Medicine and Health Sciences Commons^™

Pericardial Effusions And Cardiac Tamponade In Hospitalized Systemic Sclerosis Patients: Analysis Of The National Inpatient Sample, Bikash Basyal, Waqas Ullah, Chris T. Derk

Abington Jefferson Health Papers

Introduction

Clinically significant pericardial effusions and cardiac tamponade in systemic sclerosis (SSc) patients is uncommon and the factors that contribute to progression of pericardial involvement in SSc patients have not been well established.

Methods

A review of the national inpatient sample database was performed looking SSc related hospitalizations between 2002 and 2019. Data was collected on patients with pericardial effusions and cardiac tamponade and analyzed to identify and describe patient characteristics and comorbidities.

Results

Out of a total of 523,410 SSc hospitalizations, with an overall inpatient mortality rate of 4.7% (24,764 patients), pericardial effusion was identified in 3.1% of all …

Uncovering The Effects Of Covid-19 On In-Hospital Cardiac Arrest – A Living Systematic Review And Meta-Analysis, Karol Bielski, Michal Pruc, Zubaid Rafique, Frank William Peacock, Jaroslaw Chmielewski, Lech Panasiuk, Lukasz Szarpak, Nicola Luigi Bragazzi, Izabela Chojnowska-Ćwiąkała

Faculty, Staff and Students Publications

Introduction and objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic and had a negative impact on the entire health care system. To understand the effect of COVID-19 on outcomes of in-hospital cardiac arrest (IHCA), a systematic review and meta-analysis of studies was designed to compare the pre- and intra-pandemic periods of adult patients who suffered cardiac arrest, and additionally by performing a sub-analysis related to COVID-19 positive vs. negative patients in the same group of patients.

Material and methods: To evaluate the impact of COVID-19 on IHCA outcomes a systematic review and meta-analysis was performed. Pubmed …

Insulin Resistance And Insulin Handling In Chronic Kidney Disease, Vishnu P Parvathareddy, Jiao Wu, Sandhya S Thomas

Faculty, Staff and Students Publications

Insulin regulates energy metabolism involving multiple organ systems. Insulin resistance (IR) occurs when organs exhibit reduced insulin sensitivity, leading to difficulties in maintaining glucose homeostasis. IR ensures decades prior to development of overt diabetes and can cause silent metabolic derangements. IR is typically seen very early in the course of chronic kidney disease (CKD) and is evident even when the estimated glomerular filtration rate (eGFR) is within the normal range and IR persists at various stages of kidney disease. In this article, we will discuss insulin handling by the kidneys, mechanisms responsible for IR in CKD, measurements and management of …

Author Correction: Spatial Organization Of The Mouse Retina At Single Cell Resolution By Merfish, Jongsu Choi, Jin Li, Salma Ferdous, Qingnan Liang, Jeffrey R Moffitt, Rui Chen

Faculty, Staff and Students Publications

No abstract provided.

Associations Between Plasma, Imaging, And Cerebrospinal Fluid Biomarkers With Driving Behavior And Cognitive Tests: Implications For Biomarker Usefulness, Catherine M Roe, Sayeh Bayat, Ganesh M Babulal

2020-Current year OA Pubs

BACKGROUND: Declines in instrumental activities of daily living like driving are hallmarks sequelae of Alzheimer's disease (AD). Although driving has been shown to be associated with traditional imaging and cerebrospinal fluid (CSF) biomarkers, it is possible that some biomarkers have stronger associations with specific aspects of driving behavior. Furthermore, associations between newer plasma biomarkers and driving behaviors are unknown.

OBJECTIVE: This study assessed the extent to which individual plasma, imaging, and CSF biomarkers are related to specific driving behaviors and cognitive functions among cognitively normal older adults.

