Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

Enhanced Recovery Of High-Quality Dna From Limited Ffpe Tissue For Advancing Cancer Genomics, Shweta Singh, Sierra Vidaurri, Astrid Perez, Anupam Dhasmana, Swati Dhasmana, Monica Betancourt-Garcia, Murali Yallapu, Subhash Chauhan, Sheema Khan

School of Medicine Publications

Archived formalin-fixed paraffin-embedded (FFPE) tissue samples are crucial assets in cancer research. However, despite the availability of commercial DNA purification kits, researchers face persistent challenges. The limited tissue availability, formalin-induced crosslinking, and DNA fragmentation in FFPE blocks often results in low DNA yield and compromised quality, hindering downstream applications. In this study, we optimized and standardized DNA purification methods to achieve high-yield, high-integrity DNA, making it ideal for DNA library preparation and high-throughput sequencing. Therefore, we optimized DNA extraction protocols using two Qiagen kits, the QIAamp DNA FFPE Tissue Kit and the QIAamp DNA FFPE Advanced Kit. The optimized methods …

Joint Disease And Demographic Factors In Clinical Populations Of Medically Underserved Communities, Blake C. Martin, Juan Lopez-Alvarenga, Michael Sander

School of Medicine Publications

Background: The Rio Grande Valley is a medically underserved, demographically unique population that warrants the exploration of various conditions.

Objectives: We sought to analyze the demographic disparities between the different types of common joint conditions in this community. We hypothesized that osteoarthritis would be the most common joint condition and that the demographics between the various joint conditions would vary depending on age, sex, BMI, and ethnicity.

Methods: This was a retrospective cohort, from January 1, 2018, to September 4, 2024. Patients’ charts were obtained using the ICD-10 diagnosis codes M15-M19 for osteoarthritis, M05-M06 for rheumatoid arthritis, M10 or M1A …

Biodegradable Pcl–Plga Electrospun Nanofibers For Localized Cancer Therapy, Rahul Tiwari, Pranav, Joel Delossantos, Eswara N.H.K. Ghali, Luis Chavez, Vishal Sharad Chaudhari, Songyang Han, Subhash Chauhan, Murali Yallapu

School of Medicine Publications

Localized chemotherapy offers a promising strategy to improve therapeutic efficacy while minimizing the systemic toxicity of conventional cancer treatment, particularly following tumor resection. Electrospun nanofibers are well suited for this purpose due to their high porosity, extracellular matrix-mimicking architecture, and capacity for localized drug release. In this study, electrospun nanofibers based on PCL and PLGA were developed for localized cancer therapy. Three distinct nanofibrous architectures were fabricated: PCL nanofibers, PCL−PLGA blended nanofibers, and PCL−PLGA multilayered (tetra-layered) nanofibers, and their encapsulation efficiency was determined by high-performance liquid chromatography (HPLC). Scanning electron microscopy confirmed uniform, bead-free nanofibrous morphologies, while Fourier transform infrared …

Phosphate-Mediated Regulation Of Intracellular Calcium Dynamics, Huma Shahzad, Mohammed S. Razzaque

School of Medicine Publications

Phosphate (Pi) and calcium (Ca2+) are essential mineral ions that play coordinated roles in maintaining normal cellular functions. While various steps of calcium signaling are well characterized, emerging evidence suggests the critical role of both intracellular and extra cellular phosphate in regulating intracellular Ca2+. In the cytoplasm, phosphate influences ATP production and organelle calcium buffering and influences the activity of calcium pumps, such as sarcoplasmic/endoplasmic reticulum Ca2+-ATPase (SERCA) and the plasma membrane Ca2+-ATPase (PMCA). Extracellular phosphate, taken up via sodium-dependent phosphate transporters, triggers signaling cascades that affect the processes of calcium influx, storage, and release. Additionally, high extracellular phosphate levels …

Obesity Rise Plateaus In Developed Nations And Accelerates In Developing Nations, Ncdrf Collaboration, Bin Zhou, Nowell H. Phelps, Agnese Galeazzi, Olivia N. O’Driscoll, James E. Bennett, Lakshya Jain, Ysé D’Ailhaud De Brisis, Gladys E. Maestre, Jesus D. Melgarejo

