Medicine and Health Sciences Commons^™

Balancing Autonomy And Safety In The Care Of A Senior Patient: To Place Or Not To Place?, Jessica Flores, Kelsey Endari, Daniel Aragon, Chelsea Chang

Research Symposium

According to the Census Bureau, the United States will have more than 20% of its population above age 65 by 2030, bringing ethical dilemmas in balancing risk and autonomy in geriatric patients to the forefront. Many geriatric persons rely on social support to fulfill their safety and autonomy needs, but those who lack a network are faced with increased challenges.

An 80-year-old male with a history of multiple comorbidities presents to the UTRGV-DHR internal medicine outpatient clinic. His medical history includes coronary artery disease, heart failure, atrial fibrillation, chronic kidney disease, basal cell carcinoma of the nose, gout, tobacco abuse …

Beta-3 Adrenergic Receptor Blockade Prevents Alterations In Feeding Behavior In Lymphoma-Bearing Mice In A Sex-Dependent Manner, Isaias Gutierrez-Leal, Diana Caballero-Hernández, Alonso Orozco-Flores, Moises Franco-Molina, Ricardo Gomez-Flores, Patricia Tamez-Guerra, Cristina Rodríguez-Padilla

Research Symposium

Introduction: Cancer cachexia is a metabolic syndrome defined by an ongoing loss of adipose and muscular tissue and is characterized by a reduced food intake. Local b-3 adrenergic receptor activation in adipose tissue induces lipolysis, whereas b-3 signaling in tumors has been shown to be tumorigenic in some cancer models. Therefore, b-3 signaling may be a therapeutic target in cancer cachexia. The aim of this study was to assess the role of b-3 adrenergic signaling in feeding behavior, body composition, and tumor progression in the L5178Y-R murine lymphoma model.

Methods: In our study we used BALB/c mice of both sexes, …

Adapting A Medication Reconciliation Process To The Family Medicine Outpatient Setting, Iliana M. Chapa, James Fahey, Adrian Sandoval

Research Symposium

The Institute of Healthcare Improvement states that “medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking” so that physicians may know what medications the patient is taking, at what dose, and to identify any discrepancies between prescriptions during the patient encounter. However, the medication reconciliation rates of the DHR Family Medicine Center are not optimal as many med reconciliations remain uncompleted. An adapted protocol from a previous quality improvement project done at DHR Women’s Clinic in 2020 was implemented to seek to improve medication reconciliation rates.

This Quality Improvement Project …

A Case Report Of A Primary Cerebral Abscess Due To Nocardia Asteroides In An Immunocompetent Patient, Ileana Elita Mendez, Nicole Marie Barreto, Alan Lanurias, Luis Alberto Rosas

Research Symposium

Background: Brain abscesses caused by Nocardia are rarely reported and have high mortality. It usually affects patients who are immunocompromised and initiates as a lung infection that disseminates hematogenously, though it can also affect those immunocompetent. Cerebral nocardiosis imitates brain tumors, which can delay the initiation of the appropriate antibiotic therapy.

Case Description: We present a case of a 64-year-old immunocompetent male with multiple cerebral abscesses who presented with headaches, left-sided weakness, and ataxia. Upon imaging, multiple brain lesions were revealed. The patient underwent craniotomy and drainage of the mass. He was initially empirically treated, though cultures later grew Nocardia …

Spectral Doppler Ultrasonography Of Hepatic Vein In A Patient With Atrial Fibrillation And Rapid Ventricular Rate, Hector Arredondo, Oscar J. Lopez

Research Symposium

Background: Point of Care ultrasound (POCUS) is a tool that enables the clinicians to objectively assess hemodynamics at the bedside. Recently, a novel concept of venous excess Doppler ultrasound (VExUS) grading system has been proposed to assess venous congestion at the organ level in real time. This concept evaluates the presence of severe flow abnormalities in 2 or more veins (of the hepatic, portal, and kidney parenchymal veins) with a dilated IVC (≥2 cm). There are reports in literature that tachyarrhythmias alter the flow pattern in the hepatic veins.

