Medicine and Health Sciences Commons^™

Autonomic Dysfunction In Gastroesophageal Reflux Disease. The Neurogastro-Cardiac Axis: Friend Or Foe?, Sergio Sobrino-Cossio, Jorge Cossío-Aranda, Elymir S. Galvis-García, Gualberto Mateos-Pérez, Óscar Teramoto-Matsubara, Jesús A. González-Hermosillo, Juan C. Lopez Alvarenga, Mustafa Azizoglu, José M. Remes-Troche

School of Medicine Publications

Gastroesophageal reflux disease (GERD) is a complex and highly prevalent entity. Impaired gut-brain communication is associated with autonomic dysfunction. Modulation of the autonomic nervous system controls gastrointestinal functions. In GERD, a decrease in vagal tone (parasympathetic activity) and an increase in sympathetic activity with autonomic balance shifted towards the sympathetic system have been reported. Clinical questionnaires and non-invasive measurement of heart rate variability may be useful in patients with GERD to detect autonomic dysfunction. Restoration of parasympathetic system activity (mainly neuromodulation), with subsequent improvement of parasympathetic activity, will reduce the intensity of autonomic symptoms and GERD, improving quality of life. …

Evaluating The Potential Of Herbal Extracts As Treatment In Immune Thrombocytopenia: A Review Of Evidence And Limitations, Russel Wiggins, Jihoo Woo, John Nicholas Cauba, Shizue Mito

School of Medicine Publications

Immune thrombocytopenia, formerly idiopathic thrombocytopenia purpura (ITP), is an autoimmune disease characterized by the depletion of platelets below 100,000/µL when other causes of thrombocytopenia have been ruled out. It is associated with several infectious pathologies, disease states, and as a known side effect and complication of several drugs and chemotherapies. Standard treatment calls for glucocorticoid-mediated immunosuppression, intravenous immunoglobin transfusion, platelet stimulation, platelet transfusion, and splenectomy in instances of chronic and severe disease. While standard treatments are often effective, some cases prove resistant, and more commonly, some patients are unable to tolerate standard treatment protocols or opt out of surgical intervention. …

Novel Approach To Advance Directive Training: Hospice And Palliative Care Fellow Led Workshop Feasible And Effective In Increasing Confidence In End Of Life Conversations, Chelsea Chang, Jose Cano, Juan Lopez-Alvarenga, Josenny Rodriguez Paez, Sonya R. Montes, Rosa White, Meghana Rao

School of Medicine Publications

Despite the benefits of Advance directives, approximately only 1 in 3 U.S adults have documented advance directives. In medical school and residency, learners are often not taught or given very brief information on conducting end-of-life planning conversations with patients. Due to this deficiency, some institutions have conducted advance directive workshops but not many have been both palliative fellow and resident led, though some have been led by a geriatric fellow. Therefore, we approached advance directives with a resident and palliative fellow-led workshop. We aimed to develop and conduct a workshop on advance directives to assess feasibility and effectiveness in raising …

Gene-Environment Interactions In Non-Alcoholic Fatty Liver Disease: Insights From Mexican American Populations, Eron G. Manusov, Vincent P. Diego, Marcio Almeida, Jacob Galan, Auwal A. Bala, Marco Arriaga, Natasha Garcia-Rodriguez, Renee Hernandez, Satish Kumar, John Blangero, Sarah Williams-Blangero

School of Medicine Publications

Nonalcoholic Fatty Liver Disease (NAFLD) is a prevalent and complex condition influenced by both genetic and environmental factors. This chapter explores the genotype-by-environment interactions that contribute to the development and progression of NAFLD in the Mexican American population. Using advanced genetic epidemiology and bioinformatics approaches, we investigated how specific genetic variants interact with environmental factors such as depression, acculturation stress, and social determinants of health, to influence NAFLD risk and severity. Our findings reveal significant genotype-by-environment interactions for key NAFLD-related traits, including HbA1c, AST/ALT ratio, and steatosis-controlled attenuation parameter (CAP). We also discuss the application of cutting-edge proteomic and transcriptomic …