METHODS: We analyzed naturalistic driving behavior from cognitively healthy older drivers (N = …

Lack Of Methylation Changes In Gjb2 And Rb1 Non-Coding Regions Of Cochlear Implant Patients With Sensorineural Hearing Loss, Angelo Augusto M Sumalde, Ivana V Yang, Talitha Karisse L Yarza, Celina Ann M Tobias-Grasso, Ma Leah C Tantoco, Elizabeth Davidson, Abner L Chan, Mahshid S Azamian, Teresa Luisa G Cruz, Seema R Lalani, Maria Rina T Reyes-Quintos, Eva Maria Cutiongco-De La Paz, Regie Lyn P Santos-Cortez, Charlotte M Chiong

Faculty, Staff and Students Publications

OBJECTIVE: Recent advances in epigenetic studies continue to reveal novel mechanisms of gene regulation and control, however little is known on the role of epigenetics in sensorineural hearing loss (SNHL) in humans. We aimed to investigate the methylation patterns of two regions, one in

METHODS: We investigated an RB1 promoter region that was previously identified as differentially methylated in children with SNHL and lead exposure. Additionally, we investigated a sequence in an enhancer-like region within GJB2 that contains four CpGs in close proximity. Bisulfite conversion was performed on salivary DNA samples from 15 children with SNHL and 45 unrelated ethnically-matched …

Current Approaches To Spinal Cord Protection During Open Thoracoabdominal Aortic Aneurysm Repair, Joseph S Coselli, Scott A Lemaire, Vicente Orozco-Sevilla, Ourania Preventza, Marc R Moon, Lauren M Barron, Subhasis Chatterjee

Faculty, Staff and Students Publications

Spinal cord deficit (SCD) is a feared complication after thoracoabdominal aortic aneurysm repair. Vigilant management throughout the perioperative period is necessary to reduce the risk of SCD. Measures for preventing SCD during the intraoperative period include preoperative optimization and recognizing patients at a higher risk of SCD. In this manuscript, we discuss intraoperative adjuncts including utilization of cerebrospinal fluid drainage, left heart bypass, mild hypothermia, selective reimplantation of intercostal and lumbar arteries, and renal and visceral vessel perfusion. From the operative to the postoperative period, careful attention to avoiding hypotension and anemia is important. If SCD is recognized early, therapeutic …

Deep Representation Learning Identifies Associations Between Physical Activity And Sleep Patterns During Pregnancy And Prematurity, Neal G Ravindra, Peinan Zhao, Erik D Herzog, Sarah K England, Et Al.

2020-Current year OA Pubs

Preterm birth (PTB) is the leading cause of infant mortality globally. Research has focused on developing predictive models for PTB without prioritizing cost-effective interventions. Physical activity and sleep present unique opportunities for interventions in low- and middle-income populations (LMICs). However, objective measurement of physical activity and sleep remains challenging and self-reported metrics suffer from low-resolution and accuracy. In this study, we use physical activity data collected using a wearable device comprising over 181,944 h of data across N = 1083 patients. Using a new state-of-the art deep learning time-series classification architecture, we develop a 'clock' of healthy dynamics during pregnancy …

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) is a workforce development pipeline project aimed at permanently augmenting UTRGV’s institutional capacity to address shortage of an Integrated Behavioral Health (IBH) competent workforce locally, regionally and nationally. Our initiative, aligned with UTRGV strategic priorities and key initiatives, will integrate basic(model specific strategy and operational elements), mid-level (role identity and profession specific behavioral competencies specific to each health profession), and advanced (behavioral medicine clinical skills) applications of the evidence based PCBH model of delivery. A PCBH focused delivery system (clinical and educational), in which primary care providers …

Influence Of Age, Race, And Ethnicity On Pre-Hospital Stroke Time Intervals In The Rio Grande Valley., Elio E. Garcia Sosa

Research Symposium

Currently, stroke represents one of the leading causes of death in the USA. Despite recent advances in acute stroke management such as thrombolytic administration and/or endovascular intervention, many patients remain ineligible for these treatments due to delay in treatment. There has been a great emphasis by healthcare professionals on improving “door to needle” time with very encouraging results. Unfortunately, there still exists a gap in these delays, and that is the onset to hospital presentation interval. This study aims at evaluating the time interval from the onset of the symptoms to when the patient presents to the healthcare facility. The …

Cell-Based Experimental Evidence To The Anti-Covid-19 Potential Of Ashwagandha And Honeybee Propolis Ingredients, Renu Wadhwa, Durai Sundar, Yoshiyuki Ishida, Keiji Terao, Sunil C. Kaul

