Digital Commons Network^™

Bridging Knowledge And Practice: Exploring The Medical City Arlington Internal Medicine Handbook, Laura Montoya, Evangelista Ezenduka, Shivani Agarwal, Mike Nguyen, Fatima Safi, Nikhil Madhav, Dallin Beus, George Yeung, Hayan Kundi

North Texas Research Forum 2025

Internal medicine residents face a wide range of challenging medical conditions during their training and need to be equipped with both the knowledge and flexibility to handle whatever comes their way. As part of a collaborative initiative, we present the Medical City Arlington Internal Medicine Handbook, a practical resource built by residents, for residents. This handbook brings together practical insights, evidence-based practices, and specialized clinical expertise, all with the goal of enhancing the diagnostic and treatment skills of internal medicine practitioners. It covers a broad spectrum of conditions, from common ailments to rare and complex diseases, and provides in-depth management …

Hemophagocytic Lymphohistiocytosis In A 55-Year-Old Female With Dengue Fever: A Case Report, Martin Twumampofo, Huy Vuong, Karen Valadez-Cuen, Oswaldo Renteria, Hector Zepeda

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

The Importance Of Early Source Control: A Case Of Resistant Mrsa, Jack Demirjian, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Disseminated Fusarium Infection To Lung, Liver, And Brain In An Acute Promyelocytic Leukemia (Apml) Patient; A Case Report, Lane F. Smith, Alexandria Goyer, Ali Al-Nahi, Neil Bhangoo, Yi Lei, Zara Soomro, Amy Nguyen-Pham, Tasaduq Mir

North Texas Research Forum 2025

Background: Disseminated fusarium, primarily affecting immunocompromised individuals, is associated with persistent fevers, rash, and lung involvement. Despite interventions, mortality rate remains high, exceeding 75% for disseminated disease. There are only 26 documented cases worldwide between 1974 and 2022 with CNS involvement. This case highlights a rare presentation of disseminated fusarium infection involving the lungs, liver, and brain in a 53-year-old male with acute promyelocytic leukemia (APL), highlighting critical diagnostic and therapeutic challenges. Case Presentation: A 53-year-old male with a history of APL with PML/RARA fusion t (15,17) after chemotherapy presented with persistent fevers, rash, encephalopathy, and severe sepsis while undergoing …

Implementation Of Interdisciplinary Approaches In Dermatology Residency Program, Dina Zamil, Nicole Nyamongo, Alexandria Brown Marrs, Joanne Jacob, Soo Jung Kim

Gulf Coast Division GME Research Day 2025

No abstract provided.

Managing Kaposi Sarcoma In Controlled Hiv: A Case Study On Cutaneous Manifestations And Multidisciplinary Care, Rafael Do Valle, Reem Ayoub, Henry Lim, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Kaposi Sarcoma (KS) is a soft tissue sarcoma that affects the linings of blood and lymphatic vessels. It occurs, primarily in immunocompromised individuals. It is caused by the Human Herpesvirus 8. There are four recognized forms of KS: AIDS-related, iatrogenic, classic, and endemic. Each form varies in demographics and manifestation. AIDS-related KS occurs in HIV-positive individuals, while iatrogenic KS develops in transplant patients undergoing immunosuppressive therapy. Classic KS is typically seen in elderly males from specific geographic regions, and endemic KS affects young individuals in certain areas of Africa. Clinical manifestations of KS include red, purple, or brown papules …

Streptococcus Intermedius In The Setting Of Adalimumab Use, Gerardo Martinez Arroyo, Amelia Mellor, Joseph Prokop, Oscar Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Fatal Overlapping Cns Infections: Radiologic Correlates Of Ventriculitis, Encephalitis, And Meningitis​, Jesse F. Simon, Sara Darwish, Stephanie Nagy, Richard Shalmiyev, David Kosoy, Bryan Rubio, Gustavo Pantol, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: This case study explores an uncommon triad of encephalitis, ventriculitis, and meningitis complicated by ischemic strokes and seizures in a COVID-19-positive patient. Prior studies suggest that bacterial meningitis and encephalitis can lead to cerebral infarctions due to inflammation and vascular injury.1,2,5 Ventriculitis, in particular, is rarely observed and typically is seen as a severe complication of meningitis, and can be managed with neurosurgical interventions such as CSF shunt placement, ventricular drains, or other intracranial devices.3,4 The simultaneous presentation of all three conditions in a single patient is rare and poses significant challenges from a diagnostic and management standpoint.

