Medical Specialties Commons^™

Pumping Iron - How Do Race And Gender Affect The Risk Of Anemia In A Cohort Of Predominantly Hispanic Heart Failure (Hf) Patients Seen In A Community Hospital In The Rio Grande Valley (Rgv)?, Michael Lapelusa, Andrea M. Cordero-Reyes, Francisco Avellan, Daniella Concha, Laura Garcia, James Hanley

School of Medicine Publications

Introduction Anemia in patients with heart failure (HF) is common. Data reported shows a variable prevalence ranging from 10-40%. Additionally, it has also been demonstrated that it is associated with poor outcomes. Multiple risk factors have been shown to contribute to the presence of anemia in HF patients (1). We were interested in determining the risk factors for anemia in HF patients in our population in the lower Rio Grande Valley.

Methods We performed a retrospective chart review of patients admitted with a diagnosis of HF (Heart Failure with Preserved Ejection Fraction HFpEF, Heart Failure with Reduced Ejection Fraction HFrEF …

Enhancing Cognitive Engagement Of Pre-Clinical Undergraduate Medical Students Via Video Cases And Interactive Quizzes In Problem-Based Learning, Syeda Sadia Fatima, Kulsoom Ghias, Kauser Jabeen, Saniya Sabzwari

Department of Biological & Biomedical Sciences

Background: Problem-based learning (PBL) is one of the main pedagogical approaches utilized in the undergraduate medical education (UGME) program at a private medical college in Karachi, Pakistan. Video-enhanced cases and formative assessments were introduced at the end of PBL sessions to evaluate their effectiveness in enhancing student engagement.
Methods: A mixed methods study was conducted with Year 2 medical students (n=102; divided into 11 groups) and faculty (n=11) facilitating the PBL process. Of the 10 PBL cases, five were converted to video-enhanced cases and five were kept as paper-based, “traditional” cases. “Micro” videos were used to introduce clinical scenarios, augmented …

Star-Related Lipid Transfer Protein 10 (Stard10): A Novel Key Player In Alcohol-Induced Breast Cancer Progression, Andrea Floris, Jia Luo, Jacqueline A. Frank, Jennifer Zhou, Sandro Orrù, Michela Biancolella, Sabina Pucci, Augusto Orlandi, Paolo Campagna, Antonella Balzano, Komal Ramani, Maria Lauda Tomasi

Pharmacology and Nutritional Sciences Faculty Publications

Background: Ethanol abuse promotes breast cancer development, metastasis and recurrence stimulating mammary tumorigenesis by mechanisms that remain unclear. Normally, 35% of breast cancer is Erb-B2 Receptor Tyrosine Kinase 2 (ERBB2)-positive that predisposes to poor prognosis and relapse, while ethanol drinking leads to invasion of their ERBB2 positive cells triggering the phosphorylation status of mitogen-activated protein kinase. StAR-related lipid transfer protein 10 (STARD10) is a lipid transporter of phosphatidylcholine (PC) and phosphatidylethanolamine (PE); changes on membrane composition of PC and PE occur before the morphological tumorigenic events. Interestingly, STARD10 has been described to be highly expressed in 35–40% of ERBB2-positive breast …

Exploring In Silence: Hearing And Deaf Infants Explore Objects Differently Before Cochlear Implantation, Mary K. Fagan

Communication Sciences and Disorders Faculty Articles and Research

Infant development has rarely been informed by the behavior of infants with sensory differences despite increasing recognition that infant behavior itself creates sensory learning opportunities. The purpose of this study of object exploration was to compare the behavior of hearing and deaf infants, with and without cochlear implants, in order to identify the effects of profound sensorineural hearing loss on infant exploration before cochlear implantation, the behavioral effects of access to auditory feedback after cochlear implantation, and the sensory motivation for exploration behaviors performed by hearing infants as well. The results showed that 9-month-old deaf infants explored objects as often …

Incidental Renal Cell Carcinoma In Pelvic Malignancies, Fatima Shaukat, Muhammad Atif Mansha, Nasir Ali, Agha Muhammad Hammad Khan, Ahmed Nadeem Abbasi