Case presentation: We present a case of a 88-year-old gentleman with …

Prevalence Of Metabolic Syndrome In Hiv Patients Under Antiretroviral Treatment In Capasits From Reynosa, Tamaulipas, Gala Alondra Mireles Contreras, Anabel Alonso Bocanegra, Juan Carlos Martinez Hernandez, Jose Francisco Flores Gomez, Esperanza Milagros Garcia Oropesa

Research Symposium

Introduction: Highly effective antiretroviral therapy has been demonstrated a decrease in morbidity, mortality, life expectancy and quality of life of HIV-infected patients. However, HIV-infected persons, over time of receiving antiretroviral treatment, may develop different metabolic disorders, such as adipose tissue, lipid metabolism and the development of arterial hypertension, increase in BMI, decrease in HDL cholesterol and insulin resistance which can with lead to the development of metabolic syndrome. Methodology: A cross-sectional observational study was carried out, the sample consisted of 122 HIV patients on ART. All patients signed an informed consent form. Sociodemographic data and clinical history were collected. Subsequently, …

Representation Of Racial And Ethnic Minorities And Their Preferences For Mood Stabilizing Treatment Selection For Bipolar Disorder: A Systematic Review, Francisco J. Barrera, Manuel Gardea, Juan Garzon, Ryan Toledo, Ana Paula Bonner, Andrea Maraboto, Mark Frye, Ihsan Salloum

Research Symposium

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years¹Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.² Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the …

Characterization Of The Female Reproductive Cycle In The Syrian Hamster (Mesocricetus Auratus), Fernando Dominguez, Esperanza Alaniz, Alexandra Chalons, Mario Gil

Research Symposium

Gender and biological sex are important variables in biomedical research, and a female’s reproductive status is an important factor that plays a role in and impacts health outcomes. Understanding how the female reproductive cycle affects behavior may help in the development of treatments that can be implemented in a clinical setting. Following Dr. Orsini's protocol, published in 1961, to identify and document the different stages of the female hamsters’ 4-day estrous cycle, we characterized the female hamsters’ estrus cycle by inspecting vaginal discharge phenomena. Orsini (1961) named day 1 discharge of the cycle as translucent (TS), day 2 as postestrus …

Hollow Bulb Definitive Obturation Of A Post-Covid Mucormycosis Maxillectomy Defect – A Case Report., Ravi M B, Prakash P, Sai Pranathi Putta, Anupama Aradya, Rashmi S, Dhakshaini M R

International Journal of Health and Allied Sciences

The novel Coronavirus, also known as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), causes COVID-19.In the wake of COVID-19, incidences of mucormycosis were rising alarmingly, especially rhino-orbital-cerebral mucormycosis.Most cases required surgical intervention followed by the fabrication of obturators.A hollow obturator is the most practical, convenient, and cost-effective solution for prosthodontic rehabilitation. A patient with pain overthe maxillary region (left) reported to the department of Prosthodontics and Crown & Bridge. His past medical history revealed that he tested and recovered from SARS-CoV-2. Clinical, radiographic, and smear tests confirmed rhino-cerebral mucormycosis with post covid pneumonia. Surgical left partial maxillectomy performed 4 months …

Geospatial Artificial Intelligence (Geoai): Applications In Health Care, K S Sahana, C B Karthik, Mounika M Sree, M Chaithra, Stavelin K Abhinandithe, B Snehalatha, R Sridhar, S Balasubramanian, B Madhu

International Journal of Health and Allied Sciences

GeoAI is a new emerging research area that refers to set of technologies that integrate AI technology with a diversity of GIS (Geographic Information System) techniques. The present study observed that GeoAI goes beyond current GIS expectations and into the domain of possibility in the not-too-distant future. This emerging interdisciplinary science will lead us to sustainable decisions and explore the most suitable solutions to the existing problems. GeoAI has the potential to transform current geography and geomatics programs by incorporating a GeoAI dimension into modern GIS curricula. In this review, we have studied the application GeoAI in various healthcare fields. …

