Digital Commons Network^™

Osimertinib Activates A Tgf-Β2-Dependent Secretory Program That Drives Lung Adenocarcinoma Progression, Madhurima Ghosh, Chao Wu, Abhishek Kumar, Monique Nilsson, John V Heymach, Weina Zhao, Jiang Yu, Xin Liu, Na Ding, Shike Wang, Guan-Yu Xiao, Angelo Chen, Kate Grimley, William K Russell, Chad J Creighton, Xiaochao Tan, Jonathan M Kurie

Faculty, Staff and Student Publications

EGFR-mutant lung adenocarcinomas (LUADs) that are vulnerable to the EGFR antagonist osimertinib (Osi) eventually relapse, owing in part to the emergence of drug-tolerant persister (DTP) cells that arise through epigenetic mechanisms. Intratumoral DTP cells can herald a worse clinical outcome, but the way in which DTP cells influence LUAD progression remains unclear. Osi-resistant (OR) cells exhibit typical DTP cell features, including a propensity to undergo senescence and epithelial-mesenchymal transition (EMT), which can activate heightened secretory states. Therefore, we postulated that OR cells influence LUAD progression through paracrine mechanisms. To test this hypothesis, we utilized congenic pairs of EGFR-mutant LUAD cell …

The Impact Of Vascular Management On Postoperative Complications In Patients Undergoing Surgery For Retroperitoneal Leiomyosarcoma, Neha Malik, Seokhun Kim, Christopher P Scally, Emily Z Keung, Heather Lillemoe, Keila E Torres, Kelly K Hunt, Sophia Khan, Christina L Roland, Heather G Lyu

Faculty, Staff and Student Publications

Background: Retroperitoneal leiomyosarcomas are aggressive malignancies. Complete surgical resection with negative margins is crucial to decrease the risk of recurrence but can be risky due to vascular involvement. The aim of our study was to evaluate the different approaches to IVC and renal vein management and their impact on postoperative complications.

Methods: We performed a retrospective review of patients who underwent surgery for retroperitoneal leiomyosarcoma with IVC and/or renal vein involvement at our institution from 2016 to 2024. Patients were stratified by intraoperative vascular management, including ligation only versus varying forms of vascular reconstruction. Postoperative complications, including bleeding, transfusions, the …

Women's Preferences For Home-Based Self-Sampling Or Clinic-Based Testing For Cervical Cancer Screening, Joël Fokom Domgue, Monalisa Chandra, Olajumoke Oladoyin, Manali Desai, Robert Yu, Sanjay Shete

Faculty, Staff and Student Publications

Importance: While home-based self-sampling for cervical cancer screening is an evidence-based strategy proven to increase screening access and uptake, it is not currently recommended in the US despite recent Food and Drug Administration approval of the first at-home self-sampling device. Little nationally representative research has examined preference for and drivers of home-based self-sampling over clinic-based testing (the standard of care).

Objective: To assess women's perspectives about, reasons for considering, and factors associated with preferring at-home self-sampling for cervical cancer screening.

Design, setting, and participants: This population-based cross-sectional study used data from the 2024 Health Interview National Trends Survey (HINTS 7), …

Dispersion-Enhanced Nitrogen-Centered Photocatalysis Of The Direct Hydrogen Atom Transfer, Jiasong Zhang, Kaitong Zhuang, Ramon Trevino, Babu Raj Dhungana, Huiying Sun, Shuyu Yin, Yuting Li, Jacob A Sanchez, Xiaoyu Xia, Ramy Elerian, Yao Sun, Seth O Fremin, Chao Huang, Min He, Maosheng Cheng, Oleg V Larionov, Shengfei Jin

Faculty, Staff and Student Publications

The development of structurally distinct and modular photocatalysts for direct hydrogen atom transfer (HAT) has emerged as a key frontier in radical-mediated C-H functionalization of strong carbon-hydrogen bonds. Despite the largely untapped potential across the fields of organic synthesis, medicinal chemistry, and materials science, few classes of direct HAT photocatalysts are currently known, and the approaches to enhancing their photocatalytic activity remain underdeveloped. We report herein the development of nitrogen-centered direct HAT photocatalysts based on the acridine framework, which leverage a C9-ortho-biaryl substituent for enhancing the photocatalytic activity through stabilizing dispersion interactions with the substrate as the key steering effect. …