Department of Radiation Oncology

Simultaneous diagnosis of renal cell carcinoma with pelvic malignancies is rare but a well-documented phenomenon. It is not uncommon to have incidental renal masses on imaging done for investigating other tumors. There are no established guidelines for the treatment of patients with dual malignancies. The management of such patients is challenging and requires a multidisciplinary approach. We present a series of three cases with a diagnosed pelvic malignancy but further workup revealed a kidney tumor. Both the malignancies were evaluated individually and diagnosed as two different primary neoplastic lesions. This case series examines each distinct patient's presentation, discusses the diagnosis, …

Cdk4 Inhibitors Thwart Immunity By Inhibiting Phospho-Rb-Nf-Kb Complexes, Seung J. Kim, Samuel Asfaha, Frederick A. Dick

Paediatrics Publications

PD-L1 plays a central role in immune recognition of cancer cells. In this issue of Molecular Cell, Jin et al. (2019) report that a phosphorylated retinoblastoma protein contacts the DNA-binding domain of p65 NF-kB, thereby blocking transcription of PD-L1.

Quantitative Clinical And Autoimmune Assessments In Stiff Person Syndrome: Evidence For A Progressive Disorder., Goran Rakocevic, Harry Alexopoulos, Marinos C. Dalakas

Department of Neurology Faculty Papers

BACKGROUND: Stiff Person Syndrome (SPS) is an under-diagnosed disorder that affects mobility and the quality of life of affected patients. The aim of the study is to describe the natural history of SPS, the extent of accumulated disability and the associated clinical and immunological features in patients followed for up to 8 years in a single center.

METHODS: Our collective cohort included 57 SPS patients. Additionally, 32 of these patients were examined every 6 months for a two-year period in a longitudinal study protocol, to assess disease progression using quantitative measures of stiffness and heightened sensitivity.

RESULTS: The most frequent …

Ctcf Governs The Identity And Migration Of Mge-Derived Cortical Interneurons., Adrienne Elbert, Daniel Vogt, Ashley Watson, Michael Levy, Yan Jiang, Emilie Brûlé, Megan E Rowland, John Rubenstein, Nathalie G Bérubé

Paediatrics Publications

The CCCTC-binding factor (CTCF) is a central regulator of chromatin topology recently linked to neurodevelopmental disorders such as intellectual disability, autism, and schizophrenia. The aim of this study was to identify novel roles of CTCF in the developing mouse brain. We provide evidence that CTCF is required for the expression of the LIM homeodomain factor LHX6 involved in fate determination of cortical interneurons (CINs) that originate in the medial ganglionic eminence (MGE). Conditional

An Artificial Intelligence Approach To Detect Visual Field Progression In Glaucoma Based On Spatial Pattern Analysis., Mengyu Wang, Lucy Q. Shen, Louis R. Pasquale, Paul Petrakos, Sydney Formica, Michael V. Boland, Sarah R. Wellik, Carlos Gustavo De Moraes, Jonathan S. Myers, Osamah Saeedi, Hui Wang, Neda Baniasadi, Dian Li, Jorryt Tichelaar, Peter J. Bex, Tobias Elze

Wills Eye Hospital Papers

Purpose: To detect visual field (VF) progression by analyzing spatial pattern changes.

Methods: We selected 12,217 eyes from 7360 patients with at least five reliable 24-2 VFs and 5 years of follow-up with an interval of at least 6 months. VFs were decomposed into 16 archetype patterns previously derived by artificial intelligence techniques. Linear regressions were applied to the 16 archetype weights of VF series over time. We defined progression as the decrease rate of the normal archetype or any increase rate of the 15 VF defect archetypes to be outside normal limits. The archetype method was compared with mean …

A State-Level Study Of Opioid Use Disorder Treatment Access And Neonatal Abstinence Syndrome, Elizabeth R. Wolf, Sebastian T. Tong, Roy T. Sabo, Steven H. Woolf, Kassie Abbinanti, James Pecsok, Alex H. Krist

Pediatrics Publications

Background Adult opioid use and neonatal abstinence syndrome (NAS) are growing public health problems in the United States (U.S.). Our objective was to determine how opioid use disorder treatment access impacts the relationship between adult opioid use and NAS.

Methods We conducted a cross-sectional state-level ecologic study using 36 states with available Healthcare Cost and Utilization Project State Inpatient Databases in 2014. Opioid use disorder treatment access was determined by the: 1) proportion of people needing but not receiving substance use treatment, 2) density of buprenorphine-waivered physicians, and 3) proportion of individuals in outpatient treatment programs (OTPs). The incidence of …

Alternative Care Models For Management Of Diabetes, Sarah Tsai

Presentations

Describes effort to improve A1C in teens using motivational interviewing vs. traditional patient/provider interaction in real-world clinic setting.