Medical School Watercooler Newsletter - September 28, 2023, Lindsey Lyle

Watercooler Newsletter

This is the September 28, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Research participants needed for study on menopause in the workplace
• Meet a Med Student: Jonathan Swint
• Scammell retires from the Whiddon college of medicine
• Menger named vice chair for the department of Neurosurgery

Long-Term Evaluation Of Clinical Success And Safety Of Omadacycline In Nontuberculous Mycobacteria Infections: A Retrospective, Multicenter Cohort Of Real-World Health Outcomes., Amer El Ghali, Taylor Morrisette, Sara Alosaimy, Kristen Lucas, Maria G Tupayachi-Ortiz, Raaga Vemula, Carly Wadle, Julie V Philley, Carlos Mejia-Chew, Yasir Hamad, Ryan W Stevens, John D Zeuli, Andrew J Webb, Christina T Fiske, Anahit Simonyan, Christo L Cimino, Mehriban Mammadova, Virginia E Umana, Rodrigo Hasbun, Saira Butt, Kyle C Molina, Michael Thomas, Emily A Kaip, Jeannette Bouchard, Tristan W Gore, Catessa Howard, M Gabriela Cabanilla, Dana J Holger, Jeremy J Frens, Melissa Barger, Aaron Ong, Keira A Cohen, Michael J Rybak

HPD Articles

Infections due to nontuberculous mycobacteria (NTM) continue to increase in prevalence, leading to problematic clinical outcomes. Omadacycline (OMC) is an aminomethylcycline antibiotic with FDA orphan drug and fast-track designations for pulmonary NTM infections, including Mycobacteroides abscessus (MAB). This multicenter retrospective study across 16 U.S. medical institutions from January 2020 to March 2023 examined the long-term clinical success, safety, and tolerability of OMC for NTM infections. The cohort included patients aged ≥18 yr, who were clinically evaluable, and` had been treated with OMC for ≥3 mo without a previous diagnosis of cystic fibrosis. The primary outcome was 3 mo clinical success, …

Remote Ischaemic Conditioning Combined With Bimanual Task Training To Enhance Bimanual Skill Learning And Corticospinal Excitability In Children With Unilateral Cerebral Palsy: A Study Protocol Of A Single Centre, Phase Ii Randomised Controlled Trial, Swati M Surkar, John D Willson, Jessica M Cassidy, Shailesh Kantak, Charity G Patterson

Department of Rehabilitation Medicine Faculty Papers

INTRODUCTION: Children with unilateral cerebral palsy (UCP) have difficulty in bimanual coordination that restricts the child's independence in daily activities. Although several efficacious interventions to improve bimanual coordination exist, these interventions often require higher training doses and have modest effect sizes. Thus, there is a critical need to find an effective priming agent that, when paired with task-specific training, will facilitate neurobiological processes to enhance the magnitude of training effects and subsequently improve functional capabilities of children with UCP. The aim of this study is to determine the effects of a novel priming agent, remote ischaemic conditioning (RIC), combined with …

An Immunohistochemical Anomaly: A Case Report And Systematic Review Of Myofibroblastoma Of The Breast, Mohamad Kaki, Sarah Klein, Chinar Singh, Breanne Kothe, Jose Martin

HPD Articles

Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion …

Anchoring On Hyperglycemia And Sepsis In The Presence Of An Unforeseen Thyroid Storm, Andrew M. Joseph, Monica Karas, Victor H. Camba, Brian M. Martin, John Preece

HPD Articles

Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trauma, drugs, and sepsis. Identifying TS as a diagnosis is challenging to pinpoint due to its similar presentation to more common pathologies like sepsis and diabetic ketoacidosis (DKA). Here, we present a case of a 31-year-old African-American woman with type 2 diabetes mellitus following sepsis secondary to Escherichia coli pyelonephritis and …

A New Hybrid Graft For Open Thoracoabdominal Aortic Aneurysm Repair, Sabine Helena Wipper, Tilo Kölbel, Julia Dumfarth, Hubert Schelzig, Anthony L Estrera, Harleen K Sandhu, Florian Enzmann, E Sebastian Debus

Faculty, Staff and Student Publications

No abstract provided.

