Diseases Commons^™

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). …

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 …

Unusual Inflammatory Presentation For Locally Advanced Papillary Thyroid Carcinoma, Ana I. Vargas, Samuel K. Snyder

Research Symposium

Background: Thyroid cancer usually presents as a thyroid nodule. If the history implies rapid growth of the nodule, new onset hoarseness or presence of ipsilateral cervical lymphadenopathy then it should raise concern for malignancy. Deep neck infection/inflammation has rarely been reported as initial presentation and these patients are potentially misdiagnosed.

Case Presentation: We present a 56-year-old male who comes to clinic for evaluation of left neck nodule. He started two weeks prior with sudden neck swelling associated with erythema and pain in his lower neck that caused choking sensation and swallowing discomfort, he was prescribed Bactrim and prednisone with improvement …

Understanding The Resources, Barriers, Facilitators And Interests About Aging And Dementia Research Of Community Members From The Rio Grande Valley, Karla Daniela Lopez Lorenzo, Rosa V. Pirela Mavarez, Gabriela Osuna, Kendra Stine, Nathalie Chacon, Noe Garza, Gladys E. Maestre

Research Symposium

Background: One of ten people aged 65 develops Alzheimer’s Disease and it is one of the sixth-leading cause of death in the United States. The Rio Grande Valley (RGV) is mostly constituted by Hispanic/Latinos (93%), a population that has a 1.5X increased risk of AD onset. Nevertheless, there are not enough resources to support people living with dementia and their care partners. This study will leverage research efforts deployed by the RGV Alzheimer’s Disease Resource Center for Minority Aging Research to understand the social representations about the resources, barriers, facilitators, and interests of the RGV community about dementia and Alzheimer’s …

Acute Eosinophilic Pneumonia In A Patient With Long Standing Behcet’S Syndrome, Juan C. Naranjo, Shadi J. Estefahani, Christine E. Loftis, Emilia Dulgheru

Research Symposium

Background: Behcet’s syndrome (BS) is a multisystemic disease that frequently manifests as oral and genital ulcers. Pulmonary involvement occurs in approximately 18% of patients and can have complex clinical manifestations, including vascular disease, hemorrhage, infarctions, and organizing pneumonia. Broad-spectrum radiological findings like loss of lung volume, lung opacities, and indistinct nodular or reticular lesions have been described. There is little data on the association between Behcet’s disease and eosinophilic pneumonitis; the latest is usually characterized by eosinophilic infiltration of the lung parenchyma caused by a hypersensitivity reaction to an inhaled antigen. Patients usually present with nonproductive cough, dyspnea, fever, and …

That Which Keeps On Giving - A Case Of Class Iv Diffuse Proliferative Lupus Nephritis In A Hispanic Woman With Underlying Systemic Lupus Erythematosus, Josenny L. Rodriguez-Paez, Christine E. Loftis, Rosa White-Guedez

Research Symposium

Background: Glomerulonephritis is the primary cause of morbidity and mortality of systemic lupus erythematosus (SLE). Lupus nephritis is characterized by immune complex deposition in the mesangium leading to complement activation and hypocomplementemia. Studies show that up to 60% of adults with lupus develop renal involvement and it has been well established that Hispanic patients show poorer outcomes than Caucasians despite advances in treatment. Preserved kidney function with new-onset proteinuria should raise clinical suspicion for acute lupus nephritis. Further evaluation with a kidney biopsy is paramount in establishing a diagnosis, helping to define treatment strategy, and determining response to treatment.

Case …

Improvement Of Diabetic Retinopathy Screening Of Diabetic Patients Seen At The Internal Medicine Clinic​​, Jorge Nadal, Carol Soler, Mery Bartl, Jose Gomez, Michelle Lopez, Blesset Alexander, Gabriel Lora, Azucena Del Real, Maria Pesantez, Sergio Saenz, Jorge A. Bernal

Research Symposium

Diabetic retinopathy (DR) is a leading cause of vision loss globally. The International Diabetes Federation (IDF) estimated the global population with diabetes to be 463 million in 2019 and 700 million in 2045. Retinopathy is a highly specific neurovascular complication of both type 1 and types 2 diabetes, and the prevalence strongly correlates to both the duration of diabetes and the level of glycemic control. Regular follow-up with early detection and treatment of vision-threatening retinopathy enables the prevention of up to 98% of visual loss due to diabetic retinopathy.

