Medical Pharmacology Commons^™

Circrna-Based Antimir Therapy: A Novel Approach To Hypertension Treatment, Vahideh Tarhriz, Kamran Hosseini, Leila Abkhooie, Eric Lazartigues

School of Medicine Faculty Publications

The increasing recognition of the types and functions of non-coding RNAs has opened new avenues for their use as novel therapeutic strategies in the treatment of chronic diseases such as hypertension. While most preclinical and clinical studies on hypertension focus on prognosis and treatment, there are still no specific therapeutic approaches for primary and essential hypertension. Modest efficacy and reduced long-term adherence to treatment underscore the need for novel, mechanism-based strategies to address the underlying molecular mechanisms. AntimiRs, as synthetic RNA molecules, and circular RNAs (circRNAs), as naturally occurring RNA species that function as microRNA sponges, could play a crucial …

Low Dose Aspirin Is Associated With Improved 30-And 92-Day Outcomes In Patients With Acute Pancreatitis: A Multinational Multicenter Analysis, Do Han Kim Md, Donghyun Ko Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

Currently, no medications are known to formally treat or prevent acute pancreatitis (AP). Significant attention has been devoted to aspirin (ASA), with rodent models showing that it is associated with decreased inflammatory cytokine levels and protects against acinar cell necrosis. Current human studies, which are limited to retrospective inpatient outcomes only on the index hospitalization for AP, do suggest that patients on ASA have improved outcomes. The aim of our study was to explore de 30- and 90- day outcomes of patients with AP on long-term ASA use.

Valproate Use Is Associated With Higher Mortality And Hepatic Decompensationin Patients With Masld/ Mash: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate is a widely used anti-seizure medication for treating epilepsy. However, it significantly impacts lipid metabolism by interfering with the beta-oxidation pathway of fatty acids in mitochondria. This disruption is expected to accelerate the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) in patients on chronic valproate therapy. The aim of this study is to determine whether the chronic use of valproate increases the risk of liver-related and cardiovascular events

Sglt-2 Inhibitor Use Is Associated With Lower Mortality In Patients With Alcoholic Cirrhosis And Type 2 Diabetes Mellitus: A Multinational Analysis, Do Han Kim Md, Donghyun Ko, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

In our study, we aimed to investigate whether SGLT2 inhibitors are associated with a reduced risk of all-cause mortality, liver-related events, and cardiovascular outcomes in patients with alcoholic cirrhosis and T2DM.

Valproate Use Is Associated With Lower Hepatic And Cardiovascular Outcomes When Compared To Levetiracetam In Patients With Masld/Mash: A Multinationalanalysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate and levetiracetam are commonly used to manage epilepsy. While valproate is well-documented to significantly affect lipid metabolism, less is known about the effects of levetiracetam. Given this, worse outcomes in MASLD/MASH are anticipated in patients treated with valproate.

The aim of our study is to compare hepatic and cardiovascular outcomes in MASLD/MASH patients treated with valproate versus levetiracetam.

Immune-Related Adverse Events Associated With Pembrolizumab In Dmmr/Msi-H Colorectal Cancer: A Single Arm Safety Meta-Analysis, Joshi Simran, Saman Javid, Gaurav Sharma, Corinne Caissie, Armando Dominguez-Diaz

Posters

Pembrolizumab, a PD-1 checkpoint inhibitor, enhances immune response and has proven effective against various cancers, including melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma.

Clinical trials have also shown its efficacy in treating various types of cancers with different mismatch-repair statuses. However, the spectrum and frequency of immune-related adverse events (irAEs) in the dMMR (deficient mismatch repair) / MSI-H (microsatellite instability-high) colorectal cancer remain underexplored.

Therefore, this meta-analysis aims to evaluate pembrolizumab's safety profile in this colorectal cancer subset.