Spontaneous Celiac Artery Dissection Treated By Balloon Angioplasty, Emanuel R Tenorio, Gustavo S Oderich

Faculty, Staff and Student Publications

No abstract provided.

Development Of A Xylose-Inducible Promoter And Riboswitch Combination System For Manipulating Gene Expression In Fusobacterium Nucleatum, Bibek G C, Peng Zhou, Arindam Naha, Jianhua Gu, Chenggang Wu

Faculty, Staff and Student Publications

Inducible gene expression systems are important for studying bacterial gene function, yet most exhibit leakage. In this study, we engineered a leakage-free hybrid system for precise gene expression controls in Fusobacterium nucleatum by integrating the xylose-inducible expression system with the theophylline-responsive riboswitch. This innovative method enables concurrent control of target gene expression at both transcription and translation initiation levels. Using luciferase and the indole-producing enzyme tryptophanase (TnaA) as reporters, we demonstrated that the hybrid system displays virtually no observable signal in the absence of inducers. We employed this system to express FtsX, a protein related to fusobacterial cytokinesis, in an …

Comparative Study Of Guanidine-, Acetamidine- And Urea-Based Chloroaluminate Electrolytes For An Aluminum Battery, Iwan Sumarlan, Anand Kunverji, Anthony J Lucio, A Robert Hillman, Karl S Ryder

Faculty, Staff and Student Publications

Aluminum-based batteries are a promising alternative to lithium-ion as they are considered to be low-cost and more friendly to the environment. In addition, aluminum is abundant and evenly distributed across the globe. Many studies and Al battery prototypes use imidazolium chloroaluminate electrolytes because of their good rheological and electrochemical performance. However, these electrolytes are very expensive, and so cost is a barrier to industrial scale-up. A urea-based electrolyte, AlCl3:Urea, has been proposed as an alternative, but its performance is relatively poor because of its high viscosity and low conductivity. This type of electrolyte has become known as an ionic liquid …

Cabozantinib And Il-27 Combinatorial Therapy For Bone-Metastatic Prostate Cancer, Shreya Kumar, Grace E. Mulia, Marxa L. Figueiredo

Purdue University Libraries Open Access Publishing Fund

Introduction: Prostate cancer is the second leading cause of cancer-related death among American men. Prostate tumor cells exhibit significant tropism for the bone and once metastasis occurs, survival rates fall significantly. Current treatment options are not curative and focus on symptom management. Immunotherapies are rapidly emerging as a possible therapeutic option for a variety of cancers including prostate cancer, however, variable patient response remains a concern. Chemotherapies, like cabozantinib, can have immune-priming effects which sensitize tumors to immunotherapies. Additionally, lower doses of chemotherapy can be used in this context which can reduce patient side effects. We hypothesized that a combination …

Bad To The Bone. Not All Bone Tumors Are Cancer: Case Of Long Bone Osteomyelitis, Tat W. Yau, Bennet D. Franz, Hanadi A. Osman, Jessica C. Rivera, Ashaur Azhar

School of Medicine Faculty Publications

Long bone osteomyelitis could mimic bony tumor in clinical presentation and imaging studies. We present a case of a 47-year man who presented with leg pain, weight loss and night sweats that initially was thought to be related to osteosarcoma, later suffered a pathologic fracture from Staphylococcus aureus osteomyelitis. This case highlights the importance of source control of infection and careful clinical evaluation including radiographic and pathologic findings that can help physicians to differentiate between competing diagnoses.

