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2022

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Preeclampsia Is Associated With Reduced Isg15 Levels Impairing Extravillous Trophoblast Invasion, Asli Ozmen, Anthony O Odibo, Et Al Jan 2022

Preeclampsia Is Associated With Reduced Isg15 Levels Impairing Extravillous Trophoblast Invasion, Asli Ozmen, Anthony O Odibo, Et Al

2020-Current year OA Pubs

Among several interleukin (IL)-6 family members, only IL-6 and IL-11 require a gp130 protein homodimer for intracellular signaling due to lack of intracellular signaling domain in the IL-6 receptor (IL-6R) and IL-11R. We previously reported enhanced decidual IL-6 and IL-11 levels at the maternal-fetal interface with significantly higher peri-membranous IL-6 immunostaining in adjacent interstitial trophoblasts in preeclampsia (PE) vs. gestational age (GA)-matched controls. This led us to hypothesize that competitive binding of these cytokines to the gp130 impairs extravillous trophoblast (EVT) differentiation, proliferation and/or invasion. Using global microarray analysis, the current study identified inhibition of interferon-stimulated gene 15 (


Experiences Using A Multidisciplinary Model For Treating Injection Drug Use Associated Infections: A Qualitative Study, Nathanial S Nolan, Emily Gleason, Laura R Marks, Tracey Habrock-Bach, Stephen Y Liang, Michael J Durkin Jan 2022

Experiences Using A Multidisciplinary Model For Treating Injection Drug Use Associated Infections: A Qualitative Study, Nathanial S Nolan, Emily Gleason, Laura R Marks, Tracey Habrock-Bach, Stephen Y Liang, Michael J Durkin

2020-Current year OA Pubs

Background: Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to …


Efficient T Cell Migration And Activation Require L-Plastin, Hemant Joshi, Sharon Celeste Morley Jan 2022

Efficient T Cell Migration And Activation Require L-Plastin, Hemant Joshi, Sharon Celeste Morley

2020-Current year OA Pubs

Rapid re-organization of the actin cytoskeleton supports T-cell trafficking towards immune sites and interaction with antigen presenting cells (APCs). F-actin rearrangement enables T-cell trafficking by stabilizing adhesion to vascular endothelial cells and promoting transendothelial migration. T-cell/APC immune synapse (IS) maturation also relies upon f-actin-anchored LFA-1:ICAM-1 ligation. Therefore, efficient T-cell responses require tight regulation of f-actin dynamics. In this review, we summarize how the actin-bundling protein L-plastin (LPL) regulates T-cell activation and migration. LPL enhances f-actin polymerization and also directly binds to the β2 chain of the integrin LFA-1 to support intercellular adhesion and IS formation in human and murine T …


Beta-Adrenergic Antagonist Tolerance In Amyloid Cardiomyopathy, Stuart Ramsell, Carlos Arias Bermudez, Cyril Ayuk Mbeng Takem Baiyee, Brandon Rodgers, Samir Parikh, Salem Almaani, Nidhi Sharma, Samantha Lorusso, Miriam Freimer, Elyse Redder, Naresh Bumma, Ajay Vallkati, Yvonne Efebera, Rami Kahwash, Courtney M Campbell Jan 2022

Beta-Adrenergic Antagonist Tolerance In Amyloid Cardiomyopathy, Stuart Ramsell, Carlos Arias Bermudez, Cyril Ayuk Mbeng Takem Baiyee, Brandon Rodgers, Samir Parikh, Salem Almaani, Nidhi Sharma, Samantha Lorusso, Miriam Freimer, Elyse Redder, Naresh Bumma, Ajay Vallkati, Yvonne Efebera, Rami Kahwash, Courtney M Campbell

2020-Current year OA Pubs

Background: Beta-adrenergic antagonists or blockers (BB) are a cornerstone of cardiac therapy for multiple indications. However, BB are considered relatively contraindicated in amyloid cardiomyopathy due to poor tolerance. This intolerance is hypothesized to be due to concomitant neuropathy and significant restrictive cardiomyopathy. This study analyzes the incidence and characteristics of BB tolerance in patients with amyloid cardiomyopathy.

