Medicine and Health Sciences Commons^™

Perioperative Chemoimmunotherapy Induces Strong Immune Responses And Long-Term Survival In Patients With Hla Class I-Deficient Non-Small Cell Lung Cancer, Marta Molina-Alejandre, Francisco Perea, Virginia Calvo, Cristina Martinez-Toledo, Ernest Nadal, Belén Sierra-Rodero, Marta Casarrubios, Joaquín Casal-Rubio, Alex Martinez-Martí, Amelia Insa, Bartomeu Massuti, Santiago Viteri, Isidoro Barneto Aranda, Delvys Rodriguez-Abreu, Javier De Castro, Joaquín Mosquera Martínez, Manuel Cobo, Ignacio I Wistuba, Edwin R Parra, Javier Martín-López, Diego Megías, Rafael Muñoz-Viana, Federico Garrido, Natalia Aptsiauri, Francisco Ruiz-Cabello, Mariano Provencio, Alberto Cruz-Bermúdez

Faculty, Staff and Student Publications

BACKGROUND: Loss of human leukocyte antigen (HLA) class I expression and loss of heterozygosity (LOH) are common events implicated in the primary resistance of non-small cell lung cancer (NSCLC) to immunotherapy. However, there is no data on perioperative chemoimmunotherapy (ChIO) efficacy or response mechanisms in the context of HLA class I defects.

METHODS: Baseline HLA class I tumor status (HLA-deficient (HLA-DEF) or HLA-proficient (HLA-PRO)) was determined by DNA LOH combined with immunohistochemistry for protein levels in tissue of 24 patients with NSCLC treated with perioperative nivolumab plus chemotherapy from NADIM trial (NCT03081689). We integrated HLA tumor status with molecular data …

Estrogen Plus Progestin And Colorectal Cancer: Long-Term Findings From The Women's Health Initiative Randomized Clinical Trial, Rowan T Chlebowski, Aaron K Aragaki, Kathy Pan, Juhua Luo, Thomas E Rohan, Karen C Johnson, Jean Wactawski-Wende, Su Yon Jung, Qian Xiao, Sayeh Lavasani, Joann E Manson, Michael S Simon

Faculty, Staff and Student Publications

We report long-term colorectal cancer findings from the Women’s Health Initiative trial where 16,608 postmenopausal women with a uterus were randomized to daily conjugated equine estrogen (CEE) 0.625 mg, plus medroxyprogesterone acetate (MPA) 2.5 mg, or placebo. When intervention ended after 5.6-years, while there were 44% fewer colorectal cancers in the intervention group (43 vs 72, P = 0.003), the cancers more commonly were lymph node positive (59.0% vs 29.4%, P = 0.003). Now after cumulative 24-year follow-up, with 431 breast cancers, CEE plus MPA no longer influenced colorectal cancer incidence (215 [0.15, annualized rate %] vs 216 [0.15], HR …

Analisis Aktivitas Fisik Pekerja Mal Pelayanan Publik Kota Cilegon, Muhammad Syifa Abdy Mulya, Indri Hapsari Hapsari Susilowati

National Journal of Occupational Health and Safety

Physical activity is important because it has so many benefits. Even so, there are still many workers who are exposed to the risk of lack of physical activity. For this reason, it is necessary to know what affects the implementation of physical activity in workers. Quantitative design was used with a cross sectional study on 58 Cilegon Public Service Mall workers who met the criteria. As a result, 65.5% of workers are classified as active, 34.5% of workers are inactive and 12% of workers do not carry out any physical activity at all. Level of education (p value = 0.005), …

Apixaban Versus Enoxaparin To Prevent Venous Thromboembolism In Post-Operative Patients With Gynecologic Cancers At An Urban Academic Medical Center, Victoria Diamond, Katherine Gerber, Geno J. Merli, Rebecca J. Mercier, Aaron Shafer, Norman G. Rosenblum

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: A recent clinical trial demonstrated that the use of apixaban was safe and equal to enoxaparin (LMWH) in post-operative gynecologic oncology patients. This study aimed to determine if these findings are applicable in a diverse patient population at a single site urban academic medical center.