Cd8+ T Cells In The Tumor Microenvironment Modulate The Response To Endocrine Therapy In Breast Cancer, Fabiana Napolitano, Yunguan Wang, Dhivya R Sudhan, Paula I Gonzalez-Ericsson, Luigi Formisano, Nisha Unni, Shahbano Shakeel, James Z Zhu, Khushi Ahuja, Lei Guo, María Rosario Chica-Parrado, Yuki Matsunaga, Pamela Luna, Chang-Ching A Lin, Yasuaki Uemoto, Kyung-Min Lee, Hongli Ma, Nathaniel J Evans, Alberto Servetto, Saurabh Mendiratta, Spencer D Barnes, Roberto Bianco, Yisheng V Fang, Lin Xu, Jeon Lee, Tao Wang, Justin M Balko, Gordon B Mills, Marilyne Labrie, Ariella B Hanker, Carlos L Arteaga

Faculty, Staff and Student Publications

The role of the tumor immune microenvironment (TIME) in modulating responses to antiestrogen therapy in hormone receptor-positive (HR+) breast cancers remains unclear. We analyzed pre- and on-treatment biopsies from patients with HR+ breast cancer treated with letrozole to induce estrogen deprivation (ED). Stromal tumor-infiltrating lymphocytes, assessed by H&E staining, and immune-related gene sets, including IFN-γ signaling genes, measured by RNA-Seq, were increased in ED-resistant tumors. Cyclic immunofluorescence and spatial transcriptomics revealed an abundance of CD8+ T cells and enhanced antigen processing and immune gene signatures in ED-resistant tumors. In this group, the expression of CXCL9, CXCL10, and CXCL11 - chemokine …

Mom Is Developing Too: Preliminary Evidence For The Reciprocal Effects Of Infant Sensory Reactivity And Maternal Behavior, Emily C. Sweiss, Vincent Berardi, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Caregiver sensitivity to infant cues is well-established as a predictor of child development. Infants also actively influence their social environment, especially their caregivers, even from their earliest days. Sensory reactivity, characterized as hypo- (under) and hyper- (over) responding to environmental stimuli, is one domain of development that is likely to influence caregiver-infant interaction, due to its role in regulating emotions and responses to both physical and social stimuli. Although sensory reactivity could be an important target for improving caregiver-child interaction, the longitudinal, reciprocal relations between infant sensory reactivity and caregiver behaviors are currently unknown. In the present proof-of-concept study, we …

Fedda-Tsformer: Federated Domain Adaptation With Vision Timesformer For Left Ventricle Segmentation On Gated Myocardial Perfusion Spect Image, Yehong Huang, Chen Zhao, Rochak Dhakal, Min Zhao, Guang-Uei Hung, Zhixin Jiang, Weihua Zhou

Michigan Tech Publications

BACKGROUND: Accurate assessment of left ventricular function is essential for diagnosing and managing cardiovascular disease. Gated myocardial perfusion SPECT (MPS) enables simultaneous evaluation of perfusion and function, but reliable contour extraction is challenged by image noise, resolution limits, and anatomical variability. Multi-center validation is further restricted by data privacy concerns, underscoring the need for robust and privacy-preserving contouring methods. METHODS: In this study, we propose a novel approach, FedDA-TSformer, which integrates Federated Domain Adaptation with the TimeSformer model for the task of left ventricle segmentation using MPS images. The proposed model captures spatial and temporal features through a Divide-Space-Time-Attention mechanism, …

Midlife Wellness: Building Healthy Lifestyle Habits To Ensure Quality Of Life, Naomi Brower, Elizabeth Davis

All Current Publications

Life expectancy has increased significantly, but women often spend their later years in poor health unless they take proactive steps to build healthy habits early. This fact sheet provides information on healthy habits women can develop to help manage hormonal changes during perimenopause and menopause and reduce long-term health risks.