Methods: Through a single-center retrospective chart review, patients with amyloid cardiomyopathy, confirmed by endomyocardial biopsy or technetium-99 pyrophosphate scan, were identified and clinical data was collected. Statistical methods included Chi-square test and two sample

Results: Of 135 cardiac amyloidosis patients, 27 patients (20.0%) …


Checkpoint Blockade-Induced Cd8+ T Cell Differentiation In Head And Neck Cancer Responders, Liye Zhou, Paul Zolkind, Obi Griffith, Et Al Jan 2022

Checkpoint Blockade-Induced Cd8+ T Cell Differentiation In Head And Neck Cancer Responders, Liye Zhou, Paul Zolkind, Obi Griffith, Et Al

2020-Current year OA Pubs

BACKGROUND: Immune checkpoint blockade (ICB) response in recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) is limited to 15%-20% of patients and underpinnings of resistance remain undefined.

METHODS: Starting with an anti-PD1 sensitive murine HNSCC cell line, we generated an isogenic anti-PD1 resistant model. Mass cytometry was used to delineate tumor microenvironments of both sensitive parental murine oral carcinoma (MOC1) and resistant MOC1esc1 tumors. To examine heterogeneity and clonal dynamics of tumor infiltrating lymphocytes (TILs), we applied paired single-cell RNA and TCR sequencing in three HNSCC models.

RESULTS: Anti-PD1 resistant MOC1esc1 line displayed a conserved cell intrinsic immune evasion signature. …


Phase I Clinical Trial Evaluating The Safety And Efficacy Of Adp-A2m10 Spear T Cells In Patients With Mage-A10+ Advanced Non-Small Cell Lung Cancer, George R Blumenschein, Siddhartha Devarakonda, Ramaswamy Govindan, Et Al Jan 2022

Phase I Clinical Trial Evaluating The Safety And Efficacy Of Adp-A2m10 Spear T Cells In Patients With Mage-A10+ Advanced Non-Small Cell Lung Cancer, George R Blumenschein, Siddhartha Devarakonda, Ramaswamy Govindan, Et Al

2020-Current year OA Pubs

BACKGROUND: ADP-A2M10 specific peptide enhanced affinity receptor (SPEAR) T cells (ADP-A2M10) are genetically engineered autologous T cells that express a high-affinity melanoma-associated antigen A10 (MAGE-A10)-specific T-cell receptor (TCR) targeting MAGE-A10

METHODS: Eligible patients were HLA-A*02 positive with advanced NSCLC expressing MAGE-A10. Patients underwent apheresis; T cells were isolated, transduced with a lentiviral vector containing the TCR targeting MAGE-A10, and expanded. Patients underwent lymphodepletion with varying doses/schedules of fludarabine and cyclophosphamide prior to receiving ADP-A2M10. ADP-A2M10 were administered at 0.08-0.12×10

RESULTS: Eleven patients (male, n=6; female, n=5) with NSCLC (adenocarcinoma, n=8; squamous cell carcinoma, n=3) were treated. Five, three, and three …


Episodic Memories Among Irritable Bowel Syndrome (Ibs) Patients: An Important Aspect Of The Ibs Symptom Experience, Gregory S Sayuk, Carol S North, David E Pollio, Britt M Gott, David H Alpers Jan 2022

Episodic Memories Among Irritable Bowel Syndrome (Ibs) Patients: An Important Aspect Of The Ibs Symptom Experience, Gregory S Sayuk, Carol S North, David E Pollio, Britt M Gott, David H Alpers

2020-Current year OA Pubs

Objective: Some IBS patients possess detailed memories of the events surrounding their bowel symptom onset ("episodic memories"). In this exploratory study we sought to: (1) examine memory relationship with gastrointestinal (GI) symptom severity, extraintestinal symptoms, and mood; (2) qualitatively explore memory valence and content in IBS patients with or without episodic memories.