Intraoperative Finding Of Vascular Malformation During Carpal Tunnel Release: A Case Report, Mark S. Anderson, Moheb S. Moneim

UNM Orthopaedic Research Journal

Carpal tunnel release is a common surgical procedure performed by hand surgeons. The procedure is typically straightforward; however, uncommon causes of median nerve compression encountered intraoperatively may add complexity. We describe a 67-year-old man with carpal tunnel syndrome and an intraoperative finding of a compressive vascular malformation during a mini-open carpal tunnel release. A space-occupying malformation of a persistent median artery was bisecting the nerve and thought to be responsible for the patient’s symptoms. The compression was relieved through extended carpal tunnel release without requiring removal of the vascular malformation. The patient’s symptoms improved postoperatively. Hand surgeons undertaking this procedure …

Chronic Volar Lunate Dislocation Resulting In Carpal Tunnel Syndrome: A Case Report, Travis D. Blood, Amanda J. Fantry, Nathan T. Morrell

UNM Orthopaedic Research Journal

Lunate dislocations are rare injuries caused by highenergy trauma disrupting the ligamentous restraints that connect the lunate to the carpus. We describe a case of missed volar lunate dislocation 10 years after the initial injury. The patient presented to our clinic with symptoms of carpal tunnel syndrome after falling on an outstretched arm. He had increasing paresthesias in his median nerve territory and underwent a proximal row carpectomy with release of the transverse carpal ligament. At 2 years postoperatively, successful outcomes were noted with an 80° arc of motion of the carpus and complete resolution of carpal tunnel symptoms. Although …

Ipsilateral Femoral Neck And Shaft Fractures With A Floating Knee Injury: A Case Report, Matthew T. Philippi, Scott M. Sandilands, Paul J. Goodwyn, Samer Kakish

UNM Orthopaedic Research Journal

Isolated ipsilateral fractures of the femoral neck and shaft are rare injuries. Similarly, a floating knee (ie, ipsilateral fractures of the femur and tibia) is uncommon. We describe a 34-year-old man with ipsilateral fractures of the femoral neck and shaft with an ipsilateral floating knee after a motorcycle collision. He was treated with operative fixation, and was walking without assistive devices at his most recent follow-up appointment in February 2019. We believe this to be a unique combination of injuries not yet described in studies.

Intraoperative Finding Of Flexor Carpi Radialis Avulsion During Closed Distal Radius Fracture: A Case Report, Camille Aubin-Lemay, Deana Mercer

UNM Orthopaedic Research Journal

Distal radius fractures are a common reason for orthopaedic consultations in emergency departments and outpatient orthopaedic clinics. Ruptures of the extensor pollicis longus tendon have been regularly described in conjunction with distal radius fractures, whereas only five cases of flexor tendon injuries have been reported. We describe a patient with acute rupture of the flexor tendon identified during operative fixation of the distal radius fracture. The tendon avulsion was repaired at the same time as fracture fixation; unfortunately, the patient was lost to follow-up. This case highlights the importance of a careful physical examination in treating high-energy traumatic injuries and …

Diagnosis Of Leprosy Using Sural Nerve Biopsy Findings: A Case Report, Bridgette M. Love, Deana Mercer, Amber West, Karen S. Santacruz, Elizabeth A. Mikola

UNM Orthopaedic Research Journal

Leprosy, also known as Hansen disease, is an uncommon chronic disease caused by the slowly growing acid-fast bacilli, Mycobacterium leprae. Leprosy has tropism for peripheral nerves and skin and can also be found in the upper respiratory tract, eyes, and nasal mucosa. When left untreated, there can be considerable nerve damage resulting in paralysis, blindness, and the crippling of hands and feet. Although infrequent in the United States, leprosy has been diagnosed in patients exposed to armadillos, an animal reservoir. We describe an 80-year-old man who presented with a 6-year history of chronic erythematous, macular rash, and progressive symmetric sensory …

Multiple Pterygium Syndrome With Severe Knee Flexion Contracture: A Case Report, Jory Wasserburger, Garrett Waller, Scott Plaster, David M. Bennett