Case …

Inpatient Utilization Among Medicaid Members With Substance Use And Serious Mental Illness In Oregon, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Elevated Neutrophil-To-Lymphocyte Ratios In Schizophrenia: Insights From A Precision Medicine Cohort (Preprint), Alec J. Pupo, Connor J. Stinson, Chinwendu Madukwe, Stephanie H. Felgoise

Internal Medicine Resident Research

Systemic inflammation has been increasingly implicated in the pathophysiology of schizophrenia. The neutrophil-to-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has not been thoroughly investigated in large, demographically-matched schizophrenia cohorts. Using data from the All of Us Research Program, we analyzed participants with schizophrenia (n = 396) matched to controls (n = 396) by sex, race, and age. NLR was calculated as the ratio of each participant’s median neutrophil count to median lymphocyte count across all available measurements, excluding extreme values (NLR > 7). Distribution normality was assessed using the Shapiro–Wilk test, and group differences were evaluated with the …

Case Study: A Severe Presentation Of Chronic Eosinophilic Pneumonia., Revati Kalluri, Mari Kai

Books, Presentations, Posters, Etc.

Case Presentation: Chief Complaint •55-year-old male with history of COPD, current 1 pack/day smoker, and 2-month history of hypoxic respiratory failure presents with increased shortness of breath. History of Present Illness •Initially hospitalized for a motor vehicle collision with course complicated by acute hypoxic respiratory failure due to eosinophilic pneumonia and treated with a 14-day prednisone taper. •Few days after discharge, he represented with acute hypoxic respiratory failure thought to be from a COPD exacerbation and treated with a short steroid taper. •Now, represents few days later with continued tachypnea, tachycardia, hypotension, and hypoxia.. Discussion: •Broad Differential including Pneumonia, Fat …

Physical Ablative Methods And Cancer Cell Death: Implications For Immunity And Therapies, Alessandra Rossi, Claudia Muratori

Bioelectrics Publications

Surgery has traditionally been a cornerstone in cancer treatment, yet its feasibility can be limited by factors such as tumor location and patient health conditions. When surgery is not viable, thermal and pulsed electric field (PEF)-based ablation technologies offer valuable alternatives. Emerging evidence suggests that these approaches not only target tumors effectively but also stimulate antitumor immune responses. In this review, we begin by examining the distinctive features of hyperthermic treatments (radiofrequency and microwave ablation), cryoablation, and PEF-technologies. Subsequently, we discuss the mechanisms of cell death, stress responses, and release of danger signals triggered by these diverse ablation technologies. Finally, …

Immune Checkpoint Inhibitors: Friend Or Foe, Antonio Cordova, Jesse Powell, Whitney Elg-Salsman, Caroline Mcculley

Books, Presentations, Posters, Etc.

Introduction: • Many cancers use mechanisms to escape killing by the immunesystem. • Cancer cells can mimicimmune checkpoint proteins such as cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) ligand and the programmed death1 receptor ligand (PD-L1) toinhibit the T-cell response. • Immune checkpoint inhibitors (ICI's) are a novel set of monoclonalantibody cancer therapies. • ICI'sblockcheckpoint proteins from binding with their partner proteins oncancer cells thus allowing T-cells to kill tumor cells. • ICIs have promising anti-cancer results. • ICIs are also associated with immune related adverse events(irAEs), including dermatitis, pneumonitis, colitis,hepatitis, nephritis. • A rare but seriousirAEisICI-associated myositis causing bulbar and …

Early Management Of Kodamaea Ohmeri Infection In A Diabetic Patient With Recurrent Otitis Externa: A Case Report, Madison Groom, Linette Diaz, Ryan Fernandez, Jose Vasquez

West Florida Division GME Research Day 2025

No abstract provided.

