Medicine and Health Sciences Commons^™

Clinical And Social Profile Of Patients With Pulmonary Tuberculosis In Reynosa, Tamaulipas, Selena Zavala-Pérez, Erika A. Vargas-Orozco, Juan Carlos Hernandez-Martinez, José Francisco Flores-Gómez, Marisol Rosas-Diaz, Esperanza Milagros Garcia-Oropesa

Research Symposium

Background: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It generally causes pulmonary tuberculosis, with symptoms such as fever and expectoration. In 2020, the total number of tuberculosis cases worldwide was about 9.8 million, with a mortality of 1.5 million. In Mexico, pulmonary tuberculosis represents 79% of the total cases of tuberculosis, with an incidence of 24 cases per 100,000 inhabitants. Tamaulipas ranks fifth nationally. This study seeks to determine the frequency in which social and risk factors associated with predisposition to tuberculosis occur in the population of Reynosa, Tamaulipas.

Methods: Through an observational and descriptive study, data were …

Evaluating Internal Medicine Resident Cardiology Knowledge By In-Service Training Exam Performance: A Four-Year Review, Schamma Salomon, Chelsea Chang

Research Symposium

Introduction: The In-Service Training Examination in Internal Medicine (IM-ITE) has been offered annually to all trainees in U.S. medical residency programs since 1988. Its purpose is to provide residents and program directors with an objective assessment of each resident's performance on a written, multiple-choice examination and the performance of the residency program compared with that of its peers. This study aims to determine which measurable educational objectives contributed to improving In-training examinations in cardiology and which did not. Furthermore, we hope to highlight the strengths and weaknesses of the current knowledge to objectively evaluate and improve our cardiology rotation and …

Erk Required For Lipopolysaccharide-Induced Tlr4 Internalization In Macrophages, Sara M. Reyna, Phoebe Fang-Mei Chang

Research Symposium

Background: Insulin resistance is associated with low circulating levels of lipopolysaccharide (LPS). Binding of LPS to Toll like receptor 4 (TLR4) leads to the internalization and trafficking of TLR4 resulting in activation of downstream signaling pathways. TLR4 internalization in macrophages leads to the activation of pro-inflammatory signaling pathways and production of factors linked to the development of insulin resistance. The extracellular signal-regulated kinase 1 and 2 (ERK1 and 2) are activated downstream of TLR4 and are associated with insulin resistance. We hypothesized that ERK1 and ERK2 regulate TLR4 internalization in macrophages when exposed to LPS.

Methods: We examined whether inhibition …

Non-Prescribed Pain Reliever Trends From 2011-2020 And Their Effects On Uninsured Americans’ Mental Health, Samantha M. Guajardo, Wan-Lin Chang

Research Symposium

Background: In 2019, it was reported by the National Survey of Drug Use and Health (NSDUH) that 10.1 million Americans misuse pain relievers, and of those individuals, 50.8% were not prescribed by a health care provider. The same report also indicates that there is a direct correlation between substance use and mental health disorders (NSDUH, 2019). In 2020, the NSDUH reported that 49.5% of Americans do not receive mental health treatment for their substance use disorder. Of that percentage, 30.4% did not receive treatment for health insurance reasons. According to the CDC, 31.6 million Americans reported not being insured in …

Implementation Of An Immediate Postpartum Long-Acting Reversible Contraception Program In A Southern Texas Border Population, Samantha G. Alvarado, Elizabeth Cook, Dawn Jensen, Molly Chapman, Saul Rivas, Diane Ju

Research Symposium

Background: Expanding contraceptive access in a Southern Texas border population can reduce the number of unintended and short-interval pregnancies, which have been associated with poor maternal and neonatal health outcomes. Healthcare encounters can be maximized to include immediate postpartum long-acting reversible contraception (IPP LARC) as an additive to the healthcare access many women have during pregnancy. The implementation of the IPP LARC Program allowed for the provision of accessible LARCs to fulfill the contraceptive needs of our patient population. This program was supported by Medicaid reimbursements and a private teaching grant that was awarded to the University of Texas Rio …

