Medical Specialties Commons^™

Spindle-Cell Mesothelioma Arising From The Right Pleura: A Case Report And Review Of The Literature, Duc Khiem Ngo, Karina Torres, Sobia Hassan Memon, Carlos T. Ramos Jr.

Research Symposium

Background: Spindle cell mesothelioma, or Sarcomatoid mesothelioma, is a rare and insidious type of malignant mesothelioma with a high mortality rate. It arises from mesothelial surfaces of the pleural cavity, peritoneal cavity, tunica vaginalis, or pericardium, and it is usually associated with asbestos exposure. Spindle cell mesothelioma could be challenging to treat because most patients have advanced disease at presentation with an average prognosis of six months. In this case report we present a rare case of spindle-cell mesothelioma arising from the right pleura.

Case presentation: An 82-year-old male with a history of atrial fibrillation and coronary artery disease, status …

Delayed Management Of Pfo After Stroke Presentation In A Healthy Hispanic Female, Diana Othon Martinez, Barbara Malaga-Espinoza, Nestor Gerardo Astorga, Vamsikalayan Borra, Roque Mifuji

Research Symposium

Background: Strokes are a leading cause of long term disability. Around 800,000 people in the USA have a stroke every year. (CDC) 25% of the population have a Patent foramen ovale (PFO). Stroke in the presence of PFO has been described to be found in up to 40% of patients with “embolic stroke of undetermined source”, otherwise known as cryptogenic strokes. Despite the aforementioned prevalence, there is mixed data on PFO management options. Current management guidelines include dual anti-platelet therapy, anticoagulants, and percutaneous transcatheter closure. Some studies suggest that PFO might be an incidental finding in patients with cryptogenic stroke. …

Navigating The Viral Maze: A Twisted Tale Of Ebv-Induced Autoimmune Hemolytic Anemia With Hepatitis, Blesset Alexander, Mery Bartl, Alfarooq Alshaikhli, Michelle Lopez

Research Symposium

Background: Epstein Barr Virus (EBV) is a widely disseminated virus known to cause infectious mononucleosis and a range of associated conditions. Autoimmune hemolytic anemia (AIHA) is a rare complication of EBV infection, with only a small percentage of cases reported in the literature. We present a unique case of a young female patient with a complex autoimmune pattern, later found to be associated with EBV.

Case Presentation: A 22-year-old Hispanic female with no past medical history presented to the Emergency Department with generalized weakness, nausea, left upper quadrant pain, and jaundice progressing for one week. Physical examination revealed scleral icterus, …

Hemophagocytic Syndrome, Radhika Mehta, Bareera Akhtar

Research Symposium

Background: Hemophagocytic syndrome is a rare and potentially fatal disorder characterized by abnormal immune activation leading to multiorgan dysfunction. Although genetic mutation is the most common cause in the pediatric population, adults often present with HPS secondary to infection, autoimmune disease or malignancy. Hodgkin’s lymphoma is a type of lymphoma characterized by Reed Sternberg cells. HL can cause various complications including hemophagocytic syndrome. This is a case of a 22-year-old male with incidental pancytopenia and jaundice, found to have Hodgkin’s lymphoma and hemophagocytic syndrome.

Case Presentation: A 22-year-old male with no significant past medical history presented to the Emergency Department …

Anaphylaxis After Avocado Ingestion In A Patient Located In The Rio Grande Valley, Eric Sanchez, Andreina Baird Borja, David London, Daniela Hernandez, Jose Gomez Casanovas

Research Symposium

Background: The avocado is an integral part of the Tex-Mex cuisine, especially in the Rio Grande Valley. Cases of severe anaphylactic reaction related to avocado mostly occur with previous history of latex-sensitization, also known as "latex-fruit syndrome," rather than caused by avocado alone. One of the major identified avocado allergens is the protein Prs a 1, a chitinase that helps the plant for protection and has cross-reaction with natural rubber latex allergens. According to the most recent national survey done in 2014, the prevalence of anaphylaxis in the United States ranged from 1.6% to 5.1%. Food reactions accounted as the …

Hiding In Plain Sight: Renal Cell Carcinoma Due To Suspected Von Hippel-Lindau Syndrome, Eric Sanchez, Andreina Baird Borja, Jose Gomez Casanovas, Alcibiades Fleires, Daniela Hernandez

Research Symposium

Background: Von Hippel-Lindau (VHL) is a hereditary autosomal dominant disease that affects several organs, characterized by the presence of cysts and tumors, more commonly associated with the central nervous system, eyes, and visceral organs. Prevalence in the US is estimated to be 1 per 30,000.

