Medicine and Health Sciences Commons^™

You Are What You Eat, Allyson Ditmars

BUHealth

The gut microbiome is the wide array of good and bad bacteria found in the digestive tract of all humans. Although the composition of gut microbiota is developed before someone is even born, there are nutritional decisions made in adulthood that can impact the health of the gut. Certain nutritional foods can increase the diversity of the gut and create a beneficial environment. On the other hand, many foods found in the common American diet can negatively impact the microbiome. The gut can suffer from a poor diet when the permeability of the intestinal barrier and the diversity richness is …

Locked Up: A Look Into Healthcare Behind Bars, Ella Davis

BUHealth

The United States incarceration rate is the highest in the world. Incarcerated individuals are guaranteed a right to healthcare but, it falls short in many correctional facilities, as systemic barriers and inadequate funding often result in substandard care and poor health outcomes. There are multiple challenges that come with providing healthcare in prisons such as limited resources, lack of funding, and staff shortages. Prisoners at every level of the correctional system are known to be less healthy than the general population, and despite multiple efforts to improve healthcare, many prisoners still receive inadequate healthcare. Improving prison healthcare and increasing funding …

Development And Validation Of A Predictive Model For Childhood Mortality After A Traumatic Brain Injury: Analysis Of The National Trauma Data Bank, Jooby Joy, Axel Moreira, Kevin Chorath, Karthik Rajasekaran, Alvaro Moreira

Research Colloquium

Introduction: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children. While most TBI-related admissions are mild, identifying early predictors of poor outcome may assist clinicians with timely medical decisions and effective triage utilization.

Objective: We sought to develop and validate a clinical tool for predicting in-hospital death in children after a traumatic brain injury.

Methods: Data was collected for children (≤18 years) from the National Trauma Data Bank between the years of 2007 to 2015. We included children who sustained any TBI, defined as: (i) open and closed skull fractures, (ii) cerebellar, cortical, or brain …

A Natural Near-Infrared Fluorescent Probe For Cancer Cell Imaging, Benilde E. Adriano, Nycol M. Cotto, Neeraj Chauhan, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

Research Colloquium

Introduction: Near-Infrared (NIR) fluorescence-based imaging is a noteworthy and safer strategy for cancer cells/tissues imaging compared to radiological imaging. NIR fluorescence offers deep tissue penetration and have minimal obstruction by autofluorescence and photon scattering [1]. There are several NIR dyes including indocyanine green (ICG) [2] and IR-1061 [3] that allow high-resolution tissue imaging. However, these dyes possess some low-quality characteristics which limit their use, namely photo instability, toxicity, poor water solubility, and short half-lives [4]. Therefore, more efficient and effective alternatives are urgently required to provide the desired clinical outcomes. Chlorophyll (Chl) is a natural dietary NIR fluorescence emitting …

Aids-Associated Kaposi's Sarcoma Complicated With Covid-19, Adriana Saavedra-Simmons, Veronica Salazar

Research Colloquium

Introduction: Several studies have not found a significant increase in risk of poor outcomes in people with HIV (PWH) who are coinfected with COVID-19. However, the majority of PWH in the studies were stable with their highly active antiretroviral therapy (HAART) regimen. We present a case of AIDS-associated Kaposi’s sarcoma (KS) with superimposed COVID-19 infection.

Case Description: Our patient is a 21-year old Hispanic male with recent diagnosis of HIV-1 who presented to the ED with generalized facial swelling and right lower extremity edema associated with shortness of breath (SOB) and palpitations. He denied fever, chills, weight loss, chest pain, …

Development Of Targeted Drug Delivery System To Improve Immunotherapy In Pancreatic Cancer, Poornima Devi Shaji, Ana Martinez Bulnes, Nirnoy Dan, Subhash C. Chauhan, Sheema Khan, Murali M. Yallapu

Research Colloquium

Introduction: About 95% of tumor arises from epithelial cell lining ducts known to be pancreatic ductal adenocarcinomas, with less than 5-7% survival rate. Unfortunately, little progress has been seen in the outcomes of patients with PDAC as tumor develops high desmoplasia and chemo-resistance to chemotherapeutic drugs, such as gemcitabine (Gem). Immunotherapy has shown promising results in other cancers but limited response in pancreatic cancer due to desmoplasia and fibrotic tumor microenvironment. A recently identified mucin, MUC13 is aberrantly expressed in pancreatic tumors but not in normal pancreas. Due to its high membrane expression, MUC13 may serve as an excellent target …

