile Platforms, Reita N. Agarwal, Rajesh Aggarwal, Pridhviraj Nandarapu, Hersheth Aggarwal, Ashmit Verma, Absarul Haque, Manish Tripathi

School of Medicine Publications and Presentations

Background: The whole of humanity has suffered dire consequences related to the novel coronavirus disease 2019 (COVID-19). Vaccination of the world base population is considered the most promising and challenging approach to achieving herd immunity. As healthcare organizations took on the extensive task of vaccinating the entire U.S. population, digital health companies expanded their automated health platforms in order to help ease the administrative burdens of mass inoculation. Although some software companies offer free applications to large organizations, there are prohibitive costs for small clinics such as the Good Health Associates Clinic (GHAC) for integrating and implementing new self-scheduling software …

Evidence Of Areca Nut Consumption In The United States Mainland: A Cross‑Sectional Study, Irene Tami‑Maury, Suzanne Nethan, Jessy Feng, Hongyu Miao, George Delclos, Ravi Mehrotra

School of Medicine Publications and Presentations

Background

Areca nut (AN) is an addictive substance consumed in the Southeast region and is highly associated with oral premalignant lesions and oral cancer. The impact of AN use in the United States (US) is largely unknown, but the products are readily available and probably used by a significant fraction of Asian immigrants or descendants living in the US. We aimed at assessing AN use prevalence among the Asian community in Houston, Texas.

Methods

A cross-sectional questionnaire was used to interview adult individuals (≥ 18 years of age) who self-identified as Asian immigrants or descendants residing in Houston. Means, frequencies, …

Clinicians' Perceptions Of The Health Status Of Formerly Detained Immigrants, Kathryn Hampton, Ranit Mishori, Marsha Griffin, Claire Hillier, Elizabeth Pirrotta, Nancy E. Wang

School of Medicine Publications and Presentations

Background: In the past decade, the U.S. immigration detention system regularly detained more than 30,000 people per day; in 2019 prior to the pandemic, the daily detention population exceeded 52,000 people. Inhumane detention conditions have been documented by internal government watchdogs, and news media and human rights groups who have observed over-crowding, poor hygiene and sanitation and poor and delayed medical care, as well as verbal, physical and sexual abuse.

Methods: This study surveyed health professionals across the United States who had provided care for immigrants who were recently released from immigration detention to assess clinician perceptions about the adverse …

Breakthrough Medicines During The Covid-19 Pandemic Era, Eswara Naga Hanuma Kumar Ghali, Vijian Dhevan, Shravan K. Narmala, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

School of Medicine Publications and Presentations

No abstract provided.

Photography: A Culturally Sensitive Bereavement Aid?, Rebecca M. Reséndiz Rodriguez

School of Medicine Publications and Presentations

No abstract provided.

The Ctsa University Of Texas Health Science Center (Uthsc) Northeast—Tyler And Rio Grande Valley Success Story: How Rural, Underserved Academic Communities Rapidly Built A Robust Engine For Collaborative Covid-19 Clinical Research, Steven Idell, David D. Mcpherson, Jessica Martin, Andrew N. Dentino, Luis Ostrosky- Zeichner, Julia V. Philley, Paul Mcgaha, Megan Devine, Jacqueline Bronicki, Daniel D. Karp

School of Medicine Publications and Presentations

In 2018, The University of Texas Health Science Center– Tyler and University of Texas Rio Grande Valley were invited to develop clinical research units for an existing Clinical and Translational Science Award (CTSA) consortium with the objective to equip medically underserved, economically disadvantaged communities and subsequently to deploy COVID-19 clinical trials in response to a public health emergency.