Intouch Week Of February 2, 2026, New York Medical College

InTouch

• Campus Illumination and Panel Discussion Honors Holocaust Remembrance Day
• Where Experience Becomes Evidence: Advancing Transplant Education at NYMC
• D.P.T. Student Experience
• Love at NYMC

Amyloidosis Of Bridging Veins Is A Pathologic Feature Of Alzheimer's Disease, Leon C D Smyth, Daan Verhaege, Elio Standen-Bloom, Yue Wu, Steffen E Storck, Pavle Boskovic, Benjamin A Plog, Tornike Mamuladze, Jose A Mazzitelli, Zhuoying Wang, Daniel D Lee, Gwendalyn J Randolph, Katherine E Schwetye, Song Hu, Jonathan Kipnis, Et Al.

2020-Current year OA Pubs

Alzheimer's disease (AD) is characterized by the accumulation of extracellular aggregated amyloid beta, resulting from impaired waste clearance. We recently identified new cerebrospinal fluid (CSF) efflux structures termed arachnoid cuff exit (ACE) points and speculated that these may be impacted in AD, leading to impaired waste clearance function. Using 5XFAD mice, we found progressive amyloidosis of bridging veins at ACE points. Indeed, in 5XFAD mice, there is impaired CSF efflux to the dura mater, impaired CSF flow along bridging veins, and impaired blood flow through bridging veins. These observations suggest that ACE point amyloidosis plays a role in waste clearance …

Mapping The Causal Chain From Genetic Risk Variants To Lipid Dysmetabolism In Parkinson’S Disease, Ruth B De-Paula, Jonggeol Kim, Herve Rhinn, Hiba Saade, Fatima Chavez, Téah Segura, Maria Valeria Lozano, Michelle Etoundi, Karla Silos, Naomi Kass, Viktoriya Korchina, Harshavardhan Doddapaneni, Eric Venner, Joseph C Masdeu, Valory Pavlik, Melissa M Yu, Chi-Ying R Lin, Joseph Jankovic, Aron S Buchman, Donna Muzny, Richard A Gibbs, Sarah H Elsea, Asa Abeliovich, Peter Lansbury, Nora Vanegas-Arroyave, Chad A Shaw, Joshua M Shulman

Faculty, Staff and Students Publications

The molecular pathways linking genetic variants to Parkinson's disease (PD) onset and progression remain incompletely defined; however, risk alleles in multiple genes, including GBA1, strongly implicate lipid metabolism. To systematically identify causal biomarker signatures, we analyzed comprehensive metabolome profiles from blood plasma in 149 PD patients and 150 controls, along with complementary genetic, RNA-sequencing, and metabolic data from other available clinical and pathologic cohorts. Using colocalization and summary-data-based Mendelian randomization, we tested whether expression and metabolic quantitative trait loci mediate the association between implicated genetic variants and PD risk. We further integrated differential metabolomics and proteomics from blood and brain …

Demographic And Clinicopathologic Factors Associated With Colorectal Adenoma Recurrence, Usman Ayub Awan, Qingyuan Song, Kristen K Ciombor, Adetunji T Toriola, Jungyoon Choi, Timothy Su, Xiao-Ou Shu, Kamran Idrees, Kay M Washington, Wei Zheng, Wanqing Wen, Zhijun Yin, Xingyi Guo

2020-Current year OA Pubs

IMPORTANCE: Current colorectal surveillance guidelines emphasize adenoma characteristics but overlook temporal, racial, and sex-based heterogeneity in recurrence risk, a gap that limits equitable and personalized care.

OBJECTIVE: To evaluate the associations of demographic factors, obesity, and adenoma features with recurrence risk over time in a large longitudinal surveillance cohort.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included adults who underwent their first colonoscopic polypectomy between January 1990 and July 2024 at a tertiary medical center.