A Curious Case Of Heart Failure With Reduced Ejection Fraction In A Lupus Patient, Farah Khan Md

Posters

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with cardiovascular risks, including coronary artery disease (CAD) and typically heart failure (HF) with preserved ejection (HFpEF). We report an SLE patient with ventricular arrhythmias and HF with reduced ejection fraction (HFrEF) due to myocarditis, responding positively to Guideline-Directed Medical Therapy (GDMT) for both conditions

A Review Of Praziquantel Resistance In Schistosomes And The Future Of Schistosomiasis Control, Gabriela G. Eastham

Senior Honors Theses

Schistosomiasis is a group of both acute and chronic parasitic trematode infections of the genus Schistosoma. Praziquantel (PZQ) has been the drug of choice to treat schistosomiasis for decades. Though it is effective against all three clinically relevant species, heavy reliance on PZQ has led to concerns of schistosome resistance, especially in areas that have implemented this drug in mass drug administration (MDA) programs. Although there is currently insufficient evidence to conclude that schistosomes are becoming resistant to PZQ on a large scale, other control methods are a necessity to best treat and eliminate schistosomiasis. This article summarizes the …

Combined Inhibition Of Lysine-Specific Demethylase 1 And Kinase Signaling As A Preclinical Treatment Strategy In Glioblastoma, Lea Stitzlein

Dissertations and Theses (Open Access)

Glioblastoma is the most common primary malignant brain tumor in adults, with limited treatment options resulting in a poor prognosis. Lysine-specific demethylase 1 (LSD1) is overexpressed in glioblastoma and contributes to tumor growth and treatment resistance. Inhibitors of LSD1 have shown preclinical promise but have had limited clinical development for glioblastoma. Given the frequent kinase pathway alterations in glioblastoma, the interplay between LSD1 inhibition and kinase signaling pathways was investigated to identify vulnerabilities that could be exploited through rationally designed combination therapies. We hypothesized that LSD1 inhibitors would activate kinase signaling pathways, such as MAPK, and the addition of kinase …

Pembrolizumab-Associated Acute Esophageal Necrosis: A Case Report And Literature Review, Mark Tawfik, Elie Bou Sanayeh, Stephanie Chain, Ahmed Elfiky, Stephen Mulrooney

HCA Healthcare Journal of Medicine

Background

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. They pose challenges, particularly in the form of immune-related adverse events (irAEs). Although cases of gastrointestinal irAEs have been well-documented, acute esophageal necrosis (AEN) characterized by a circumferential blackening and fragility of the esophagus, weeks after immunotherapy discontinuation, has not been reported.

Case Presentation

A 75-year-old diabetic male who was recently diagnosed with high-grade papillary urothelial cancer with liver and retroperitoneal metastases and had undergone radical cystectomy with ileal conduit urinary diversion, presented to the hospital for sepsis secondary to a urinary tract infection. While in the hospital, he experienced hematemesis, …

Diabetes Mellitus And Associated Vascular Disease: Pathogenesis, Complications, And Evolving Treatments, Kazi Islam, Rahib Islam, Ivan Nguyen, Hassan Malik, Humza Pirzadah, Barsha Shrestha, Isabella B. Lentz, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Diabetes mellitus is a metabolic disorder, characterized by elevated blood sugar levels (hyperglycemia) and insulin dysregulation. This disease is associated with morbidity and mortality, including significant potential vascular complications. High levels of hyperglycemia lead to not only elevated levels of reactive oxygen species but also advanced glycation end products, which are detrimental to the vascular endothelium and reduce protective compounds such as nitric oxide and prostacyclin. This damage contributes to the development of both macrovascular and microvascular complications. The present investigation explores the pathophysiological mechanisms of diabetic vascular complications and evaluates current management strategies, including lifestyle modifications, pharmacological treatments, and …

Diabetes: Non-Invasive Blood Glucose Monitoring Using Federated Learning With Biosensor Signals, Narmatha Chellamani, Saleh Ali Albelwi, Manimurugan Shanmuganathan, Palanisamy Amirthalingam, Anand Paul