UNM Orthopaedic Research Journal

Multiple pterygium syndrome, a subgroup of arthrogryposis multiplex congenita, is characterized by the webbing of different parts of the body. We describe a child who developed 140° flexion contractures of the popliteal fossa, which complicated mobility, skin care, and general hygiene. After seeking multiple opinions, the parents elected to proceed with through-knee amputation of both knees. At 6 month follow-up, the child had been fitted with bilateral prostheses and was able to ambulate with assistance. The findings of the current case suggest that in extreme cases of multiple pterygium syndrome, through-knee amputations may represent a predictable and functional treatment option …

Leukocytoclastic Vasculitis In A 66-Year-Old Woman After Fusion Of The Second Right Metatarsocuneiform Joint Using Titanium Plate And Screws: A Case Report, Sarah K. Brown, Christopher Kurnik, Emily M. Altman, Richard A. Miller

UNM Orthopaedic Research Journal

Metallic orthopaedic implants are known to instigate cutaneous reactions; however, the mechanism by which this occurs is not fully understood. Contact dermatitis after implantation of stainless steel fracture plates was first described in 1966, and similar reactions to various implants have been documented subsequently. Leukocytoclastic vasculitis (LCV) is an inflammatory condition of small dermal blood vessels resulting from neutrophil invasion, degranulation, and cell death caused by a type III hypersensitivity reaction. No studies have reported use of titanium orthopaedic implants resulting in LCV. We describe a 66-year-old woman who developed LCV after the fusion of her second right metatarsocuneiform joint …

Achilles Tendon Ruptures In Two Male Athletes In Ncaa Division I: Report Of Two Cases, Lisa Hardy, Michele Bliss, Garyn Worrall, James Slauterbeck

UNM Orthopaedic Research Journal

Major tendon ruptures are rare, with an Achilles tendon rupture (ATR) being the most frequent type. Reported cases most commonly involve male recreational athletes who have increased body mass indexes and are between ages 30 and 50 years. We describe two male athletes in Division I of the National Collegiate Athletic Association who underwent surgical repair for treating an ATR associated with running-related activities. In contrast to other cases, both patients had normal body mass indexes. These two cases identify high-level athletes who underwent operative Achilles tendon repair and returned to their sport at a similar level or high level …

Inclusion Body Myositis In A Middle-Aged Woman With Knee Pain And Weakness: A Case Report, Jacob Christensen, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Weakness and osteoarthritis are common concerns for orthopaedic and primary care physicians when caring for aging adults. We describe a 58-year-old woman with a history of Sjogren syndrome and knee osteoarthritis. She presented to our clinic for injection of viscosupplementation in her left knee, and review of her medical records revealed right hand weakness at 7 years after the onset of symptoms. Findings of muscle biopsy and multiple electromyograms revealed inclusion body myositis, primarily affecting the deep finger flexors and quadriceps muscles. On the basis of this diagnosis, physical therapy and supportive care were recommended. The results of the current …

An Uncommon Presentation Of Coxa Saltans: A Case Report, Christopher S. Bossart, Christopher A. Mcgrew, Rebecca A. Dutton

UNM Orthopaedic Research Journal

Coxa saltans, or “snapping hip,” refers to various conditions that produce a palpable or audible snapping of the hip after movement. We present an uncommon case of coxa saltans in a patient with a snapping proximal hamstring tendon. Findings of dynamic ultrasound evaluation were used to confirm the source of snapping, characterized by a lateral subluxation of the conjoint tendon over the ischial tuberosity. Our patient was treated nonoperatively, and we observed mild improvement of her symptoms. Few cases of similar pathological findings have been described, with varying causes of tendon instability. The results of the current case may help …

Use Of Titanium Mesh Cage In Treating A Subtrochanteric Defect: A Case Report, Lucas D. Winter, James A. Dollahite, Rick Gehlert

UNM Orthopaedic Research Journal

Titanium mesh cages have been used during fixation of segmental defects in long bones; however, use in the subtrochanteric region of the proximal femur is a novel application. We describe a 38-year-old, 330-lb man with a highly comminuted fracture about the right femur after a gunshot wound. Immediate treatment involved use of a cement spacer. Findings of follow-up imaging showed about 26° external rotational deformity and 2-cm limb shortening. To correct the rotational abnormality and limb length discrepancy, a cylindrical titanium mesh cage and custom-made femur locking plate with a cancellous bone autograft were used. Subsequently, successful bridging was obtained …

Understanding And Improving Patient Satisfaction In Orthopaedic Surgical Procedures: A Review, Paul J. Johnson

