Medicine and Health Sciences Commons^™

From Skin To Spleen To Brain: Full-Spectrum Embolic Complications In Staphylococcus Aureus Endocarditis, Jose J. Loayza Pintado, Jorge Aboytes Trevino, Julian Galindo, Mohammad Aqeel, John Cauba, Joshua Nwose, Andres Suarez Parraga

Research Symposium

Background: Infective endocarditis (IE) results from bacterial adhesion to endocardial tissue and valvular apparatus. While viridans group streptococci and Enterococcus species are associated with subacute disease, Staphylococcus aureus, including methicillin-resistant strains (MRSA), is a leading cause of more acutely destructive presentations. The entry of these pathogens can occur through surgical and dental procedures, intravenous drug use, or less apparent etiology. Classic peripheral stigmata (Osler nodes, Janeway lesions, splinter hemorrhages, Roth spots) are now uncommon but clinically meaningful. Current guidelines emphasize rapid multimodality imaging to detect cerebral and systemic emboli in symptomatic IE. We present a 50-year-old man with S. aureus …

The Bubble, The Blockage, And The Barrier: Weighing Pfo Against Moyamoya In An Stroke Mechanism Diagnostic Challenge In Down Syndrome With Achalasia, Jose J. Loayza Pintado, Adolfo Nava, Jose Donis Castaneda, Taiwo Ajani, Cesar Uribe

Research Symposium

Background: Paradoxical embolism through a PFO or small ASD is a common mechanism of stroke in young adults, and randomized trials plus contemporary guidelines support closure in carefully selected 18–60-year-olds to reduce recurrence. Individuals with Down syndrome frequently have congenital heart lesions, raising the pretest probability of shunt-mediated stroke. Yet Down syndrome is also linked to moyamoya arteriopathy, creating diagnostic ambiguity when intracranial narrowing is seen on first-pass imaging. We present a 34-year-old woman with Down syndrome, an acute MCA infarct, and a mildly positive bubble study in whom TEE was deferred for achalasia, illustrating a cardiology-led diagnostic challenge that …

Antimicrobial Susceptibility And Targeted Molecular Detection Of Methicillin Resistance Determinants In Staphylococcus Spp. Isolated From Broiler Bco Lesions, Woro Wulandari Kalanjati, Chrystalee Ailani Alvarez, Anh Dang Trieu Do, Adnan Ali Khalaf Alrubaye

School of Integrative Biological & Chemical Sciences Faculty Publications

Background/Objectives: Antimicrobial resistance (AMR) in Staphylococcus spp. associated with poultry production is an emerging concern with implications for animal and public health. This study aimed to characterize antimicrobial susceptibility patterns and detect targeted methicillin resistance determinants in Staphylococcus isolates recovered from broiler chickens affected by bacterial chondronecrosis with osteomyelitis (BCO). Methods: A total of 200 bacterial isolates were evaluated, of which 167 were confirmed as Staphylococcus spp. Species identification was performed using presumptive phenotypic characterization followed by 16S rRNA gene sequencing. Antimicrobial susceptibility was assessed using disk diffusion, while presumptive methicillin-resistant phenotypes were evaluated using oxacillin screening and CHROMagar MRSA. …

Impact Of Insurance On In-Hospital Mortality And Other Outcomes Among Patients With Acs And Cardiogenic Shock: A Nationwide Analysis From 2022., Renzo Aller, Aura Calderon

Research Symposium

Introduction: Insurance coverage may significantly affect access to timely and advanced cardiovascular therapeutic interventions within the United States. Among individuals experiencing acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS), variations based on the primary payer may play a role in subsequent in-hospital outcomes. We conducted a retrospective analysis to determine whether insurance status correlates with in-hospital mortality and other outcomes among patients with AMI and CS, utilizing the NIS database.