METHODS: This was a retrospective cohort study of patients who underwent an exploratory laparotomy for confirmed or presumed gynecologic cancer from the years 2017-2023 at a single-site urban academic medical center. Venous thromboembolism (VTE) prophylaxis with LMWH was standard practice at our institution up until January 2021 after which apixaban became standard for post-operative …

Reviewer Acknowledgements, Randy Wykoff, Emily Wilson

Journal of Appalachian Health

We at the Journal of Appalachian Health would like to thank the multitude of reviewers who have volunteered their time, talents, and attention to the journal. Reviewers help us consider the rigor and quality of the submissions we receive, and their willingness to read material ahead of publication ensures we can bring timely research to our readers in Appalachia and further afield.

Impacts Of The Covid-19 Pandemic On Intimate Partner Violence And Child Maltreatment Services In Rural Northwest North Carolina, Elisabeth G. Galphin, Adam Hege, Amy Dellinger Page

Journal of Appalachian Health

The current study examined the impact of the COVID-19 pandemic on IPV and child maltreatment services in rural northwestern North Carolina. Qualitative interviews were conducted with eight professionals representing six service organizations across four counties. The findings highlighted challenges these agencies faced throughout the pandemic, new risks for the clients served, and positive outcomes. In addition, it has been a useful learning experience as public health and social service agencies learn to serve their communities more effectively moving forward. This is especially relevant for rural communities, as it has put public health preparedness at the forefront.

Assessing Chronic Pain Among Adults Diagnosed With Diabetes Residing In Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Courtney Ortz, Ellen Combs, Md. Tofial Azam, Philip M. Westgate, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Appalachian populations have some of the highest rates of overdose and comorbidity, all of which are considered risk factors for and contributors to chronic pain.

Purpose: The purpose of this study was to examine the associations of comorbidity, disability (physical limitations), and depression with chronic pain among a community-based sample of Appalachian adults living with diabetes.

Methods: This study used baseline data to conduct a secondary analysis of cross-sectional data (n=356). Data included sociodemographic, disability (physical limitations), chronic pain, and depression measures. These data were collected and analyzed from 2017–2019. Multiple logistic regression was used to investigate the association …

The Impact Of Primary Care Physician Capacity On Preventable Hospitalizations: Identifying Bright Spots In The Appalachian & Mississippi Delta Regions, Michael Topmiller, Peter J. Mallow, Hoon Byun, Mark Carrozza, Yalda Jabbarpour

Journal of Appalachian Health

Introduction: Several studies have documented that higher rates of primary care physicians are associated with lower rates of preventable hospitalizations. Counties with higher rates of preventable hospitalizations are found in the Appalachian and Mississippi (MS) Delta Regions.

Purpose: (1) To determine if the association of primary care capacity with preventable hospitalizations is different in the Appalachian and MS Delta regions compared to the rest of the U.S., and (2) to explore primary care capacity in counties with lower-than-expected preventable hospitalization rates.

Methods: This study modeled preventable hospitalizations with primary care physicians (PCP) per 100,000 (PCP capacity) while controlling for several …

Psychosocial Factors, Stress And Sleep Among Rural Appalachian Kentucky Residents With Type 2 Diabetes Mellitus, Blake Dipaola, Zoe Taylor, Eric Hennemann, Brittany L. Smalls, Philip M. Westgate, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Rural Appalachian residents experience higher rates of most chronic diseases, including type 2 diabetes mellitus (T2DM). Stress and sleep deficiency also are common in the region.

Purpose: To better understand these associated health burdens, the relationship among these conditions and psychosocial factors—such as depressive symptoms, distress, empowerment, and social support—was examined among Appalachian residents with T2DM.

Methods: Using data collected from a community-based sample of Appalachian adults with T2DM, the study examined whether psychosocial factors were associated with perceived stress (Cohen Perceived Stress Scale) and self-reported sleep deficiency (Epworth Sleepiness Scale). Multilevel linear mixed effects regression modeling was used …

Nutrition Education Needs And Barriers Of Uninsured Clients Who Utilize Free Clinics In Western North Carolina, Manan Roy, Alisha Farris, Erin Loy, Lauren Sastre, Danielle L. Nunnery

Journal of Appalachian Health

Introduction: Many uninsured adults rely on free health clinics for prevention and treatment of chronic disease. Little is known about the nutrition education needs of adults served by free health clinics, especially those living in counties within the Western North Carolina Appalachian Mountain Region.