School of Public Health Faculty Publications

Diabetes is a growing global health concern, affecting millions and leading to severe complications if not properly managed. The primary challenge in diabetes management is maintaining blood glucose levels (BGLs) within a safe range to prevent complications such as renal failure, cardiovascular disease, and neuropathy. Traditional methods, such as finger-prick testing, often result in low patient adherence due to discomfort, invasiveness, and inconvenience. Consequently, there is an increasing need for non-invasive techniques that provide accurate BGL measurements. Photoplethysmography (PPG), a photosensitive method that detects blood volume variations, has shown promise for non-invasive glucose monitoring. Deep neural networks (DNNs) applied to …

Ahr Activation At The Air-Blood Barrier Alters Systemic Microrna Release After Inhalation Of Particulate Matter Containing Environmentally Persistent Free Radicals, Ankit Aryal, Ashlyn C. Harmon, Alexandra Noël, Qingzhao Yu, Kurt J. Varner, Tammy R. Dugas

School of Public Health Faculty Publications

Particulate matter containing environmentally persistent free radicals (EPFRs) is formed when organic pollutants are incompletely burned and adsorb to the surface of particles containing redox-active metals. Our prior studies showed that in mice, EPFR inhalation impaired vascular relaxation in a dose- and endothelium-dependent manner. We also observed that activation of the aryl hydrocarbon receptor (AhR) in the alveolar type-II (AT-II) cells that form the air-blood interface stimulates the release of systemic factors that promote endothelial dysfunction in vessels peripheral to the lung. AhR is a recognized regulator of microRNA (miRNA) biogenesis, and miRNA control diverse signaling pathways. We thus hypothesized …

Safety And Efficacy Of 112 Mg Intranasal Esketamine In Patients With Treatment-Resistant Depression: A Retrospective Observational Study From Outpatient Community Clinics, Kirsten Brinkmeier, Michael Kritzer, Brandon Doan, Cecilia Li, Nicholas Mischel

Medical Student Research Symposium

This retrospective study examined the safety and efficacy of 56, 84, and 112 mg intranasal (IN) esketamine via medical record review of 24 patients with treatment resistant depression (TRD). Doses ranged from 56 mg to 112 mg and were titrated across sessions to maximize individual response while considering tolerability. Treatment response was defined by reduction in average Patient Health Questionnaire-9 (PHQ-9) scores. Tolerability was defined by blood pressures at baseline, 40 minutes after, and 2 hours after drug administration. Patients ranged from 19 to 60 years old (average 38.87), and 15 (62.5%) were female. Patients received an average of 1 …

Prevalence And Trends Of Polypharmacy Among U.S. Adults On Statin, 1999–2018, Mohamed A. Badheeb, Riyadh Saif Md, Ibrahim Hassan Md, Mostafa Elbanna Md, Shady Abohashem Md

Posters

Polypharmacy is increasing among cardiovascular patients, but national data on trends in statin users are limited. This study evaluated polypharmacy prevalence and trends among U.S. adults on statins, focusing on differences by age, gender, race/ethnicity, education, poverty, insurance, and statin adherence.

Single Dose Nivolumab And Ipilimumab Treatment Causing Complete And Durable Response In Extensive Stage - Small Cell Lung Cancer Complicated By Severe Sensory Autoimmune Neuropathy, Aaron Lobo Md, Nur Rahman Md, Nicholas Blondin Md, Neal Fischbach

Posters

The use of immune checkpoint inhibitors (ICI) in recent years has increasingly emerged as a second-line treatment in the management of extensive-stage small cell lung cancer (ES-SCLC) compared to conventional chemotherapy alone.

The use of combined ICI therapy by inhibiting two distinct pathways in patients with ES-SCLC has been evaluated in clinical trials. The increase incidence of immune related adverse events (Ir-AE) in these trials due to excessive immune system activation or multiple organ disorders has posed serious clinical challenges.