In this case, we present a 31 year old male from an underserved population in the Rio Grande Valley, presenting with multiple cerebellar and visceral lesions. The rarity of genetic disorders proves to be a diagnostic and management challenge.

Case Presentation: The case is about a 31 year old male with no apparent past medical …

Oncoplastic Nipple Sparing Mastectomy And Immediate Reconstruction In Non-Ideal Candidates, Aaron I. Dadzie, Paul Berry

Research Symposium

Background: Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). In satisfactory surgical candidates, this procedure allows for superior aesthetic outcomes compared to other mastectomy techniques and minimizes the need for additional procedures to reconstruct the nipple. Here, we summarize the established treatment standards and suggest an expansion of the established surgical techniques and selection criteria of NSM …

Ampullary Carcinoma In A Veteran With Exposure To Agent Orange, Eunbee Cho, Shreel Patel, Roy Subash Kondapavuluru

Research Symposium

Introduction: Agent Orange(2,3,7,8-Tetrachlorodibenzo-p-dioxin), also referred to as “dioxin”, is a herbicide, extensively used during the Vietnam War. It is proven to be associated with various types of cancers, including chronic B-cell leukemias, Monoclonal gammopathy of undetermined significance(MGUS), Non-Hodgkin’s and Hodgkin’s lymphoma, as well as diseases such as diabetes mellitus type II and Parkinson’s disease. Primary ampullary carcinoma is a rare cancer of the gastrointestinal tract, with an incidence of 4 to 10 cases per million population. They can occur sporadically or in the setting of a hereditary syndrome. The etiology of sporadic ampullary tumors remains uncertain. Here, we present a …

Hodgkin's Lymphoma-Associated Thoracic Central Venous Obstruction, Eunbee Cho

Research Symposium

Introduction: Hodgkin's lymphoma is a malignancy of the lymphatic system characterized by the presence of Reed-Sternberg cells. B symptoms, lymphadenopathy of the cervical and/or supraclavicular nodes, and mediastinal mass are some common initial clinical manifestations of Hodgkin’s lymphoma. This abstract presents a case study of a 33-year-old man diagnosed with type IV classic type nodular Hodgkin’s lymphoma who presented with brachiocephalic vein compression, resulting in left chest wall edema. This case highlights the importance of recognizing and investigating uncommon presentations of Hodkin's lymphoma to ensure timely diagnosis and management.

Case: A 33-year-old man without significant past medical history presented with …

Hape (High-Altitude Pulmonary Edema) - Hiking Trip From Texas To Colorado Turns Into Nightmare, Eunbee Cho, Jessica Marcela Daza, Shakirat Ganiyu

Research Symposium

Introduction: High-altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that typically occurs in lowlanders who ascend rapidly to altitudes greater than 2,500 meters to 3,000 meters (8,200 feet to 10,000 feet) above sea level. Risk factors for developing HAPE include a history of high altitude illness, rapid ascent without acclimatization, and comorbidities that impair ventilation or respiration. The southern part of Texas is one of the regions with the lowest altitude in the United States. It has proximity to Colorado, well known for its Rocky Mountain National Park, with elevations from 7,890 feet to 14,259 feet. This case presents …

A Systems Biology Approach Unveils A Critical Role Of Dpp4 In Upper Gastrointestinal Cancer Patient Outcomes, Sudhir Kotnala, Anupam Dhasmana, Swati Dhasmana, Shafiul Haque, Murali Yallapu, Manish Tripathi, Meena Jaggi, Subhash Chauhan