Small Molecule With Big Impact: Metarrestin Targets The Perinucleolar Compartment In Cancer Metastasis, Vivek Kashyap, Bhuvnesh Sharma, Divya Pandey, Ajay K. Singh, Godwin Peasah-Darkwah, Bhupesh Singh, Kuldeep K. Roy, Murali Yallapu, Subhash Chauhan

School of Medicine Publications

Metarrestin (ML246) is a first-in-class pyrrole-pyrimidine-derived small molecule that selectively targets the perinucleolar compartment (PNC). PNC is a distinct subnuclear structure predominantly found in solid tumor cells. The occurrence of PNC demonstrates a positive correlation with malignancy, serving as an indicator of tumor aggressiveness, progression, and metastasis. Various promising preclinical results have led to the clinical translation of metarrestin into a first-in-human trial. This review aims to summarize (i) the current understanding of the structure and function of PNC and its role in cancer progression and metastasis, (ii) key findings from studies examining the effect of metarrestin on various cancers …

Interaction Between Type 2 Diabetes And Past Covid-19 On Active Tuberculosis, Liz E. Calles-Cabanillas, Genesis P. Aguillón-Durán, Doris Ayala, Jose A. Caso, Miguel Garza, Mateo Joya-Ayala, Raúl Loera-Salazar, America Cruz-González, John M. Thomas Iii, Blanca I. Restrepo

School of Medicine Publications

Background

The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era has been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship.

Methods

A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along …

Genome-Wide Association Analyses Identify Distinct Genetic Architectures For Age-Related Macular Degeneration Across Ancestries, Bryan R. Gorman, Georgios Voloudakis, Robert P. Igo Jr., Tyler Kinzy, Christopher W. Halladay, Tim B. Bigdeli, Biao Zeng, Sanan Venkatesh, Matthew P. Johnson, John Blangero

School of Medicine Publications

To effectively reduce vision loss due to age-related macular generation (AMD) on a global scale, knowledge of its genetic architecture in diverse populations is necessary. A critical element, AMD risk profiles in African and Hispanic/Latino ancestries, remains largely unknown. We combined data in the Million Veteran Program with five other cohorts to conduct the first multi-ancestry genome-wide association study of AMD and discovered 63 loci (30 novel). We observe marked cross-ancestry heterogeneity at major risk loci, especially in African-ancestry populations which demonstrate a primary signal in a major histocompatibility complex class II haplotype and reduced risk at the established CFH …

The Internist's Post V.1 N.10, The University Of Texas Rio Grande Valley. School Of Medicine, Eunbee Cho, Osiris Fernandez, Hector D. Preciado, Sobia Memon, Diana Acosta Pozo, Corey Haines, Roque Mifuji Lira, Martha Solis, Cesar Gutierrez

School of Medicine Publications

No abstract provided.

Leaders’ Perspectives On Approaches And Challenges In Enacting Faculty Vitality In The Contemporary Landscape Of Academic Medicine: A Deductive Thematic Analysis, Jennifer L. Allie, Robert Tillman, Beatriz Tapia, Elza Mylona, Koko Aung, Janet F. Williams

School of Medicine Publications

Continual changes in organizational structures within medical schools have contributed to the expanded scope and the centralization of faculty affairs offices, which support faculty administration and supportive functions. Using qualitative interviews, we investigated the perspectives of academic medicine faculty affairs leaders regarding their offices’ priorities in sustaining faculty vitality in the face of current and anticipated challenges. A semi-structured interview protocol based on the researchers' practical knowledge, informed by the study's research inquiries, and pertinent academic literature guided the interviews. Deductive thematic analysis approach was used to identify the patterns and themes across the interviews. Our analysis revealed a central …

Mexican Clinical Practice Guidelines For Adult Overweight And Obesity Management, Emma A. Chávez-Manzanera, Juan M. Vera-Zertuche, Martha Kaufer-Horwitz, Verónica Vázquez-Velázquez, José R. Flores-Lázaro, Leonor Mireles-Zavala, Raúl Calzada-León, Juan C. Garnica-Cuellar, Verónica Sánchez-Muñoz, Juan Carlos Lopez Alvarenga

School of Medicine Publications

Purpose

To develop Mexico’s first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers.