The Fortify Resilience Initiative, Nausheen Jamal, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. In order to address the multitude of threats to physician wellness and to mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this Initiative from the Office of GME will strengthen existing wellbeing pathways while expanding additional solutions that will work to sustain wellbeing. Utilizing a combination of prevention, promotion, and intervention strategies …

An Ngqd Based Diagnostic Tool For Pancreatic Cancer, Ryan Ketan Ajgaonkar, Bong Lee, Alina Valimukhametova, Anton Naumov, Giridhar Akkaraju

Research Symposium

Background: Pancreatic cancer remains difficult to detect at early stages which contributes to a poor five-yearsurvival rate. Therefore, early detection approaches based on novel technologies should be explored to address this critical health issue. Nanomaterials have recently emerged as frontrunners for diagnostic applications due to their small size in the 1-100 nm range, which facilitates one-on-one interactions with a variety of biomolecules like oligonucleotides and makes them suitable for a plethora of detection and delivery applications. In this work, the presence of specific pancreatic cancer miRNA (pre-miR-132) is detected utilizing the fluorescence properties of highly biocompatible nitrogen-doped graphene quantum dots …

Further Decoding The Molecular Relationship Between Pancreatic Ductal Adenocarcinoma And Diabetes Mellitus, Russell Moreland Iii, Anupam Dhasmana, Subhash C. Chauhan, Sheema Khan

Research Symposium

Background: Pancreatic ductal adenocarcinoma (PDAC) is a devastating malignancy, especially as there are no current reliable methods of screening. A significant relationship between PDAC and Diabetes Mellitus (DM), specifically a new onset of diabetes mellitus (NOD). The molecular network of PDAC and new onset DM is not completely understood. We sought to investigate the molecular network of these two diseases with the ultimate goal of identifying potential biomarkers to aid in the screening of PDAC.

Methods: We conducted a review for relevant articles concerning the molecular relationship between PDAC and DM. We compiled a list of 74 genes which have …

Palmitoylation As A Regulator Of Maguk Proteins Postsynaptic Localization, Rozena Shirvani-Arani, Santiago Balderas, Yonghong Zhang, Xioaqian Fang

Research Symposium

Synaptic plasticity is the ability of the brain to make changes and the changes occur at synapses. To achieve the complicated functions, a good number of proteins are present at synapse and are called synaptic proteins. To stabilize these proteins at synapses, proteins are modified through posttranslational modifications (PTMs). The most studied PTMs include phosphorylation, acetylation, ubiquitination, glycosylation, palmitoylation, etc. Palmitoylation is a type of lipid modification and has received more attention recently for its contribution to protein trafficking, localization, and interaction in various synaptic plasticity. The membrane-associated guanylate kinase (MAGUK) family includes PSD-95, PSD-93 (also known as chapsyn-110), SAP102, …

Stroke Mimics: A Challenge For The Clinician, Khairiya Haj-Yahya, Rodolfo Singleterry, Dayan Ojeda Damas, Carlos Ramos, Laura Garcia, Meghan Danielle Cantu

Research Symposium

Background: Stroke is defined as an acute neurologic injury that is the result of a disruption in cerebral perfusion due to the blockage or rupture of an artery. Ischemic infarcts represent up to 87% of all strokes, and most commonly present with sudden onset, focal neurologic deficits that are consistent with a vascular etiology. Approximately 30% of patients presenting to the Emergency Department with stroke-like symptoms are unfortunately stroke mimics.

Stroke mimics such as syncope, sepsis, seizure, and migraines can present with stroke-like symptoms and are often indistinguishable from true strokes. The study conducted will serve to provide medical residents …

Recurrent Hemarthrosis Secondary To Erosive Patellofemoral Arthritis Treated With Arthroplasty: A Report Of 3 Cases, Rachael A. Turner, Justin N. Duke, Trevor G. Murray, Jared R.H. Foran

Research Symposium

Background: Spontaneous hemarthrosis of the knee joint in the elderly population is a rare phenomenon and is mostly seen in those with osteoarthritis. The identified causes of spontaneous hemarthrosis in this demographic include subchondral bone bleeding, meniscal tear, genicular artery bleeding, and the use of anticoagulants. Hemarthrosis caused by isolated patellofemoral bleeding, as in this case series, has been rarely documented and poorly described.