Methods: ACS patients in the 2022 NIS were categorized as STEMI or NSTE-ACS using appropriate ICD‐10 codes. Patients with both types of ACS and cardiogenic shock were included in …

The Triple Threat: Hiv, Nonadherence, And Substance Use Driving Premature Coronary Events, Jose J. Loayza Pintado, Taiwo Ajani, Angelica Lopez Jesus, Aura Calderon, Jose Pena

Research Symposium

Background: People living with HIV (PLWH) experience nearly double the risk of premature atherosclerotic cardiovascular disease and often present with acute coronary syndromes at younger ages [1]. Chronic inflammation, immune activation, and drug–drug interactions between antiretrovirals and antiplatelet agents further contribute to accelerated atherosclerosis and poor outcomes after percutaneous coronary intervention (PCI) [2,3]. Importantly, in-stent restenosis (ISR) remains disproportionately frequent in PLWH despite modern drug-eluting stents, with medication nonadherence compounding risk [4]. We present a young woman with HIV and recurrent myocardial infarction due to rapid ISR, underscoring the impact of inflammation, adherence, and pharmacologic interactions on secondary prevention.

Case …

Survival Outcomes And Tumor Site Distribution By Molecular Subtype In Breast Cancer Patients Under 40, Muhammad Noorani, Shubhank Goyal, Sierra Viduarri, Aura Calderon, Christine Pham, Shweta Singh, Mutaaz Ahmed, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Shubash Chauhan, Diane Nguyen, Sidketa Fofana, Sheema Khan

Research Symposium

Background: Screening guidelines for breast cancer typically begin at age 40, leaving younger women at risk for delayed detection. The survival outcomes and tumor site patterns by subtype in this younger population remain underexplored. Our analysis leverages comprehensive national data to fill this critical knowledge gap, offering one of the most detailed evaluations to date of molecular subtype distribution, prognostic disparities, and anatomical presentation in women under 40.

Methods: Using the SEER 18 registry, we identified 5,026 female patients diagnosed under age 40 with invasive breast cancer in 2018. This year was selected for the most recent data available on …

Severe Cold Agglutinin Hemolytic Anemia Secondary To Mycoplasma Pneumoniae And Epstein-Barr Virus Co-Infection In An Elderly Patient, Aura Mc Calderon, Jose Loayza, Luis Salcedo, Ivan Mogollon, Asmik Asatrian

Research Symposium

Introduction: Cold autoimmune hemolytic anemia (AIHA) is an uncommon, complement-mediated hemolysis typically driven by IgM autoantibodies; secondary forms are often infection-related. Severe, transfusion-refractory presentations are rare in older adults. We present an elderly patient with Mycoplasma pneumoniae and Epstein–Barr virus co-infection complicated by life-threatening cold agglutinin hemolysis.

Case report: Upon admission, a 79-year-old male patient presented with a one-week history of fatigue, pyrexia, nasal congestion, and dyspnea; examination findings revealed pallor, bibasilar crackles, and mild splenomegaly. Laboratory investigations indicated the presence of severe hemolytic anemia accompanied by compensatory reticulocytosis and thrombocytosis (hemoglobin 5.5 g/dL, hematocrit 17.2%, MCV 100 fL, reticulocytes …

Iptacopan-Responsive Pnh With Pancytopenia: Hematologic Normalization And Dose Adjustment For Transaminitis, Aura Mc Calderon, Jose Loayza, Francisco Arias, Catherine Matos, Bharat Peddinani, Diane Nguyen

Research Symposium

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal hematopoietic stem-cell disorder driven by loss of GPI-anchored complement regulators (CD55, CD59), leading to complement-mediated intravascular hemolysis, cytopenias, and thrombosis. We report a new PNH diagnosis in a young woman with severe pancytopenia who achieved hematologic improvement on oral iptacopan, requiring dose adjustments for mild liver enzyme elevation.