School of Medicine Publications

Gastrointestinal (GI) cancers comprise of cancers that affect the digestive system and its accessory organs. The late detection and poor prognosis of GI cancer emphasizes the importance of identifying reliable and precise biomarkers for early diagnosis and prediction of prognosis. The membrane-bound glycoprotein dipeptidyl-peptidase 4 (DPP4), also known as CD26, is ubiquitously expressed and has a wide spectrum of biological roles. The role of DPP4/CD26 in tumor progression in different types of cancers remains elusive. However, the link between DPP4 and tumor-infiltrating cells, as well as its prognostic significance in malignancies, still require further investigation. This study was intended to …

Nonalcoholic Fatty Liver Disease, Liver Fibrosis, And Structural Brain Imaging: The Cross-Cohort Collaboration, Galit Weinstein, Adrienne O'Donnell, Stefan Frenzel, Tian Xiao, Amber Yaqub, Pinar Yilmaz, Robert J. De Knegt, Gladys E. Maestre, Debora Melo Van Lent, Michelle Long

School of Medicine Publications

Background and purpose

Prior studies reported conflicting findings regarding the association of nonalcoholic fatty liver disease (NAFLD) and liver fibrosis with measures of brain health. We examined whether NAFLD and liver fibrosis are associated with structural brain imaging measures in middle- and old-age adults.

Methods

In this cross-sectional study among dementia- and stroke-free individuals, data were pooled from the Offspring and Third Generation cohorts of the Framingham Heart Study (FHS), the Rotterdam Study (RS), and the Study of Health in Pomerania. NAFLD was assessed through abdominal imaging. Transient hepatic elastography (FibroScan) was used to assess liver fibrosis in FHS and …

Higher Procedural Volumes Are Associated With Faster Treatment Times, Better Functional Outcomes, And Lower Mortality In Patients Undergoing Endovascular Treatment For Acute Ischemic Stroke, Raul G. Nogueira, Diogo C. Haussen, Eric E. Smith, Jie-Lena Sun, Ying Xian, Brooke Alhanti, Rosalia Blanco, Brian Mac Grory, Mohamed F. Doheim, Ameer E. Hassan

School of Medicine Publications

Objective We aimed to characterize the association of hospital procedural volumes with outcomes among acute ischemic stroke (AIS) patients undergoing endovascular therapy (EVT).

Methods This was a retrospective, observational cohort study using data prospectively collected from January 1, 2016, to December 31, 2019, in the Get With The Guidelines-Stroke registry. Participants were derived from a cohort of 60,727 AIS patients treated with EVT within 24 hours at 626 hospitals. The primary cohort excluded patients with pretreatment NIHSS6 hours, and inter-hospital transfers. There were two secondary cohorts: (1) EVT metrics cohort: excluded patients with missing data on time from door-to-arterial-puncture; (2) …

Use Of A Borate-Based Bioactive Glass Martix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi V. Dove, Connor Krolikowski

School of Podiatric Medicine Publications

Hardware exposure is a challenging complication following foot and ankle surgery due to the high risk of infection, biofilm formation, and delayed healing. In two consecutive cases, the bioactive glass matrix combined with particulate micromatrix successfully eradicated the wound infection and biofilm, resulting in full granulation of the wound and successful wound closure. Here we present a novel bioactive glass matrix that successfully managed exposed hardware in an infected foot, providing a promising treatment strategy for managing these complications and preventing further morbidity.

Postoperative Antibiotics For Diabetic Patients With Complicated Appendicitis, Bill D. Pope Iii, Alejandro J. Candil

MEDI 9331 Scholarly Activities Clinical Years

This retrospective study, conducted at Valley Baptist Medical Center from March 14, 2020, to December 3, 2023, explores the impact of postoperative antibiotics on diabetic patients with complicated appendicitis. Out of 494 appendectomy patients, 17 diabetic patients with complicated appendicitis were analyzed. Of these, 15 received postoperative antibiotics, with 2 developing infections (13%), while the 2 did not receive postoperative antibiotics and remained infection-free. The study acknowledges limitations in sample size and the subjective nature of defining complicated appendicitis. These findings contribute to ongoing discussions on postoperative antibiotic practices, particularly in diabetic patients with complicated appendicitis.