EXPOSURES: Demographic variables included race and ethnicity, sex, obesity (body mass index >30), family history of colorectal cancer (CRC) or polyps, and age at …

Clinical Features Of Infantile Epileptic Spasms Syndrome: A Systematic Review, Xiao Meng, Danielle S Takacs, Yashaswini Kelagere, Zihan Zhang, Sanjanaa Seshadri, Jiyeon Cha, Ming Li, Lei-Shih Chen

Faculty, Staff and Students Publications

Introduction

Infantile Epileptic Spasms Syndrome (IESS) is a severe epilepsy in children between one month and two years of age. Urgent referral of possible IESS cases from pediatricians and family physicians who care for children to neurologists for diagnosis and treatment has been shown to significantly improve patient health outcomes. Yet, a comprehensive list of IESS clinical features is lacking. We conducted a systematic review of studies to report IESS clinical features.

Methods

Articles from the MEDLINE Complete and Embase databases were searched from the earliest years of databases availability (1979) to July 31, 2024. We followed the Preferred Reporting …

Lysine Demethylase 4a (Kdm4a) Maintains Basal Body Architecture And Protects Against Ciliary Destabilization, Manga Motrapu, Lindsey Hudson, Pratim Chowdhury, Xiaoli Wang, Yuya Nakatani, Sofia Vargas-Hernandez, Sung Y Jung, Menuka Karki, Cheryl Walker, Anna-Karin Gustavsson, Ruhee Dere

Faculty, Staff and Students Publications

Primary cilia are sensory organelles essential for signaling and defects in formation, maintenance or structure underlie diverse ciliopathies. Here, we identify lysine demethylase 4A (KDM4A) as a previously unrecognized mediator of ciliogenesis. Using genetic depletion and pharmacologic inhibition, we show that KDM4A is required for cilia assembly and maintenance. Super-resolution imaging reveals KDM4A localization at the basal body, where it distinctively wraps around the centrioles. We uncover a direct interaction between KDM4A and Rootletin (CROCC), a structural protein mediating centriole cohesion, and demonstrate that KDM4A loss increases inter-centriolar distances, implicating basal body architecture in ciliary failure. Together, these findings define …

Mechanical Characterization Of Petg – Carbon Fiber Composite Parts Using 3d Printing For Drone Frame Application, Murugesan Palaniappan, P Manoj Kumar, P Arunkumar, Dawit Tafesse Gebreyohannes

Faculty, Staff and Students Publications

PETG (Polyethylene Terephthalate Glycol)–Carbon Fiber composites fabricated using fused deposition modeling are emerging as promising alternatives for lightweight UAV structures; however, their performance is strongly influenced by internal infill architecture and structural design. From an initial set of 21 infill patterns, five mechanically efficient patterns (Tri-Hexagon, Triangle, Support Cubic, Rectilinear, and Quarter Cubic) were shortlisted and evaluated through tensile, wear, impact, and hardness tests. Rectilinear infill exhibited the highest tensile strength (35 N/mm2) and superior wear resistance under loads up to 30 N, while Quarter Cubic showed comparable tensile performance (34 N/mm2). Support Cubic infill demonstrated the highest impact energy …

Slc7a8 Is Essential For Metabolic Fitness And Function Of Th2 Cells, Santosh K Panda, Do-Hyun Kim, Pritesh Desai, Shitong Wu, Patrick Fernandes Rodrigues, Raki Sudan, Yizhou Liu, Haerin Jung, Intelly Lee, Susan Gilfillan, Marina Cella, Steven J Van Dyken, Marco Colonna

2020-Current year OA Pubs

Amino acids are essential for the activation and function of CD4 T helper (Th) cells, which differentiate into Th1, Th2, Th17, and Treg subsets to coordinate immune responses. While specific amino acid transporters have been identified for Th1, Th17, and Tregs, a transporter regulating Th2 cells remains unknown. This study identifies SLC7A8 as a Th2-specific amino acid transporter in the Th compartment. We found that Slc7a8 expression is upregulated in Th2 cells compared with other T helper subsets, and Slc7a8 deficiency impairs Th2 cell proliferation and cytokine production. Furthermore, SLC7A8 was found to be crucial for an effective type 2 …

Estimated Effectiveness Of 2024-2025 Covid-19 Vaccination Against Severe Covid-19, Kevin C Ma, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

IMPORTANCE: As SARS-CoV-2 JN.1 lineage descendants continue to evolve, evaluating COVID-19 vaccine effectiveness (VE) against severe COVID-19 remains important to guide vaccination strategies.