Case Report: On February 27, 2025, a 38-year-old female patient exhibited symptoms of progressive fatigue, dyspnea, and jaundice. Initial laboratory assessments indicated the presence of severe hemolytic anemia accompanied by pancytopenia, hemoglobin level recorded at 4.7 g/dL, white blood cell count at 1.6×10³/µL (absolute …

Expression And Functional Significance Of The G Protein–Coupled Estrogen Receptor (Gper) In Breast Cancer Subtypes, Sierra E. Vidaurri, Shweta Singh, Valerie E. Ledezma, Rajasekhar Baru, Emma Garza, Francisco Flores, Muhammad Noorani, Shubhank Goyal, Aura Calderon, Alexander Lim, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Subhash Chauhan, Diane Nguyen, Sheema Khan

Research Symposium

Background: The G protein–coupled estrogen receptor (GPER) mediates rapid non-genomic estrogen signaling and has been implicated in breast cancer progression and aggressiveness. However, its expression patterns across molecular subtypes and its direct functional contribution to tumor behavior remain incompletely defined. The objective of this study was to comprehensively characterize GPER expression in breast cancer tissues and to functionally validate its role in regulating tumor cell proliferation and migration using genetic modulation approaches.

Methods: GPER expression was evaluated in breast cancer cell lines and patient tumor tissues using immunohistochemistry (IHC), Western blotting, and RT-PCR. Tumors were classified into Luminal A, Luminal …

Clinical Outcomes In Neutropenic Fever At A South Texas Community Hospital In Hispanic Patients., Bharat K. Peddinani, Aura Calderon, Ramon Elizondo-Romo, Elizabeth Mills-Reyes, Everardo Cobos

Research Symposium

Background: Febrile neutropenia (FN) remains a high-acuity complication of myelosuppressive chemotherapy, yet outcomes in Hispanic patients—particularly in South Texas—are underrepresented. We compared outcomes of FN admissions among Hispanic adults with solid tumors versus hematologic malignancies at a community hospital in the Rio Grande Valley.

Methods: We conducted a retrospective cohort study of adult hospital admissions for FN from January 2022 through January 2025. Inclusion criteria were age ≥18 years, FN documented in the emergency department, active chemotherapy for a solid or hematologic malignancy, and Hispanic ethnicity. Of 139 charts screened, 97 met criteria (46 solid tumors; 51 hematologic malignancies). Primary …

From Risk Factor To Cause Of Death: Hypertensive Heart Disease And The Changing Composition Of Heart Disease Mortality In Texas Compared With The United States, 1999–2020, Jose J. Loayza Pintado, Angelica Lopez Jesus, Aura Calderon, Jorge Aboytes Trevino, Daniela Hernandez

Research Symposium

Background: Heart disease mortality has declined nationwide, but Texas continues to experience higher rates than the United States overall. At the same time, hypertensive heart disease (HHD) has become more prominent within cardiovascular mortality statistics. Whether this shift reflects a growing hypertension-driven contribution to the Texas–U.S. gap has not been well quantified. We compared long-term trends in HHD mortality and the presence of HHD on death certificates among heart disease deaths in Texas versus the United States.

Methods: We analyzed CDC WONDER Underlying Cause of Death and Multiple Cause of Death files, 1999–2020, restricted to decedents aged ≥25 years. HHD …

Gper As A Therapeutic Target In Breast Cancer: Pharmacologic Inhibition And Microbiome Associations, Sierra E. Vidaurri, Shweta Singh, Valerie E. Ledezma, Rajesekhar Baru, Emma Garza, Francisco Flores, Muhammad Noorani, Shubhank Goyal, Aura Calderon, Alexander Lim, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Subhash Chauhan, Diane Nguyen, Sheema Khan

Research Symposium

Background: The G protein–coupled estrogen receptor (GPER) mediates rapid estrogen signaling that promotes proliferation, migration, and therapeutic resistance in breast cancer, including in hormone receptor–negative subtypes. Notably, standard endocrine therapies may inadvertently activate GPER, highlighting the need for direct targeting of this pathway. The objectives of this study were to evaluate GPER as a therapeutic target using pharmacologic modulators and to determine how GPER-driven tumor behavior relates to tumor microbiome composition across breast cancer subtypes.