Recent Findings

A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and …

Endovascular Thrombectomy For Childhood Stroke (Save Childs Pro): An International, Multicentre, Prospective Registry Study, Peter B. Sporn, Kartik Bhatia, Todd Abruzzo, Lisa Pabst, Stuart Fraser, Melissa G. Chun, Warren Lo, Ahmed Othman, Sebastian Steinmetz, Ameer E. Hassan

School of Medicine Publications

Background

Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.

Methods

In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular …

Cryoablation Of Primary Breast Cancer Tumors Induces A Systemic Abscopal Effect Altering Time (Tumor Immune Microenvironment) In Distant Tumors, Flávia Sardela De Miranda, Dalia Martinez-Marin, Rachel L. Babcock, Maribel Castro, Geetha P. Boligala, Sonia Y. Khan, Kathryn L. Furr, Isabel Castro-Piedras, Nicholas Wagner, Dakota E. Robison

School of Medicine Publications

Introduction: Despite recent advances, triple-negative breast cancer (TNBC) patients remain at high risk for recurrence and metastasis, which creates the need for innovative therapeutic approaches to improve patient outcomes. Cryoablation is a promising, less invasive alternative to surgical resection, capable of inducing tumor necrosis via freeze/thaw cycles. Necrotic cell death results in increased inflammatory signals and release of preserved tumor antigens, which have the potential to boost the local and systemic anti-tumor immune response. Thus, compared to surgery, cryoablation enhances the activation of T cells leading to an improved abscopal effect, defined as the occurrence of a systemic response after …

Accelerating Heritability, Genetic Correlation, And Genome-Wide Association Imaging Genetic Analyses In Complex Pedigrees, Brian Donohue, Si Gao, Thomas E. Nichols, Bhim M. Adhikari, Yizhou Ma, Neda Jahanshad, Francis J. Mcmahon, Elizabeth M. Humphries, William Burroughs, John Blangero

School of Medicine Publications

National and international biobanking efforts led to the collection of large and inclusive imaging genetics datasets that enable examination of the contribution of genetic and environmental factors to human brains in illness and health. High-resolution neuroimaging (~104–6 voxels) and genetic (106–8 single nucleotide polymorphic [SNP] variants) data are available in statistically powerful (N = 103–5) epidemiological and disorder-focused samples. Performing imaging genetics analyses at full resolution afforded in these datasets is a formidable computational task even under the assumption of unrelatedness among the subjects. The computational complexity rises as ~N2–3 (where N is the sample size), when …

Lipid-Based Niclosamide Delivery: Comparative Efficacy, Bioavailability, And Potential As A Cancer Drug, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Niclosamide, an FDA-approved anti-parasitic drug, has demonstrated significant potential as a repurposed anti-cancer agent due to its ability to interfere with multiple oncogenic pathways. However, its clinical application has been hindered by poor solubility and bioavailability. Lipid-based nanocarrier systems such as liposomes, solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), and lipid nanoemulsions (LNE), along with lipid prodrugs, have successfully been employed by researchers to overcome these limitations and improve niclosamide’s pharmacokinetic profile. Lipids are the core organic compounds which serve as the foundation of these advanced drug delivery methods and in turn play a critical role in enhancing niclosamide’s …

