Medicine and Health Sciences Commons^™

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 …

Implementation Of A Training Module On Alcohol Prevention For Promotoras On A Border Community In The Rio Grande Valley., Noe Garza, J Escareno, Alvaro Diaz-Badillo, Ihsan Salloum

Research Symposium

Background: Complications due to unhealthy alcohol use are widely spread, and there is a significant unmet need for prevention and treatment in the community. The South Texas-Mexico border region consists of over ninety percent of Hispanics and suffers from a significant shortage of physicians. Alcohol-related problems are highly unrecognized and untreated in this large Hispanic population due to the shortage of healthcare providers, low education levels, and limited trust in the health care system. Prevention efforts should be designed to prevent or reduce the risk of developing alcohol addiction.

Methods: The proposed module focuses on enhancing the Promotoras or Community …

Critical Reflection In Practice: Generating Knowledge From The Interactions With Promotores For Engagement In Neurocognitive Disorders, Noe Garza, Ney Alliey-Rodriguez, Rosa V. Pirela, Gladys E. Maestre

Research Symposium

Background: Colonias are underserved areas along the Texas-Mexico border, with high incidences of neurocognitive disorders, dementia, and Alzheimer's disease (AD). Our goal is to build capacity to reduce risk, facilitate treatment for affected individuals, and provide caregiver support. Our aim was to construct an approach that was reflective and would reveal the rich and diverse ways in which people make meaning of their experiences and interactions with scientists, faculty, staff and students.

Methods: We examined our work with local community health workers. (CHWs), promotores in Spanish, to establish contact with, engage, mobilize, and educate the Hispanic communities of the Lower …

Frequency Of Icu Specific Interventions After Middle Meningeal Artery, Niti Dharwadkar, Sohum Desai, Ameer E. Hassan, Wondwossen G. Tekle

Research Symposium

Background: Middle meningeal artery embolization (MMAE) is increasingly performed for the treatment of chronic subdural hematomas. Some authors have described managing minimally symptomatic patients with MMAE in the outpatient setting. Our practice, however, has been to routinely admit patients after MMAE to the neuro-intensive care setting. Objective of this research is to analyze the frequency of ICU level interventions after MMAE in the neuro-intensive care unit.

Methods: A consecutive series of MMA embolizations for cSDH were retrospectively reviewed from 2020 to 2022 at Valley Baptist Medical Center in Harlingen, TX, USA. Frequency of ICU specific interventions such as need for …

Taking The Load Off: Device Lead-Induced Severe Tricuspid Regurgitation And Right-Sided Heart Failure Treated With Transcatheter Aortic Valve Implantation (Tavi), Nina Shyama Appareddy, Michaela Iglesia, Ayman Khaddam, Henry Kwang, Eduardo Flores

Research Symposium

Background: Interference of device leads with closure of the tricuspid leaflets can cause severe tricuspid regurgitation (TR) and right-sided heart failure, as can heart failure with reduced ejection fraction (HFrEF) and left sided valve disease. We report a case treated with transcatheter aortic valve implantation (TAVI) with improved TR.

Case: A 78-year-old male with coronary artery disease status post remote myocardial infarction and coronary bypass, HFrEF with left ventricular ejection fraction 35-40%, and inducible ventricular tachycardia status post AICD placement presented with worsening dyspnea on exertion, easy fatigue, lower extremity edema, anasarca and abdominal bloating. Transthoracic echocardiography demonstrated severe aortic …

Subtotal Iliac Vein Occlusion Secondary To May-Thurner Syndrome, Nina Shyama Appareddy, Jose Ramos, Usman Sheriff

Research Symposium

Background: May Thurner Syndrome (MTS), an anatomical variant present in over 20% of the population, can present with iliofemoral deep venous thrombosis (DVT) caused by compression of the common iliac vein by the adjacent iliac artery.

Case: An 86 year old male with coronary artery disease presented with left lower extremity swelling. Ultrasound revealed acute iliofemoral region DVT. This clot, extending from the groin to the ankle, placed him at high risk for pulmonary embolism and post-thrombotic syndrome.

Decision-making: Patient was placed on heparin drip. Venogram performed at 48 hours showed extensive clot in the superficial femoral, common femoral and …

Socio-Contextual Factors Predicting Pericardial Effusion And Mortality In Patients With Confirmed Sars-Cov2 In A South Texas Hospital. A Preliminary Analysis, Nina Shyama Appareddy, Cesar Peralta, Juan Carlos Alvarenga, Charles Mild

Research Symposium

Introduction: Few pericardial effusion (PEf) cases have been reported in the literature amongst adult hospitalized patients with SARS-CoV2. The goal of our study is to determine the frequency and risk factors of PEf amongst adult hospitalized patients with SARS-CoV2 and its effect on mortality.