Methods: Breast cancer cell lines representing Luminal A (MCF7), Luminal B (BT474), HER2-enriched (SKBR3), and triple-negative (HCC38, MDA-MB-453, MDA-MB-231) subtypes were treated with Ormeloxifene (ORM). …

When A Pain Crisis Isn’T Only A Crisis: Delayed Hemolytic Transfusion Reaction With Hyperhemolysis In Adult Sickle Cell Disease., Bharat K. Peddinani, Conrad Chouinard, Aura Calderon, Maria I. Lopez, Diane Nguyen

Research Symposium

Introduction: Delayed hemolytic transfusion reaction (DHTR) in adults with sickle cell disease (SCD) is frequently mistaken for vaso-occlusive crisis (VOC) or evolving acute chest syndrome (ACS). New alloantibodies may be absent or delayed, so reflex transfusion can worsen hemolysis. Programs now emphasize routine post-transfusion surveillance and a protocolized, transfusion-sparing response when DHTR is suspected.

Case Presentation: A 35-year-old man with hemoglobin SS SCD, hypertension, chronic kidney disease, and recurrent priapism presented with severe left-leg pain two weeks after receiving two units of packed red blood cells for pre-operative optimization. Baseline hemoglobin (Hb) was ~6 g/dL; he was off disease-modifying therapy. …

Seeing The Pattern: Optic Neuritis, Multifocal Mri Lesions, And The Early Diagnosis Of Multiple Sclerosis, Jose J. Loayza Pintado, William Reckley, Aura Calderon, Luis Gaitan

Research Symposium

Background: Optic neuritis is a common neuro-ophthalmic emergency and may be the first clinical manifestation of inflammatory demyelinating disease. In the acute setting, clinicians must rapidly distinguish multiple sclerosis (MS) from important mimics, particularly when optic nerve involvement is accompanied by spinal cord lesions. A structured approach integrating phenotype, MRI lesion distribution and activity, and cerebrospinal fluid (CSF) markers can support timely diagnosis and guide counseling regarding long-term management. We report a young man presenting with unilateral optic neuritis and prior transient neurologic episodes, highlighting a practical diagnostic framework applicable to emergency and inpatient care.

Case Presentation: A 27-year-old man …

Prevalence And Practice Patterns Of Facial Plastic And Reconstructive Procedures Among Otolaryngologists: A National Medicare Claims Analysis, Justin Z. Heckman, Shizue Mito

MEDI 9331 Scholarly Activities Clinical Years

Facial plastic and reconstructive procedures represent a small but relatively well-reimbursed component of ENT Medicare billing. Of 860 otolaryngologists identified in the 2023 CMS Physician and Other Practitioners Public Use File, 104 (12.1%) billed at least one facial plastic CPT code, with a mean of 16.9 services per participating provider. A total of 1,756 facial plastic services were rendered, representing 0.16% of total ENT Medicare volume, with a cumulative reimbursement of $584,834. Mean reimbursement per facial plastic provider-CPT combination was $435, compared to $104 across all ENT services, a 4.2-fold difference. Facial plastic billing was concentrated in non-rural settings (95.5%) …

Investigation Of Electrochemical Transport, Gate Leakage, And Transconductance Behavior In Pedot:Pss Organic Electrochemical Transistors, Vinay Bhudhraja, Bilal Khan, Abijeet Mehta

Health & Biomedical Sciences Faculty Publications

Organic Electrochemical Transistors (OECTs) are promising candidates for low-voltage bioelectronic systems due to their high transconductance, mixed ionic–electronic transport, and compatibility with flexible substrates. In this work, we investigate the electrochemical transport, gate leakage, and transconductance behavior of screen-printed PEDOT:PSS OECTs, with emphasis on the relationship between ionic coupling and output characteristics. Key electrical and electrochemical parameters—including drain current modulation, transconductance evolution, gate current behavior, and capacitance–voltage response—were systematically analyzed to elucidate the mechanisms governing device operation. The results reveal clear trade-offs between parasitic resistance, volumetric electrochemical capacitance, and effective gate control, which in turn influence signal integrity and amplification …