School of Medicine Publications

Global reporting of obesity is commonly based on comparisons over multiple decades1 and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3–4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small …

Emerging Near-Infrared Targeted Imaging Pharmaceutics For Ovarian Cancer, Angel J. Phillip, Annu Karithara, Subhash Chauhan, Murali Yallapu

School of Medicine Publications

Background: Accurate intraoperative identification of ovarian cancer is challenging, as standard techniques such as visual inspection, palpation, and histopathology often fail to detect microscopic disease. Residual tumor contributes to poor cytoreductive outcomes, high recurrence rates, and chemoresistance. Near-infrared (NIR) imaging using tumor-specific biomarkers has emerged as a promising approach to enhance intraoperative visualization and improve tumor margin delineation. Methods: A focused literature review was conducted using PubMed to identify preclinical and clinical studies evaluating NIR image-guided strategies in ovarian cancer. Studies involving tumor-targeted probes against folate receptor alpha, α3-integrin, mesothelin, and CA125 were included, with emphasis on probe design, delivery, …

Impact Of Intravenous Thrombolysis On Aspiration Thrombectomy Outcomes: An Imperative Trial Subgroup Analysis, Maxim Mokin, Reade Andrew De Leacy, William Mack, Raul G. Nogueira, Shahram Majidi, Dana Tomalty, Jan Vargas, Brett L. Cucchiara, Kenneth V. Snyder, Victoria Parada

School of Medicine Publications

Background The impact of intravenous (IV) thrombolysis on the outcomes of aspiration thrombectomy as the primary endovascular approach to stroke in patients with large vessel occlusion is unknown.

Methods The Imperative Trial was a prospective, investigational device exemption, multicenter trial of first-line aspiration thrombectomy that assessed the safety and efficacy of the Zoom System, including a novel 0.088 inch aspiration catheter in patients with stroke within 8 hours of onset. We compared procedural, technical, and clinical outcomes of aspiration thrombectomy based on whether patients had received IV thrombolytics prior to the intervention.

Results Among the 260 patients treated with front-line …

Diabetic Nephropathy Masquerading As Systemic Disease: The Critical Role Of Renal Biopsy In A Young Uninsured Woman With Nephrotic Syndrome, Yolanda V. Gutierrez, Alexis Vargas Del Toro, Cristina Kochi Yamamoto, Jose Loayza Pintado, Andres Suarez-Parraga

School of Medicine Publications

Nephrotic syndrome can have overlapping features across multiple diseases, making diagnosis difficult without tissue confirmation. We describe a 30-year-old uninsured Hispanic woman with type 1 diabetes, hypertension, and CKD3B who presented with nephrotic syndrome, sepsis, and progressive muscle weakness. Her pleural effusions, periorbital changes, elevated free light chains, and dysphagia raised concern for systemic conditions such as amyloidosis or polymyositis, especially given inconsistent outpatient follow-up. Because her management would differ significantly depending on the underlying cause and due to the high risk of loss to follow-up, a renal biopsy was pursued. Serologic studies were unremarkable, and biopsy ultimately confirmed diabetic …

Consensus Guidelines On Inferior Petrosal Sinus Sampling: A Guideline From The Society Of Vascular And Interventional Neurology Guidelines And Practice Standards Committee, Farhan Siddiq, Hunter Brooks, Esra Demirtas, Ibrahim Ahmad Bhatti, Sami Al Kasab, Adam De Havenon, Robin Novakovic, Ossama Y. Mansour, Cynthia L. Kenmuir, Ameer E. Hassan

School of Medicine Publications

Background: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard test to distinguish Cushing disease (CD) from ectopic adrenocorticotropic hormone (ACTH) secretion when biochemistry confirms ACTH-dependent Cushing syndrome and pituitary magnetic resonance imaging is equivocal. However, practice varies widely between centers, leading to false negatives, misinterpretation, sampling errors, and avoidable risk. Neurointerventionalists performing BIPSS have lacked dedicated, procedure-focused guidance.