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 …

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.

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.

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.

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 …

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 …

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), …

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 …

Obesity Management In Primary Care Medicine: A Review Of Obesity Perception And Barriers To Weight Loss, Asma Syed, Saima Siddiqui

Research Symposium

Background: This project addresses the obesity epidemic in America. According to the CDC, in 2018, the US obesity prevalence was 42.4%. Obesity is linked to many conditions including heart disease, stroke, type 2 diabetes, and certain types of cancer. Successfully treating obesity can decrease these leading causes of preventable and premature deaths. A proper understanding of the successes and failures of current obesity management in primary care medicine with the help of qualitative research through patient and provider interviews can elucidate the best practices to reduce the burden of disease in America.

Methods: A review of literature was conducted …

An Unusual Case Of Chronic Superior Mesenteric Vein Thrombosis, Ans Albustamy, Eric Sanchez, Oscar Lopez, Schamma Salomon

Research Symposium

Introduction:Intestinal ischemia can be caused by any process that reduces intestinal blood flow. Mesenteric venous thrombosis (MVT) describes thrombosis of the superior or inferior mesenteric vein, and represents approximately 10 percent of all cases of acute mesenteric ischemia. The incidence of MVT has increased over the past 40 years, likely as a result of greater use of abdominal CT, and may present with acute abdominal pain or as an asymptomatic incidental finding on abdominal imaging. We present a rare and unusual case of MVT.

Case presentation: A 42 year old female with decompensated alcoholic liver cirrhosis presented to the …

Euglycemic Diabetic Ketoacidosis With A Decompensated Hypothyroidism In The Setting Of A Recent Cerebrovascular Accident: A Case Report, Jose Gerardo Gomez Casanovas, Alfarooq Alshaikhli, Sergio Saenz, Daniela Hernandez

Research Symposium

Euglycemic diabetic ketoacidosis (EDKA) is an underdiagnosed endocrine emergency. It consists of an increased anion gap metabolic acidosis (pH < 7.3 or serum bicarbonate < 18 mmol/L), moderate ketonuria with a blood glucose levels

The Patient is a 73-year-old female with a past medical history of Diabetes Mellitus, Hypertension, Hyperlipidemia, Hypothyroidism and deafness and muteness since birth. Patient had a recent ischemic stroke 5 days prior to the admission and was admitted at a different hospital for management of her stroke. Patient left against medical advice and presented to our ED later that day complaining of rectal prolapse. Of note, the patient is non-compliant with her medications. Upon admission, she is alert, oriented, and in …

A Stomach Bug? Not What You May Think: A Case Of Post-Viral Gastroparesis Caused By Sars-Cov-2, Adrienne Anderson, Nina Shyama Appareddy, Jose Ramos, Grecia Dominguez Rivera, Robinson Pena, Jose E. Campo Maldonado

Research Symposium

Gastroparesis has a wide range of etiologies including diabetes, medications, post-surgical, post-viral and idiopathic (1). SARS-CoV-2 can cause gastrointestinal symptoms which typically resolve within the first few weeks of infection (2). However, some sequelae persist beyond the initial infectious period.

Measuring Blood Pressure In Primary Care For Accurate Diagnosis And Decision Making: Implementing Evidence-Based Protocols Across A Health System, Gertrude W. Manchester, Deirdre C. Donahue, Catarina I. Kiefe, Lori Pelletier, Marie A. Sosa, Sheri A. Keitz

The Lahey Journal

Abstract

Background: Evidence-based blood pressure (BP) measurement is required for optimal clinical decision-making while improper measurement risks daily diagnostic and therapeutic errors.

Objective: To implement and sustain an evidence-based BP measurement protocol without extra resources and disseminate the protocol across a primary care network.