Methods: Referral IBS patients

Results: 14/29 (48.3%) of IBS subjects endorsed episodic memories of IBS symptom onset, often GI infections/enteritis (35.7%). Recall of the exact year (69%) and month (60%) of symptom onset were common. Episodic memories were associated with greater IBS symptom severity/bother, higher anxiety/depression, and poorer …


Predictors Of Lung Adenocarcinoma With Leptomeningeal Metastases: A 2022 Targeted-Therapy-Assisted Molgpa Model, Milan Zhang, Jiayi Tong, Weifeng Ma, Chongliang Luo, Huiqin Liu, Yushu Jiang, Lingzhi Qin, Xiaojuan Wang, Lipin Yuan, Jiewen Zhang, Fuhua Peng, Yong Chen, Wei Li, Ying Jiang Jan 2022

Predictors Of Lung Adenocarcinoma With Leptomeningeal Metastases: A 2022 Targeted-Therapy-Assisted Molgpa Model, Milan Zhang, Jiayi Tong, Weifeng Ma, Chongliang Luo, Huiqin Liu, Yushu Jiang, Lingzhi Qin, Xiaojuan Wang, Lipin Yuan, Jiewen Zhang, Fuhua Peng, Yong Chen, Wei Li, Ying Jiang

2020-Current year OA Pubs

Objective: To explore prognostic indicators of lung adenocarcinoma with leptomeningeal metastases (LM) and provide an updated graded prognostic assessment model integrated with molecular alterations (molGPA).

Methods: A cohort of 162 patients was enrolled from 202 patients with lung adenocarcinoma and LM. By randomly splitting data into the training (80%) and validation (20%) sets, the Cox regression and random survival forest methods were used on the training set to identify statistically significant variables and construct a prognostic model. The C-index of the model was calculated and compared with that of previous molGPA models.

Results: The Cox regression and random forest models …


Neors: A Neonatal Resting State Fmri Data Preprocessing Pipeline, Vicente Enguix, Jeanette Kenley, David Luck, Julien Cohen-Adad, Gregory Anton Lodygensky Jan 2022

Neors: A Neonatal Resting State Fmri Data Preprocessing Pipeline, Vicente Enguix, Jeanette Kenley, David Luck, Julien Cohen-Adad, Gregory Anton Lodygensky

2020-Current year OA Pubs

Resting state functional MRI (rsfMRI) has been shown to be a promising tool to study intrinsic brain functional connectivity and assess its integrity in cerebral development. In neonates, where functional MRI is limited to very few paradigms, rsfMRI was shown to be a relevant tool to explore regional interactions of brain networks. However, to identify the resting state networks, data needs to be carefully processed to reduce artifacts compromising the interpretation of results. Because of the non-collaborative nature of the neonates, the differences in brain size and the reversed contrast compared to adults due to myelination, neonates can't be processed …


Exploring The Role Of Low-Density Neutrophils During Mycobacterium Tuberculosis Infection, Ananda N Rankin, Skyler V Hendrix, Sumanta K Naik, Christina L Stallings Jan 2022

Exploring The Role Of Low-Density Neutrophils During Mycobacterium Tuberculosis Infection, Ananda N Rankin, Skyler V Hendrix, Sumanta K Naik, Christina L Stallings

2020-Current year OA Pubs

Tuberculosis (TB) is caused by infection with the bacterium


Dual Orexin Receptor Antagonists For Treatment Of Insomnia: A Systematic Review And Meta-Analysis On Randomized, Double-Blind, Placebo-Controlled Trials Of Suvorexant And Lemborexant, Habibolah Khazaie, Masoud Sadeghi, Sepideh Khazaie, Max Hirshkowitz, Amir Sharafkhaneh Jan 2022

Dual Orexin Receptor Antagonists For Treatment Of Insomnia: A Systematic Review And Meta-Analysis On Randomized, Double-Blind, Placebo-Controlled Trials Of Suvorexant And Lemborexant, Habibolah Khazaie, Masoud Sadeghi, Sepideh Khazaie, Max Hirshkowitz, Amir Sharafkhaneh

Faculty, Staff and Students Publications

Study objectives: Recent treatment guidelines for chronic insomnia recommend pharmacological and non-pharmacological therapies. One of the contemporary drug options for insomnia includes dual orexin receptor antagonist (DORA), such as suvorexant and lemborexant. We conducted a systematic review and meta-analysis for the treatment of insomnia with suvorexant and lemborexant based on randomized, double-blind, placebo-controlled Trials.