Methods: Using the Society of Vascular and Interventional Neurology Guidelines and Practice Standards framework, a multidisciplinary panel (endocrinology, interventional neuroradiology, and endovascular neurosurgery) performed a systematic review through August 2025 and developed recommendations graded by class of recommendation and level of …

Extrapulmonary Small Cell Carcinoma Presenting As Bilateral Papilledema, Hyponatremia, Encephalitis, Seizures, Crmp5-Igg Reactivity, And Prominent Anterior Tubular Perivascular Spaces, Ramsis Benjamin, Drew Thomas, Nina Mourao, J. Judd Fite, Brianna Woodliff, Shubhank Goyal

School of Medicine Publications

Background: Paraneoplastic syndromes that affect both the optic disc and the brain parenchyma typically harbor antibodies directed toward CV2/collapsin response-mediator protein 5 (anti-CRMP5), amphiphysin, Ma antigen 2 (Ma2/Ta), and Yo. The most common cancers linked to anti-CRMP5 antibodies include small-cell lung carcinoma (SCLC), followed by thymoma, renal cell carcinoma, and thyroid papillary carcinoma. A long-held belief explains papilledema as related to increased pressure within the subarachnoid space or the microvascular capillaries, but intracranial pressures within the normal standard range may exist in a person with a paraneoplastic syndrome and papilledema. The glymphatic system, a central waste-clearance conduit, may play a …

Olanzapine-Based Vs Neurokinin-1 Receptor Antagonist Antiemetic Regimens In Highly Emetogenic Chemotherapy: Systematic Review And Meta-Analysis Of Efficacy And Safety, Advaitha Mv, Nikhilesh Anand, Biacin Babu, Ayoola Awosika, Uttam Udayan, Jacqueline Mendoza, Alissa Lopez, Brahmaiahchari Rangachari, Sabyasachi Maity, Bharathi Gadad

School of Medicine Publications

Background: Chemotherapy-induced nausea and vomiting is common in patients who receive highly emetogenic chemotherapy (HEC). Olanzapine acts on multiple neurotransmitters and effectively reduces delayed-phase nausea.

Aim: To compare the safety and efficacy of olanzapine-based vs neurokinin-1 receptor antagonist-based antiemetic regimens in adults receiving HEC.

Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines and searched various databases like PubMed, Scopus, etc., between 2020-2025. 14 studies were included in the systematic review with 11 meeting the criteria for meta-analysis. Primary outcomes were complete response (no vomiting, no rescue medication) and nausea control during acute (0-24 hours), …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Ariana L. Garza, Audrey C. Choh, John Blangero, Cici X. Bauer, Stefan A. Czerwinski, Miryoung Lee

School of Medicine Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults. Methods: We analyzed 676 non-Hispanic white adults (18–95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

Development Of Research Direction At The Hospital General De México In The Last Two Decades, Juan C. Lopez-Alvarenga, José D. Carrillo-Ruiz, Galileo Escobedo, América Guadalupe Arroyo Valerio, Miguel Fonseca-Sanchez, Gustavo Acosta-Altamirano

School of Medicine Publications

No abstract provided.

Identification Of Lipid Quantitative Trait Loci Linked With Cardiometabolic Disease In Asian Indians And Europeans: A Genome-Wide Association Study And Mendelian Randomization, Madhusmita Rout, Christopher E. Aston, Ravindranath Duggirala, Harald H. H. Goring, Oliver Fiehn, Dharambir K. Sanghera

School of Medicine Publications

Background: Genetic mechanisms that predispose people to type 2 diabetes (T2D) and cardiovascular disease (CVD) remain poorly understood, partly because of a lack of sufficient data on non-European ethnic groups. Extending these evaluations to diverse cohorts is essential for gaining insights into the molecular pathways involved in disease development among human populations. In this study, we aimed to evaluate the genetic connection between the human lipidome and cardiometabolic disorders. We conducted a metabolite genome-wide association study (mGWAS) in a Punjabi population from India, along with multi-layer replication studies using the UK Biobank and other independent European and non-European cohorts.