Methods: This preliminary analysis included 48 consecutive patients with confirmed SARS-CoV2 admitted from 08/01-08/31/2021. Socio-demographic data and risk factors for coronary artery disease were recorded. Echocardiography was reviewed for evidence of PEf. A comparison of patients with effusion, no effusion, and no echo was performed with chi-square, t-test, ANOVA, and probability of death using logistic regression …

Development And Validation By Rp-Hplc Method For The Estimation Of Piperine Coenzyme Q10 In Bulk And Pharmaceutical Dosage Form, Nikita Sharma, Mrinmoy Sarkar, Pooja Chawla

Research Symposium

Safety is the fundamental principle in the provision of pharmaceutical products for health care of human being. Nutritional supplements used in medical practice are gaining considerable momentum in the world during the past decades. But this supplement is needed to be analysed before releasing in market to avoid any complications. A combination of piperine and coenzyme Q10 is used as nutritional supplement. As no analytical method has been developed for their simultaneous estimation a simple, specific, sensitive, precise and accurate RP-HPLC method was developed for the determination of CoQ10 and piperine in bulk or pharmaceutical dosage form. Coenzyme is very …

Alzheimer’S Disease Studies In The Tex-Mex Border: Dissecting A Complex Multifactorial Problem, Ney Alliey-Rodriguez, Rosa V. Pirela, Alvaro Diaz-Badillo, Karla Lopez Lorenzo, Noe Garza, Frank Gilliam, Eron G. Manusov, Gladys E. Maestre

Research Symposium

Purpose: Alzheimer’s Disease (ALZ) is the leading cause of dementia in the aging population, and Latinos have >3 times higher risk to develop dementia than the overall US population. Although several studies have examined for possible causes of this increased risk, lack of comprehensive information plus a reduced number of Latino samples available in each study have hindered the answers.

Description: The University of Texas Rio Grande Valley has joined two large studies looking for multiple biomarkers associated with ALZ: The South Texas Alzheimer’s Center Clinical Data Repository and Biobank (STAC) and the Texas Alzheimer’s Research and Care Consortium (TARCC). …

Development Of Surgery Guided Nir Fluorescent Probe Nanoparticles For Cancer Imaging, Neeraj Chauhan, Pallabita Chowdhury, Prashanth Kumar Bhusetty Nagesh, Elham Hatami, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

Research Symposium

Background: Early-stage detection is crucial for successful breast cancer treatment and can significantly reduce breast cancer associated death rates. There are several diagnostic approaches available for early breast cancer diagnosis but lack tumor specificity and expose patients with radiation. Therefore, there is a crucial need to develop newer and safer imaging modalities. Indocyanine green (ICG), an FDA approved Near InfraRed (NIR) fluorescent probe-based imaging for early cancer detection and image guided surgery, has gained noticeable attention for the clinical applications as it has high sensitivity, low cost, and real-time visualization/imaging capabilities without ionizing radiation. However, ICG has several limitations associated …

Trusted Sources Of Health Information During The Covid-19 Pandemic, Michael Machiorlatti, Candace Robledo, Cliff Clark

Research Symposium

Background: As the role of media has evolved with display and consumption of health information, the need to decipher the quality of the information has become exceedingly important. This became more important during the covid-19 pandemic, when information was being formulated and released nearly real-time. Prior to the pandemic, government agencies, health professionals and authorities were generally trusted sources of information. Additionally, information passed more casually through family and acquaintances was also something people tended to rely upon. This paper explores the self-reported trustworthiness of different health information sources during the pandemic and also seeks to rank the importance from …

Optimization Of A Protocol For Temporary Deafferentation And Proof-Of-Concept Of Effectiveness For Upper Limb Rehabilitation, Monica Lozano Garcia, Kelsey A. Potter-Baker, Chelsea Erazo Macias, Victoria Cuello

Research Symposium

Background: Temporary deafferentation (TD) is a technique that uses short-term anesthesia, to inactivate sensation pathways from stronger muscles so that the brain releases inhibition that was placed on weaker muscles, thereby strengthening them. Unfortunately, there are many methods to do TD, and an optimized protocol for TD has yet to be fully developed. Here, we sought to optimize a protocol for TD using 5% lidocaine cream. Then, as a proof-of-concept, we evaluated hand dexterity and muscle strength was improved after a single session of TD. We hypothesized that triceps would show a gain in strength, with minimal changes in hand …

