Medicine and Health Sciences Commons^™

It Takes A Big Heart To Shape Atrophic Hepatocytes: Hypoxic Hepatitis Secondary To Congestive Heart Failure, Lina Pedraza Sanchez, Jose Rivera, Cynthia Rivas, Grigoriy Rapoport, Michelle Lopez

Research Colloquium

Introduction: Hypoxic hepatitis (HH) also known as ischemic hepatitis is the result of a hypoperfusion state during diffuse hepatic injury¹. The incidence of HH is 2:1000 of patients within any hospital care level. 94% of HH are related to chronic heart failure (HF). In this setting, hepatic dysfunction occurs as a result of passive venous congestion². The most common predisposing factors are acute heart failure and shock states, however, more than half of the cases are not related to any hemodynamic change, thus, underrecognized.

Case description: A 77-year-old woman is admitted to the hospital for acute …

Case Report: Liver Failure In A 4-Month-Old Male With Sma Type 2 After Gene Therapy/Onasemnogene Abeparvovec (Zolgensma), Juliana Hager, Dustin J. Paul

Research Colloquium

Introduction: Spinal muscular atrophy (SMA) is characterized by muscle weakness and atrophy resulting from progressive degeneration of the anterior horn cells in the spinal cord and the brain stem nuclei. The onset of weakness ranges from before birth to adulthood. The weakness is symmetric, proximal > distal, and progressive.

Onasemnogene abeparvovec (ZOLGENSMA) is a viral vector-based gene therapy designed to deliver a functional copy of the human survival motor neuron (SMN) gene to the motor neuron cells of patients with spinal muscular atrophy (SMA). It was approved in May 2019 in the USA for the treatment of pediatric patients aged < 2 years with SMA and bi-allelic mutations in the SMN1 gene. There has been significant motor function gain from the patients in and out of the clinical trials

However, …

Plasmid Midiprep: A Method To Purify Plasmids For Recombinant Dna Studies, Adithya Anilkumar, Kyle Doxtater, Samantha Lopez, Sudhir Kotnala, Justin Wendel, Manish Tripathi

Research Colloquium

A fundamental aspect of molecular biology involves exploring the properties and functions of specific genes. The rise of recombinant DNA technology has vastly improved and simplified functional studies by allowing scientists to isolate specific genes using restriction enzymes and plasmids providing greater precision. Plasmids take great significance in downstream studies, which is why quantity and quality of the plasmids purified is important. In this study, we isolated and purified recombinant plasmids in microgram quantities to confirm the yield, quantity, and quality using spectral and size fractionation methods. We also assessed the plasmids for application in downstream studies. We found the …

Public Communication Of Science: The Experience Of The Rio Grande Valley Alzheimer’S Disease Resource Center For Minority Aging Research, Amanda J. Guerrero, Rosa V. Pirela, Gladys E. Maestre

Research Colloquium

Introduction: There are multiple models of public communication of science. Some models focus on communication within the science community, while others involve public participation. At the Rio Grande Valley AD-RCMAR, we hope to implement a public outreach program to aid in the dissemination of accurate information regarding Alzheimer’s disease and related dementias.

Objective: The purpose of this project was to identify behavioral change models that will allow the RGV AD-RCMAR to increase awareness and engagement of brain aging, including Alzheimer’s disease, within the Rio Grande Valley.

Methods: A literature review was conducted to identify models of behavioral change that will …

A 3- And 6- Month Follow-Up To A Student-Led Approach To Patient Safety In Pre-Clinical Curriculum, Nelson D. Gonzalez, Sahar Panjwani, Daniel Nwosuocha, Lauren Bayliss, Ayleen Godreau

Research Colloquium

Introduction: Preventable medical errors are currently the third leading cause of death in the United States following heart disease and cancer. In light of this, integration of formal patient safety education into undergraduate medical education has been encouraged by the World Health Organization. This study aimed to assess the change in patient safety knowledge, attitudes, and beliefs in students after early exposure to patient safety during pre-clinical years.