Methods …

Muc13-Associated Molecular Interactome In Pancreatic Cancer, Anupam Dhasmana, Swati Dhasmana, Rajasekhar Baru, Abigail Gomez, Shafiul Haque, Sheema Khan, Murali Yallapu, Subhash Chauhan

School of Medicine Publications

Mucin-13 (MUC13) has emerged as a critical molecular player involved in tumorigenesis, cancer progression, metastasis, and evasion of immune surveillance, including in pancreatic cancer. In this report, we identified MUC13 molecular interactome using an integrated immunoprecipitation and liquid chromatography–mass spectrometry (accession no. of protein data JPST004189) approach combined with systems network biology to determine its plausible functional protein–protein interaction network and associated oncogenic mechanisms. This study reveals a total of 54 key MUC13 interactor proteins (including cyclin-dependent kinase 1, catenin delta 1, Caludin-1, ErbB3-binding protein 1, basic transcription factor 3, tight junction protein 1, etc.). Interestingly, the majority of these …

Construction And Characterization Of Novel Mycobacterium Tuberculosis-Derived Triple And Quadruple Knockout Vaccines Against Tuberculosis, Omar Garnica, Raja Veerapandian, Kishore Das, Abhishek Mishra, Varsha Rawat, Areanna Carmona, Vivek Chauhan, Rakesh Kumar, Jessica Chacon, Shrikanth S. Gadad, Subramanian Dhandayuthapani

School of Medicine Publications

Tuberculosis (TB) is a deadly disease that claims the lives of over a million people each year worldwide. The Bacille Calmette-Guérin vaccine has long been used to protect against TB, but it produces variable effects across different populations and fails to protect against adult pulmonary TB. Therefore, there is an urgent need for alternative vaccines that can offer better protection. We have developed a strategy for the rational deletion of virulence-related genes in Mycobacterium tuberculosis (Mtb) to create hyperattenuation that also enhances immunogenicity. Previously, we generated both single (∆fbpA) and double knockout (DKO) (∆fbpA-∆sapM) mutants of …

Intensive Versus Standard Blood Pressure Control After Endovascular Thrombectomy In Acute Ischemic Stroke: A Meta‐Analysis Of Randomized Controlled Trials, Tallal Mushtaq Hashmi, Mushood Ahmed, Hadiah Ashraf, Muhammad Shakir, Ibrahim Ahmad Bhatti, Faizan Ahmed, Ahmad Alareed, Ali Hasan, Gregg C. Fonarow, Ameer E. Hassan

School of Medicine Publications

Background: The optimal strategy for blood pressure management following mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion remains a subject of ongoing research.

Methods: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to June 20, 2025. Randomized controlled trials comparing intensive versus standard blood pressure control following mechanical thrombectomy for acute ischemic stroke were included. The primary outcomes were excellent functional outcome (modified Rankin Scale score 0-1 at 90 days) and good functional outcome (modified Rankin Scale score 0-2 at 90 days). Pooled odds ratios (ORs) with 95% CIs were calculated using a random-effects …

Vascular Burden Attenuates The Tdp-43-Tmem106b Pathological Relationship In Neurodegenerative Disease With And Without Alzheimer Disease Neuropathological Change, Matthew B. Dopler, Cole Corbett, Angelique D. Gonzalez, Ali Ghaseminejad-Bandpey, Mallory Keating, Kyra M. Clarke, Oluwaseun B. Ogunbona, Gladys Maestre, Sudha Seshadri, Shahroo Etemadmoghadam, Margaret E. Flanagan