Methods: We conducted a comprehensive search on three databases (PubMed/Medline, Web of Science, and Cochrane Library) till August 14, 2021, without any restrictions to retrieve the relevant articles. The effect sizes were computed presenting the pooled mean difference or risk ratio along with 95% confidence interval …


Highlights From International Conference On Cancer Health Disparities 2021, Murali M. Yallapu, Jorge L. Teniente, Andrew Tsin, Subhash C. Chauhan Jan 2022

Highlights From International Conference On Cancer Health Disparities 2021, Murali M. Yallapu, Jorge L. Teniente, Andrew Tsin, Subhash C. Chauhan

School of Medicine Publications

The first International Conference on Cancer Health Disparities (ICCHD) was held on August 13-14, 2021, in Harlingen, TX, USA. This two-day ICCHD-2021 was organized by the University of Texas Rio Grande Valley, School of Medicine (UTRGV-SOM). About 200 national and international delegates from 10 countries attended this hybrid meeting in person and through online digital platforms. The event delegates were representatives from National Institutes of Health (NIH), Cancer Prevention and Research Institute of Texas (CPRIT), and the City of Harlingen, in addition to clinicians, faculty, researchers, scientists, bioinformaticians, geneticists, bioethicists, and others. Under the theme of Cancer Health Disparities, this …


The Enhancing Neuroimaging Genetics Through Meta-Analysis Consortium: 10 Years Of Global Collaborations In Human Brain Mapping, Paul M. Thompson, Neda Jahanshad, Lianne Schmaal, Jessica A. Turner, Anderson M. Winkler, Sophia I. Thomopoulos, Gary F. Egan, Peter Kochunov Jan 2022

The Enhancing Neuroimaging Genetics Through Meta-Analysis Consortium: 10 Years Of Global Collaborations In Human Brain Mapping, Paul M. Thompson, Neda Jahanshad, Lianne Schmaal, Jessica A. Turner, Anderson M. Winkler, Sophia I. Thomopoulos, Gary F. Egan, Peter Kochunov

School of Medicine Publications

This Special Issue of Human Brain Mapping is dedicated to a 10-year anniversary of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium. It reports updates from a broad range of international neuroimaging projects that pool data from around the world to answer fundamental questions in neuroscience. Since ENIGMA was formed in December 2009, the initiative grew into a worldwide effort with over 2,000 participating scientists from 45 countries, and over 50 working groups leading large-scale studies of human brain disorders. Over the last decade, many lessons were learned on how best to pool brain data from diverse sources. Working groups …


Enigma-Anxiety Working Group: Rationale For And Organization Of Large-Scale Neuroimaging Studies Of Anxiety Disorders, Janna Marie Bas-Hoogendam, Nynke A. Groenewold, Moji Aghajani, Gabrielle F. Freitag, Anita Harrewijn, Kevin Hilbert, Neda Jahanshad, Sophia I. Thomopoulos, Paul M. Thompson, Anderson M. Winkler Jan 2022

Enigma-Anxiety Working Group: Rationale For And Organization Of Large-Scale Neuroimaging Studies Of Anxiety Disorders, Janna Marie Bas-Hoogendam, Nynke A. Groenewold, Moji Aghajani, Gabrielle F. Freitag, Anita Harrewijn, Kevin Hilbert, Neda Jahanshad, Sophia I. Thomopoulos, Paul M. Thompson, Anderson M. Winkler

School of Medicine Publications

Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the …


Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M Talha, Gregg C Fonarow, Salim S Virani, Javed Butler Jan 2022

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M Talha, Gregg C Fonarow, Salim S Virani, Javed Butler

Faculty, Staff and Students Publications

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …


The Effects Of Body Tempering On Force Production, Flexibility And Muscle Soreness In Collegiate Football Athletes, Christopher B. Taber, Roy Colter, Jair J. Davis, Patrick A. Seweje, Dustin P. Wilson, Jonathan Z. Foster, Justin J. Merrigan Jan 2022