Novel Therapy Targeting Mutant-Krasg12d And Galectin-1 In Pancreatic Cancer, Ana I. Martinez Bulnes, Nirnoy Dan, Poornima Devi Shaji, Swathi Holla, Murali M. Yallapu, Sheema Khan

Research Colloquium

Introduction: Although, surgical resection and chemotherapy are the gold standard for treating Pancreatic Ductal Adenocarcinoma (PDAC), low patient survival rate remains the problem. The activating point mutation of the KRAS on codon-12 is present in 70–95% of PDAC cases and so far, no success has been achieved to inhibit KRAS. KRASG12D regulates cell proliferation, differentiation, apoptosis. Recent preliminary and published studies show high Galectin-1 (Gal-1) levels in both pancreatic cancer and stromal cells, which modulate tumor microenvironment and metastasis. Additionally, genetic deletion of gal1 inhibits metastasis and improves survival in KRAS mouse model of PDAC (1). Therefore, our objective is …

Volume 24, Issue 2

Medical Muse

No abstract provided.

Hepatoprotective Role Of Cucurbitacin D On Benzo[A]Pyrene Induced Liver Injury, A. Rodriguez, Mohammed Sikander, Shabnam Malik, M. Vela, Fathi T. Halaweish, Meena Jaggi, Sumeet S. Chauhan

Research Colloquium

Background: Epidemiological findings show the strong correlation of co-morbidity factors including smoking with the development and progression of liver cancer. Moreover, benzo[a]pyrene, a main component of tobacco smoke, is extremely carcinogenic and contributes to liver injury as well. Cucurbitacin, chemically classified as triterpenes, have shown diverse biological activities including potent antioxidant, anti-inflammatory and anti-cancer activities. However, their hepatoprotective activities are not completely understood.

Objective: In the present study, we investigated the cytoprotective activity of novel analog of cucurbitacin, cucurbitacin D, against benzo[a]pyrene-induced liver injury in human HepG2 cells.

Method: Proliferation, clonogenicity, migration, invasion, Western blotting and qPCR analysis were conducted …

Pharmacological Restoration Of Pkd1: A Novel Strategy For Prostate Cancer Therapy, Mohammed Sikander, Shabnam Malik, A. Rodriguez, Aditya Ganju, Bilal B. Hafeez, Fathi T. Halaweish, Subhash C. Chauhan, Meena Jaggi

Research Colloquium

Background: Prostate cancer has poor prognosis owing to late diagnosis and ineffective multimodal clinical treatment. Extensive efforts are ongoing to establish methods that can resolve the expression of genes implicated in disease development and treatment. Previously, we reported that Protein Kinase D1 (PKD1), a serine threonine kinase, controls a number of tumor suppressor functions including cell aggregation, cell motility, cell proliferation, and cell invasion. Thus, PKD1 is considered as an emerging therapeutic target for prostate cancer treatment.

Objective: To investigate the restoration of PKD1 by a pharmacological modulator ormeloxifene, which showed well-defined PK/PD and safety profiles in humans.

Methods: Proliferation, …

Mucin 13 Expression Correlates With Tumor Development In Hepatocellular Carcinoma, Shabnam Malik, Mohammed Sikander, Deepshikha Pande Katare, S. Mishra, S. K. Jain, P. Khan, Subhash C. Chauhan, Meena Jaggi

Research Colloquium

Background: Hepatocellular carcinoma (HCC) has a poor prognosis due to ineffective therapeutic modality and lack of early diagnostic marker. Accumulating studies have shown that elevated expression of mucin 13 as potential oncogene and predictive biomarker for various cancer. However, very little is known about its expression and function for development and progression of HCC Objective: To investigate mucin 13 expression in chemically induced hepatocellular carcinoma model.

Methodology: Diethyl nitrosamine (DEN) and 2-Acetylaminofluorene (2-AAF) induced method was employed for the development of hepatocellular carcinoma in Male Wistar rats. Serum and tissues were collected at regular interval of time and routinely validated …

Severe Hypokalemia Secondary To Distal Renal Tubular Acidosis In A Hispanic Man, Aramide Mikhail Tijani, Himabindu Kolli, Suneet Johal, Maria Najam, Fatimah Bello, J. M. Paredes

Research Colloquium

Introduction: Renal tubular acidosis is a rare renal disorder that can cause severe electrolyte imbalances which can be life threatening.