Case: Three patients presented with recurrent hemarthrosis secondary to erosive patellofemoral arthritis. Recurrent hemarthrosis from the eroded patellofemoral subchondral bone has not been well described. Each patient presented with symptoms secondary to painful effusions that …

Patients Achieving 90°/45°/0° Intraoperative Stability Do Not Require Hip Precautions Following Posterior Approach Total Hip Arthroplasty: A Prospective Randomized Study, Rachael A. Turner, Marlie R. Mounts, Nimesh B. Patel, Erin N. Snelling, Raquel E. Phillips, Dean A. Levesque, Jared R.H. Foran

Research Symposium

Background: Hip precautions are traditionally employed after posterior total hip arthroplasty (THA). The primary purpose was to investigate the necessity of hip precautions after posterior approach THA. We hypothesized that eliminating precautions in patients that achieved appropriate intraoperative stability would not increase the dislocation rate.

Methods: Randomized controlled trial of 346 consecutive eligible patients undergoing primary THA with a mean follow-up of 2.3 years (range 11 months to 3.7 years). Exclusion criteria: lumbar fusion, scoliosis, abductor insufficiency, inability to achieve intraoperative stability with combined 90° flexion and 45° internal rotation in 0° adduction. Fisher's exact test was used to compare …

Non-Syndromic Multi Focal Non-Ossifying Fibroma: A Diagnostic Challenge Of Giant-Cell Rich Lesions, Rachael A. Turner, Andres M. Burbano, Kevin J. Orellana, Duncan Ramsey

Research Symposium

Background: Diagnosing GCL can be extremely difficult due to the rarity of these lesions. Histologically many benign GCL mimic each other and can further be mistaken for a malignant GCL. Additionally confusing the diagnosis, many benign GCL have significant morphological overlap. However, it is of utmost importance to arrive at an accurate diagnosis as treatment varies significantly based on the pathology. Our patient presentation highlights that differentiating GCLs can be a diagnostic challenge as illustrated. Our review of the literature found scarce reports of multifocal non-ossifying fibroma. In this case report, we describe a non-syndromic multifocal non-ossifying fibroma successfully …

Giardia Lamblia Reactive Arthritis Mimicking Acute Periprosthetic Knee Infection: A Case Report, Rachael A. Turner, Justin N. Duke, Jared R.H. Foran

Research Symposium

Background: The difficulty in diagnosing Periprosthetic joint infection (PJI) is exacerbated by the more varied presentation of PJI and the lower synovial fluid WBC count thresholds applied when a prosthesis is present. Multiple reports have described pseudosepsis after total knee arthroplasty (TKA) due to gout or pseudogout. Further confusing the picture, periprosthetic infection also frequently coexists with crystalline arthropathy. Our review of the literature revealed no reports describing reactive arthritis (ReA) mimicking acute infection in the setting of previous TKA. In this case report, we describe a pseudo-periprosthetic infection of a well-functioning TKA secondary to ReA in the setting of …

A Moyamoya Case Report On A Patient With Slurred Speech And Right-Hand Weakness, Priyasha Suri, Mery Bartl, Don Rajan, Natalia Pinto, Daniela Hernandez

Research Symposium

Background: Moyamoya angiopathy (MMA) is a cerebrovascular disease affecting about one in a million people. It is characterized by progressive stenosis of the terminal portion of the internal carotid arteries leading to cerebral hypo-perfusion which in turn induces neo-angiogenesis in the deep parts of the brain. Patients are predisposed to ischemic and hemorrhagic strokes. Diagnosis is usually made with magnetic resonance imaging (MRI) and a magnetic resonance angiogram (MRA) to evaluate the brain and its blood vessels. Symptomatic patients should undergo surgical interventions. A few studies have shown that the superficial temporal artery to middle cerebral artery bypass combined with …