Breaking The Iv Habit: Oral Antibiotics For Gram-Negative Bacteremia In The Modern Era, Adam Albadawi, Maria Milko

West Florida Division GME Research Day 2025

No abstract provided.

First Reported Case Of Upadacitinib-Induced Cmv Viremia And Pneumonitis In Ulcerative Colitis, Wilfredo Jhoel Javier-Rojas, Alvin Boyd Newman-Caro, Mamoon Guellai, Vamsee Mupparaju, Sreekanth Chandrupatla, Yizhi Lin, Ivan Rascon-Aguilar

West Florida Division GME Research Day 2025

No abstract provided.

Inked And Infected: A Case That Highlights The Emerging Concern Of Tattoo-Associated Mycobacterium Abscessus, Tory Starzyk, Neena Edupuganti

West Florida Division GME Research Day 2025

No abstract provided.

The Final Beat: A Case Report On Recurrent Endocarditis And The Ethical Dilemmas Of Surgical Futility, Jenie Yeh, Marek Solomianko, Robert Sanchez

West Florida Division GME Research Day 2025

No abstract provided.

Rare Case Of Fungal Osteomyelitis Affecting An Intramedullary Lag Screw, Matthew C. Watterson, Robert T. Rella, Timothy K. Summers, David Michaeli, Jess Mullens

Western Journal of Orthopaedics

Osteomyelitis is an infection of the bone that is most commonly of bacterial origin. Cases of fungal osteomyelitis are rare, and treatment often requires a prolonged course of antimicrobials. The authors report a case of a 72-year old man with fungal osteomyelitis affecting an intracortical lag screw, which was discovered during fixation of the left femoral shaft following an injury that occurred 68 years after placement of the affected lag screw. Chronic osteomyelitis can be indolent and subclinical, with the patient experiencing no signs or symptoms of the disease despite having bone infection for decades. This condition may become clinically …

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

Depletion Of Adipose Stroma-Like Cancer-Associated Fibroblasts Potentiates Pancreatic Cancer Immunotherapy, Joseph Rupert, Alexes Daquinag, Yongmei Yu, Yulin Dai, Zhongming Zhao, Mikhail G Kolonin

Faculty, Staff and Student Publications

This study shows that populations of CAFs have distinct effects on pancreatic cancer progression and shows that depletion of CAFs expressing adipose markers potentiates tumor/metastasis suppression effects of immune checkpoint blockade.

Assessing Impact Of Molecular Diagnostics On Time To Optimal Antibiotic Therapy In Pediatric Staphylococcal Bacteremia, Manith Humchad, Kelly Williamson

Williams Honors College, Honors Research Projects

Timely optimization of antibiotic therapy is critical in pediatric patients with blood infections, particularly those caused by Staphylococcus aureus. This retrospective study evaluated the impact of molecular diagnostics on time to optimal therapy and discontinuation of unnecessary antibiotics at Akron Children’s Hospital from January 2020 to April 2023. Patients with Methicillin-resistant Staphylococcus aureus (MRSA) were more likely to be on appropriate empiric therapy (i.e. vancomycin) before culture results, whereas Methicillin-sensitive Staphylococcus aureus (MSSA) cases were de-escalated to beta-lactams. The median time to optimal therapy was 3.7 hours for episodes of MSSA. Infectious Disease (ID) consultation significantly influenced antibiotic management, with …

The Passing Of A Giant In Proteoglycan Research: Robert J. Linhardt (1953–2025), Renato V. Iozzo, Fuming Zhang, Paul L. Deangelis

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Week 96 Results Of Bictegravir/Emtricitabine/Tenofovir Alafenamide For Hiv Treatment In People With Substance Use Disorders, Joshua P. Havens, Sara Bares, Elizabeth Lyden, Nada A. Fadul, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: The BASE study (NCT03998176), a phase 4, 48-week (W), single-arm, prospective trial, revealed that the use of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV and substance use disorders (PWH/SUD) was safe and effective without emergent antiretroviral resistance despite incomplete adherence. Here, we present the W96 results.