Research Symposium

Background: The COVID-19 pandemic emerged in December 2019 by a novel strain of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) has led to new endeavours in repurposing of existing drugs, anti-COVID-19 vaccine and drug development. Natural products, due to their general safety and wider availability, have attracted research and public attention. In this study, we report anti-COVID potential of compounds from honeybee propolis and Ayurvedic herb, Ashwagandha. Effect of active ingredients was studied on human cell surface receptors (ACE-2:Angiotensin Converting Enzyme-2/Spike protein and TMPRSS2:Transmembrane Protease Serine 2), critical for virus infection and virus main protease (Mpro, essential for virus replication), …

Pro- And Anti-Inflammatory Biomarkers As Predictors Of Response To Valproate In Patients With Comorbid Alcohol Use And Bipolar Disorder-Preliminary Findings, Ilya Blokhin, Lisa Harlow, Eleonore Beurel, Feng Miao, Dana Ascherman, Claes Wahlestedt, Ihsan Salloum

Research Symposium

Objective/Hypothesis: Bipolar disorder (BD) has the highest association with alcohol and other substance use disorders compared to other major psychiatric disorders. This patient population is particularly challenging to treat. We have previously shown that some patients with co-occurring alcohol use and bipolar disorders respond to the GABAergic agonist valproate (VPA), which is known to modulates the dopaminergic system, and also as an epigenetic modifier. Predictors of therapeutic response to VPA in patients with AUD/BD are not known, and the subgroup which would benefit from VPA is still to be identified. Recent evidence suggests that AUD promotes a pro-inflammatory state while …

Using Cartesian Coordinate Systems To Create, Classify, And Retrieve Biomedical Time-Series: Applications To 24-Hour Ambulatory Blood Pressure Monitoring, Antonio Garcia, Gladys E. Maestre, John Blangero, Jesus D. Melgarejo, Julio Facelli

Research Symposium

Background: Ambulatory Blood Pressure Measurement (ABPM) allows physicians to monitor blood pressure variability under everyday living conditions and predicts clinical outcomes better than conventional blood-pressure measurement. ABPM can demonstrate mean arterial pressure (MAP) behavior over 24 hours relevant to clinical practice, such as nocturnal hypertension or increased blood pressure variability. We hypothesized that individuals with the same cardiovascular health status would have the same MAP signal (MAPs) waveform.

Methods: This study reutilizes a data subset from the IDACO Consortium to create 24-hour MAPs. We assigned all the MAPs to data matrix X, performed principal components analysis (PCA) to X, and …

Dpyd Pathogenic Variants Associated With Fluoropyrimidines Toxicity, Diana Cristina Pérez-Ibave, Noé Israel Oliva-García, Irasema Ramos-Martínez, Francisco Javier Villarreal Alvarado, Valeria Jimena Gómez Ordaz, Jonatán Isaí Cortes Alfaro, Carlos Horacio Burciaga-Flores, Juan Francisco González-Guerrero, Oscar Vidal-Gutiérrez, Maria De Lourdes Garza-Rodriguez

Research Symposium

Background: Genetic variants in dihydropyrimidine dehydrogenase gene (DPYD) coding for the key enzyme (DPD) of fluoropyrimidines (FPs) catabolism. DPYD contributes to the development of severe FPs-related toxicity, and pathogenic DPYD variants detection reduces side effects and complications associated with FP-toxicity. The allelic frequency of these variants in the Mexican population is currently unknown.

Methods: The study was carried out at the Centro Universitario Contra el Cáncer (CUCC) of the Universidad Autónoma de Nuevo León (UANL) in Monterrey México. Genomic DNA was isolated from 154 subjects using the QIAamp DNA Blood Midi kit (QIAGEN) following the manufacturer's recommendations. We …

Self-Inflicted Injuries Racial-Based Differences In Substance Abuse And In Potential Years Of Life Lost, Demba Fofana, Joy Alvarado, Sidketa Fofana, Jeffrey Skubic

Research Symposium

Background and Methods: Suicide is a leading cause of death in the US. Substance abuse is a known risk factor for suicide. The exact correlation between substance abuse and suicide is unknown. In addition, the potential years of life lost due to suicide is unknown. A 10-year review (2007-2016) of self-inflicted injury individuals in the National Trauma Data Bank (NTDB) is performed. Pearson Chi-square statistical test is utilized for the analysis.