Las Caras De Belleza En Madrid, Virginia L. Piccirillo

Cultivating Emotional Intelligence through the Humanities in Spain

Las Caras de la Belleza en Madrid, España explora cómo la belleza femenina ha sido representada, celebrada y cuestionada a través del arte, la poesía y la experiencia cultural. A través de museos como el Prado y el Thyssen-Bornemisza, este documental analiza la evolución de los ideales de belleza desde representaciones clásicas inspiradas por Venus hasta interpretaciones contemporáneas que desafían los estándares tradicionales. Mediante obras visuales, el poema Ilustre y hermosísima María y reflexiones personales, el proyecto invita a reconsiderar la relación entre belleza, identidad y feminidad, demostrando que la verdadera belleza existe en múltiples formas y perspectivas.

Emotional Intelligence Documentary - The Art Of Compassion: Learning From Spain, Poetry, And Medicine, Emily E. Morin

Cultivating Emotional Intelligence through the Humanities in Spain

The Art of Compassion: Learning from Spain, Poetry, and Medicine explores how art, literature, and cultural experiences can deepen compassion and inform more human-centered healthcare. Drawing on works encountered during a Medical Humanities study abroad program in Spain, the documentary examines compassion as a skill that can be cultivated through self-reflection, recognition of shared vulnerability, and appreciation of multiple perspectives. Through analysis of poetry by Lope de Vega, Jaime Sabines, and Yehuda Halevi, alongside artworks by Diego Velázquez, Francisco Goya, and Pablo Picasso, the film connects themes of empathy, suffering, identity, and healing to contemporary clinical practice. The documentary also …

Seizure-Induced Resolution Of Depressive And Psychotic Symptoms In A Pregnant Patient: A Case Of Spontaneous Neuromodulation, Ariel E. Sosa Gomez, Ryan M. Go, David Valdez

School of Medicine Publications

Many individuals with epilepsy often develop major depressive disorder (MDD), creating a complex interplay that exacerbates outcomes for affected individuals. The relationship between these disorders may be mediated by overlapping neurobiological mechanisms, including disturbances in the limbic system, neurotransmitter imbalances, and the psychosocial stressors of chronic illness. While the co-occurrence typically leads to a worsening of symptoms, rare instances have been reported in which seizure activity appears to ameliorate psychiatric symptomatology. We present the case of a 23-year-old pregnant Hispanic female with a longstanding history of treatment-resistant depression with psychotic features and epilepsy, who demonstrated full remission of depressive and …

Gene × Sex Interactions On Cognition In The Philadelphia Neurodevelopmental Cohort, Josephine Mollon, Emma M. Knowles, Samuel R. Mathias, Amanda Rodrigue, Ruben C. Gur, Juan M. Peralta, Daniel J. Weiner, Elise B. Robinson, Armin Raznahan, Raquel E. Gur, John Blangero, Laura Almasy, David C. Glahn

School of Medicine Publications

Background: Small differences between females and males in cognitive abilities have been consistently reported, but the factors underlying these sex differences remain unclear. Social and cultural factors are thought to play a key role, but studies on this topic have been inconclusive. Examination of genetic factors may shed some light on the mechanisms underlying cognitive sex differences.