L(D)-Tyrosine-Mediated One-Step Chiral Graphene Production For Chirality-Dependent Sensing, Fnu Pranav, Ali Ashraf, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

Research Symposium

Background: Chirality has been the most iconic phenomenon that occurred in nature. The idea of mirror-image asymmetry associated with the biological entity is still unsolved The emergence of 2D layered nanomaterials which have already shown amazing properties and a wide range of applications, especially in the areas of sensing.Amino acids enantiomers have similar physical and chemical properties however their physiological responses get changed based on the enantiomers. For example, L from amino acids helps body in protein formation, and generation of biological signals etc. whereas the D-form may cause toxic effects. We have developed a novel and facile synthesis method …

Synthesis, Biological Evaluation And Molecular Docking Studies Of Novel 3,5- Disubstituted 2,4-Thiazolidinediones Derivatives, Pooja A. Chawla

Research Symposium

Thiazolidinediones (TZDs) are a new class of antidiabetic drugs, having an insulin sensitizing effect in patients with type 2 diabetes. We report here the synthesis A series of thirteen 2,4-thiazolidinedione derivatives. The 2,4-thiazolidinedione ring's fifth position was used as a site for Knoevenagel condensation to generate the compounds listed in the title. The synthesised derivatives were characterised using a variety of physicochemical and spectral analyses, including IR, Mass, 1H-NMR, ¹³C-NMR, and elemental analysis. By using the carrageenan-induced rat paw edoema method, the alloxan-induced diabetes in wistar rats method, and the FRAP (ferric reducing antioxidant power) method, respectively, the derivatives …

Without A Rash! A Diagnostic Dilemma For Vzv Vasculopathy, Paulina Vega Enriquez, Jose E. Campo Maldonado

Research Symposium

Varicella zoster virus vasculopathy is a condition that can classically present with a dermatomal zoster rash followed by a neurological deficit. The possible neurological manifestations and disease range are extensive. Diagnosis becomes more challenging in patients whose presentation does not include a rash, often causing cognitive errors and delay in treatment. We present a case of an 85-year-old patient, who developed stroke-like symptoms, initially with normal MRI, to later progress to multiple evolving enhancing lesions seen in subsequent MRIs. This case also represents the anchoring, that we as physicians can have when a patient with risk factors for stroke or …

Coccidioides Immitis Presenting With Acute Hydropneumothorax In An Immunocompetent Patient From South Texas, Paulina Vega Enriquez, Cesar A. Peralta, Yaman Gibran, Maxwell Hill, Jose E. Campo Maldonado

Research Symposium

Coccidioidomycosis is a disease caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii that predominates in dry climates and it is endemic in Southern California and Arizona. Coccidioides is also found in parts of West Texas and a long the Rio Grande River, however, incidence tends to decrease in areas close to the Gulf of Mexico due to increased humidity. Coccidioidomycosis is more commonly a subclinical and self-limited disease in up to sixty percent of cases. Acute pneumonia (Valley fever), extra thoracic disseminated infection and complications occur more frequently in immunocompromised hosts. We present a case of severe coccidiomycosis …

A Dangerous Complication Of Acute Pancreatitis: Abdominal Compartment Syndrome, Paulina Vega Enriquez, Henry Kwang

Research Symposium

Abdominal compartment syndrome (ACS) is defined by an increased in intra-abdominal pressure (>20 mmHg) associated with new organ dysfunction. The mortality is reported to be approximately 50%, even with surgical abdominal decompression. Pancreatitis is a well-known risk factor of ACS and is associated with increased mortality and morbidity. We describe a COVID-19 positive patient, with recurrent acute pancreatitis secondary to hypertriglyceridemia, who developed ACS. Patients with this combination have critically elevated rates of mortality and morbidity, but fortunately our patient was discovered early and managed promptly.