Here we report a dramatic and durable response to combined immune checkpoint blockade without chemotherapy and discuss the relationship between …

A Preliminary Analysis Of Transaminitis Observed In Oxandrolone Versus Testosterone Therapy In Major Burn Injury, Alexandra Dewitt, Athena Hoppe, Anastasiya Ivanko, Victoria Miles

School of Medicine Faculty Publications

57th Annual Meeting of the American Burn Association, ABA 2025, April 8 - 11, 2025, Phoenix, AZ

Unlocking Precision Using K-Means++- Improved Genetic Algorithm-Radial Basis Function Neural Network: Data-Driven Evolution Of Smart Gloves For Gesture Recognition, Liang Xiao Ding, Kuan Way Chee, Hong Lü, Anand Paul, Jeonghong Kim, Jang Myung Lee

School of Public Health Faculty Publications

Human-computer interaction technologies have been used since the 1970s but have only gained growing popularity in recent years with new design paradigms. Ongoing research and development in gesture recognition systems with broad application prospects have focused on improving accuracy and real-time performance as well as the robustness of specific machine learning algorithms against environmental conditions. This paper addresses the accuracy enhancement of a novel Fifth Dimension Technologies data-glove-based gesture recognition system using a genetic-algorithm (GA)-trained k-means++-improved radial basis function (RBF) or GK-RBF neural network. First, we analyzed and modeled the sensor distribution in the data glove and proposed joint constraints …

A Deep Sparse Capsule Network For Non-Invasive Blood Glucose Level Estimation Using A Ppg Sensor, Narmatha Chellamani, Saleh Ali Albelwi, Manimurugan Shanmuganathan, Palanisamy Amirthalingam, Emad Muteb Alharbi, Hibah Qasem Salman Alatawi, Kousalya Prabahar, Jawhara Bader Aljabri, Anand Paul

School of Public Health Faculty Publications

Diabetes, a chronic medical condition, affects millions of people worldwide and requires consistent monitoring of blood glucose levels (BGLs). Traditional invasive methods for BGL monitoring can be challenging and painful for patients. This study introduces a non-invasive, deep learning (DL)-based approach to estimate BGL using photoplethysmography (PPG) signals. Specifically, a Deep Sparse Capsule Network (DSCNet) model is proposed to provide accurate and robust BGL monitoring. The proposed model’s workflow includes data collection, preprocessing, feature extraction, and predictions. A hardware module was designed using a PPG sensor and Raspberry Pi to collect patient data. In preprocessing, a Savitzky–Golay filter and moving …

Long-Term Neurocognitive And Behavioral Outcomes In Survivors Of Pediatric Brain Tumors: A Systematic Review, Tori Sayers, Megan W. Szobody, Nina Mourao, Blake C. Martin, Sriya Gullapalli, Kory Punch, Tirath Patel, Murali Yallapu, Bharathi Shrikanth Gadad

Research Symposium

Background: Pediatric populations have an increased susceptibility for brain tumors and suffer from neurocognitive impairment due to the neoplasm itself, and side effect of subsequent treatments. This causes many patients to experience a subpar quality of life (QoL), affecting academic endeavors, social interaction and mental well-being. Increasing our understanding of the long-term effects associated with brain tumors and the side effects from our current treatment methodology will help us formulate better treatment protocols and improve survivors’ QoL. This review aims to investigate different long-term neurocognitive and behavioral outcomes in pediatric brain tumor survivors, as well as evaluate how various treatment …

An Endocrine Enigma: The Implications Of Pembrolizumab Therapy, Miguel A. Lopez, Mario Trujillo Acosta, Jose Romero Villarreal Calderon, Laura Garcia