Case: A 21-year-old man presented to the ED on account of generalized weakness and body aches of one day duration. He reported no past medical history other than a previous episode of similar symptoms with improvement after IV hydration and electrolytes replacements about 2 months prior. He was not taking any medications and denied vomiting, diarrhea nor any significant family history. He admitted to alcohol and marijuana use.

Physical examination was significant for reduced muscle power, tone, and reflexes in …

Assessing The Mental Health Of Older Hispanic/Latinx Adults: Focus On The Impact Of The Hispanic Cultural Value Of Fatalismo On Depressive Symptomatology, Anna J. Prado, Amie Bostic, Mario Gil

Research Colloquium

Introduction: The impact of depression in older Hispanic/Latinx adults in the United States is poorly understood. The influence of the deeply embedded Hispanic/Latinx cultural value of fatalismo, referring to the belief that one’s future is predetermined and related to feelings of helplessness, has been found to negatively impact their psychological health [1, 2]. The present study explores the association between the Hispanic/Latinx cultural value of fatalismo and mental health.

Objective: To contribute to the identification and understanding of psycho-social-cultural determinants of depression in the Hispanic/Latinx population.

Methods: Using data from the Health and Retirement Study (HRS) …

A Preliminary Timeline Of The Midbrain Development In The Monodelphis Domestica Animal Model, Ismael Perez, John L. Vandeberg, Mario Gil

Research Colloquium

Introduction: The Brazilian short-tailed opossum (Monodelphis Domestica) is an understudied animal model compared to the Mus musculus that has been identified as a perfect candidate to study neurodevelopment (Baggott, L. & Moore, H., 1990). What makes the Monodelphis Domestica a perfect specimen for neurodevelopment is that the embryo develops outside the pouch of the mother providing easy noninvasive access to track changes across different developmental stages (Mate et al., 1994).

Objective: The objective of the study is to compare the area and volume in the development of the Monodelphis’s midbrain across three different developmental stages. Our research is beneficial because …

Assessing Morbidity In Patients With Greater Trochanteric Pain Syndrome (Gtps), Sonia Wadekar, Joel Wells

Research Colloquium

Introduction: Greater trochanteric pain syndrome (GTPS) continues to be a challenge among orthopedics to rid discomfort for their patients, especially since there are few studies on characterization of GTPS morbidity.

Objective: The purpose of this study is to characterize the morbidity of GTPS in order to aid orthopedics in providing an early diagnosis and better treatment/care options for their patients.

Methods: A total of 156 patients were included from January of 2016 to July of 2020. Refer to Figure 1 for a visual of inclusion criteria. All patient information was taken from first appointment notes, operative notes, chart reviews, and …

Severe Hyponatremia Associated With Partial Empty Sella Syndrome, Lily Chen, Shyama Appareddy, Laura Garcia

Research Colloquium

Hyponatremia, serum sodium concentration < 135 mmol/L, is further classified by patient volume status. Symptoms are dependent on the acuity of sodium loss. Acute onset hyponatremia can present with confusion, disorientation, headache, agitation, vomiting, and lethargy. Patients with hyponatremia warrant a thorough workup and can be a leading manifestation of hypopituitarism in the geriatric population. A 77 year old patient, history of pituitary adenoma, presented with generalized symptoms of fatigue, gait instability, poor appetite and confusion associated with severe hyponatremia and hypoglycemia. The patient has a history of pituitary adenoma treated with cabergoline, hypothyroidism treated with levothyroxine and gonadal insufficiency treated with testosterone, with no reported history of diuretic use. On admission, the patient had a sodium level of 116 mmol/L. While the patient reported improvement in symptoms, patient’s confusion was noted to persist despite appropriate correction of sodium and glucose. Patient had an AM cortisol of 4 mcg/dL. Cosyntropin test was conducted and noted to be negative. MRI Brain with Gadolinium revealed empty sella turcica with a small amount of enhancing pituitary tissue, which may indicate a response to previous cabergoline therapy. Despite negative cosyntropin results, the patient was suspected to have relative adrenal insufficiency due to multiple acute stressors including illness, hospitalization, disruption of routine and abrupt smoking cessation. Patient was given a trial of hydrocortisone with improvements noted in his mental status, strength and appetite. Thus, careful consideration should be given towards adrenal insufficiency secondary to hypopituitarism as an etiology for severe hyponatremia.