Public Perceptions Of Peripheral Nerve Surgery On Social Media: A Narrative Review, Nicholas Obias, James Hughes

School of Podiatric Medicine - Student Research

Objective: The intent of this study is to conduct a Narrative review of the Public Perceptions of Peripheral Nerve Surgery on Social Media.

Introduction: Peripheral nerve surgery is an effective therapeutic modality for difficult diagnoses such as peripheral neuropathy, neuromas, and complex regional pain syndrome. This study aims to explore public perceptions of peripheral nerve surgery on Instagram, a popular social media site. Information on posts such as authorship, relevance, accuracy, and purpose were collected. Conclusions from this study may direct efforts to enhance medical advice and improve patient education for extremity nerve surgeons.

Methods: Searches were conducted in September …

Comparative Effect Of Zoledronic Acid, High Glucose Levels, And Oxidative Stress On Macrophage Viability, Bryan Liu, Denae Cantu, Deborah Seixas, Cláudia Cristina Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Zoledronate (Zol) is an antiosteoclastic drug widely utilized for osteoporosis and bone metastases, and it may be used off-label for managing diabetic Charcot neuroarthropathy¹. Since macrophages share common precursors with osteoclasts, their function may also be affected by Zol. Herein, we hypothesize that Zol impairs macrophage responses, potentially hindering their viability and host defense in diabetic conditions.

Methodology: Raw 264.7 macrophages were seeded at 2.5 x 10³ in 96-well plates for viability assays. Cells were tested under normal glucose (25 mM), high glucose (ranging from 45 to 70 mM), and high oxidative stress (ranging …

Energy Expenditure In Partial-Foot Amputees With Diabetes: A Scoping Review, Nicholas Obias, Madeleine G. Mehaffey, Amanda Killeen

School of Podiatric Medicine - Student Research

Objective: The energy cost of walking in amputees is often cited in modern scientific literature and clinical rationales for determining amputation levels. However, many referenced papers do not study diabetic populations with partial foot amputations (PFAs) – relatively widespread conditions in podiatric patient populations. Commonly cited papers include Waters (1976), which is significantly dated, Goktepe (2010), which studies traumatic PFAs in a military academy, and Jeans (2011), which studies traumatic PFAs in pediatric populations. These papers do not study diabetic populations and PFAs specifically. We hoped to find a study population more reflective of diabetic patients with PFAs.

Methods: …

Do We Need Another Frame? A Scoping Review On External Fixator Reuse, Nicholas Obias, James Hughes, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

Statement of Purpose: External fixators in the United States are sold as single-use devices. Though their efficacy is well documented, they remain underutilized due to expense. The aim of this study is to determine if it is safe to reprocess and reuse external fixator components to lower the cost burden of surgeries using external fixation.

Introduction: External fixation is a critical but costly modality for upper and lower limb pathologies, such as trauma, deformity correction, and nonunion. Despite the clinical effectiveness of external fixation using delta, ilizarov, and hexapod frames, its application in the United States as a single-use device …

Amniotic Graft Applications On A Healthy Elderly Patient With Neglected Chronic Wound Due To Trauma, Maya D. Kaafarani, Brittney White, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: AM grafts are angiogenic, anti-inflammatory, anti-fibrotic, anti-microbial, non-immunogenic, and decrease the total time for complex, chronic wounds to heal. This poster will explore a single case study using an AM graft on an elderly male with a chronic wound and provide a brief overview of the general application of AM in chronic wounds.