Results: Our results also indicate that those tested positive for substance abuse have a higher Hospital Discharge Disposition death rate compared to those who were tested negative, 56.79\% who …

Validated Rp-Hplc Method For Simultaneous Estimation Of Ofloxacin And Racecadotril In Bulk And Combined Pharmaceutical Formulations, Debashree Debasish Das, Pooja Chawla

Research Symposium

Combined drug dosage forms are highly used since they can target more than one disease. For Ofloxacin and Racecadotril in bulk and combined dosage form a simple ,accurate and precise stability indicating simultaneous method was developed and validated by RP-HPLC (in isocratic system ) as per ICH Q₂ R₁ and FDA guidelines. This method was carried out by waters X bridge stainless steel C₁₈ Column (250mm X4.6mm,5 micro meter) packed with ODS as stationary phase and methanol : acetonitrile :water (40:40:20 ) as mobile phase. As the pKa of both OFL and RAC are strong acidic mobile …

Cms Sepsis Bundle Compliance Analysis At The Time Of Patient Admission During The Covid-19 Pandemic In A Community Hospital In South Texas, Jose Ramos, Daniel Habenicht, Carlos Ramos

Research Symposium

Background: Sepsis remains an important cause of mortality in hospitals across the globe. The Centers for Medicare and Medicaid Services (CMS) have increased efforts to lower the mortality rate in sepsis patients via the CMS quality measure. The COVID-19 pandemic changed how we conduct healthcare and key elements of sepsis management might have been compromised, affecting the CMS sepsis bundle compliance rate. Our goals were to determine whether compliance rates were affected and to further analyze the mortality rates associated with sepsis management during the COVID-19 pandemic.

Methods: A retrospective chart review was conducted to analyze the adherence to the …

Qi In Resident Leadership Workshop, Heidi Y. Pareja, Chelsea H. Chang, Daniel Aragon, Deepu George

Research Symposium

Background: Many residency programs provide some type of leadership training for chief residents. As these emerging leaders transition into their role, it is imperative to provide them with skills and knowledge to help them develop their leadership style. UTRGV’s department of Graduate Medical Education (GME) organized their first “Resident Leader Workshop” for all rising Chiefs and GME Resident Leadership Council (RLC) members. Using a pre and post survey, participants provided feedback on the effectiveness of knowledge and skills presented during the workshop.

Methods: All residency and fellowship rising Chiefs and GME RLC members were invited. The workshop took place …

Bitten To The Bone: A Case Of Anxiety-Induced Osteomyelitis, Jose A. Rivera, Daniel Aragon, Daniela Hernandez

Research Symposium

Background: Onychophagia is a habitual nail-biting disorder, usually associated with mental or emotional diseases. It affects 20–30% of the population in all age groups. Human bites have the potential to become serious injuries due to high virulence in the human oral flora and may often require hospital admission, antibiotics and even debridement in the operating room. Thus, repetitive nail biting has the potential to be limb-threatening if not treated early and appropriately.

Case Presentation: Patient is a 49-year-old gentleman with a past medical history of severe refractory anxiety treated with hydroxyzine and scheduled alprazolam, after failing multiple other treatments, …

Residential Treatment Of Substance Use Disorder And Related Comorbidities In Older Adults, Dale J. Dyben

Research Symposium

Purpose: Substance Use Disorders (SUD) are a leading contributor to health problems and premature mortality in the United States. Stigma and misconceptions about persons with SUD contribute to negative outcomes. The misconception that older adults do not suffer from severe SUD has contributed to a paucity of treatment options that meet the unique needs this population.

Description: The Center for Older Adult Recovery (COAR) at Hanley Center in West Palm Beach, Florida provides a model for residential treatment of older 65 and older with severe SUD and related medical and mental health comorbidities. Older adults who meet DSM-V diagnostic …

Quality Improvement In Healthcare: A Practical Guide For Providers, Jeremy Ellis

Transformative Medicine

No abstract provided.

The Adverse Effects Of Proton Pump Inhibitors And How To De-Escalate Therapy, Christina Swiger, Mary Hoang, Emily Wagner, Maley Zents

Transformative Medicine

This article discusses how many patients, both inpatient and outpatient, are initiated on proton pump inhibitors (PPIs) for stomach acid related symptoms, as well as for prophylaxis. These medications may inadvertently be continued long-term. Chronic use of PPIs can result in adverse events, such as vitamin deficiencies, community-acquired pneumonia, and an increased risk for Clostridium difficile infection. Clinicians should periodically evaluate the need for PPIs in patients and discontinue as appropriate.