Research Symposium

Disorders of the endocrine system are a potential complication of cancer treatment despite newer immunotherapy agents holding promise to improve patient outcomes. Breast cancer in particular requires pharmacologic intervention based on the receptor positivity. For example, a triple negative workup often requires neoadjuvant therapy with the newer immunotherapy agent pembrolizumab. Clinicians should be aware of the potential adverse effects of this drug, most notably adrenal insufficiency. This case follows a 52 year old hispanic female patient with a history of triple negative left sided breast cancer on immunotherapy with pembrolizumab, who presented to the emergency department after a syncopal episode …

In-Silico Modeling And Characterization Of Kcc2 Protein Interaction With A Small Molecule Direct Agonist Identifies Potential Binding Sites For Modulating Behaviors Associated With Substances Of Abuse, William Hai Dang Ho, Alfred Amendolara, Kenyon Mitchell, Jaden Miner, Ruth Northcott, Braxton Bingham, Andrew J. Payne

Annual Research Symposium

Purpose

KCC2 is a potassium-chloride cotransporter that plays a critical role in neuronal function by regulating GABAergic signaling via chloride gradients. Maintaining this concentration gradient is crucial for balancing excitation and inhibition in the brain. While KCC2 dysregulation has been implicated in epilepsy and seizures, recent studies suggest that KCC2 inhibition results in phenotypes mirroring those seen in chronic opioid dependence. As such, increasing evidence support KCC2 being a potential therapeutic target for modulating behaviors associated with substances of abuse. Currently, only a few direct small molecule agonists against KCC2 have been reported, and no definitive active site on the …

Investigating The Impact Of Tirzepatide Treatment On Alcohol And Cigarette Consumption, Yvannia Gray, Benjamin Latey, Hayden Mcaffee, Karissa Mccown, Seth Maki, Victoria Nguyen, Andrew Payne

Annual Research Symposium

No abstract provided.

Effect Of Vitamin K Supplementation On Insulin Resistance: A Review, Samantha Mccord, Rebecca Willier, Kaitlyn Kirby, Kaylin Mahoney, Lance Dillon, Rileigh Rahrig, Brianna Lu, Joshua Honaker, Emily Eddy

Pharmacy and Wellness Review

Insulin resistance is one of the pathological hallmarks that leads to the development of type II diabetes mellitus (T2DM). Around 40% of people aged 18 to 44 living in the United States have insulin resistance. Recent research, coupled with a better understanding of how vitamin K functions in the body, suggests that this vitamin could potentially help reduce insulin resistance. Vitamin K is not included in the American Diabetes Association (ADA) guidelines for the treatment of insulin resistance, but it has been shown to have some benefits in patients with T2DM. It may also serve as a treatment option for …

The Application And Innovation Of Casgevy On Sickle Cell Disease, Emily Tackett, Le Thien Truc Pham, Hannah Salamie, Arin Wade, Allison Provenzale, Alexander Defranco, Ashley Jacob, Brianna Lu, Joshua Honaker, Amy Stockert

Pharmacy and Wellness Review

Casgevy, sickle cell anemia, SCA, sickle cell disease, SCD, CRISPR/Cas9, hydroxyurea, hemoglobin, Hb, l-glutamine, voxelotor, Crizanlizumab, Lyfgenia, stem cells, genetics, pharmacogenetics, pharmacogenomics

Poor Birth Outcomes Related To Cannabis Use In Pregnancy, Reese Weissenfluh, Madison Hall, Branden Kadlubowski, Makayla Eversole, Elizabeth Clary, Layla Dials, Brenna Hissong, Brianna Lu, Joshua Honaker, Manoranjan D'Souza

Pharmacy and Wellness Review

Pregnancy, a period of dynamic physiological changes, necessitates careful consideration of external influences on maternal and fetal health. Despite increasing legalization and prevalence, the impact of cannabis use during gestation remains a topic of significant concern and investigation.