OBJECTIVE: To estimate the VE of the 2024-2025 COVID-19 vaccines against COVID-19-associated hospitalization and severe in-hospital outcomes overall and by time since dose (7-89, 90-179, and ≥180 days), JN.1 descendant lineage (KP.3.1.1, XEC, LP.8.1), and spike protein mutations associated with immune evasion.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, test-negative, case-control study conducted by the Investigating Respiratory Viruses in the Acutely Ill Network included adult patients (aged ≥18 years) hospitalized between September 1, 2024, and April 30, 2025, …

Costs Of Single Maintenance And Reliever Therapy Vs Traditional Therapy For Asthma, Tri Pham, Abigail R Barker, Sarah A Eisenstein, Eliot Jost, Anna Volerman, Krutika Chauhan, Ross C Brownson, Timothy Mcbride, Mark D Huffman, Kaharu Sumino, Lynn B Gerald, Mario Castro, Anne E Dixon, James G Krings

2020-Current year OA Pubs

IMPORTANCE: Despite strong guideline support, single maintenance and reliever therapy (SMART) for asthma is underused in the US. Limited insurance coverage of SMART-compatible inhalers remains a major barrier to its adoption.

OBJECTIVE: To compare the annual asthma management costs of SMART vs traditional therapy from a US health care payer perspective.

DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation used a probabilistic decision-tree model with Monte Carlo simulations to compare the total asthma management costs for patients prescribed SMART vs traditional therapy, conducting analyses from September 1, 2024, to March 13, 2025. Input data were extracted through a systematic review of …

Longitudinal Multiomic Signatures Of Ards And Sepsis Inflammatory Phenotypes Identify Pathways Associated With Mortality, Narges Alipanah-Lechner, Pratik Sinha, Et Al.

2020-Current year OA Pubs

BACKGROUNDCritically ill patients with acute respiratory distress syndrome (ARDS) and sepsis exhibit distinct inflammatory phenotypes with divergent clinical outcomes, but the underlying molecular mechanisms remain poorly understood. These phenotypes, derived from clinical data and protein biomarkers, were associated with metabolic differences in a pilot study.METHODSWe performed integrative multiomics analysis of blood samples from 160 patients with ARDS in the ROSE trial, randomly selecting 80 patients from each latent class analysis-defined inflammatory phenotype (hyperinflammatory and hypoinflammatory) with phenotype probability greater than 0.9. Untargeted plasma metabolomics and whole-blood transcriptomics at day 0 and day 2 were analyzed using multimodal factor analysis (MEFISTO). …

The Use Of Acupuncture To Address Health Disparities In The Treatment Of Low Back Pain, Vivian Li, Alexander Reals, Deepa Manda, Elizabeth Loomis

Advances in Clinical Medical Research and Healthcare Delivery

Low back pain (LBP) is a leading cause of disability, and treatment often involves a combination of pharmacological and non-pharmacological therapies. Acupuncture is a medical treatment and ideology rooted in traditional Chinese medicine that utilizes applying small needles or pressure to specific points in the body. Utilized as an adjunct to supplement standard medical care, acupuncture is a procedure that can be done in a primary care setting. Multiple studies have shown efficacy in treating acute or chronic back pain, with up to 1.5% of the US population having used acupuncture at one point.