Association Of Cutaneous Manifestations With Admission Duration Among Dengue Fever Patients In Rural, Underserved Philippines, Patricia Marie Guzman

Research Symposium

Background: Dengue fever (DF) is endemic to the Philippines, where it poses a major public health concern, especially in rural and medically underserved areas. Recent literature has underscored the clinical significance of rash in DF, reporting that cases with rash are associated with less severe complications than cases without. The aim of this study is to determine whether the presence of dermatological symptoms is associated with a shorter admission duration among DF patients in a rural, underserved area in the Philippines. This association may in turn aid in the management and triaging of DF cases, particularly in underserved areas …

Patchy Alopecia In A Young Adult With A Generalized Rash, Oscar Rodrigo Zamudio Herrera, Nevin Varghese

Research Symposium

Background: Syphilis is a sexually transmitted infection that has been increasing in the United States. The prevalence of syphilis rose by 6.8% during 2019-to 2020. Secondary syphilis typically presents with a generalized maculopapular rash on palms and soles, however, can also have subtle dermatological findings such as alopecia. Syphilitic alopecia is an atypical manifestation of secondary syphilis, seen in 2.9 to 7% of the cases.

Case presentation: An 18-year-old Hispanic male presented to the clinic after noticing patchy loss of hair on the scalp for 2 weeks and one week of generalized non pruritic rash. His past medical history was …

A Swinging Heart: Relevance Of Point Of Care Ultrasound In The Diagnosis Of An Atypical Complication Of Acute Pericarditis, Oscar Rodrigo Zamudio Herrera, Nevin Varghese

Research Symposium

Background: Cardiac tamponade is a life-threatening condition, that results from progressive or acute accumulation of fluid in the pericardial space impairing cardiac hemodynamics. It is a rare complication of acute pericarditis. About two-thirds of acute pericarditis present with pericardial effusion. Of which, hemodynamic instability is seen in 3-5% of the cases. Point of Care Ultrasound is a cost-effective tool that aids in the prompt identification of life-threatening conditions such as tamponade.

Case presentation: 36-year-old male presented with complaints of fever and dyspnea on exertion for 4 days. He reported being tachycardic at home on his personal pulse oximeter. Past medical …

Mediastinal Mass Presenting As An St-Elevation Mi, Oscar J. Lopez, Gabriel J. Lora Ferreira, Carlos B. Ceron

Research Symposium

Background: MINOCA is defined as a clinical syndrome in which there is myocardial ischemia in the setting of normal coronary arteries. Different causes include coronary spasms, SCAD, or external compression, e.g., by a mediastinal mass. CT or MRI would show presence of the mass, deferring any need for coronary angiography.

Case: The patient is a 57-year-old lady with a past medical history of hypertension who presented to the ED complaining of shortness of breath associated with chest pain. Upon evaluation her vitals were BP 126/76, HR 94, RR 18, O2 98% on room air. Physical exam was unremarkable. Troponin peaked …

Microrna-34a And Long Non-Coding Rna Malat1 Is Associated With Hpv Status And Viral Load In Premalignant Cervical Lesions, Orlando Solis-Coronado, Juan A. García-Quiñones, Mariel Aracely Oyervides-Muñoz, Victor Treviño, Celia N. Sanchez-Dominguez, Antonio A. Pérez-Maya, Diana Cristina Perez-Ibave, Oscar Vidal-Gutierrez, Juan Francisco González-Guerero, Genaro A. Ramírez-Correa, María Lourdes Garza-Rodríguez

Research Symposium

Background: Cervical cancer (CC) is one of the most common gynecological malignancies in the world, and human papillomavirus (HPV) infection is the most important risk factor for their development. Although there are methods for the early detection of CC and HPV infection, but there are not highly sensitive and specific, for it´s necessary to investigate alternatives such as miR-34a and MALAT1, implicated in the pathogenesis of CC. The objective was to evaluate the association of HPV status, viral load, the presence of coinfections, and the grade of CC precursor lesions with miR-34a and MALAT1 expression in patients with high …

A Case Of A Reversible Cause Of Psychosis: Thyroid Storm, Richard G. Wagner Jr, Shyama Appareddy, Khalid Sheikh, Laura Garcia, Nayeli Zarate, Nancy Marilyn Vergara