The Effects Of Body Tempering On Force Production, Flexibility And Muscle Soreness In Collegiate Football Athletes, Christopher B. Taber, Roy Colter, Jair J. Davis, Patrick A. Seweje, Dustin P. Wilson, Jonathan Z. Foster, Justin J. Merrigan

Exercise Science Faculty Publications

There has been limited research to explore the use of body tempering and when the use of this modality would be most appropriate. This study aimed to determine if a body tempering intervention would be appropriate pre-exercise by examining its effects on perceived soreness, range of motion (ROM), and force production compared to an intervention of traditional stretching. The subjects for this study were ten Division 1 (D1) football linemen from Sacred Heart University (Age: 19.9 ± 1.5 years, body mass: 130.9 ± 12.0 kg, height: 188.4 ± 5.1 cm, training age: 8.0 ± 3.5 years). Subjects participated in three …


Application Of Accentuated Eccentric Loading To Elicit Acute And Chronic Velocity And Power Improvements: A Narrative Review, Justin Merrigan, Jonathon Borth, Christopher B. Taber, Timothy J. Suchomel, Margaret Jones Jan 2022

Application Of Accentuated Eccentric Loading To Elicit Acute And Chronic Velocity And Power Improvements: A Narrative Review, Justin Merrigan, Jonathon Borth, Christopher B. Taber, Timothy J. Suchomel, Margaret Jones

Exercise Science Faculty Publications

No abstract provided.


Twelve Week Calcium Collagen Chelate Or Calcium Plus Vitamin D Supplementation Does Not Affect Bone Metabolism In Trained Cyclists, Beau K. Greer, Christopher Mojock, Bahram Arjmandi, Jeong-Su Kim, Michael Ormsbee, Lynn Panton Jan 2022

Twelve Week Calcium Collagen Chelate Or Calcium Plus Vitamin D Supplementation Does Not Affect Bone Metabolism In Trained Cyclists, Beau K. Greer, Christopher Mojock, Bahram Arjmandi, Jeong-Su Kim, Michael Ormsbee, Lynn Panton

Exercise Science Faculty Publications

The purpose of the present study was to determine whether 12 weeks of calcium collagen chelate (CCC) supplementation during habitual training would affect body composition, bone mineral density (BMD), and biomarkers of bone metabolism in competitive cyclists. Twenty trained (maximal aerobic capacity > 50 ml/kg/min, mean training volume: 28 h/wk) male cyclists performed maximal exercise testing and 40-km time trials (TT) on an electronically braked cycle ergometer. BMD of the whole body, lumbar spine (L1-L4), and both hips were measured via dual-energy X-ray absorptiometry (DXA). The cyclists were assigned to one of two groups: 1) 6 g/d of CCC with 600 …


Adult Memory T Cell Responses To The Respiratory Syncytial Virus Fusion Protein During A Single Rsv Season (2018-2019), Brittani N Blunck, Laura S Angelo, David Henke, Vasanthi Avadhanula, Matthew Cusick, Laura Ferlic-Stark, Lynn Zechiedrich, Brian E Gilbert, Pedro A Piedra Jan 2022

Adult Memory T Cell Responses To The Respiratory Syncytial Virus Fusion Protein During A Single Rsv Season (2018-2019), Brittani N Blunck, Laura S Angelo, David Henke, Vasanthi Avadhanula, Matthew Cusick, Laura Ferlic-Stark, Lynn Zechiedrich, Brian E Gilbert, Pedro A Piedra

Faculty, Staff and Students Publications

Respiratory Syncytial Virus (RSV) is ubiquitous and re-infection with both subtypes (RSV/A and RSV/B) is common. The fusion (F) protein of RSV is antigenically conserved, induces neutralizing antibodies, and is a primary target of vaccine development. Insight into the breadth and durability of RSV-specific adaptive immune response, particularly to the F protein, may shed light on susceptibility to re-infection. We prospectively enrolled healthy adult subjects (n = 19) and collected serum and peripheral blood mononuclear cells (PBMCs) during the 2018–2019 RSV season. Previously, we described their RSV-specific antibody responses and identified three distinct antibody kinetic profiles associated with infection …