Sexual Well-Being Among Medical Residents At A Community-Based Academic Institution, Fiore Casale, Hinduja Nallamala, Todd Foster, Christine Alicea, Laurel Fick

Journal of Wellness

Introduction: Medical residency training is demanding, with challenging workloads, long hours, and excessive stress that impact residents’ physical, mental, and emotional health. Although the concept of health and wellness in residency has become more widespread across programs, few studies have explored the sexual health of medical residents during training.

Methods: To better understand the current state of sexual health and well-being of resident physicians, physicians in training across Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Transitional Year, and General Surgery completed anonymous surveys that incorporated validated questionnaires, including the International Index of Erectile Function (IIEF) and the Index of Premature Ejaculation …

Advances In Diagnosis And Management Of Atypical Spinal Infections: A Comprehensive Review, Glenn A. Gonzalez, Guilherme Porto, Eric Tecce, Yazan Shamli Oghli, J. Miao, Matthew O'Leary, Daniela Perez Chadid, Michael Vo, James Harrop

Department of Neurosurgery Faculty Papers

Atypical spinal infections (ASIs) of the spine are a challenging pathology to management with potentially devastating morbidity and mortality. To identify patients with atypical spinal infections, it is important to recognize the often insidious clinical and radiographic presentations, in the setting of indolent and smoldering organism growth. Trending of inflammatory markers, and culturing of organisms, is essential. Once identified, the spinal infection should be treated with antibiotics and possibly various surgical interventions including decompression and possible fusion depending on spine structural integrity and stability. Early diagnosis of ASIs and immediate treatment of debilitating conditions, such as epidural abscess, correlate with …

Gene-By-Environment Interaction In Non-Alcoholic Fatty Liver Disease And Depression: The Role Of Hepatic Transaminases, Eron G. Manusov, Vincent P. Diego, Edward Abrego, Kathryn Herklotz, Marcio A. Almeida, Xi Mao, Sandra L. Laston, John Blangero, Sarah Williams-Blangero

School of Medicine Publications

Non-alcoholic fatty liver disease (NAFLD) encompasses a range of liver conditions, from benign fatty accumulation to severe fibrosis. The global prevalence of NAFLD has risen to 25-30%, with variations across ethnic groups. NAFLD may advance to hepatocellular carcinoma, increases cardiovascular risk, is associated with chronic kidney disease, and is an independent metabolic disease risk factor. Assessment methods for liver health include liver biopsy, magnetic resonance imaging, ultrasound, and vibration-controlled transient elastography (VCTE by FibroScan). Hepatic transaminases are cost-effective and minimally invasive liver health assessment methods options.

This study focuses on the interaction between genetic factors underlying the traits (hepatic transaminases …

Supradiaphragmatic Origin Of The Celiac Trunk Leading To Median Arcuate Ligament Syndrome With Superior Mesenteric Artery Involvement, Martina Rama, Wissam Nasser, Prashanth Palvannan, Sara Belko, Paul Dimuzio, Francesco Palazzo

Department of Surgery Faculty Papers

Median arcuate ligament (MAL) syndrome (MALS) is a rare condition caused by compression of the celiac artery by the MAL. Symptoms include abdominal pain, nausea, and weight loss. Rarely, the MAL can compress both the celiac artery and the superior mesenteric artery (SMA). We describe the case of a young man with MALS involving the celiac artery and SMA. Laparoscopic release of the MAL was performed, and the patient had resolution of his symptoms at 6 months of follow-up. A review of the literature identified only six cases of MALS involving the SMA and celiac artery, making this a rare …