Validation Of Human Telomere Length Multi-Ancestry Meta-Analysis Association Signals Identifies Pop5 And Kbtbd6 As Human Telomere Length Regulation Genes, Rebecca Keener, Surya B. Chhetri, Carla J. Connelly, Margaret A. Taub, Matthew P. Conomos, Joshua Weinstock, Bohan Ni, Benjamin Strober, Stella Aslibekyan, John Blangero

School of Medicine Publications

Genome-wide association studies (GWAS) have become well-powered to detect loci associated with telomere length. However, no prior work has validated genes nominated by GWAS to examine their role in telomere length regulation. We conducted a multi-ancestry meta-analysis of 211,369 individuals and identified five novel association signals. Enrichment analyses of chromatin state and cell-type heritability suggested that blood/immune cells are the most relevant cell type to examine telomere length association signals. We validated specific GWAS associations by overexpressing KBTBD6 or POP5 and demonstrated that both lengthened telomeres. CRISPR/Cas9 deletion of the predicted causal regions in K562 blood cells reduced expression of …

Developing A Bilingual Health Education Program To Identify And Address Healthcare Misinformation In A Border Community, Sara Mansour, Nathan Holland, Sergio Saucedo, Amadeus Ramirez, Mariela Lane, Joshua Salisbury, Komal Marwaha, Lorena Fernandez, Jesse Allen, Ricardo Belmares

School of Medicine Publications

El Paso Health Education and Awareness Team (EP-HEAT®) is a bilingual program focused on increasing health awareness and dispelling health-related misinformation in the U.S.-Mexico border region. EP-HEAT® consists of students, faculty, staff, and Promotoras. The primary objective of EP-HEAT® is to empower the community with healthcare resources in a culturally acceptable way. EP-HEAT® established the bilingual “In the Hot Seat with EP-HEAT®: Dispelling Myths in Healthcare” series commonly referred to as Myth Busters events. Community members were surveyed following the events. Our results showed the majority of EP-HEAT® event attendees identified as Hispanic and were older than 46 years …

Efficacy And Safety Of Novel Anticoagulant Therapies In Patients With Chronic Kidney Disease—A Systematic Review And Meta-Analysis, Ernesto Calderon Martinez, Camila Sanchez Cruz, Edna Y. Diarte Acosta, Daniel Alejandro Aguirre Cano, Ana Maria Espinosa, Diana Othon, Flor Furman, Sebastian Obando Vera

School of Medicine Publications

Background

Chronic Kidney Disease (CKD) significantly increases the risk of cardiovascular diseases, including atrial fibrillation, which usually requires anticoagulant therapy. The effectiveness and safety of direct oral anticoagulants compared to vitamin K antagonists in patients with CKD remain insufficiently studied, particularly in the more advanced stages.

Methods

This systematic review, registered in PROSPERO (CRD42023410192), adhered to PRISMA guidelines and included randomized clinical trials and cohort studies comparing direct oral anticoagulants and vitamin K antagonists in CKD patients. Major databases were searched, and studies were selected based on strict inclusion criteria. A meta-analysis was performed using random-effects models.

Results

Twenty-three studies …

The Laboratory Opossum (Monodelphis Domestica) Is A Unique Model For Research On Zika Virus: Robust Immune Response, Widespread Dissemination, And Long-Term Persistence, André Filipe Pastor, Susan M. Mahaney, Juan Garcia Jr., Marisol Morales, Oscar Quintanilla, Marco Arriaga, John M. Thomas, John L. Vandeberg

School of Medicine Publications

The Zika virus (ZIKV) epidemic elicited a rapid commitment to the development of animal models for ZIKV research. Non-human primates (NHPs) and mice have made significant contributions to this research, but NHPs are expensive, have a long gestation period, and are available only in small numbers; non-genetically modified mice are resistant to infection. To address these deficiencies, we have established the laboratory opossum, Monodelphis domestica, as a small animal model that complements the mouse and monkey models. We developed and validated an indirect ELISA for measuring antibodies to ZIKV in opossums, as well as an immunohistochemistry (IHC) method to detect …