A Covid-19-Inspired Comprehensive Approach To Resident Wellness And 360-Degree Approach To Pandemic Preparedness And Disinfection Practices, Preet Gudimella, Unnam Nasir, Heidi Pareja

Research Colloquium

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak that had led to the coronavirus disease 2019 (COVID-19) pandemic caused stress for medical residents on the frontline. This motivated our team to implement changes in our residency program’s inpatient service. We approached resident wellness in a comprehensive manner. The changes we implemented at our site had crucial benefits for our inpatient teams. Not only did we implement conventional best practices on infection prevention, we also executed additional safety measures, addressed mental and physical health, and had COVID-19-specific skills training. Consequently, our residents were less stressed, better prepared, and more focused …

Suicide Risk In Patients With Type Ii Diabetes, Ruthzaine Lopez Bolano, Michael Machiorlatti

Research Colloquium

Introduction: The comorbidity of mental and physical disorders represents a major challenge for health care worldwide. The comorbidity of depression and diabetes can be seen as a prototypical example of mental/physical comorbidity. The prevalence of both conditions is growing, with depression twice as frequent in people with diabetes compared with those without diabetes. [1] The prevalence of depressive disorders in diabetics is the general range of 10% to 15%, which is approximately twice as high as the prevalence of depression in non-diabetics. [1] For instance, diabetic patients, and during the course of the disease, are most likely to experience …

A Systematic Review And Meta-Analysis Of Empathy Changes In Medical Students During Medical Education, Sahar Panjwani, Jiyun Lim, Matthew Hidalgo, Michael Machiorlatti, Minerva Angelica Romero Arenas

Research Colloquium

Introduction: Reduction in empathy has been explored in medical students (MS). Questions remain on whether significant changes in empathy occur during MS education.

Objective: Focusing on studies using the Jefferson Scale of Empathy medical student version (JSE-S), the authors aimed to quantify and assess reported changes across reviewed literature.

Methods: A systematic review and meta-analysis were performed using PRISMA guidelines. Criteria for inclusion were articles 1) written in English, 2) pertained to human subjects, and 3) written in the previous ten years (2009-2019). Exclusion criteria were those that 1) did not assess MS, 2) did not utilize the JSE-S, 3) …

Stem Cell Technology For Age Related Macular Degeneration Intervention, Laura Valdez

Research Colloquium

The main focus of this thesis is to study induced pluripotent stem cell derived Retinal Pigmented Epithelium (RPE) cells in various physiological conditions mimicking RPE transplantation rejection. Retinal pigmented epithelium (RPE) cells are located between the choroid and photoreceptors within the eye and are essential to provide nutrients from blood to rods and cones, as well retinoids of the visual cycle. Vision loss and various ocular diseases are attributable to the degeneration or dysfunction of the RPE cells, leading to blindness. One of the major ocular problem from RPE dysfunction is macular degeneration. Age-related macular degeneration (AMD) can be frequently …

Antifungal Prophylaxis And Risk For Invasive Mold Infections In Children With Hematologic Malignancies, Ashley Ikwuezunma, Ankhi Dutta, Maria I. Castellanos, Hana Paek, Debra L. Palazzi, Karen R. Rabin, Michael E. Scheurer, Maria M. Gramatges

Research Colloquium

Introduction: Invasive mold infections (IMI) are a leading cause of mortality in immunocompromised hosts. Children diagnosed with hematologic malignancies experience profound, prolonged neutropenia following intensive chemotherapy, and are at increased risk for infection-related outcomes. Depending on the anticipated therapeutic intensity, antimicrobial prophylaxis may be employed to mitigate risk for infection. We conducted a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), or lymphoma between 2006-2015 and determined the incidence of IMI to be 4.8% (47/976), with an exceptionally high incidence observed in patients with AML (8.1%). This observation prompted a change in clinical practice …

Exploration Of Potential Risk Factors For Texas County Covid-19 Infection Rates, Keren Kahsai, Michael Machiorlatti

Research Colloquium

There have been over 2 million COVID-19 cases within the United States. When considering where infections take place, there appears to be variability between states and even between counties (Gardner 2020). To understand the reasons underlying this phenomenon, we used Texas county data on Covid-19 infection rates and utilized auxiliary data such as age, race, gender, diabetes and obesity rates, temperature, humidity, median household income, metropolitan or rural designation, and poverty rates to see what confers greater risk for higher total infection at a county level. Our study found a positive relationship between diabetes and obesity rates and COVID-19 infection …

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 …