Research Symposium

Thyroid storm, an exaggerated manifestation of thyrotoxicosis, is a rare and life-threatening endocrine emergency. Physical and emotional stressors can precipitate thyroid storm in patients with underlying thyrotoxic conditions. Patients present with cardiac, GI and CNS dysfunction. The Burch-Wartofsky point scale predicts the likelihood of thyroid storm based upon the presence of these CNS, GI, and cardiovascular symptoms along with thermoregulatory dysfunction. A score of 45 or greater on this scale is indicative of thyroid storm. Treatment of thyroid storm includes a beta blocker, a thionamide, iodine solution, a glucocorticoid, and a bile acid sequestrant.

Thyroid storm is a recognized cause …

Microrna-145 Replacement As A Therapeutic Tool To Improve Trail Therapy, Saini Setua, Nirnoy Dan, Melida Flores Cantu, Ana Martinez Bulnes, Murali M. Yallapu, Stephen W. Behrman, Meena Jaggi, Subhash C. Chauhan, Sheema Khan

Research Symposium

Pancreatic cancer (PanCa) is a third leading cause of cancer related deaths in US. Unlike other cancers, PanCa is highly resistant to TNF-related apoptosis-inducing ligand (TRAIL) that emerges as one of the most-promising therapy in clinical trials. Our group has previously identified microRNA-145 (miR-145) is downregulated in PanCa, the restoration of which inhibits tumor growth and enhances gemcitabine sensitivity. In this study, we have observed that miR-145 restoration in PanCa cells renders them sensitive to TRAIL treatment. Therefore, we have engineered unique superparamagnetic nanoparticles (SPs) for co-delivering miR-145 and TRAIL in PanCa for improving their therapeutic response to TRAIL. The …

Years Of Education And Total Intracranial Volume: A Longitudinal Study, Okechukwu C. Erinne

Research Symposium

Background: Education is one of the factors that contribute to a higher brain reserve. Based on the brain reserve hypothesis, the greater the brain reserve, the less likely it is to develop a neurocognitive disorder, such as dementia.

Methods: Data for this study were obtained from the Open Access Series of Imaging Studies (OASIS) longitudinal magnetic resonance imaging (MRI) data in nondemented and demented adults. There was a total of 150 right-handed participants and 373 imaging sessions, with an average duration of 719 days between visits. The primary outcome was estimated total intracranial volume (eTIV). Multivariable longitudinal regression was used …

Effect Of Confinement By Sars-Cov-2 On The Degree Of Steatohepatitis In University Students From Reynosa, Tamaulipas, Odalis I. Loredo, Maria Elena Aguilar-Peña, Marisol Rosas-Díaz, Adriana Leticia Perales-Torres, Esperanza M. García-Oropesa

Research Symposium

Introduction: Healthy lifestyles are relevant for several diseases, steatohepatitis, although little known, is common in young people. There are reasons to be concerned about homebound college youth who are at risk for steatohepatitis. By restricting the mobility of the population, the risk factors for weight gain and the intake of calorie-dense foods increase, which are elements associated with steatohepatitis.

Objective: To determine the effect of confinement during the COVID-19 pandemic on the degree of steatohepatitis by comparing transient elastography results taken before and after confinement.

Method: Longitudinal study. A sample of 114 young university students of random sex was included. …

From Dream To Reality: Conducting A Thorough Physical Exam With A Cell Phone, Noel Garza, Barbara Stewart

Research Symposium

Background: The COVID-19 pandemic has prompted a surge in the utilization of telemedicine as physicians and patients attempt to protect themselves. The art of medicine is rooted in the ability to gather subjective and objective data from patients to make accurate diagnoses and recommendations. We must rely on creativity and innovation to gather this information in the new setting of telehealth in a manner with high consistency and reliability to maintain high-quality patient care.

Case Presentation: After gathering a thorough history, we work with the patient’s guardian to systematically view the patient head to toe, perform cardiopulmonary auscultation, and assess …