Cross-Sectional Survey Of Smoking Patterns During The Covid-19 Pandemic In A Tobacco Cessation And Lung Cancer Screening Program, Maria C Mejia, Roger Zoorob, Robert S Levine, Xiaofan Huang, Charles H Hennekens Jan 2022

Cross-Sectional Survey Of Smoking Patterns During The Covid-19 Pandemic In A Tobacco Cessation And Lung Cancer Screening Program, Maria C Mejia, Roger Zoorob, Robert S Levine, Xiaofan Huang, Charles H Hennekens

Faculty, Staff and Students Publications

Background: Coronavirus disease 2019 (COVID-19) produces a wide array of deleterious consequences, some of which are unintended. Data are sparse on whether, and if so, how, current cigarette smoking habits are affected by COVID-19. We describe changes to smoking habits and their correlates during the COVID-19 pandemic among participants in a tobacco cessation and lung cancer screening program.

Methods: Between June and October 2020, we conducted a cross-sectional survey of a convenience sample of 150 participants in a lung cancer screening and tobacco cessation program. The survey consisted of 3 parts: (1) changes in tobacco use, (2) impact and coping …


A Survey On Self-Medication For The Prevention Or Treatment Of Covid-19 And Distrust In Healthcare Of Veterans In A Primary Care Setting In The United States, Eva Amenta, Larissa Grigoryan, Laura Dillon, Casey Hines-Munson, John Van, Barbara Trautner Jan 2022

A Survey On Self-Medication For The Prevention Or Treatment Of Covid-19 And Distrust In Healthcare Of Veterans In A Primary Care Setting In The United States, Eva Amenta, Larissa Grigoryan, Laura Dillon, Casey Hines-Munson, John Van, Barbara Trautner

Faculty, Staff and Students Publications

BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic brought the public overwhelming and conflicting information. Rates of trust in healthcare professionals have been declining among laypersons over the past five decades. In this setting, we sought to evaluate the use of medications, both with or without a prescription, to prevent and treat SARS-CoV-2 as well as trust in healthcare among patients in a primary care clinic.

DESIGN: We surveyed 150 veterans in primary care clinic waiting rooms at a large southwestern tertiary care Veterans Affairs hospital. This survey was performed in March-November 2021.

METHODS: The survey asked about respondents' demographics, use of medications, …


Clinical Reasoning Education In The Clerkship Years: A Cross-Disciplinary National Needs Assessment, Jonathan G Gold, Christopher L Knight, Jennifer G Christner, Christopher E Mooney, David E Manthey, Valerie J Lang Jan 2022

Clinical Reasoning Education In The Clerkship Years: A Cross-Disciplinary National Needs Assessment, Jonathan G Gold, Christopher L Knight, Jennifer G Christner, Christopher E Mooney, David E Manthey, Valerie J Lang

Faculty, Staff and Students Publications

BACKGROUND: Improving clinical reasoning education has been identified as an important strategy to reduce diagnostic error-an important cause of adverse patient outcomes. Clinical reasoning is fundamental to each specialty, yet the extent to which explicit instruction in clinical reasoning occurs across specialties in the clerkship years remains unclear.

METHOD: The Alliance for Clinical Education (ACE) Clinical Reasoning Workgroup and the Directors of Clinical Skills Courses (DOCS) Clinical Reasoning Workgroup collaborated to develop a clinical reasoning needs assessment survey. The survey questionnaire covered seven common clinical reasoning topics including illness scripts, semantic qualifiers, cognitive biases and dual process theory. Questionnaires were …


Lessons Learned From An Enterprise-Wide Clinical Datathon, Andrew J Zimolzak, Jessica A Davila, Vamshi Punugoti, Ashok Balasubramanyam, Paul E Klotman, Laura A Petersen, Ryan H Rochat, Gloria Liao, Rory R Laubscher, Lee Leiber, Christopher I Amos Jan 2022