Prevalence And Economic Burden Of Osteoarthritis And Rheumatoid Arthritis In The Medically Underserved Rio Grande Valley: A Retrospective Longitudinal Analysis, John M. Gaddis, Elias Arellano, Ryan Bialaszewski, Dominic Chau-Zanetti, Tyler Torres, Elizabeth Bergman, Kelsey Baker, Bharathi Gadad

School of Medicine Publications

Introduction: Osteoarthritis and rheumatoid arthritis, two of the most common forms of arthritis worldwide, are chronic diseases affecting the joints. The Rio Grande Valley is characterized by an abundance of health disparities, with previous studies showing increased rates of multiple diseases and disorders in this region. This study aimed to determine both the prevalence and the risk-adjusted average cost of osteoarthritis and rheumatoid arthritis in the Rio Grande Valley and to compare them with the national average. We hypothesize that the prevalence and risk-adjusted average cost of osteoarthritis and rheumatoid arthritis in the Rio Grande Valley will be greater than …

Strategic Interventions In Clinical Randomized Trials For Metabolic Dysfunction-Associated Steatotic Liver Disease (Masld) And Obesity In The Pediatric Population: A Systematic Review With Meta-Analysis And Bibliometric Analysis, Isabel Omaña-Guzmán, Anthony Alanis, David Martinez, Joshua Membreno, Hector Rivera-Marrero, Alisha Valdez, Kathleen V. Carter, Beatriz Tapia, Leonel Vela, Juan Lopez-Alvarenga

School of Medicine Publications

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a prevalent hepatic condition linked to metabolic alterations. It gradually causes liver damage and potentially progresses to cirrhosis. Despite its significance, research, especially in the pediatric population, is limited, leading to contradictory findings in diagnosis and treatment. This meta-analysis aims to synthesize existing literature on therapeutic interventions for MASLD in children and adolescents.

Methods

A comprehensive search of randomized controlled clinical trials yielded 634 entries from PubMed, Scopus, and Web of Science up to 2023. Interventions included medications, behavioral modifications, dietary changes, probiotics, supplements, …

Adjunctive Middle Meningeal Artery Embolization For Subdural Hematoma, Jason M. Davies, Jared Knopman, Maxim Mokin, Ameer E. Hassan, Robert E. Harbaugh, Alexander Khalessi, Jens Fiehler, Bradley A. Gross, Ramesh Grandhi, Jason Tarpley

School of Medicine Publications

Background Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains unclear.

Methods In a prospective, multicenter, interventional, adaptive-design trial, we randomly assigned patients with symptomatic subacute or chronic subdural hematoma with an indication for surgical evacuation to undergo middle meningeal artery embolization plus surgery (treatment group) or surgery alone (control group). The primary end point was hematoma recurrence or progression that led to repeat surgery within 90 days after the index treatment. The clinical secondary end point was deterioration of neurologic function …

Advancements In Autophagy Modulation For The Management Of Oral Disease: A Focus On Drug Targets And Therapeutics, Md Ataur Rahman, Mushfiq Hassan Shaikh, Rajat Das Gupta, Nazeeba Siddika, Muhammad Saad Shaikh, Muhammad Sohail Zafar, Bonglee Kim, Ehsanul Hoque Apu

School of Medicine Publications

Autophagy is an intrinsic breakdown system that recycles organelles and macromolecules, which influences metabolic pathways, differentiation, and thereby cell survival. Oral health is an essential component of integrated well-being, and it is critical for developing therapeutic interventions to understand the molecular mechanisms underlying the maintenance of oral homeostasis. However, because of the complex dynamic relationship between autophagy and oral health, associated treatment modalities have not yet been well elucidated. Determining how autophagy affects oral health at the molecular level may enhance the understanding of prevention and treatment of targeted oral diseases. At the molecular level, hard and soft oral tissues …