School of Medicine Publications

TMEM106B, a lysosomal transmembrane protein, is a risk factor for neurodegenerative diseases, including Alzheimer disease (ad) and TDP-43 proteinopathies. TMEM106B pathology occurs in normal aging and is increased in TDP-43 proteinopathy but its role in dementia remains unclear. Cerebrovascular disease (CVD) is a driver and co-pathology of dementia, yet its contribution to TMEM106B accumulation in the context of TDP-43 and ad neuropathological changes (ADNC) has not been explored. We analyzed post-mortem human hippocampal sections spanning not-, low-, intermediate-, and high-ADNC. In secondary analyses, cases ≥65 years were stratified by TDP-43 immunopositivity and CVD severity; cases < 65 years were included to contextualize age-associated effects. TMEM106B immunoreactivity was quantified using digital pathology. Linear regression models demonstrated that age and sex (higher in females) were independent predictors of TMEM106B immunopositivity whereas Braak stage, CERAD-NP score, and Thal phase were not. The positive TDP-43-TMEM106B association was attenuated with increased CVD pathology severity, suggesting that vascular burden modifies this relationship. Sensitivity analyses restricted to LATE-NC attenuated several associations, indicating that pooled TDP-43 findings should be interpreted cautiously given possible disease heterogeneity. TMEM106B immunoreactivity was most strongly associated with age and sex, while vascular burden, rather than ADNC level, modified its relationship with TDP-43 proteinopathy.

Stroke Thrombectomy With A Novel Reperfusion System Including A 0.088′′ Aspiration Catheter: The Imperative Trial, William Mack, Reade Andrew De Leacy, Jonathan A. Grossberg, Shahram Majidi, Robert Dana Tomalty, Maxim Mokin, Jan Vargas, Kenneth V. Snyder, Brett L. Cucchiara, Victoria Parada

School of Medicine Publications

Background Mechanical thrombectomy is the standard of care for large vessel occlusion (LVO) stroke, yet most device trials focus on individual technologies rather than complete systems.

Objective To evaluate the safety and efficacy of the Zoom Reperfusion System compared with performance goals derived from a meta-analysis of trials using established thrombectomy technologies.

Methods Prospective, multicenter, non-randomized, investigational device exemption trial conducted across 26 United States centers from October 2021 to March 2024. Adults with anterior circulation LVO stroke within 8 hours of onset were treated using the Zoom System, which includes aspiration catheters ranging from 0.035″ to 0.071″, and a …

Prognostic Significance And Interplay Of Circulatory Pcsk-9–Apociii–Chemokine Axis In Type 2 Diabetes And Its Complications: A Pilot Study In North Indian Patients, Mohd Waiz, Sahir S. Alvi, Parvej Ahmad, Bodor Bin Sheeha, Paridhi Puri, Irfan Ahmad, Saheem Ahmad, M. Salman Khan

School of Medicine Publications

Background: Proprotein convertase subtilisin kexin/type-9 (PCSK-9) regulates cholesterol homeostasis through lysosomal degradation of LDL-R and also acts as a pleiotropic mediator of inflammation. Emerging evidence links PCSK-9 to diabetes pathogenesis. Given the genetic diversity and distinct lifestyle of the Indian population, investigating role of PCSK-9 in Indian type-2 diabetes mellitus (T2DM) patients is crucial. Notably, its association with ApoCIII and chemokines such as CXCL2 and MCP-1 remains unexplored.

Results: A total of 187 participants were included: Heathy control (HC; n = 50), T2DM (n = 49), T2DM with nephropathy (T2DM-N; n = 43), and T2DM with dyslipidaemia (T2DM-DL; n = …

Navigating A Delicate Balance: Antibiotic Allergy In The Setting Of Renal Infection And Diabetic Ketoacidosis, Aun Bangash, Muhammad Bangash, Ruben M. Martinez Meza

School of Medicine Publications

Acute pyelonephritis is a bacterial infection of the renal parenchyma that requires prompt recognition and antibiotic therapy to prevent complications such as sepsis and chronic renal inflammation. We present a case of a 26-year-old woman with poorly controlled type 1 diabetes mellitus and a documented beta-lactam allergy who presented with atypical symptoms, including flank pain without urinary complaints. Laboratory evaluation demonstrated leukocytosis with a negative urinalysis. CT of the abdomen revealed left lobar nephronia with early contralateral involvement of the right kidney. Given her allergy history, she was treated with levofloxacin. During her hospital stay, she developed nausea, vomiting, and …