Generalized Lymphadenopathy As The Initial Presentation Of A Young Woman With Systemic Lupus Erythematous, Mery Bartl, Christine E. Loftis, Jose Gomez, Daniela Hernandez, Emilia C. Dulgheru

Research Symposium

Background: Generalized lymphadenopathy (LAP) refers to abnormal enlargement of more than two non-contiguous lymph node regions. There are various causes of LAP, including malignancy, infection, autoimmune disorders, medications, and iatrogenic causes. Obtaining a thorough history and physical examination is paramount in identifying the underlying etiology. Most of the time further investigation with laboratory and radiographic studies should be performed to identify the cause. Patients with high-risk features should undergo a biopsy for the diagnosis of malignancy.

Case presentation: A 36-year-old lady with a remote history of COVID-19 presented with complaints of orthopnea, cough, arthralgia, and left-sided abdominal pain for the …

A Whole Clotta Pain: A Case Of Ivc Thrombosis Presenting As Severe Abdominal Pain In A Patient With Anti-Phospholipid Syndrome, Mery Bartl, Christine E. Loftis, Josenny Rodriguez-Paez, Emilia C. Dulgheru

Research Symposium

Background: Anti-phospholipid syndrome (APS) is an immune-mediated condition characterized by the presence of antiphospholipid antibodies in the setting of venous and arterial thrombosis and or pregnancy loss [1]. APS can be a primary syndrome or can be associated with connective tissue diseases such as systemic lupus erythematosus. The goal of treatment in patients with APS is to decrease the risk of thromboembolic events and the standard of care is warfarin therapy. We describe a case of a 42-year-old gentleman with a history of APS on anticoagulation with apixaban who presented to the hospital with severe abdominal pain secondary to infrarenal …

Eating Patterns Of Patients With Type 2 Diabetes Mellitus And Their Houshold First Degree Relatives. A Cross Sectional Study From Cediamet, Mariana M. Mendez, Juan C. Lopez-Alvarenga, Claudia Munguia-Cisneros

Research Symposium

During the first quarter of 2022, the hospital admissions in Mexico registered 6,575 patients with Type 2 Diabetes Mellitus (T2D), more than 61% had not received nutritional care, and in addition, 55% of the cases suffered from hypertension blood pressure and more than 14% had obesity. Clinical complications associated to a poor control of T2D were visual disability, and motor disability. It has been recognized the appearance and development of diabetes and its complications have genetic components. However, this genetic factor interacts by the presence of other environmental risk factors, such as eating habits and sedentary lifestyle. Household members can …

Necrotizing Fasciitis In A Patient With Type Ii Diabetes Mellitus - A Case Report, Mays F. Abdulazeez, Miguel Tamayo, Juan Garcia, Lester Rios, Andreina Prado, Alain Velazquez, Jose Cano, Heidi Pareja, Sunand Kallumadanda

Research Symposium

Background: Necrotizing fasciitis (NF) is a rare necrotizing soft tissue infection (NSTI) of high mortality; clinically characterized by fulminant tissue destruction and systemic signs of toxicity. Clinical manifestations include erythema (72%), extended edema (75%), severe pain (72%), fever (60%), crepitus (50%), skin bullae, necrosis, or ecchymosis (38%). Worldwide, 1:3 of patients with NF die from this rapidly progressive infection.

Case presentation: A 44-year-old female patient with a past medical history of DM type II attended ER with pain in the right inguinal area. Vital signs on admission were heart rate 113bpm, blood pressure 124/82mmHg, and temperature 38.1℃. A physical exam …

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I²PBH) initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I²PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality Integrated Behavioral Health (IBH) clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Complex Gynecology Clinic, Saul D. Rivas, Elissa Serapio, Tony Ogburn, John Ronnau, Alejandra Vega, Angela Tanguma, Andrea K. Contreras

Research Symposium

Purpose: The Area Health Education Center (AHEC) Complex Gynecology Clinic aims to reduce the shortage of women’s primary care providers in rural and medically underserved communities. The Complex Gynecologic clinic provides high quality- evidence based care to women at low or no cost regardless of immigration status, socioeconomic status, educational attainment, and age who might otherwise be unable to receive much needed care in other sites in the RGV.

Description: Some of the services offered, via grant funding, include preventive services such as well women exams, cervical cancer screening, and family planning. As well as work up and treatment for …