Methods: An in-person survey was distributed to 202 clients of two free health clinics in western North Carolina. Descriptive analyses were conducted to determine frequency distributions for food and physical activity practices, acceptable topics and strategies for nutrition education, and the acceptance and barriers for various modalities.

Results: Depending on the clinic, 49-58% of participants were …

Using Public Funeral And Obituary Listings To Identify Spikes In Excess Mortality In One Appalachian County, Allen Archer, Melissa White, Megan Quinn, Randy Wykoff

Journal of Appalachian Health

Introduction: Delays (10-22 months) in availability of official state and county-level mortality data could have significant public health consequences. The COVID-19 pandemic illuminated the need for health officials to access timely death data to identify unexpected increases in mortality in their communities.

Purpose: The purpose of this study is to determine if funeral home listings and/or newspaper obituaries could help identify excess mortality on the local level, prior to the availability of official death records.

Methods: To calculate excess mortality, four years (2017–2020) of data were collected from three sources: the state health department, online funeral home listings, and newspaper …

Aftermath: A Word To Appalachia Following Hurricane Helene, Emily Wilson

Journal of Appalachian Health

On September 27, 2024, Hurricane Helene caused massive and catastrophic flash flooding in the lower Appalachian Region, leveling towns and forever altering much of the landscape. This is an open letter to the people of Appalachia who were affected by the disaster that blindsided our region.

Enhancing Digital Health Equity: A Personalized Approach For Spanish-Speaking Patients, Marissa Witmer, Julianna Lenoir, Mph, Angela Gerolamo, Phd, Crnp, Pmhnp, Akshay Krishnan, David Rigas, Kristin L. Rising, Md, Mshp

Jefferson Center for Connected Care Posters

Background

Limited English Proficiency (LEP) is a barrier among Hispanic communities in accessing digital health tools including patient portals.¹

Patient portals provide patients with access to their electronic medical records. With portals, patients can schedule visits, message providers, check test results, and order medication refills, among other tasks.

Portal use has been shown to help patients better manage chronic diseases, enhance doctor-patient relationships, improve patient understanding and awareness of health status, and increase adherence to therapy.²

Despite interest in using patient portals, Spanish-speaking patients often struggle to use them due to low digital literacy.³

Provision of personalized …

Perioperative Outcomes And Risks For Patients With Prinzmetal Angina Undergoing Abdominal Surgery, George Sun, Md, Matt Owrey, Md, Kevin Min, Md

Department of Anesthesiology Posters

Background

- Prinzmetal angina is a transient, reversible form of acute coronary syndrome

• Characterized by coronary artery spasms that can lead to myocardial ischemia
• Hypothesized that this phenomenon is secondary to coronary hyperreactivity from endothelial or smooth muscle dysfunction¹

- Patients with Prinzmetal angina are at high risk during surgery

• Up to 50% of patients may experience myocardial infarction, fatal arrhythmia, or unstable angina during non-cardiac surgery²
• Limited data looking at postoperative outcomes in patients with Prinzmetal angina

- Goal: Evaluate whether individuals with Prinzmetal angina are at greater risk of mortality, myocardial infarction, and arrhythmia during abdominal surgery

The Role Of Peptides In Combatting Hiv Infection: Applications And Insights, Naiera M. Helmy, Keykavous Parang

Pharmacy Faculty Articles and Research

Peptide-based inhibitors represent a promising approach for the treatment of HIV-1, offering a range of potential advantages, including specificity, low toxicity, and the ability to target various stages of the viral lifecycle. This review outlines the current state of research on peptide-based anti-HIV therapies, highlighting key advancements and identifying future research directions. Over the past few years, there has been significant progress in developing synthetic peptide-based drugs that target various stages of the viral life cycle, including entry and replication. These approaches aim to create effective anti-HIV therapies. Additionally, peptides have proven valuable in the development of anti-HIV vaccines. In …

Development Of Polyvinyl Alcohol Hydrogels For Controlled Glucose Release In Biomedical Applications, Rosa María Quispe-Siccha, Osvaldo I. Medina-Sandoval, Abraham Estrada-Tinoco, Jorge A. Pedroza-Pérez, Adolfo Martínez-Tovar, Irma Olarte-Carrillo, Rafael Cerón-Maldonado, Arturo Reding-Bernal, Juan Lopez Alvarenga