Case Report: A healthy 92-year-old male sustained a traumatic wound to the dorsum of his foot after dropping a heavy welding torch. The wound was chronically neglected and progressed to tendons before he was taken in for evaluation and treatment. Through a series of amniotic …

Bridging Bone Health: Osteoporosis Disparities In The Rio Grande Valley, Ryan P. Bialaszewski, John M. Gaddis, Blake Martin, Philippe J. Dentino, John Ronnau

School of Medicine Publications

Introduction: Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine …

Point-Of-Care Ultrasound For The Diagnosis Of Frequent Cardiovascular Diseases: A Review, Ernesto Calderon Martinez, Edna Diarte, Diana Othon, Leonardo Rodriguez Reyes, Daniel A. Aguirre Cano, Carolina Cantu Navarro, Maria G. Ycaza, David Arriaga Escamilla, Jinal Choudhari, George Michel

School of Medicine Publications

Point-of-care ultrasound (POCUS) has emerged as an indispensable diagnostic tool in cardiology, particularly within the emergency department. This narrative synthesis provides a comprehensive exploration of POCUS applications in cardiovascular diseases, elucidating its multifaceted roles and addressing challenges. The review delves into the technical attributes of POCUS, emphasizing its noninvasive nature, radiation-free qualities, and suitability for non-radiologists. It navigates through educational strategies, stressing the importance of structured programs for the seamless integration of POCUS into clinical practice. Highlighting its efficacy, the synthesis discusses POCUS applications in various scenarios such as dyspnea, chest pain, cardiac arrest, aortic dissection, pericardial effusion, and pulmonary …

Rare Presentation Of Postpericardiotomy Syndrome After Left Atrial Myxoma Removal, Jessy Feng, Shyama Appareddy, Yaman Gibran, Aryana Garza, Jacqueline Luevano, Gustavo Garcia

School of Medicine Publications

Postpericardiotomy syndrome (PPS) is a known complication of cardiac valve surgery, but it has not been commonly reported as a postoperative complication of cardiac myxoma removal. A 78-year-old female with hypertension and atrial fibrillation presenting with angina was found to have a large left atrial myxoma (7.5 cm × 4.4 cm). The myxoma was resected; however, 1-week postoperation hemoglobin and blood pressure decreased with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Limited transthoracic echocardiogram (TTE) showed moderate pericardial effusion, confirming the diagnosis of PPS. This case highlights the importance of monitoring patients postremoval of myxoma for symptoms of …

Aged And Induced-Premature Ovarian Failure Mouse Models Affect Diestrus Profile And Ovarian Features, Ana Carolina Zucon Bacelar, Nataira Regina Momesso, Felipe Haddad Martim Pederro, Alaíde Gonçalves, Edilson Ervolino, Antonio Hernandes Chaves-Neto, Cláudia Cristina Biguetti, Mariza Akemi Matsumoto

School of Podiatric Medicine Publications

Sex hormones exert a wide influence on several systems of the human body, especially in women, who undergo intense changes in the trans and postmenopausal periods. Different experimental models are used to mimic these conditions; however, the impact on hormonal profile may be different. This study aimed to analyze and compare vaginal cytology of different post-estropausal mice models, along with their microscopical ovarian features. Forty-six C57BL/6J female mice with the ages of 4, 6 and 18 months at the beginning of the experiment, weighing about 25–28 grams, constituted five groups: NC–(negative control) animals with no treatment, OVX-SHAM—sham ovariectomized, OVX–ovariectomized, VCD–medicated …

From The Borders Edge To The Brink Of Death: A Case Of A Traumatic Pancreatic Injury And Whipple Procedure In The Rio Grande Valley, Valentine S. Alia, Ed W. Alvarado, Edward M. Diaz, Daniel Albo, Roger Galindo

School of Medicine Publications

The traumatic pancreatoduodenectomy, also known as the traumatic Whipple, is a specialized surgical procedure often reserved for extreme cases in which an individual suffers traumatic injuries to the pancreas, duodenum, or periampullary structures. Traditionally, a Whipple procedure is a complex surgery involving the removal of the head of the pancreas, duodenum, and a portion of both the bile duct and stomach, for the management of pancreatic head cancer. In underserved communities where limited access to healthcare is coupled with a higher incidence of trauma, the lack of specialized and supportive care for patients suffering from pancreatic injuries may lead to …

Preoperative Serum Albumin And Other Risk Factors Related To 30-Day Postoperative Complications In Total Ankle Arthroplasty, Jeffrey T. Bowcutt, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