Lessons Learned From An Enterprise-Wide Clinical Datathon, Andrew J Zimolzak, Jessica A Davila, Vamshi Punugoti, Ashok Balasubramanyam, Paul E Klotman, Laura A Petersen, Ryan H Rochat, Gloria Liao, Rory R Laubscher, Lee Leiber, Christopher I Amos

Faculty, Staff and Students Publications

In 2020, Baylor College of Medicine held a datathon to inform potential users of a new data warehouse, allow users to address clinical questions, identify warehouse capabilities and limitations, foster collaborations, and engage trainees. Senior faculty selected proposals based on feasibility and impact. Selectees worked with Information Technology for 2 months and presented findings. A survey of participants showed diverse levels of experience, high perceived value of the datathon, high rates of collaboration, and significant increases in knowledge. A datathon can promote familiarity with a new data warehouse, guide data warehouse improvement, and promote collaboration.


Esophageal Perforation Successfully Treated With Evt, Kavea Panneerselvam, Ronald Samuel, Robert J Sealock Jan 2022

Esophageal Perforation Successfully Treated With Evt, Kavea Panneerselvam, Ronald Samuel, Robert J Sealock

Faculty, Staff and Students Publications

Esophageal perforation is rare and carries high morbidity and mortality. A high degree of suspicion is needed for timely diagnosis and treatment. A 54-year-old man presented with fever and confusion. Imaging revealed air in the hepatic inferior vena cava and concern for a fistula between the distal esophagus and the inferior vena cava. An upper endoscopic evaluation revealed a dental floss pick penetrating the distal esophagus. The foreign body was removed, and endoluminal vacuum therapy was used to close the perforation. Endoluminal vacuum therapy is an emerging therapy to treat full-thickness gastrointestinal injuries.


Mental Health And Access To Medical Care In Patients With Chronic Cardiovascular Conditions: An Analysis Of The Behavior Risk Factor Surveillance System, Riyad Y Kherallah, Mahmoud Al Rifai, Jing Liu, Sina Kianoush, Arunima Misra, Salim S Virani Jan 2022

Mental Health And Access To Medical Care In Patients With Chronic Cardiovascular Conditions: An Analysis Of The Behavior Risk Factor Surveillance System, Riyad Y Kherallah, Mahmoud Al Rifai, Jing Liu, Sina Kianoush, Arunima Misra, Salim S Virani

Faculty, Staff and Students Publications

INTRODUCTION: Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access.

METHODS: Using a combined dataset of the 2016-2019 Behavioral Risk Factor Surveillance System, this study focused on individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, more than one year since last routine checkup, lack of a primary care physician, and cost-related medication nonadherence.

RESULTS: Among 1,747,397 participants, 27% had a chronic cardiovascular …


Management Of A Novel Autoimmune Disease, Copa Syndrome, In Pregnancy, Archana Ayyar, Rachel D Seaman, Kalpalatha Guntupalli, Mary C Tolcher Jan 2022

Management Of A Novel Autoimmune Disease, Copa Syndrome, In Pregnancy, Archana Ayyar, Rachel D Seaman, Kalpalatha Guntupalli, Mary C Tolcher

Faculty, Staff and Students Publications

BACKGROUND: COPA syndrome is a rare autoimmune disease, demonstrating an autosomal dominant inheritance pattern with variable penetration that occurs more frequently in females than males. This disease manifests in childhood as pulmonary hemorrhage, arthritis, and renal disease.

CASE: We present a case of obstetric management of a 20-year-old nulligravida patient with a diagnosis of COPA syndrome. Her case was further complicated by multiple antepartum admissions for hypoxemia and a complex psychosocial history of substance use. On her first antepartum admission, rheumatology recommended management with hydroxychloroquine, inhaled corticosteroids (budesonide), and bronchodilators (albuterol inhaler) as needed. On admission for induction of labor, …


“I Have Nothing More To Give”: Disparities In Burnout And The Protective Role Of Immigrant Status During The Covid-19 Pandemic, Gene Chibuchim Otuonye, Nancy Shenoi, Tianshi David Wu, Kalpalatha Guntupalli, Nidal Moukaddam Jan 2022