In Silico Cd4 + T-Cell Multiepitope Prediction And Hla Distribution Analysis For Marburg Virus—A Strategy For Vaccine Designing, Anupam Dhasmana, Swati Dhasmana, Ahmad Alsulimani, Sudhir Kotnala, Vivek Kumar Kashyap, Shafiul Haque, Meena Jaggi, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications and Presentations

Marburg, a RNA virus (MRV), is responsible for causing hemorrhagic fever that affects humans and non-human primates. World Health Organization (WHO), National Institutes of Health (NIH) and Centre of Disease Control and Prevention (CDC) considered this as an extremely dangerous virus, thus categorised as risk group 4, category A priority pathogen and category “A” bioterrorism agent, respectively. Despite of all these alarming concerns, no prophylaxis arrangements are available against this virus till date. In fact, the construction of immunogenic vaccine candidates by traditional molecular immunology methods is time consuming and very expensive. Considering these concerns, herein, we have designed CD4 …

Covid-19 And Chronic Diabetes: The Perfect Storm For Reactivation Tuberculosis?: A Case Series, Genesis P. Aguillón-Durán, Ericka Prieto-Martinez Dr, Doris Ayala, Juan García Jr., John M. Thomas Iii, Juan Ignacio García, Brandon Michael Henry, Jordi B. Torrelles, Joanne Turner, Eder Ledezma-Campos, Blanca I. Restrepo

School of Medicine Publications and Presentations

Background

The coronavirus disease 2019 pandemic is predicted to have a net negative effect on tuberculosis control, with an estimated excess of 6.3 million tuberculosis cases and 1.4 million deaths by 2025. Programmatic issues such as the lockdown of tuberculosis services affect all patients, while biosocial factors have a differential impact on an individual’s risk for tuberculosis or adverse tuberculosis outcomes.

Case presentation

We report three Hispanic cases of incident tuberculosis (two males, 43 and 44 years old; one female, 49 years old) after resolution of coronavirus disease episodes. Coincidentally, all cases shared a common risk factor: a chronic history …

Circulating Fatty Acids Associated With Advanced Liver Fibrosis And Hepatocellular Carcinoma In South Texas Hispanics, Jingjing Jiao, Suet-Ying Kwan, Caroline M. Sabotta, Honami Tanaka, Lucas Veillon, Marc O. Warmoes, Philip L. Lorenzi, Ying Wang, Peng Wei, Jose Luis Almeda, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Medicine Publications and Presentations

Background: Hispanics in South Texas have high rates of hepatocellular carcinoma (HCC) and nonalcoholic fatty liver disease (NAFLD). Liver fibrosis severity is the strongest predictive factor of NAFLD progression to HCC. We examined the association between free fatty acids (FA) and advanced liver fibrosis or HCC in this population.

Methods: We quantified 45 FAs in plasma of 116 subjects of the Cameron County Hispanic Cohort, 15 Hispanics with HCC, and 56 first/second-degree relatives of Hispanics with HCC. Liver fibrosis was assessed by FibroScan.

Results: Advanced liver fibrosis was significantly associated with low expression of very long chain (VLC) saturated FAs …

Implications Of Helminth Immunomodulation On Covid-19 Co-Infections, Nathalie Chacon, Leonor Chacin-Bonilla, Italo M. Cesar

School of Medicine Publications and Presentations

Coronavirus disease 2019 (COVID-19) and helminths infections can be in a synergistic epidemic in developing and suburban areas of industrialized countries. The coinfected hosts will derive a parasite-specific Th2 innate and adaptive immune response with CD4+ T cells, eosinophils, interleukin-4, interleukin-5, and interleukin-10. In the early stages of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, virus-specific Th1 cytotoxic CD8+ T cell, interleukin-6, interferon-γ, and interleukin-27 by lung are keys in controlling viral replication in the lung epithelial cells and limiting the pathology to other organs, like the intestine. CD4+ and CD8+ T cells are associated with protective immunity …

Emerging Issues In Covid-19 Vaccination In Tropical Areas: Impact Of The Immune Response Against Helminths In Endemic Areas, Leonor Chacin-Bonilla, Nathalie Chacón-Fonseca, Alfonso J. Rodriguez-Morales