School of Medicine Publications

Polyvinyl alcohol (PVA) hydrogels have a wide range of applications in the pharmaceutical and biomedicine fields due to their exceptional biophysical properties. The study focuses on preparing and characterizing capsule-shaped PVA hydrogels to enhance their biocompatibility and porosity for controlled glucose release and cell proliferation. The hydrogels were prepared using different concentrations (Cs) and molecular weights (MWs) of PVA, with two different lengths, A (10 mm) and B (20 mm), to control glucose release over 60 min. The preparation process involved PVA gel preparation and PVA hydrogel formation. A total of 500 µL of glucose was injected into all dehydrated …

Low-Frequency Stimulation Of Corpus Callosum Suppresses Epileptiform Activity In The Cortex Through Γ-Aminobutyric Acid Type B Receptor And Slow Afterhyperpolarization-Mediated Reduction In Tissue Excitability, Nrupen Pakalapati, Chia Chu Chiang, Dominique M. Durand

Faculty Scholarship

Objective: Deep brain stimulation, particularly low-frequency stimulation (LFS) targeting fiber tracts, has emerged as a potential therapy for drug-resistant epilepsy (DRE) and for generalized epilepsy, both of which pose significant treatment challenges. LFS diffusely suppresses seizures in the cortex when applied to fiber tracts like the corpus callosum (CC). Nevertheless, the specific processes responsible for suppressing epileptic activity in the cortex induced by LFS remain unclear. This study investigates the mechanisms underlying the antiepileptic effect in the cortex of LFS of the CC in coronal rodent brain slices. Methods: An in vitro 4-aminopyridine (4-AP) seizure model of cortical seizures was …

Norovirus Acute Gastroenteritis Amongst Us And European Travellers To Areas Of Moderate To High Risk Of Travellers’ Diarrhoea: A Prospective Cohort Study, Martin Alberer, Christine L Moe, Christoph Hatz, Kerstin Kling, Amy E Kirby, Lisa Lindsay, Hans D Nothdurft, Margarita Riera-Montes, Robert Steffen, Thomas Verstraeten, Henry M Wu, Herbert L Dupont

Faculty, Staff and Student Publications

BACKGROUND: Acute gastroenteritis (AGE) is a major medical condition for travellers worldwide, particularly travellers to low- and middle-income countries. Norovirus (NoV) is the most common cause of viral AGE in older children and adults, but data on prevalence and impact amongst travellers is limited.

METHODS: Prospective, multi-site, observational cohort study conducted 2015-2017, amongst adult international travellers from the US and Europe to areas of moderate to high risk of travel-acquired AGE. Participants provided self-collected pre-travel stool samples and self-reported AGE symptoms whilst travelling. Post-travel stool samples were requested from symptomatic subjects and a sample of asymptomatic travellers within 14 days …

Policy-Relevant Differences Between Secondhand And Thirdhand Smoke: Strengthening Protections From Involuntary Exposure To Tobacco Smoke Pollutants, Georg E Matt, Lydia Greiner, Rachael A Record, Heather Wipfli, Jamie Long, Nathan G Dodder, Eunha Hoh, Nicolas Lopez Galvez, Thomas E Novotny, Penelope J E Quintana, Hugo Destaillats, Xiaochen Tang, Antoine M Snijders, Jian-Hua Mao, Bo Hang, Suzaynn Schick, Peyton Jacob, Prue Talbot, E Melinda Mahabee-Gittens, Ashley L Merianos, Thomas F Northrup, Lara Gundel, Neal L Benowitz

Faculty, Staff and Student Publications

Starting in the 1970s, individuals, businesses and the public have increasingly benefited from policies prohibiting smoking indoors, saving thousands of lives and billions of dollars in healthcare expenditures. Smokefree policies to protect against secondhand smoke exposure, however, do not fully protect the public from the persistent and toxic chemical residues from tobacco smoke (also known as thirdhand smoke) that linger in indoor environments for years after smoking stops. Nor do these policies address the economic costs that individuals, businesses and the public bear in their attempts to remediate this toxic residue. We discuss policy-relevant differences between secondhand smoke and thirdhand …