Design, Setting, and Participants: A Plan-Do-Study-Act (PDSA) framework for quality improvement was used to design a standardized BP measurement protocol including a 5-minute rest period only for patients with persistently elevated blood pressure. The protocol was developed using Goldratt’s Theory of Constraints and Layers of Resistance to ensure multidisciplinary buy-in and was implemented in 3 groups …

Pca-Clf: A Classifier Of Prostate Cancer Patients Into Patients With Indolent And Aggressive Tumors Using Machine Learning, Yashwanth Karthik Kumar Mamidi, Tarun Karthik Kumar Mamidi, Md Wasi Ul Kabir, Jiande Wu, Md Tamjidul Hoque, Chindo Hicks

School of Medicine Faculty Publications

A critical unmet medical need in prostate cancer (PCa) clinical management centers around distinguishing indolent from aggressive tumors. Traditionally, Gleason grading has been utilized for this purpose. However, tumor classification using Gleason Grade 7 is often ambiguous, as the clinical behavior of these tumors follows a variable clinical course. This study aimed to investigate the application of machine learning techniques (ML) to classify patients into indolent and aggressive PCas. We used gene expression data from The Cancer Genome Atlas and compared gene expression levels between indolent and aggressive tumors to identify features for developing and validating a range of ML …

Repurposing Normal Chromosomal Microarray Data To Harbor Genetic Insights Into Congenital Heart Disease, Nephi Walton, Hoang Nguyen, Sara Procknow, Darren Johnson, Alexander Anzelmi, Patrick Jay

Department of Medicine Faculty Papers

About 15% of congenital heart disease (CHD) patients have a known pathogenic copy number variant. The majority of their chromosomal microarray (CMA) tests are deemed normal. Diagnostic interpretation typically ignores microdeletions smaller than 100 kb. We hypothesized that unreported microdeletions are enriched for CHD genes. We analyzed "normal" CMAs of 1762 patients who were evaluated at a pediatric referral center, of which 319 (18%) had CHD. Using CMAs from monozygotic twins or replicates from the same individual, we established a size threshold based on probe count for the reproducible detection of small microdeletions. Genes in the microdeletions were sequentially filtered …

Exploring Conformational Landscapes And Cryptic Binding Pockets In Distinct Functional States Of The Sars-Cov-2 Omicron Ba.1 And Ba.2 Trimers: Mutation-Induced Modulation Of Protein Dynamics And Network-Guided Prediction Of Variant-Specific Allosteric Binding Sites, Gennady M. Verkhivker, Mohammed Alshahrani, Grace Gupta

Mathematics, Physics, and Computer Science Faculty Articles and Research

A significant body of experimental structures of SARS-CoV-2 spike trimers for the BA.1 and BA.2 variants revealed a considerable plasticity of the spike protein and the emergence of druggable binding pockets. Understanding the interplay of conformational dynamics changes induced by the Omicron variants and the identification of cryptic dynamic binding pockets in the S protein is of paramount importance as exploring broad-spectrum antiviral agents to combat the emerging variants is imperative. In the current study, we explore conformational landscapes and characterize the universe of binding pockets in multiple open and closed functional spike states of the BA.1 and BA.2 Omicron …

Adjunctive Diagnostic Studies Completed Following Detection Of Candidemia In Children: Secondary Analysis Of Observed Practice From A Multicenter Cohort Study Conducted By The Pediatric Fungal Network, Rachel L Wattier, Robert F T Bucayu, Craig L K Boge, Rachael K Ross, Inci Yildirim, Theoklis E Zaoutis, Debra L Palazzi, Surabhi B Vora, Elio Castagnola, Martha Avilés-Robles, Lara Danziger-Isakov, Alison C Tribble, Tanvi S Sharma, Antonio C Arrieta, Gabriela Maron, David M Berman, Dwight E Yin, Lillian Sung, Michael Green, Emmanuel Roilides, Kiran Belani, José Romero, Pere Soler-Palacin, Eduardo López-Medina, Dawn Nolt, Ibrahim Zaid Bin Hussain, William J Muller, Sarmistha B Hauger, Natasha Halasa, Daniel Dulek, Alice Pong, Blanca E Gonzalez, Mark J Abzug, Fabianne Carlesse, Anna R Huppler, Sujatha Rajan, Catherine Aftandilian, Monica I Ardura, Arunaloke Chakrabarti, Benjamin Hanisch, Christine M Salvatore, Lena Klingspor, Elizabeth D Knackstedt, Irja Lutsar, Maria E Santolaya, Sydney Shuster, Sarah K Johnson, William J Steinbach, Brian T Fisher

Faculty, Staff and Students Publications

BACKGROUND: Adjunctive diagnostic studies (aDS) are recommended to identify occult dissemination in patients with candidemia. Patterns of evaluation with aDS across pediatric settings are unknown.