Methods: First and second-year medical students participated in the training and responses were assessed through a pre-test, immediate post-test, 3-month post-test, and 6-month post-test. The survey assessed student knowledge on aspects …

Non-Paretic Forelimb Training Does Not Interfere With Recovery Of Paretic Forelimb Strength After Experimental Middle Cerebral Artery Occlusion, Krystal Schaar Valenzuela, Elizabeth Cook, Morgan Blaker, Naomi Cohen, Deepali Bhandari, Theresa A. Jones, Timothy Schallert

Research Colloquium

Humans often compensate with their unimpaired (non-paretic) forelimb after surviving a stroke. Research in rats suggests that this can be maladaptive after focal motor cortical strokes. Forelimb weakness is understudied in rodent models of stroke.

The purpose of the study is to determine whether behavioral experience with the non-paretic forelimb differentially affects paretic forelimb strength recovery after ischemic injury caused by middle cerebral artery occlusion (MCAo). Because behavioral manipulations can influence patterns of neural connectivity post-stroke, the present study also examined how training with non-paretic limb influenced corticostriatal projections.

After training to proficiency with the preferred forelimb on the Isometric …

The Unusual Opportunistic Pathogen With Superbug Potential: A Case Of Morganella Morganii Bacteremia, Rodolfo Singleterry, Khairiya Haj-Yahya

Research Colloquium

Morganella. morganii is considered a rare and unusual cause of infection despite its vast presence worldwide. Recently there has been increasing documentation of its opportunistic ability to infect immunocompromised patients, most notably in intensive care units.

The patient is a 55-year-old female with a past medical history of diabetes mellitus(II), end-stage renal disease, hypertension, dyslipidemia, and a left above-knee amputation. She presented with shortness of breath, hypotension, and difficulties staying awake. Blood pressure on admission was 92/48 with an oxygen saturation of 82%. On physical exam, a 3cm linear non-purulent wound was found on the dorsum of her right foot. …

A System “Pump”Ed To Its Limits: A Case Of Proton Pump Inhibitor-Induced Acute Interstitial Nephritis, Jose Ramos, Heriberto Cantu, Rodolfo Singleterry, Laura Garcia

Research Colloquium

Proton pump inhibitors (PPIs) are some of the most commonly prescribed medications. Patients are given PPIs in the hospital as GI prophylaxis or sometimes as long-term therapies to reduce the symptoms of gastroesophageal reflux disease and gastrointestinal ulcers¹. There has been increasing data, including case reports implicating PPIs with acute interstitial nephritis and acute renal failure³.

A 26-year-old female with no past medical history presented to the emergency department (ED) complaining of the inability to voiding urine, facial swelling, and non-radiating, bilateral flank pain for three days. The patient was seen in the ED 10-days prior …

Multisystem Inflammatory Syndrome In Children (Mis-C): Is There A Relationship To Typhus?, Sravani Mannuru, Juliana Hager, Jacob Smith

Research Colloquium

The United Kingdom first reported in April 2020 a group of eight previously healthy children with a link to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that presented with systemic inflammation and multi-organ involvement, now named multisystem inflammatory syndrome in children (MIS-C). The Centers of Disease Control and Prevention (CDC) have reported over 1000 cases since the primary discovery as of October 2020 with 20 total deaths. [1] The clinical features of MIS-C have been previously compared to inflammatory syndromes including Kawasaki disease (KD) and toxic shock syndrome (TSS). We describe the clinical presentation and management for 3 pediatric cases with …

Functional Characterization Of The Ipsc Generated Hepatocytes Using Genome-Wide Transcriptomic Analysis, Ashley Ikwuezunma, Erica De Leon, Ana C. Leandro, Joanne E. Curran, John Blangero, Satish Kumar