METHODS: A retrospective analysis of all participants enrolled in the BASE study was completed from W48 to W96. End points of interest at W96 included the proportion of participants with viral suppression (VS; HIV RNA < 50 copies/mL [c/mL]), incidence of protocol-defined virologic failure (PDVF; 2 consecutive ≥400 c/mL), safety, adherence (percentage of days covered [PDC]), retention in care, and prevalence of ongoing substance use.

RESULTS: All enrolled BASE participants (n = 43) were included in the W96 analysis. At W48, 21 participants …

Preferences And Feasibility Of Long-Acting Technologies For The Treatment Of Hepatitis C Virus: A Survey Of Patients In Diverse Low- And Middle-Income Countries, Renae Furl, Kimberly Scarsi, Harlan Sayles, Matt Anderson, Joelle Dountio Ofimboudem, Ethel D. Weld, Imam Waked, Asmaa Gomaa, Alzhraa Al-Khatib, Fatma Mohammed Elshobary, Hailemichael Desalegn, Henok Fisseha, Sunil Solomon, Shruti Mehta, Andrew Owen, Steve Rannard, David L. Thomas, Susan Swindells

Journal Articles: Infectious Diseases

Despite available curative treatments, global rates of hepatitis C virus (HCV) infection persist with significant burden in low- and middle-income countries (LMICs). Long-acting (LA) antiviral products are in development. This study explored the challenges and opportunities in LA-HCV treatment across three LMICs: Egypt, Ethiopia and India. The survey focused on understanding barriers and facilitators to treatment, with emphasis on LA treatment preferences. Four-hundred respondents completed a survey including demographics, HCV treatment history and preferences for injections, implants and microarray patches (MAPs) compared to pills. Overall, 78% of respondents were willing to receive injections, 43% were willing to receive implants and …

Efficacy And Safety Of 4-Month Rifapentine-Based Tuberculosis Treatments In Persons With Diabetes., Ekaterina V. Kurbatova, William C. Whitworth, Lakshmi Praveena Peddareddy, Patrick P. J. Phillips, Nigel A. Scott, Kia E. Bryant, Rodney Dawson, Sandra Wagner Cardoso, Wadzanai Samaneka, Melissa Engle, Ziyaad Waja, Erin Sizemore, Wendy Carr, Kelly E. Dooley, Radojka Savic, Susan Swindells, Richard E. Chaisson, Susan E. Dorman, Payam Nahid, Nhung V. Nguyen, Aids Clinical Trials Group A5349, Tuberculosis Trials Consortium Study 31

Journal Articles: Infectious Diseases

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We explored results among study participants with diabetes. Among 2,516 randomized participants, 181 (7.2%) had diabetes. Of 166 participants with diabetes in the microbiologically eligible analysis group, 26.3% (15/57) had unfavorable outcomes in the control regimen, 13.8% (8/58) in the rifapentine/moxifloxacin regimen, and 29.4% (15/51) in the rifapentine regimen. The difference in proportion of unfavorable outcomes between the control and rifapentine/moxifloxacin arms in the microbiologically eligible analysis group was -12.5% (95% CI -27.0% to 1.9%); the difference between the control and …

Pregnancy Outcomes After Exposure To Tuberculosis Treatment In Phase 3 Clinical Trial, 2016-2020, Ekaterina V. Kurbatova, William C. Whitworth, Kia E. Bryant, Meredith G. Dixon, Kelly E. Dooley, Nigel A. Scott, Rosanna Boyd, Nicole E. Brown, Kimberley N. Chapman Hedges, Wendy Carr, Lakshmi P. Peddareddy, Grace Muzanyi, Rodney Dawson, Ziyad Waja, Neil Martinson, Jyoti S. V. Mathad, Payam Nahid, Susan Swindells, Richard E. Chaisson, Susan E. Dorman, Patrick P. J. Phillips, Aids Clinical Trials Group A5349, Tuberculosis Trials Consortium Study 31