“I Have Nothing More To Give”: Disparities In Burnout And The Protective Role Of Immigrant Status During The Covid-19 Pandemic, Gene Chibuchim Otuonye, Nancy Shenoi, Tianshi David Wu, Kalpalatha Guntupalli, Nidal Moukaddam

Faculty, Staff and Students Publications

Burnout is an epidemic, with deleterious effects on individuals, patient care, and healthcare systems. The Coronavirus Disease 2019 (COVID-19) pandemic may be exacerbating this problem. We aimed to explore socio-cultural and gender norms that modulate burnout development in physicians during the pandemic and analyze any disparities associated with gender, marital and immigration status and work-life balance. We conducted an online cross-sectional survey of physicians (August-November, 2021): The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to measure burnout, combined with a validated survey assessing work-life balance. Demographic data was obtained for each participant. MBI-HSS subscales were measured, along with work …


Meta-Analysis Comparing Outcomes Of High-Power Short-Duration And Low-Power Long-Duration Radiofrequency Ablation For Atrial Fibrillation, Dibbendhu Khanra, Abdul Hamid, Saurabh Deshpande, Anindya Mukherjee, Sanjiv Petkar, Mohammad Saeed, Indranill Basu-Ray Jan 2022

Meta-Analysis Comparing Outcomes Of High-Power Short-Duration And Low-Power Long-Duration Radiofrequency Ablation For Atrial Fibrillation, Dibbendhu Khanra, Abdul Hamid, Saurabh Deshpande, Anindya Mukherjee, Sanjiv Petkar, Mohammad Saeed, Indranill Basu-Ray

Faculty, Staff and Students Publications

OBJECTIVE: High power short duration (HPSD) ablation strategy is proposed to be more effective than low power long duration (LPLD) for radiofrequency ablation of atrial fibrillation. Although small trials abound, data from a large cohort are lacking. This meta-analysis compares all the existing studies comparing these two approaches to evaluate perceived advantages of one over the other.

METHODS: A systematic search of PubMed, EMBASE, and Cochrane databases identified studies comparing HPSD to LPLD ablation. All the analyses used the random-effects model.

RESULTS: Ablation settings varied widely across 20 studies comprising 2,136 patients who underwent HPSD and 1,753 patients who underwent …


Targeting Type I Interferons In Systemic Lupus Erythematous, Sebastian Bruera, Thandiwe Chavula, Riya Madan, Sandeep K Agarwal Jan 2022

Targeting Type I Interferons In Systemic Lupus Erythematous, Sebastian Bruera, Thandiwe Chavula, Riya Madan, Sandeep K Agarwal

Faculty, Staff and Students Publications

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with systemic clinical manifestations including, but not limited to, rash, inflammatory arthritis, serositis, glomerulonephritis, and cerebritis. Treatment options for SLE are expanding and the increase in our understanding of the immune pathogenesis is leading to the development of new therapeutics. Autoantibody formation and immune complex formation are important mediators in lupus pathogenesis, but an important role of the type I interferon (IFN) pathway has been identified in SLE patients and mouse models of lupus. These studies have led to the development of therapeutics targeting type I IFN and related pathways for …


Pcsk9 Inhibitors In The Management Of Cardiovascular Risk: A Practical Guidance, Xiaoming Jia, Mahmoud Al Rifai, Anum Saeed, Christie M Ballantyne, Salim S Virani Jan 2022

Pcsk9 Inhibitors In The Management Of Cardiovascular Risk: A Practical Guidance, Xiaoming Jia, Mahmoud Al Rifai, Anum Saeed, Christie M Ballantyne, Salim S Virani

Faculty, Staff and Students Publications

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are potent medications in the toolkit for treatment of atherosclerotic cardiovascular disease. These agents have been well studied in clinical trials supporting their efficacy in dramatically reducing low-density lipoprotein cholesterol (LDL-C) and impact on cardiovascular outcomes. Since the approval of commercial use for PCSK9 inhibitors in 2015, we have also gained significant experience in the use of these therapeutics in the real-world setting. In this article, we review current guideline recommendations, clinical trial evidence on efficacy and safety as well as data on cost-effectiveness, prescription and adherence. We focus primarily on the monoclonal …