Excess Potassium Promotes Autophagy To Maintain The Immunosuppressive Capacity Of Myeloid-Derived Suppressor Cells Independent Of Arginase 1, Ramesh Thylur Puttalingaiah, Matthew J. Dean, Liqin Zheng, Phaethon Philbrook, Dorota Wyczechowska, Timothy Kayes, Luis Del Valle, Denise Danos, Maria Dulfary Sanchez-Pino

School of Medicine Faculty Publications

Potassium ions (K+) are critical electrolytes that regulate multiple functions in immune cells. Recent studies have shown that the elevated concentration of extracellular potassium in the tumor interstitial fluid limits T cell effector function and suppresses the anti-tumor capacity of tumor-associated macrophages (TAMs). The effect of excess potassium on the biology of myeloid-derived suppressor cells (MDSCs), another important immune cell component of the tumor microenvironment (TME), is unknown. Here, we present data showing that increased concentrations of potassium chloride (KCl), as the source of K+ ions, facilitate autophagy by increasing the expression of the autophagosome marker LC3β. Simultaneously, excess potassium …

The Giab Genomic Stratifications Resource For Human Reference Genomes, Nathan Dwarshuis, Divya Kalra, Jennifer Mcdaniel, Philippe Sanio, Pilar Alvarez Jerez, Bharati Jadhav, Wenyu Eddy Huang, Rajarshi Mondal, Ben Busby, Nathan D Olson, Fritz J Sedlazeck, Justin Wagner, Sina Majidian, Justin M Zook

Faculty, Staff and Students Publications

Despite the growing variety of sequencing and variant-calling tools, no workflow performs equally well across the entire human genome. Understanding context-dependent performance is critical for enabling researchers, clinicians, and developers to make informed tradeoffs when selecting sequencing hardware and software. Here we describe a set of “stratifications,” which are BED files that define distinct contexts throughout the genome. We define these for GRCh37/38 as well as the new T2T-CHM13 reference, adding many new hard-to-sequence regions which are critical for understanding performance as the field progresses. Specifically, we highlight the increase in hard-to-map and GC-rich stratifications in CHM13 relative to the …

Cardiorespiratory Fitness And Sleep, But Not Physical Activity, Are Associated With Functional Connectivity In Older Adults, David Wing, Bart Roelands, Julie Loebach Wetherell, Jeanne F Nichols, Romain Meeusen, Job G Godino, Joshua S Shimony, Abraham Z Snyder, Tomoyuki Nishino, Ginger E Nicol, Guy Nagels, Lisa T Eyler, Eric J Lenze

2020-Current year OA Pubs

BACKGROUND: Aging results in changes in resting state functional connectivity within key networks associated with cognition. Cardiovascular function, physical activity, sleep, and body composition may influence these age-related changes in the brain. Better understanding these associations may help clarify mechanisms related to brain aging and guide interventional strategies to reduce these changes.

METHODS: In a large (n = 398) sample of healthy community dwelling older adults that were part of a larger interventional trial, we conducted cross sectional analyses of baseline data to examine the relationships between several modifiable behaviors and resting state functional connectivity within networks associated with cognition …

Glucose Metabolism Controls Monocyte Homeostasis And Migration But Has No Impact On Atherosclerosis Development In Mice, Alexandre Gallerand, Gyu Seong Heo, Hannah Luehmann, Yongjian Liu, Et Al.

2020-Current year OA Pubs

Monocytes directly contribute to atherosclerosis development by their recruitment to plaques in which they differentiate into macrophages. In the present study, we ask how modulating monocyte glucose metabolism could affect their homeostasis and their impact on atherosclerosis. Here we investigate how circulating metabolites control monocyte behavior in blood, bone marrow and peripheral tissues of mice. We find that serum glucose concentrations correlate with monocyte numbers. In diet-restricted mice, monocytes fail to metabolically reprogram from glycolysis to fatty acid oxidation, leading to reduced monocyte numbers in the blood. Mechanistically, Glut1-dependent glucose metabolism helps maintain CD115 membrane expression on monocytes and their …

Creating A Caring Culture, Julie Harrison-Swartz

Wisdom & Compassion: The LUSON Journal

Caring is a word that is synonymous with nursing. Nurses are equipped to engage in all aspects of patient care and be present. Caring and presence are also imperative in nursing education. While caring is instrumental to patient healing and outcomes, it is equally important in demonstrating care through nursing education. While convenient it is often difficult to express caring in the remote environment. This paper will describe a brief history of nursing, concept of caring, and nursing education.