Journal Articles: Infectious Diseases

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We analyzed pregnancy outcomes of women who became pregnant during the study. Among 740 women, 97 (13.1%) became pregnant. Of 102 pregnancies (in 97 participants), 30 (29.4%) participants were exposed to study drugs. Fetal loss was reported for 3/13 (23.1%) in the control regimen, 1/9 (11.1%) in the rifapentine/moxifloxacin regimen, and 1/8 (12.5%) in the rifapentine regimen. Among 21 live births in exposed pregnancies (7 in each arm), 1 infant with a congenital anomaly was reported in a participant on the …

Development Of A Proposed Selective Medium For The Isolation And Differentiation Of P. Sordellii, Dimyana Bottros

Honors Undergraduate Theses

Clostridium, a genus of anaerobic, spore-forming bacteria, includes clinically and ecologically significant species like Clostridium difficile and Paeniclostridium sordellii. C. difficile causes antibiotic-associated colitis, while P. sordellii is linked to fatal infections and spontaneous abortions. Recent studies found both species in marine sediments, suggesting their role in environmental and wildlife health disturbances, including the 2013 mass mortality of over 300 manatees in the Indian River Lagoon. However, isolating and differentiating P. sordellii is challenging due to the lack of selective media optimized for its growth. This thesis proposes a novel selective medium tailored to P. sordellii’s physiological …

Proteomic Characterization And Comparison Of The Infective And Adult Life Stage Secretomes From Necator Americanus And Ancylostoma Ceylanicum, Yide Wong, Bruce A Rosa, Luke Becker, Mali Camberis, Graham Legros, Bin Zhan, Maria Elena Bottazzi, Ricardo T Fujiwara, Edita Ritmejeryte, Thewarach Laha, Sujittra Chaiyadet, Piyanan Taweethavonsawat, Paul J Brindley, Bethany K Bracken, Paul R Giacomin, Makedonka Mitreva, Alex Loukas

Faculty, Staff and Students Publications

More than 470 million people globally are infected with the hookworms Ancylostoma ceylanicum and Necator americanus, resulting in an annual loss of 2.1 to 4 million disability-adjusted-life-years. Current infection management approaches are limited by modest drug efficacy, the costs associated with frequent mass drug administration campaigns, and the risk of reinfection and burgeoning drug resistance. Subunit vaccines based on proteins excreted and secreted (ES) by hookworms that reduce worm numbers and associated disease burden are a promising management strategy to overcome these limitations. However, studies on the ES proteomes of hookworms have mainly described proteins from the adult life stage …

Impact Of Methicillin-Resistant Staphylococcus Aureus Surveillance And Decolonization In The Nicu: The Texas Children’S Hospital Experience, Nahid Hiermandi, Catherine Foster, Judith Campbell, Krystal Purnell, Elizabeth Tocco, Tjin Koy, Kenneth Nobleza, Duc Nguyen, Lucila Marquez

Faculty, Staff and Students Publications

OBJECTIVE: To determine the impact of screening and decolonization on methicillin-resistant

STUDY DESIGN: This is a single-center retrospective cohort study comparing patient characteristics among MRSA-colonized and MRSA-infected infants, rates of MRSA infection before and after screening with targeted decolonization, and MRSA infection among those receiving single or combined decolonization agents.

SETTING: Texas Children's Hospital Pavilion for Women is a 42-bed level three neonatal intensive care units (NICU) in Houston, TX.

PATIENTS: Neonates admitted to the NICU from 2012 to 2022 were included in analysis of MRSA colonization and infection. The gestational age ranged from 22 weeks to 42 weeks.

INTERVENTIONS: …