Integrated Molecular And Multiparametric Mri Mapping Of High-Grade Glioma Identifies Regional Biologic Signatures, Leland S Hu, Fulvio D'Angelo, Taylor M Weiskittel, Francesca P Caruso, Shannon P Fortin Ensign, Mylan R Blomquist, Matthew J Flick, Lujia Wang, Christopher P Sereduk, Kevin Meng-Lin, Gustavo De Leon, Ashley Nespodzany, Javier C Urcuyo, Ashlyn C Gonzales, Lee Curtin, Erika M Lewis, Kyle W Singleton, Timothy Dondlinger, Aliya Anil, Natenael B Semmineh, Teresa Noviello, Reyna A Patel, Panwen Wang, Junwen Wang, Jennifer M Eschbacher, Andrea Hawkins-Daarud, Pamela R Jackson, Itamar S Grunfeld, Christian Elrod, Gina L Mazza, Sam C Mcgee, Lisa Paulson, Kamala Clark-Swanson, Yvette Lassiter-Morris, Kris A Smith, Peter Nakaji, Bernard R Bendok, Richard S Zimmerman, Chandan Krishna, Devi P Patra, Naresh P Patel, Mark Lyons, Matthew Neal, Kliment Donev, Maciej M Mrugala, Alyx B Porter, Scott C Beeman, Todd R Jensen, Kathleen M Schmainda, Yuxiang Zhou, Leslie C Baxter, Christopher L Plaisier, Jing Li, Hu Li, Anna Lasorella, C Chad Quarles, Kristin R Swanson, Michele Ceccarelli, Antonio Iavarone, Nhan L Tran

Faculty, Staff and Student Publications

Sampling restrictions have hindered the comprehensive study of invasive non-enhancing (NE) high-grade glioma (HGG) cell populations driving tumor progression. Here, we present an integrated multi-omic analysis of spatially matched molecular and multi-parametric magnetic resonance imaging (MRI) profiling across 313 multi-regional tumor biopsies, including 111 from the NE, across 68 HGG patients. Whole exome and RNA sequencing uncover unique genomic alterations to unresectable invasive NE tumor, including subclonal events, which inform genomic models predictive of geographic evolution. Infiltrative NE tumor is alternatively enriched with tumor cells exhibiting neuronal or glycolytic/plurimetabolic cellular states, two principal transcriptomic pathway-based glioma subtypes, which respectively demonstrate …

National Survey On The Availability Of Oncology Palliative Care Services At Tertiary General And Cancer Hospitals In China, Xiaomei Li, Xin Shelley Wang, Haili Huang, Miao Liu, Yinan Wu, Jiaojiao Qiu, Boran Zhang, Linhong Cui, David Hui

Faculty, Staff and Student Publications

Background: This nationwide survey studied the level of palliative care (PC) access for Chinese patients with cancer among cancer care providers either in tertiary general hospitals or cancer hospitals in China.

Methods: Using a probability-proportionate-to-size method, we identified local tertiary general hospitals with oncology departments to match cancer hospitals at the same geographic area. A PC program leader or a designee at each hospital reported available PC services, including staffing, inpatient and outpatient services, education, and research, with most questions adapted from a previous national survey on PC. The primary outcome was availability of a PC service.

Results: Most responders …

Neuromonitoring For Descending Thoracic And Thoracoabdominal Aortic Aneurysm Repair, Akiko Tanaka, Hung Nguyen, Holly N Smith, Anthony L Estrera

Faculty, Staff and Student Publications

No abstract provided.

Current Perioperative Management Of Cerebrospinal Fluid Drains, Shao-Feng Zhou, Akiko Tanaka, Anthony Estrera

Faculty, Staff and Student Publications

No abstract provided.

Regulation Of Syntaxin3b-Mediated Membrane Fusion By T14, Munc18, And Complexin, Rajkishor Nishad, Miguel Betancourt-Solis, Himani Dey, Ruth Heidelberger, James A Mcnew

Faculty, Staff and Student Publications

Retinal neurons that form ribbon-style synapses operate over a wide dynamic range, continuously relaying visual information to their downstream targets. The remarkable signaling abilities of these neurons are supported by specialized presynaptic machinery, one component of which is syntaxin3B. Syntaxin3B is an essential t-SNARE protein of photoreceptors and bipolar cells that is required for neurotransmitter release. It has a light-regulated phosphorylation site in its N-terminal domain at T14 that has been proposed to modulate membrane fusion. However, a direct test of the latter has been lacking. Using a well-controlled in vitro fusion assay, we found that a phosphomimetic T14 syntaxin3B …