School of Medicine Publications and Presentations

The Coronavirus Disease 2019 (COVID-19) pandemic has affected over 165 million people and caused the death of 3.4 million worldwide (up to May 20, 2021) (https://coronavirus.jhu.edu/map.html), becoming a serious problem of global public health and the worst epidemic in the last century, after the pandemic 1918 influenza. Researchers worldwide are trying to find valuable drugs against the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Some of them focused as antivirals, others targeted in other ways (e.g. immunomodulation) to relieve the symptoms of the infected patients and help lower the death toll throughout the world. Unfortunately, there is a lack of …

Research On Aging During The Venezuelan Humanitarian Crisis: The Experience Of The Maracaibo Aging Study, Gladys E. Maestre, Rosa V. Pirela, Carmen Paz, Jesus D. Melgarejo, Luis J. Mena, Carlos A. Chavez, Reinier Leendertz, Michele Petitto, Egle Silva, Gustavo E. Calmon

School of Medicine Publications and Presentations

Background

Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maracaibo Aging Study (MAS) during the deteriorating conditions in Venezuela. When the MAS began in 1997, it focused on memory-related disorders. Since then, strategic planning and proactive community participation allowed us to anticipate and address logistical, funding, and ethical challenges, and facilitated the enrollment and retention of more than 2500 subjects over 55 years of age. All participants, who are residents of the city …

Sars-Cov-2: Potencial Transmisión Feco-Oral E Implicaciones En La Propagación Y Gravedad Del Covid-19 En Venezuela. Mini-Revisión. [Sars-Cov-2: Potential Feco-Oral Transmission And Implications On The Spread And Severity Of Covid-19 In Venezuela. Mini-Review.], Leonor Chacin-Bonilla, Nathalie Chacon

School of Medicine Publications and Presentations

The recognized human-to-human transmission of SARS-CoV-2 is through respiratory droplets and contact with contaminated surfaces. However, the high transmissibility of the virus and the pattern of symptoms of COVID-19 suggest the likelihood of other forms of spread. Increasing evidence suggests that SARS‐CoV‐2 could be transmitted by the feco‐oral route. SARS-CoV-2 is known to infect gastrointestinal epithelial cells and a significant number of infected people have gastrointestinal symptoms. Viable viruses, viral RNA, and prolonged shedding of viral RNA have been detected in the feces of COVID-19 patients. The virus has been found in sewage and surface waters of several countries. The …

Addressing Neurocognitive Disorders, Dementias, And Alzheimer’S Disease In Colonias Of The Lower Rio Grande Valley: Establishing A Research Foundation Using Promotores, Noe Garza, Marucela Uscamayta-Ayvar, Gladys E. Maestre

School of Medicine Publications and Presentations

Several Texas communities along the Mexican border, including the Lower Rio Grande Valley (LRGV), are home to low-income Hispanic populations, many of whom live in underserved communities known as colonias. These areas have high incidences of neurocognitive disorders, dementia, and Alzheimer’s disease (AD); health care strategies that are culturally and linguistically appropriate for the area are needed. We aim to build capacity to reduce risk, facilitate treatment, and provide caregiver support for affected individuals. However, gaining trust of communities and presenting information about research studies in a way that is culturally appropriate is critical for engagement of underserved communities.

This …

Part I. Sars-Cov-2 Triggered 'Panic' Attack In Severe Covid-19, Elliot M. Frohman, Nicole R. Villemarette-Pittman, Esther Melamed, Roberto A. Cruz, Reid Longmuir, Thomas C. Varkey, Lawrence Steinman, Scott S. Zamvil, Teresa C. Frohman

School of Medicine Publications and Presentations

The coronavirus disease 2019 (COVID-19) pandemic has produced a world-wide collapse of social and economic infrastructure, as well as constrained our freedom of movement. This respiratory tract infection is nefarious in how it targets the most distal and highly vulnerable aspect of the human bronchopulmonary tree, specifically, the delicate yet irreplaceable alveoli that are responsible for the loading of oxygen upon red cell hemoglobin for use by all of the body's tissues.