Research Colloquium

Advances in iPSC technologies now allow us to consider non-invasive large-scale in-vitro disease modeling experiments on disease appropriate cell types in human subjects to better understand human disease pathophysiology, disease genetics and to develop better diagnostic and therapeutic technologies. We performed differential gene expression and functional annotation analysis using genome wide mRNA sequencing data to evaluate the functional and disease modeling potential of iPSC generated hepatocytes. Following the criteria moderated t statistics FDR corrected p-value ≤ 0.05 and fold change-absolute ≥ 2.0, 7,246 genes/transcripts were significantly differentially expressed iPSCs and hepatocytes. The 3,791 of these DE genes/transcripts were significantly …

Intranasal Delivery Of Human Umbilical Cord Stromal Cell Conditioned Media Improves Alveolar Growth And Vascular Remodeling In Experimental Bronchopulmonary Dysplasia, Jooby Joy, Dawn Mcdaniel, Caitlyn Winter, Michelle Noronha, Tyrelle Seno, Lauryn Winter, Rija Naqvi, Yasmeen Alayli, Maxwell Jones, Shamimunisa Mustafa, Sunil Ahuja, Alvaro Moreira

Research Colloquium

Introduction: Bronchopulmonary dysplasia (BPD) is a lung disease with high morbidity and mortality in premature neonates exposed to mechanical ventilation and oxygen support. Preclinical studies demonstrate mesenchymal stromal cell (MSC) conditioned media (CdM) improves histologic changes in BPD via the release of paracrine factors. Current modes of administration include intratracheal or intraperitoneal routes with CdM cultured in ambient air.

Objectives: The objective of this study was twofold: (i) assess the efficacy of intranasal delivery of CdM, and (ii) determine whether hypoxic preconditioning stimulates the therapeutic potential of CdM.

Methods: Newborn rat pups were randomly assigned to four groups: (1) room …

Cmv? An Uncommon Etiology For Significant Disease In The Immunocompetent Individual, Ashley Sareen, Cade Call, Sonya Saenz

Research Colloquium

A 51-year-old Hispanic male with Type 2 diabetes mellitus and dyslipidemia was admitted from the ED for evaluation of recurrent fevers, multiple joint pains, and tachycardia. Physical exam findings included cachectic appearance and right inguinal lymphadenopathy. Initial laboratory testing was significant for a WBC of 23,300 (80.2% neutrophils, 13.3% lymphocytes), Hb of 11.1, HCT of 33.1, and ESR of 120. Chest x-ray reported no acute findings and x-ray imaging of affected joints were unremarkable. Blood and urine cultures would eventually return negative. Despite acetaminophen and broad-spectrum antibiotic use, the patient continued with fevers and tachycardia, prompting further infectious and rheumatological …

Ka“Posing” A Problem In An Already Problematic Situation: A Case Of Kaposi’S Sarcoma In Hiv, Khairiya Haj-Yahya, Rodolfo Singleterry

Research Colloquium

The progression of HIV to Acquired Immunodeficiency Syndrome (AIDS) is characterized by a CD4 cell-count below 200, and/or the development of an AIDS-defining illness. Kaposi’s sarcoma is a malignant tumor that manifests as violaceous skin lesions, occurring predominately in immunosuppressed patients.

Patient is a 37-year-old male with no past medical history who presented with a 4-month history of rapid, unintentional 60lbs weight loss and worsening dysphagia. He further noted multiple dark purple, raised skin lesions on his back and extremities appearing 9 months ago. Patient was uninsured and without a primary care physician. Labs revealed elevated monocytes and a dangerously …

How To Get Ripped Muscles In 7 Days: A Case Of Daptomycin-Induced Rhabdomyolysis, Khairiya Haj-Yahya, Rodolfo Singleterry

Research Colloquium

In phase III clinical trials, the use of Daptomycin was associated with an increase in creatinine phosphokinase (CPK) levels in 2.8% of patients treated. Elevation of CPK levels greater than 5 times the upper limit of normal (10-120 mcg/L), indicates a probable diagnosis of rhabdomyolysis. Rhabdomyolysis is the breakdown of skeletal muscle and subsequent leakage of contents into the blood, causing extreme weakness and pain.