Raising Awareness About Type 2 Diabetes In Adolescents Through Theatre: A Quasi-Experimental Pretest-Posttest Study, Margaret Curry

Wisdom & Compassion: The LUSON Journal

Education for preventing type 2 diabetes in adolescents should be a high priority among school officials and healthcare providers. The purpose of this research study was to educate adolescents on type 2 diabetes and to increase awareness about this disease. The Health Promotion Model developed by Nola Pender was used as the theoretical framework for this study. A quasi-experimental before-after design was used. The seventh and eighth-grade students enrolled in physical education classes at a local school were recruited. Of the 57 students recruited, 47 completed the study. A diabetes education program geared towards kindergarten through eighth grade was used. …

Nurse Graduates’ Experiences With Pain Science – A Qualitative Study, Rachel Bee, Cynthia Goodrich

Wisdom & Compassion: The LUSON Journal

Background: While the nursing profession has made great strides in pain management over the last 20 years, patients often report being under-assessed and undertreated for pain.

Purpose: The study purpose was to understand the lived experiences of practicing nurses who had completed a baccalaureate-level pain management course during their undergraduate training. The study aims included understanding how pain management skills were implemented in the clinical arena, determining barriers to implementing pain management skills, and identifying opportunities to improve the patient experience regarding pain management.

Design: The researchers implemented a qualitative methodology with a phenomenological design. Data collection consisted of semi-structured …

Framing Medical Mission Trip: Decisions With The Code Of Ethics For Nurses, Kelly Arraf

Wisdom & Compassion: The LUSON Journal

student reflection

A Review Of 3d Printing Technology In Drug Design Applications, Hasanain Shakir Mahmood, Jinan M. Al-Mousawy, Jamal Ali Ashoor, Ashti M.H. Saeed, Alaa Abdul Razzaq Al-Nuaimi, Pegah Khosravian

Maaen Journal for Medical Sciences

Sustainable technologies such as Additive manufacturing or three-dimensional printing (3D printing) have resulted in drastic changes in a number of industries including healthcare and pharmaceuticals. The current review focuses on the achievements accomplished on the effectiveness of three-dimensional printing in the field of drug designing and development. This technology is very precise and can be customized and that gives a way of developing complicated drug delivery systems and individualized medications. Promising areas of focus are the development of particular formulations of medicinal preparations, identification of new approaches to the drug release and potential creation of specific drug production for specific …

Piezosurgery - Modern Dentistry's Innovative Tool - A Review Article, Amjed Kadhim Al-Naaly, Ahmed Fadhel Al-Quisi

Maaen Journal for Medical Sciences

Background: In implantology, piezosurgery is a novel and cutting-edge method of bone surgery. Various ultrasonic frequencies can be used for selective cutting, which preserves essential anatomical structures by only operating on solidified hard tissues. Piezoelectric osteotomy is a technique that can be used to precisely and safely prepare receptor sites for procedure implants, acquire bone grafts classified as autogenous (blocks and particles), perform osteotomies used for alveolar crest bone expansion, lift the maxillary sinus, and remove dental implants. Clinically and physiologically, the outcomes are outstanding, especially regarding osteocyte vitality.

Objectives: This review aims to highlight the advantages and …

Association Between Mri Findings Of Facet Arthropathy And Synovitis With Health-Related Outcome And Pain Scores Following Therapeutic Lumbar Facet Injections., Michael S Green, Michele Van Hal, Matthew Onimus, Christopher R Hoffman, Dhruv K C Goyal, Valeria Potigailo, Khuram S Kazmi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Low back pain is a common complaint among adults. The facet joint is a major source of lumbar pain, and therapeutic facet injections have gained popularity as a minimally invasive treatment option. In addition, magnetic resonance imaging (MRI) utilization for diagnosing low back pain has increased significantly over the past few decades. Facet synovitis is an entity characterized by edema and inflammatory changes affecting the facet joints, adjacent bone marrow, and surrounding soft tissues. Although its underlying etiology remains poorly understood, recent reports suggest a high incidence in patients with arthropathy and arthritis. It is essential to explore potential correlations …