Need For Structured Pain Management Curriculum And Competency-Based Evaluation In Gme: An Observational Study In One Internal Medicine Residency Program, Sudhagar Thangarasu, Gowri Renganathan, Barney Soskin, Lela Ruck, Vishakh Prakash, Sumedha Unnikrishnan, Jyothsna Goranti, Everardo Cobos

School of Medicine Publications

OBJECTIVES

One of the major contributing factors to the opioid crisis, marked by a surge in opioid prescriptions, includes inadequate adherence to guideline-based pain management practices, highlighting the need for a comprehensive curriculum during residency training. In this study, we aim to assess opioid exposure prevalence among hospitalized patients and examine potential associations between disease conditions, patient demographics, and opioid prescriptions during their hospital stay.

METHODS

In this retrospective cohort study at a southern California county teaching hospital, we analyzed the medical records of 2272 patients admitted to the IM resident inpatient teaching service for 1 year, from September 2017 …

Genetics Of Latin American Diversity Project: Insights Into Population Genetics And Association Studies In Admixed Groups In The Americas, Victor Borda, Douglas P. Loesch, Bing Guo, Roland Laboulaye, Diego Veliz-Otani, Jennifer N. French, Thiago Peixoto Leal, John Blangero, Ravi Duggirala, Joanne E. Curran

School of Medicine Publications

Latin Americans are underrepresented in genetic studies, increasing disparities in personalized genomic medicine. Despite available genetic data from thousands of Latin Americans, accessing and navigating the bureaucratic hurdles for consent or access remains challenging. To address this, we introduce the Genetics of Latin American Diversity (GLAD) Project, compiling genome-wide information from 53,738 Latin Americans across 39 studies representing 46 geographical regions. Through GLAD, we identified heterogeneous ancestry composition and recent gene flow across the Americas. Additionally, we developed GLAD-match, a simulated annealing-based algorithm, to match the genetic background of external samples to our database, sharing summary statistics (i.e., allele and …

Worldwide Trends In Diabetes Prevalence And Treatment From 1990 To 2022: A Pooled Analysis Of 1108 Population-Representative Studies With 141 Million Participants, Ncd Risk Factor Collaboration (Ncd-Risc), Bin Zhou, Archie W. Rayner, Edward W. Gregg, Kate E. Sheffer, Rodrigo M. Carrillo-Larco, James E. Bennett, Jonathan E. Shaw, Jesus Melgarejo, Gladys Maestre

School of Medicine Publications

Background: Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories.

Methods: We used data from 1108 population-representative studies with 141 million participants aged 18 years and older with measurements of fasting glucose and glycated haemoglobin (HbA1c), and information on diabetes treatment. We defined diabetes as having a fasting plasma glucose (FPG) of 7·0 mmol/L or higher, having an HbA1c …

Picking The Low-Hanging Fruit: The Cost-Effectiveness Of Opportunistic Diabetes Screening During Tuberculosis Contact Investigations On The Texas-Mexico Border, Robert A. Mcgowan, Henry Shelton Brown, Juan C. Lopez-Alvarenga, Blanca I. Restrepo

School of Medicine Publications

Objective: There is a known association between type 2 diabetes (diabetes) and tuberculosis (TB), and TB clinics have become hubs for new diabetes diagnosis among active patients with TB. However, despite the potential to identify diabetes patients, resources limit diabetes screening opportunities to close TB contacts. We assessed the cost-effectiveness of adding opportunistic screening for diabetes during the routine TB contact investigations conducted at TB clinics.