In the pursuit of holistic health, …

Evidence Based Management Of High Ldl-C For Prevention Of Atherosclerotic Cardiovascular Disease In Adult Patients In Resident Run Clinic: A Qi Project, Astha Prasai, Sahej Manesh Singh Arora, Hafsa Jawaid, Aakriti Jain, Omofolarin Babayale, Nauman Naeem, Hina Ukrani, Nawid Latifi, Binita Neupane, Soon-Il Song, Gaurav Sharma

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and in the United States, with significant healthcare and economic burden. Despite clear guideline recommendations, the implementation of ASCVD risk assessment and statin use for primary prevention remains suboptimal.

Methods:

A quality improvement project was conducted at a resident run clinic with an objective to improve ASCVD risk documentation and guideline-based lipid management. A total of 600 patients aged 40-75 years without a history of cardiovascular disease were randomly selected- 300 in the pre-intervention group and 300 in the post-intervention group. The intervention included didactic sessions and quick …

Rare Event: Neonatal Anaphylaxis Following Hepatitis B Vaccination – A Case Series From A Tertiary Care Center In India, Aarthi Ma, Revanth R

Advances in Clinical Medical Research and Healthcare Delivery

We report two cases of anaphylaxis following Hepatitis B vaccination in one-day-old neonates at a tertiary care hospital in India. Both cases presented with similar patterns of cutaneous reactions and respiratory symptoms shortly after intramuscular administration of the Hepatitis B vaccine. To our knowledge, this is among the few documented case series of neonatal anaphylaxis post–Hepatitis B vaccination, underscoring its rarity yet clinical importance. The cases highlight the critical importance of vigilant post-vaccination monitoring and prompt recognition of vaccine-associated adverse events in neonates. This report reviews current literature on anaphylaxis following vaccination and discusses optimal management strategies.

An Exploratory Study Of Social Determinants And Pediatric Lead Exposure In Chemung County, Ny, Jenna Mccracken, Anika Stundtner, Megan Kerbag, Madison Desantis, Jennifer Coseo, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lead exposure in children is a persistent public health concern due to its irreversible neurological and developmental effects. Children under 6 years old are particularly vulnerable due to frequent hand-to-mouth activity and increased environmental exposure. Existing literature suggests a relationship between adverse social determinants of health (SDOH), such as low parental education and residence in high-poverty areas, and elevated pediatric blood lead levels (BLLs). This study, subsidized through a community service grant from Excellus Blue Cross Blue Shield, aimed to examine the association between BLLs and SDOH among children screened at the ACCEL Community Health Clinic in Chemung County, …

Hallucinations And Diabetes – Could It Be The Hip? An Interesting Case Of Cobalt Poisoning, Mahrukh Tariq, Zauraiz Anjum

Advances in Clinical Medical Research and Healthcare Delivery

Cobalt (Co) poisoning has been described historically in beer-drinkers when cobalt was used as an additive. In present times, this type of poisoning is usually caused by occupational exposure or metal prosthesis breakdown. We present a case of Co poisoning from metal prosthesis breakdown with exceptionally high levels, and thus, some unique symptoms. Interestingly our patient not only had symptoms commonly associated with Co poisoning, e.g., paresthesia, sensory-neural hearing loss, acute kidney failure, but also developed new onset diabetes, which is not commonly associated with this type of pathology. Moreover, when we had this patient under our care, we had …

Late Bioprosthetic Valve Migration- A Rare Entity After Tavi, Sahej Arora, Ghazi Khan, Jeremiah Depta

Advances in Clinical Medical Research and Healthcare Delivery

We present a case of hemolytic anemia due to a rare complication of late bioprosthetic valve migration, who underwent successful treatment with valve in valve transcatheter aortic valve implantation. Our patient with symptomatic moderate aortic stenosis underwent the index procedure a year ago and treated for bacteremia 3 months ago, presented with hemolytic anemia and echocardiography revealing aortic paravalvular leak. The hemolysis was attributed to Bioprosthetic valve dysfunction after a negative hematological workup. The patient's aortography revealed ventricular migration of the valve, not seen on a cardiac CT scan performed before. This was followed by a successful valve in valve …

Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Major depressive disorder (MDD) is a prevalent and debilitating mental illness that affects millions globally. Traditionally, the pathophysiology of MDD was thought to be due primarily neurotransmitter imbalances. However, emerging research highlights the role of neuroinflammation in MDD pathogenesis. Elevated levels of pro-inflammatory cytokines, microglial activation, and blood-brain barrier dysfunction have been implicated in the etiology of MDD. Additionally, biomarkers such as C-reactive protein and neuroimaging findings further support the neuroinflammatory hypothesis. This growing body of evidence has led to increased interest in novel treatment approaches, including anti-inflammatory medications and lifestyle interventions, as potential therapeutic strategies. While selective serotonin reuptake …

Prompt Thyroid Hormone Replacement Reversing Severe Bradycardia & Syncope, Cassie R. Girardin, George Vega, Rohail Baig

Advances in Clinical Medical Research and Healthcare Delivery

Thyroid disease, particularly hypothyroidism, can significantly affect the cardiovascular system, leading to structural, functional, and conduction abnormalities. Hypothyroidism decreases inotropy and chronotropy and may cause bradycardia or conduction defects. Although these changes are typically reversible with thyroid hormone replacement, severe cases may necessitate pacemaker placement. This case describes an 82-year-old female with hypothyroidism, atrial fibrillation, and left bundle branch block (LBBB) who presented with recurrent syncope due to hypothyroidism-induced bradycardia with sinus pauses. Her symptoms resolved with thyroid hormone optimization, highlighting the importance of prompt recognition and treatment of hypothyroidism-related cardiac manifestations to prevent unnecessary pacemaker implantation.

Diagnostically Complex Case Of Trivalvular Infectious Endocarditis Complicated By Hiv, Hcv, Pulmonary Septic Emboli, And Epidural Abscess, Madison Baker, Natasha Singh, Rohail A. Baig, Justin Nistico

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Infective endocarditis (IE) can be visualized on echocardiograms. However, there is a significant discrepancy between transthoracic and transesophageal echocardiograms. This imaging modality is also impacted by operator dependent factors. The risk of right sided endocarditis is elevated in people who inject drugs (PWID). In individuals with human immunodeficiency virus (HIV), there is an increased risk of IE, and there is also a relationship that has yet to be fully established between hepatitis C virus (HCV) and IE.

This report describes a woman with a history of IVDU who was diagnosed with HIV/AIDS, HCV, and sepsis secondary to methicillin-resistant Staphylococcus …

A Rare Case Of Gastrointestinal Stromal Tumor Outside The Gastrointestinal Tract, Ashton I. D'Souza, Jasdeep S. Bajwa, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Extra-gastrointestinal stromal tumors are rare mesenchymal tumors occurring outside the gastrointestinal tract, comprising ~5% of all gastrointestinal stromal tumors. A 65-year-old man undergoing evaluation for nephrolithiasis was incidentally found to have a 7.2 cm mesenteric mass proven to be gastrointestinal stromal tumors on biopsy. After limited response to imatinib, the patient underwent successful surgical resection. Mesenteric gastrointestinal stromal tumors often present larger and more aggressive, but in this instance, early incidental detection permitted effective intervention. This case highlights the diagnostic challenges posed by extra-gastrointestinal stromal tumors due to their atypical location and nonspecific symptoms. Extra-gastrointestinal stromal tumors should be considered …

Successful Rituximab Therapy In Igg4-Related Sclerosing Mesenteritis, Sanjana L. Thimmannagari, Shiamak Cooper, Annie H. Yang, Abdullah M. Firoze Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Immunoglobulin G4-related disease (IgG4-RD) is an increasingly common autoimmune, multiorgan fibro-inflammatory disorder. Its involvement of organs like the pancreas, lacrimal glands, salivary glands and kidneys is well known but IgG4RD presenting as sclerosing mesenteritis is a rare entity. On imaging, it presents as a mesenteric mass and biopsy is the gold standard for confirmation as elevated serum IgG4 levels are unreliable to establish the diagnosis. Here we report a previously healthy 33-year-old African American female who presented with one week history of generalized abdominal pain. Imaging studies revealed a mass within the mesentery and post-operative biopsy of the mass confirmed …