A 50-year-old male with a past medical history of chronic osteomyelitis, presented to the ED with right foot pain with swelling. He was subsequently started on Daptomycin. During this time his CPK level was within …

Use Of Point Of Care Ultrasound In The Pre-Op Evaluation Of Dialysis Patients Needing Creation Of Permanent Arteriovenous Access – Preliminary Study, Urvashi Mathur, Sotero Peralta

Research Colloquium

Background: Non-invasive ultrasound evaluation is part of the preoperative evaluation of patients needing creation of arteriovenous access. This study requires patients to return for an additional visit for imaging or visit an outpatient imaging facility. These visits produce delays in surgery and increase costs in healthcare. Point of care ultrasound examination at the same time of initial physician visit, allows to decrease cost, improvement of anatomical planning, and decrease timing of surgery.

Methods: We reviewed the UTRGV Vascular Surgery Database from January to December 2020, for patients who has elective outpatient arteriovenous access creation, in which has pre-operative evaluation with …

Building The “Crypt” Through Non-Compliance: A Case Of Cryptococcal Meningitis In An Aids Patient, Rodolfo Singleterry, Khairiya Haj-Yahya

Research Colloquium

According to the World Health Organization (WHO), over 10-25% of hospital admissions result from patient noncompliance. This is a complex issue that has vast ripple effects as it not only worsens outcomes for patients but places a strain on the healthcare system entirely. In patients with HIV/AIDS, compliance with Antiretroviral therapy (ART) is necessary to prevent a host of potentially lethal infections.

A 33-year-old female with AIDS, presented to the ED complaining of nausea and vomiting for seven days. Throughout her hospital stay, the patient was regarded as medically noncompliant with daily episodes of refusing medications, hiding pills in her …

Effects Of Social Determinants Of Health On Disease Burden In A Case Of Takayasu Arteritis, Rodolfo Singleterry, Khairiya Hay-Yahya

Research Colloquium

Texas houses the largest uninsured population in the US with an estimated 5 million residents lacking healthcare. In the Rio Grande Valley, the combination of poverty, limited access to care, and lack of insurance poses a great barrier to healthcare management.

Patient is a 27-year-old female with a past medical history of Takayasu arteritis, migraine headaches, complete heart block with pacemaker placement, heart failure with reduced EF of 20%, and rheumatic heart disease s/p mitral valve replacement. Patient presented to the ED with a one-day history of a headache located on the right side of her head and face, described …

Steps On Establishing A Faculty Development Curriculum For Health Science Educators In A New Medical School, Beatriz Tapia, Karina Madrigal, Robert Nelson

Research Colloquium

Purpose: New Medical Schools need health science educators, to teach throughout the medical education continuum from basic science to clinical years. The need to establish a defined faculty development curriculum for health science educators will aid in standardizing best teaching practices and build a potential master teacher to move the curriculum toward active learning and innovation. The UTRGV SoM is a distributed campus, to achieve increase outreach we will offer synchronous and asynchronous online faculty development during the pandemic. This poster will share our progress to date.

Methods: A pilot, faculty development program, was established from faculty needs assessment data, …

Murine For A Bad Time: Prehospital Factor Associations With Murine Typhus Related Icu Admission, Russell H. Moreland Iii, Ayesha Khan, Denisse Ramirez, Salman Bangash, Azucena Del Real, Adriana Betancourth Alvarenga, Natalia Pinto, Chelsea H. Chang

Research Colloquium

Introduction: Across South Texas rates of murine typhus related hospitalization have been on the rise (1). Murine typhus is flea borne febrile illness caused by the bacterium Rickettsia typhi. Murine typhus is easily treated with doxycycline but is commonly underdiagnosed (2). Rarely murine typhus can cause hospitalization and ICU admission (3). To gain a greater understanding of the clinical course of severe murine typhus, our team has set out to identify novel clinical findings associated severe murine typhus courses.

Methods: Medical records were obtained from adults with suspected murine typhus admitted to Doctor’s Hospital at Renaissance in Edinburg, Texas, …

Establishing A Mentoring Program For Health Science Educators In A New Medical School, Karina Madrigal, Beatriz Tapia, Robert Nelson

Research Colloquium

Purpose: New Medical Schools need mentoring programs to enhance the personal and professional development of mentees and mentors. The need to establish a mentoring support mechanism is critical. This poster will share our progress to date.