“What Pattern Does This Ecg Show?”, Ravi Choxi, Arun Kundra

Transformative Medicine

No abstract provided.

A Medical Spanish Curriculum Model For Resident Physicians, Jessica Castro, Meghna Lama, Victor A. Cabello, Luis A. Murillo

Transformative Medicine

No abstract

Utilizing A Web-Based Program For Educational Material Distribution In An Obgyn Residency Program, Sarah Dreibelbis, Peter F. Schnatz

Transformative Medicine

Background: Online modules and assignments are commonly used for continuing education among residents. Ensuring ease of distribution and access to learning modules, assignments and simulations allows for the efficient completion of these tasks.

Objective: The purpose of this quality improvement project is to propose a new method for distribution of educational material and assignments to improve resident satisfaction and ease of completion as well as tracking completion by the program manager.

Methods: A survey was sent to the 2020-21 academic year OBGYN residents regarding the current in-hospital folder-based distribution of resources. Based on the survey feedback, a checklist was designed …

Pericardial Hematoma Following Coronary Angiography, Davin Evanson, Allegra Delman, Michael Romeo

Transformative Medicine

Introduction: Pericardial hematoma is defined as an accumulation of blood in the pericardial space, located in close proximity to the myocardium and deep to the fibrous pericardial sac, which encloses the heart.

Case Description: We present a rare case of pericardial hematoma following percutaneous coronary intervention in an individual presenting with stenotic vein graft following symptoms of a myocardial infarction. Initial computed tomography (CT) scan demonstrated hematoma in the pericardial space. This finding was managed conservatively and hematoma was deemed stable on serial CT scans.

Discussion: In this urgent situation, CT imaging proves valuable due to its speed, convenience, and …

Diagnostic Criteria Of Takotsubo Cardiomyopathy In The Clinical Setting: A Case Report, Annu R. Suresh Md, Yi-Ju Chen Md, Richa Neupane Md, Jessica Cunningham Md

Transformative Medicine

Introduction

Takotsubo cardiomyopathy (TTS) is a rare condition related to stress featuring apical hypokinesis. Current guidelines suggest that the exclusion of other causal factors like myocarditis is required to diagnose TTS. However, we propose that the existing diagnostic criteria for TTS, particularly, required exclusion of myocarditis, adds to the challenge of making this diagnosis in the clinical setting. Hereby, we present a case with basal hypokinesis that could have been attributed to a conjunction of reverse Takotsubo syndrome (rTTS) with viral or toxic myocarditis.

Case Presentation:

A 29-year-old female complained of acute persistent chest pain, palpitations, and vomiting after smoking …

A Survey Evaluating Extent Of Undergraduate Medical Education Regarding Sex-Based Differences In Pathophysiology, Ashni Nadgauda, Tej Ganti, Amanda Horowitz, Matthew Coates, Aditya Brahmbhatt, Ana Nunez, Peter Schnatz

Transformative Medicine

Introduction

A historical gap in research on sex differences in health outcomes has led to a lack of education on sex-based differences in pathophysiology. The primary objective of this research study was to survey pathophysiology professors of medical schools in the United States (US) to understand the current extent to which the impact of sex on disease is included in the pre-clinical curricula of undergraduate medical institutions in the US.

Methods

A survey tool was created via literature review to assess the extent of education on sex-based differences in pathophysiology. This survey was distributed using the Qualtrics electronic platform to …

Welcome To The Fall Issue Of Transformative Medicine, Adam Sigal

Transformative Medicine

No abstract provided.

Architectural Features Of Streetscapes And Aging In Cameron County, Texas: Preliminary Results, Cristian Maestre, Michael Minor, Rosa V. Pirela, Noe Garza, Alvaro Diaz-Badillo, Karla D. Lopez-Lorenzo, Ney Alliey-Rodriguez, Gladys E. Maestre

Research Symposium

The impact of architectural features in urban settings reveals priorities for its residents and the integration of social and natural environments. It has been estimated that 23% of global deaths to the environments in which people live. We aim to characterize the most prevalent architectural features of Cameron County, Texas streetscapes and analyze their role in health promotion and healthy aging.