METHODS: Candidemia episodes were included in a secondary analysis of a multicenter comparative effectiveness study that prospectively enrolled participants age 120 days to 17 years with invasive candidiasis (predominantly candidemia) from 2014 to 2017. Ophthalmologic examination (OE), abdominal imaging (AbdImg), echocardiogram, neuroimaging, and lumbar puncture (LP) were performed per clinician discretion. Adjunctive diagnostic studies performance and positive results were determined per episode, within 30 days from candidemia onset. Associations of aDS performance with episode characteristics …

Differential Effects Of Pancreatic Cancer-Derived Extracellular Vesicles Driving A Suppressive Environment, Anurag Purushothaman, Jacqueline Oliva-Ramírez, Warapen Treekitkarnmongkol, Deivendran Sankaran, Mark W Hurd, Nagireddy Putluri, Anirban Maitra, Cara Haymaker, Subrata Sen

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) cells display extensive crosstalk with their surrounding environment to regulate tumor growth, immune evasion, and metastasis. Recent advances have attributed many of these interactions to intercellular communication mediated by small extracellular vesicles (sEVs), involving cancer-associated fibroblasts (CAF). To explore the impact of sEVs on monocyte lineage transition as well as the expression of checkpoint receptors and activation markers, peripheral blood monocytes from healthy subjects were exposed to PDAC-derived sEVs. Additionally, to analyze the role of sEV-associated HA in immune regulation and tissue-resident fibroblasts, monocytes and pancreatic stellate cells were cultured in the presence of PDAC sEVs …

Pet Imaging Of Microglia Using Pbr28suv Determines Therapeutic Efficacy Of Autologous Bone Marrow Mononuclear Cells Therapy In Traumatic Brain Injury, Supinder S Bedi, Michael C Scott, Max A Skibber, Akshita Kumar, Henry W Caplan, Hasen Xue, David Sequeira, Alison L Speer, Fanni Cardenas, Franciska Gudenkauf, Karen Uray, Amit K Srivastava, Alan R Prossin, Charles S Cox

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) results in activated microglia. Activated microglia can be measured in vivo by using positron emission topography (PET) ligand peripheral benzodiazepine receptor standardized uptake values (PBR28suv). Cell based therapies have utilized autologous bone marrow mononuclear cells (BMMNCs) to attenuate activated microglia after TBI. This study aims to utilize in vivo PBR28suv to assess the efficacy of BMMNCs therapy after TBI. Seventy-two hours after CCI injury, BMMNCs were harvested from the tibia and injected via tail-vein at 74 h after injury at a concentration of 2 million cells per kilogram of body weight. There were three groups of …

An Ecchordosis Physaliphora, A Rare Entity, Involving The Central Nervous System: A Systematic Review Of The Literature, Rajesh K Gupta, Thejasvi A Reddy, Ashutosh Gupta, Rohan Samant, Carlos A Perez, Anam Haque

Faculty, Staff and Student Publications

Ecchordosis physaliphora (EP) is a benign notochordal remnant, which is often an incidental finding; however, it can rarely present with neurological symptoms. We performed a systematic review of the literature for cases of symptomatic EP published in PubMed, Web of Science and Embase from January 1982 to May 2023. This is the largest review to date and revealed 60 cases including ours. Headache (55%) and CSF rhinorrhea (32%) were the most frequent clinical manifestations. The majority of symptomatic EP lesions were located in the prepontine region (77%) and required surgical resection (75%). EP should be considered in patients with neurologic …

Inhibition Of Trap1 Accelerates The Dna Damage Response, Activation Of The Heat Shock Response And Metabolic Reprogramming In Colon Cancer Cells, Nobel Bhasin, Prerna Dabral, Lakmini Senavirathna, Sheng Pan, Ru Chen

Faculty, Staff and Students Publications

BACKGROUND: Colorectal cancer (CRC) is one of the major causes of cancer-related mortality worldwide. The tumor microenvironment plays a significant role in CRC development, progression and metastasis. Oxidative stress in the colon is a major etiological factor impacting tumor progression. Tumor necrosis factor receptor-associated protein 1 (TRAP1) is a mitochondrial member of the heat shock protein 90 (HSP90) family that is involved in modulating apoptosis in colon cancer cells under oxidative stress. We undertook this study to provide mechanistic insight into the role of TRAP1 under oxidative stress in colon cells.

METHODS: We first assessed the The Cancer Genome Atlas …