Research design and methods: We used a Markov-based model to simulate the costs of diabetes screening, management and health outcomes, including the incidence of complications and death. All costs were considered from a health …

Endovascular Treatment Of Patients With Acute Ischemic Stroke With Tandem Lesions Presenting With Low Alberta Stroke Program Early Computed Tomography Score, Milagros Galecio-Castillo, Mudassir Farooqui, Waldo R. Guerrero, Marc Ribo, Ameer E. Hassan, Mouhammad A. Jumaa, Afshin A. Divani, Michael G. Abraham, Nils Petersen, Johanna T. Fifi

School of Medicine Publications

Background: Recent trials confirmed the efficacy and safety of endovascular thrombectomy in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS); however, evidence in tandem lesions is limited. This study evaluates endovascular thrombectomy safety and efficacy in patients with acute large-vessel occlusion with tandem lesions, stratified by baseline ASPECTS.

Methods and results: We conducted a retrospective analysis of data from 16 centers. Inclusion criteria included the following: age ≥18 years, anterior circulation tandem lesions, endovascular thrombectomy onset, and ≥70% internal carotid artery stenosis/occlusion. Patients were categorized into low (0-5) and high (6-10) ASPECTS. Inverse probability of treatment weighting …

Unmasking A Silent Threat: Celiac Disease Revealing Coronary Artery Disease – A Case Report [Desenmascarando Una Amenaza Silenciosa: Enfermedad Celíaca Revelando Enfermedad Arterial Coronaria – Reporte De Caso], Jose Fernando Vargas-Ledo, Maria Eugenia Torres-Perez, Mario Trujillo-Acosta, Monica Olvera-Lopez

School of Medicine Publications

Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals, marked by inflammation and the production of anti-tissue transglutaminase antibodies. Although CD patients often have lower body mass indexes and LDL levels, systemic inflammation can lead to endothelial dysfunction and accelerated atherosclerosis, potentially increasing the risk of coronary artery disease (CAD). We present a case of a 46-year-old female with CD who developed multivessel CAD, ultimately requiring coronary artery bypass grafting. This case highlights the significant cardiovascular risk associated with CD, suggesting that inflammation and genetic factors may contribute to atherosclerosis. While the precise mechanisms …

The Emerging Role Of Long Noncoding Rnas In Sorafenib Resistance Within Hepatocellular Carcinoma, Puneet Vij, Mohammad Shabir Hussain, Sanjaya Satapathy, Everardo Cobos, Manish Kumar Tripathi

School of Medicine Publications

Hepatocellular carcinoma (HCC), a liver cancer originating from hepatocytes, is a major health concern and among the most common malignancies worldwide. Sorafenib, approved by the U.S. F.D.A., is the primary first-line treatment for patients with advanced HCC. While the preferred first-line systemic regimen for HCC is immunotherapy with Atezolizumab plus bevacizumab or Tremelimumab-actl + durvalumab, Sorafenib is still an alternative recommended regimen. While some patients with advanced HCC may benefit from Sorafenib treatment, most eventually develop resistance, leading to poor prognosis. Long noncoding RNAs (lncRNAs) have been found to play a critical role in tumorigenesis and the development of HCC, …

Implications Of Pediatric Extracorporeal Cardiopulmonary Resuscitation Simulation For Intensive Care Team Confidence And Coordination: A Pilot Study, Toluwani Akinpelu, Nikhil R. Shah, Karen Weaver, Nicole Muller, James Mcelroy, Utpal S. Bhalala

School of Medicine Publications

Introduction

Extracorporeal cardiopulmonary resuscitation (ECPR) is associated with improved outcomes in select populations, however, crisis resource management (CRM) in this setting is logistically challenging. This study evaluates the impact of ECPR simulation on self-perceived confidence and collaboration of intensive care unit team members.

Methods

This is a prospective observational study analyzing data obtained between July 2018–December 2019. This study focused on non-surgical members of critical care team consisting of pediatric intensivists, resident physicians, registered nurses, respiratory therapists. Participants were expected to perform cardiopulmonary resuscitation (CPR) during the ECPR event, participate in code-team responsibilities and provide ancillary support during cannulation. Pre- …