This study investigates effects of preoperative albumin on 30-day TAA outcomes. Additionally, other preoperative risk factors are addressed, including American Anesthesia Society (ASA) class, functional status, chronic obstructive pulmonary disease (COPD), diabetes, smoking status, time of operation, and age. Outcomes assessed were readmission, return to operating room, surgical site infection, wound dehiscence, and total length of stay (TLOS). Data was extracted from the National Surgical Quality Improvement Program database. Bivariate comparisons were analyzed using correlation coefficients, t tests, or chi-squared tests; multivariate comparisons used linear or logistic regression. Our data showed no significant correlation between serum albumin and patients with …

A Model Of Immediate Implant Placement To Evaluate Early Osseointegration In 129/Sv Diabetic Mice, Cláudia Cristina Biguetti, Alexandra Arteaga, Bhuvana Lakkasetter Chandrashekar, Evelin Rios, Ryan Margolis, Danieli C. Rodrigues

School of Podiatric Medicine Publications

Purpose: To analyze the process of early oral osseointegration of titanium (Ti) implants in diabetic 129/Sv mice through microCT and histologic and immunohistochemical analysis.

Materials and methods: A group of 30 male 129/Sv mice was equally subdivided into two groups: (1) nondiabetic (ND), in which mice did not undergo systemic alterations and received a standard diet, and (2) diabetic (D), in which mice were provided a high-fat diet from the age of 6 weeks until the conclusion of the study and received two intraperitoneal (IP) injections of streptozotocin (STZ) at a concentration of 100 mg/Kg each. Each mouse underwent extraction …

Revolutionizing Fracture Fixation In Diabetic And Non-Diabetic Rats: High Mobility Group Box 1-Based Coating For Enhanced Osseointegration, Alexandra Arteaga, Cláudia Cristina Biguetti, Bhuvana Lakkasetter Chandrashekar, Javier La Fontaine, Danieli C. Rodrigues

School of Podiatric Medicine Publications

Chronic inflammation and hyperglycemia in diabetic patients increase the risk of implant failure and impaired fracture healing. We previously developed and characterized a titanium (Ti) coating strategy using an imidazolium-based ionic liquid (IonL) with a fully reduced, non-oxidizable High Mobility Group Box 1 (HMGB1) isoform (Ti-IonL-HMGB1) to immunomodulate tissue healing. In this study, we used an open reduction fracture fixation (ORIF) model in non-diabetic (ND) and diabetic (D) rats to further investigate the effectiveness of this Ti-IonL-HMGB1 coating on orthopedic applications. Ninety male Lewis rats (12–15 weeks) were divided into D (n = 45) and ND (n = …

Using Plastinated Cadaveric Models For Anatomical Study Of Dorsalis Pedis Artery And Its Variation, Steven Bolton, Ifunanya Monube, Hooman Tabatabai-Mir

School of Podiatric Medicine - Student Research

The dorsalis pedis artery is a main artery of the dorsum of the foot. It directly arises from the anterior tibial artery and travels distally to the base of the 1st metatarsal. Its main function includes supplying oxygenated blood to the dorsal surface of the foot. A weak dorsalis pedis pulse is an indication of underlying circulation issue, such as peripheral vascular disease. Anatomical variations of the artery are not uncommon, including the total absence of the artery. Branching variations occur in approximately 10% of the population. Knowledge of these variations is critical for surgeons to prevent surgical complications

Limited Clinical Utility Of Routine Mycobacterial Cultures For The Management Of Diabetic Foot Infections, Laila M. Castellino, Clare Mccormick-Baw, Tyler Coye, Peter A. Crisologo, John J. Hanna, Francesca Lee, Andrew Clark, Michael Fanning, Amanda L. Killeen

School of Podiatric Medicine Publications

Mycobacterial infections of the foot and ankle are uncommon. In a cohort of 2340 patients with diabetic foot infection (DFI) in a region with increased prevalence of mycobacterial disease, we identified no clinically significant positive cultures over a 3-year period. Routine mycobacterial culture of DFIs is of limited clinical utility.