Methods: Using data from the Philadelphia Neurodevelopmental Cohort, a large, general population sample of individuals aged 8 to 21 years old (N = 4,694), we tested for sex differences in the genetic factors (i.e., Gene × Sex interactions) underlying cognitive ability. Participants completed …

Vitamin D–Amp Axis In Host Defense Against Fungal Infections, Nuraly S. Akimbekov, Ilya Digel, Svetlana K. Sakhanova, Kuanysh Tastambek, Dinara K. Sherelkhan, Mohammed S. Razzaque

School of Medicine Publications

Vitamin D–mediated regulation of antimicrobial peptides (AMPs) is an important focus in innate immunology and is aimed at elucidating the role of vitamin D in enhancing antimicrobial defense. AMPs are short protein chains that serve as a first line of defense against invading pathogens, including fungi, bacteria and viruses. Unlike conventional antibiotics, AMPs are produced endogenously and are less likely to induce antimicrobial resistance, making them promising candidates for treating infections caused by drug-resistant pathogens. Studies indicate that optimal vitamin D levels are essential for activating antimicrobial pathways and regulating AMPs that target multiple fungal pathogens. This article summarizes recent …

Secondary Cutaneous Involvement In Peripheral T-Cell Lymphoma: Diagnostic Frameworks, Staging Integration, And Therapeutic Implications, Aura Calderon, Jose Loayza Pintado, Cristina Kochi, Jared Hensley, Andres Suarez Parraga, Everardo Cobos

School of Medicine Publications

The occurrence of secondary cutaneous manifestations in peripheral T-cell lymphoma (PTCL) is relatively infrequent and can resemble benign dermatoses, leading to diagnosis delays. We present the case of a 78-year-old female patient with a diagnosis of PTCL affecting the left parotid gland, who experienced a 2-day sudden and intensely pruritic skin eruption, which progressed from both forearms to the trunk, involving more than 50% of the total body surface area. Initially, the eruption was managed as a hypersensitivity reaction with antihistamines and corticosteroids, with temporary symptomatic relief; however, the rapid clinical progression in the context of an established diagnosis of …

The Putative Role Of Oral Microbiome In Premature Aging During Hiv Infection: What Do We Know?, Carlos Solá-Morlá, Daphne Alcalá-Zúñiga, Juan Araujo, Maria Da Gloria Bonecini-Almeida, Upal Roy, Josué Pérez-Santiago

Health & Biomedical Sciences Faculty Publications

Despite improvements in life expectancy, people with HIV (PWH) are at risk of developing HIV-associated comorbidities at a younger age when compared to HIV-uninfected individuals. This premature aging process can be attributed to various factors, such as the prolonged exposure to combination antiretroviral therapy (cART), inflammation, microbial perturbances and oxidative stress. Similarly to the gut, oral dysbiosis occurs in HIV-1 infection, with cART and inflammation playing a crucial role. This gives rise to an enrichment of pathogenic microorganisms that in turn, elicit an immune response tied to chronic inflammation. Consequently, cART exposure, dysbiosis and persistent inflammation in HIV-1 infection have …

Calcium Signaling And Postsynaptic Density Dynamics: The Roles Of Calmodulin In Synaptic Protein Regulation, Keyaa Dilip Shah, Yonghong Zhang

School of Integrative Biological & Chemical Sciences Faculty Publications

Calcium signaling in neuronal cells is the principal mechanism underlying learning and synaptic plasticity, whereas the postsynaptic density (PSD) is an important center where calcium-dependent processes are organized and regulated. This review explores the roles of calmodulin (CaM) in facilitating calcium-dependent modulation of the activities of synaptic proteins in the PSD. We focus on the molecular processes through which CaM interacts with calcium signals to regulate the function, localization, and interactions of central synaptic proteins, including calcium/calmodulin-dependent protein kinase II (CaMKII), membrane-associated guanylate kinases (MAGUKs), and N-methyl-D-aspartate (NMDA) receptors. We aim to summarize recent advances in structural, biochemical, and imaging …

Perceived Microaggressions Among Student Physical Therapists During Their Doctor Of Physical Therapy Education: A Mixed-Methods Study, Andrea Lopes Sauers, Rita Ator, Patrice Ayala, Jaime González, Suzanne O'Neal

Physical Therapy Faculty Publications

Introduction: Microaggressions, although often subtle and unintentional, have a significant impact. These actions emerge from stereotypes and can affect the recipient's sense of belonging. This study aimed to report the prevalence of perceived microaggressions among student physical therapists and to explore these experiences during their academic journey.