Methods: A pilot mentoring program was established for junior faculty. These faculty members were paired with an associate professor or professor to serve as mentors for career development and engage in a focused scholarly project over a nine-month period.

Typically, the junior faculty is within the first three years of appointment and hold the rank of assistant professor. Each mentee will have 10% protected …

Ut Health Rgv Covid-19 Testing Report, Jefferson T. R. Chandler, Beatriz Tapia

Research Colloquium

Purpose: This health surveillance project's goal was to organize de-identified data received from UT Health RGV with the intent to provide timely reporting to testing sites and health affairs directors. We aimed to explore how testing rates differ between counties, testing sites and age groups from March 30 through August 7, 2020. We looked at different demographics and compared the positivity rates for each testing site. For this report, we will detail information for the pediatric population (ages 0-18).

Materials and Methods: A codebook and database were created with information about COVID-19 test data to formulate reports to the testing …

Psychotropics Prescription In Primary Care, Ruthzaine Lopez Bolano

Research Colloquium

Background: The study aimed to measure the prevalence of psychotropic prescriptions in primary care at four UTRGV clinical sites. Based on the results, this paper serves to inform and educate primary care providers of their current practices and treatment options when diagnosing mental health disorders and prescribing psychotropics.

Methods: This study used EMR data from January to March 2021 in four primary care clinics affiliated with the UT Health RGV system. Primary care patients from January to March 2021 and who were diagnosed with mood disorders (including Depression, Anxiety, and Bipolar Disorder) were included in this quality improvement study.

Results: …

A Novel Approach To Target Tumor Immune Microenvironment And Improve Checkpoint Immunotherapies, Poornima Devi Shaji, Ana Martinez, Melida Flores Cantu, Anupam Dhasmana, Meena Jaggi, Stephen W. Behrman, Murali M. Yallapu, Subhash C. Chauhan, Sheema Khan

Research Colloquium

Background: Pancreatic cancer remains 3^rd deadliest disease, with less than 7-10% survival rate. Little progress has been seen in patient’s outcome due to high desmoplasia and chemo-resistance. Immunotherapy has shown promising results in cancers, except pancreatic cancer due to their characteristic fibrotic tumor microenvironment. The therapies are unable to penetrate fibrotic tumor leading to insufficient availability of therapeutic drugs at the tumor site. A recently identified mucin, MUC13 is aberrantly expressed in pancreatic tumors but not in normal pancreas, that makes it an excellent protein tumor target. This study is unique as it utilizes MUC13Ab for targeting the pancreatic …

Survival Disparities Between Border And Non-Border Counties In Colorectal Cancer Patients Using The Tcr, Michael Machiorlatti, Michael Brian Lapelusa

Research Colloquium

Along the US Texas Mexico border constant migration, developing medical infrastructure and income disparity leads to poorer access to healthcare and poorer health outcomes. Given 32 of the 254 counties in TX are on the border with roughly 9.8% of the Texas residing in these counties (2.8 million people), this represents a significant population susceptible to adverse health outcomes. We investigate comparisons between border and non-border counties as well as how sociodemographic and diagnostic criterion influence survival of colorectal cancer. Data was obtained from the Texas Department of State Health Service’s TCR. Patients were 18 or older and excluded for …

Case Report Of Chylothorax From Venous Cannulation, Maria Najam, Suneet Johal, Nevin Varghese

Research Colloquium

Background: Chylothorax is the accumulation of the lymphatic fluid in the pleural space. Diagnosis of chylothorax is confirmed with pleural fluid analysis demonstrating triglycerides greater than 110 and cholesterol level less than 200mg/dl. Rarely, chylothorax can occur from damage to the thoracic duct from central venous cannulation