In most symptomatic individuals, the disease is a mild immune-mediated syndrome, with limited damage to the lung tissues. About 20% of those affected experience a disease course characterized …

Part Ii. High-Dose Methotrexate With Leucovorin Rescue For Severe Covid-19: An Immune Stabilization Strategy For Sars-Cov-2 Induced 'Panic' Attack, Elliot M. Frohman, Nicole R. Villemarette-Pittman, Roberto A. Cruz, Reid Longmuir, Vernon Rowe, Elizabeth S. Rowe, Thomas C. Varkey, Lawrence Steinman, Scott S. Zamvil, Teresa C. Frohman

School of Medicine Publications and Presentations

Here, in Part II of a duology on the characterization and potential treatment for COVID-19, we characterize the application of an innovative treatment regimen for the prevention of the transition from mild to severe COVID-19, as well as detail an intensive immunotherapy intervention hypothesis. We propose as a putative randomized controlled trial that high-dose methotrexate with leucovorin (HDMTX-LR) rescue can abolish 'PANIC', thereby 'left-shifting' severe COVID-19 patients to the group majority of those infected with SARS-CoV-2, who are designated as having mild, even asymptomatic, disease. HDMTX-LR is endowed with broadly pleiotropic properties and is a repurposed, generic, inexpensive, and widely …

Does Maternal Asthma Contribute To Racial/Ethnic Disparities In Obstetric And Neonatal Complications?, Katrina F. Flores, Candace Robledo, Beom Seuk Hwang, Kira Leishear, Katherine Grantz, Pauline Mendola

School of Medicine Publications and Presentations

Purpose

Examine whether maternal asthma contributes to racial/ethnic differences in obstetric and neonatal complications.

Methods

Data on White (n=110,603), Black (n=50,284) and Hispanic (n=38,831) singleton deliveries came from the Consortium on Safe Labor. Multi-level logistic regression models, with an interaction term for asthma and race/ethnicity, estimated within-group adjusted odds ratios (aOR) for gestational diabetes, gestational hypertension, preeclampsia, placental abruption, premature rupture of membranes, preterm delivery, maternal hemorrhage, NICU admissions, small for gestational age (SGA), apnea, respiratory distress syndrome, transient tachypnea of the newborn, anemia and hyperbilirubinemia after adjustment for clinical and demographic confounders. Non-asthmatics of the same racial/ethnic group were …

Preconception And Early Pregnancy Air Pollution Exposures And Risk Of Gestational Diabetes Mellitus, Candace Robledo, Pauline Mendola, Edwina H. Yeung, Tuija Männistö, Rajeshwari Sundaram, Danping Liu, Qi Ying, Seth Sherman, Katherine Grantz

School of Medicine Publications and Presentations

Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk.

Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5μm (PM2.5) and PM2.5 constituents, PM ≤ 10μm (PM10), nitrogen oxides (NOx), carbon monoxide, sulfur dioxide (SO2) and ozone (O3) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1-24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. …

Geospatial Relationships Of Air Pollution And Acute Asthma Events Across The Detroit–Windsor International Border: Study Design And Preliminary Results, Lawrence D. Lemke, Lois E. Lamerato, Xiaohong Xu, Jason C. Booza, John J. Reiners Jr., Delbert M. Raymond Iii, Paul J. Villeneuve, Eric Lavigne, Dana Larkin, Helene J. Krouse

School of Medicine Publications and Presentations

The Geospatial Determinants of Health Outcomes Consortium (GeoDHOC) study investigated ambient air quality across the international border between Detroit, Michigan, USA and Windsor, Ontario, Canada and its association with acute asthma events in 5- to 89-year-old residents of these cities. NO2, SO2, and volatile organic compounds (VOCs) were measured at 100 sites, and particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) at 50 sites during two 2-week sampling periods in 2008 and 2009. Acute asthma event rates across neighborhoods in each city were calculated using emergency room visits and hospitalizations and standardized to the overall age and gender distribution of …