Recent studies have shed light on the consequences of in utero cannabis exposure, encompassing both fetal and maternal outcomes. Notably, several studies have identified associations between cannabis exposure during pregnancy and adverse fetal outcomes, including small-for-gestational-age birth, altered neurodevelopment, preterm birth, and increased risk of neonatal morbidity. Evidence to date underscores the urgent need for education, intervention, and regulatory oversight regarding cannabis …

Improving Vitamin B12 Monitoring In Metformin-Treated Patients: A Quality Improvement Project, Himal Kharel, Zeni Kharel, Abdullah A. Orakzai, Aditya Sanjeevi, Prajjwol D. Bhatta, Ali S. Mohamed, Tripti Jain, Aniket-Vijay Rao, Daniel Idoate Domench, Mouna Reghis, Hassan Saeed

Advances in Clinical Medical Research and Healthcare Delivery

Background: Although periodic vitamin B12 monitoring is recommended for patients on chronic metformin therapy, the recommendation is not adequately followed. Similar quality improvement project in the past had failed due to ongoing COVID-19 pandemic.

Objectives: The main objective of this study is to evaluate the impact of focused educational lectures on vitamin B12 screening rates. Our target study population included diabetics and prediabetics on chronic metformin therapy.

Design: Quality improvement pre-post design

Participants: Internal Medicine residents

Intervention: Educational sessions on the importance of vitamin B12 screening in this population

Outcomes: Proportion of patients undergoing vitamin B12 screening pre and post-intervention …

Evaluation Of Hyponatremia Management Pathway, Mahmoud Ammar Pharmd, Jonathan M. Siner, Mary Judson, Christopher Winterbottom

Abstracts

Society of Critical Care Medicine's (SCCM) 2025 Critical Care Congress:

Evaluation of Hyponatremia Management Pathway Implementation in a Large Academic Health System

Submission Number: 1894079

Patients with severe hyponatremia managed using the Care Signature pathway were more likely to receive hypertonic saline and had lower mortality rates compared to those not managed with the pathway. These results suggest that the pathway can improve clinical outcomes and reduce resource use. Further studies are needed to evaluate its impact on other patients’ outcomes and long-term effectiveness.

The Mitochondria As An Emerging Target Of Self- Renewal In T-Cell Acute Lymphoblastic Leukemia, Majd Al-Hamaly, Evelyn Winter, Jessica S. Blackburn

Markey Cancer Center Faculty Publications

Acute lymphocytic leukemia (ALL) is the most common leukemia in children, with the T-cell subtype (T- ALL) accounting for 15% of those cases. Despite advancements in the treatment of T-ALL, patients still face a dismal prognosis following their first relapse. Relapse can be attributed to the inability of chemotherapy agents to eradicate leukemia stem cells (LSC), which possess self-renewal capabilities and are responsible for the long-term maintenance of the disease. Mitochondria have been recognized as a therapeutic vulnerability for cancer stem cells, including LSCs. Mitocans have shown promise in T-ALL both in vitro and in vivo, with some currently in …

Real-World Satisfaction And Experience With Injection And Autoinjector Device For Ofatumumab Indicated For Multiple Sclerosis., Amy Perrin Ross, Jacqueline Nicholas, Ming-Hui Tai, Stephen Yeung, Nazneen Fatima Shaikh, Helen Chen, Mariana Fernandes, Aaron Cortright, Kevin Hawkins

Neuroscience Articles

BACKGROUND: To evaluate the overall satisfaction, device usability, and injection experience of MS patients self-administering ofatumumab using the Sensoready

METHODS: This US-based, cross-sectional survey study included patients with MS (≥ 18 years) who self-administered ofatumumab using the Sensoready device within the previous 12 months of the survey. Eligible patients were administered a 30-item de novo questionnaire that focused on overall device satisfaction, device usability, convenience/flexibility for travel with the device, user confidence, injection experience, and time to administer the injection. Ratings were measured on Likert and numeric rating scales, with higher scores indicating positive responses.

RESULTS: Overall, 105 patients with …