Case Presentation: A 48-year-old female with presented with gradual onset of shortness of breath for five days. She was noted to be hypoxic on arrival and was placed on non-rebreather oxygen therapy. Physical exam revealed decreased breathing sounds on the right side and was also noted for the right internal jugular dialysis catheter. …

Outcomes After Rib Fracture In Elderly Patient Due To Blunt Trauma At Doctors Renaissance Hospital, Lord Crescens Mvoula, David Weaver, Monica Michelle Betancourt-Garcia, Jeffrey Skubic

Research Colloquium

Background: Blunt trauma remains the most common traumatic reason for presentation at a hospital. Despite their frequency, there remains high morbidity and mortality. This is particularly true amongst the elderly. About 16.5 percent of the American population was 65 years old or over in 2019. This number is projected to reach 22 percent in 2050.

Some clinical guidelines requiring admission to an intensive care setting in trauma centers for elderly patients with two or more rib fractures have been adopted by some trauma centers. Usage of these guidelines may lead to significant decreases in hospital stats, ICU stats, and use …

The Reality Of Virtual Undergraduate Medical Education: Hands-On Learning In A Hands-Free World, Layla Nejad, Paola Ibarra, Aleena Flores, Robert Nelson Jr.

Research Colloquium

Background & Purpose: In the wake of the current COVID-19 pandemic, medical education has been forced to rely on virtual experiences including skills workshops, patient interactions, and oral exams. The virtual reality (VR) technology that currently exists has the potential to enhance undergraduate medical learning by improving information retention, clinical skills, and communication; however, most undergraduate medical education (UME) curricula lack its integration and use. Introducing VR to the UTRGV School of Medicine (SOM) could incorporate all existing learning styles and update the virtual world where medical students live and learn, leading to more versatile future-physicians.

Methods: We have explored …

A Case Of Disseminated Cryptococcosis, Suneet Johal, Shadi Jafari-Esfahani, Maria Najam, Luis Rosas

Research Colloquium

Background: Cryptococcus is an invasive fungal infection, typically acquired through inhalation. It is found in soil contaminated with bird droppings and it can disseminate to the lungs, meninges, and skin. In the United States, the incidence of cryptococcosis is estimated to be about 0.4-1.3 cases per 100,000 population with the most common species being Cryptococcus Neoformans and Cryptococcus Gatti. Cryptococcosis is commonly seen in HIV patients, however, immunocompromised individuals with cancer, solid organ transplants, or chronic glucocorticoid therapy are also at high risk.

Case Presentation: A 69-year-old male with history of polymyositis and granulomatosis polyangiitis on chronic steroids presents to …

Long-Term Survival After Stage Iiib Gallbladder Adenocarcinoma, Shiv Govindji, Rohan Jeyarajah, Shankar Logarajah

Research Colloquium

Patients with gallbladder adenocarcinomas are rare but present with low five-year survival rates. However, there are patients that survive long after their diagnosis with late-stage gallbladder cancer. The objective of this clinical case report is to highlight factors which may have contributed to this patient’s current 15-year survival to provide further insight on the prognosis of aggressive gallbladder adenocarcinomas.

A 43-year-old woman presented to the clinic with back pain. She had an ultrasound which showed dilated bile ducts and a filling defect with endoscopic retrograde cholangiopancreatography. A gall bladder mass was found and biopsied. Biopsy concluded the mass to be …

Uterine Serous Carcinoma: A Rare Presentation Of An Uncommon Type Of Cancer, Shadi Jafari-Esfahani, Fatimah Bello

Research Colloquium

Introduction: Endometrial adenocarcinoma is the most common type of uterine cancer and is divided into two types; type 1 includes 80 percent of the cases while type 2 comprises 10 to 20 percent, with latter being more aggressive. Type 2 endometrial cancer is of serous or clear cell histology and abnormal uterine bleeding is the most common clinical presentation. This case portrays an infrequent presentation of uterine cancer.

Case Presentation: A 73-year-old woman with past medical history of hypertension and diabetes mellitus type 2 presents to the emergency room with chief complaint of nausea and abdominal bloating for 2 months, …