Review of literature: Microaggressions can disrupt the learning environment, hinder students' academic and professional development, and contribute to a culture perpetuating inequality and exclusion. To date, no studies have explored the impact of microaggressions on student physical therapists.

Subjects: Second- and third-year student physical therapists (n = 101) were invited to participate.

Methods: …

Decentralizing Dementia Research To The Us–Mexico Border: The Rio Grande Valley Ad-Rcmar As A Model For Translational Equity, Gladys E. Maestre, John Blangero, Eron Manusov, Gabriel A. De Erausquin, Francisco Fernandez, Silvia Mejia-Arango, Vincent P. Diego, Juan C. Lopez-Alvarenga, Claudia Alaniz, Neyra García, Rosa V. Pirela, Andrew Tsin, Michael Mahaney

School of Medicine Publications

Translational equity means ensuring that diagnostics, treatments, care models, and prevention strategies are developed and implemented so they work for populations with the greatest burden and least access to care. In Alzheimer's disease and related dementias (ADRD), where most evidence derives from highly educated, non-Hispanic White participants at large academic centers, translational equity is critical to prevent misclassification, limited access, and widening disparities and to ensure that underrepresented communities shape how new knowledge moves into practice. Hispanic and other populations in the United States are disproportionately affected by ADRD yet remain underrepresented in research, with gaps especially pronounced in high-poverty …

Understanding And Overcoming Innate And Acquired Mapk Inhibition Resistance In Anaplastic Thyroid Cancer, Peter Y F Zeng, Jalna Meens, Amir Hossein Karimi, Harrison Pan, Matthew J. Cecchini, Laura Jarycki, Sarah B. Ryan, Alice E. Dawson, Mushfiq H. Shaikh, David A. Palma

School of Medicine Publications

Anaplastic thyroid cancer (ATC) is highly lethal. Although patients with the BRAFV600E alteration respond to the type I RAF inhibitor (RAFi) dabrafenib with trametinib, most rapidly develop adaptive or acquired resistance. Here, multi-region whole-genome, high-coverage whole-exome, and single-nuclei RNA sequencing of tumors from ATC patients undergoing type I RAFi and MEKi therapy reveals that reactivation of the mitogen-activated protein kinase (MAPK) pathway, along with immunosuppressive macrophage proliferation, may underlie the development of acquired resistance. Screening of several RAFi reveals that ATC cell lines are exquisitely sensitive to the type II RAFi naporafenib, which inhibits EphA2-mediated MAPK signaling. Further, naporafenib and …

Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps

School of Medicine Publications

Background: Alzheimer disease and related dementias (ADRD) are more prevalent in Black and Hispanic older adults and are also more likely to be undetected and misdiagnosed. The purpose of this study was to engage with Black and Hispanic communities about interest in and support needed for memory screening.

Methods: Participants were recruited from established community partners of the South Texas Alzheimer's Disease Research Center to engagein a 90-minute listening session. The session was recorded with participants' permission, and a thematic analysis was conducted by 2 independent coders.

Results: Sixteen individuals (81% female, 88% Hispanic or Black) from various perspectives participated …

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko

School of Medicine Publications

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ dysfunction, with high untreated mortality that can be effectively reduced with timely plasma exchange (PLEX) and immunosuppressive therapy. However, several conditions can produce a clinically similar pseudo-TMA picture, among which severe vitamin B12 deficiency is an underrecognized and potentially treatable mimic that occurs due to ineffective intramedullary erythropoiesis, megaloblastic fragmentation of structurally abnormal erythrocytes, and pancytopenia in the absence of true endothelial injury or ADAMTS13 deficiency. We present a 74-year-old female patient who presented with altered mental status, bradycardia, and severe …