UNM Orthopaedic Research Journal

Orthopaedic surgeons and their hospitals are being evaluated and reimbursed according to their ability to provide patient satisfaction. It behooves physicians to learn how patient satisfaction is evaluated, how patient satisfaction may be improved, and how improvements in patient satisfaction may positively influence patient outcomes both subjectively and objectively. The purpose of this review is to illuminate how evaluation works, how patient factors may affect or correlate with increased satisfaction, and how physicians can improve actions to enhance patient satisfaction. Notably, studies have found that improved care coordination, nursing follow-up, provider listening skills, providing realistic yet positive expectations, and sitting …

Complete Great Toe Sesamoid Excision: A Case Series, James A. Dollahite, Benjamin D. Packard, Richard A. Miller

UNM Orthopaedic Research Journal

Background: Hallux sesamoids notably contribute to the biomechanics of the great toe. Although frequently ignored or forgotten, injury to the hallux sesamoids can be debilitating. Conservative management remains the initial approach for symptomatic sesamoid disorders, but surgical excision is an option. We performed a retrospective case series to examine the preoperative characteristics and postsurgical outcomes of patients who underwent great toe sesamoidectomy.

Methods: We reviewed medical records of patients who underwent great toe sesamoidectomy performed by a single surgeon (RAM) during a 10-year period (26 patients, 28 procedures). Data collected included smoking status, prior first ray surgical treatment, highlevel athlete …

Periprosthetic Joint Infections: A Review, Jay J. Wojcik

UNM Orthopaedic Research Journal

No abstract provided.

Biomechanical Strength And Bulk Comparisons Between The Open-Book Technique And The Pulvertaft Method For Peroneal Tendon Transfer: A Pilot Study, Matthew Blue, Christian Douthit, Adam N. Wooldridge, Austin Williams, Micah Lierly-Chick, Kerry Gilbert, Jerry Grimes

UNM Orthopaedic Research Journal

Background: The Pulvertaft method has classically been used for the transfer of various tendon injuries owing to its biomechanical strength; however, this method has been shown to be bulky. We describe the open-book technique, which can offer comparable structural integrity with a decreased bulk. The purpose of this study was to determine whether the openbook technique is biomechanically equivalent to the Pulvertaft method for treating peroneal tendon injuries.

Methods: We evaluated five pairs of human cadaveric ankles. Within each pair, one specimen was randomly assigned to either the Pulvertaft or the open-book group. Using sharp dissection, the tendons were severed …

Comparison Of Joint Compression And Pull- Out Strength Of 6.5-Mm Self-Drilling Screws With Headed And Headless In Subtalar Arthrodesis: A Pilot Study, Christian Douthit, Matthew Blue, Adam N. Wooldridge, Micah Lierly-Chick, Kerry Gilbert, Jerry Grimes

UNM Orthopaedic Research Journal

Background: In patients with degenerative osteoarthritis of the subtalar joint, surgical treatment can include subtalar arthrodesis. Notably, mechanical factors such as compression and pull-out strength contribute to successful union, which can be achieved through use of headed or headless cannulate screws. The purpose of this study was to compare the resultant joint compressive force and pull-out strength between use of a headless 6.5-mm self-drilling cannulated compression screw and a more traditional headed 6.5- mm self-drilling cannulated compression screw.

Methods: This study used the calcaneus and talus from six paired fresh frozen specimens. The soft tissues were stripped and the joint …

The Future Of Infection Surveillance At Ambulatory Surgical Centers, Jenna Godfrey, Jory Wasserburger, Scott Plaster, Susan Kellie, Julia Manweiler, Robert C. Schenck Jr

UNM Orthopaedic Research Journal

Background: The Centers for Medicare and Medicaid (CMS) has begun mandating infection surveillance at surgical sites, which started in hospitals and is now in ambulatory surgical centers (ASCs). We found a 0.1% increase in infection rate between 2005 and 2007, which prompted us to examine the issue further. The purpose of the current study was to summarize the results of an investigation after an outbreak of infection at our ASC, specifically attempting to identify a common pathogen, vector, or unknown lapses in infection prevention. Additionally, we relate our experience to current trends in infection prevention at ASCs by examining the …

Comparison Of Intraoperative Fluoroscopy To Postoperative Weight-Bearing Radiographs Obtained 4 To 6 Weeks After Bunion Repair With A Chevron Osteotomy, Amber L. Price, Travis M. Hughes, Christopher Kurnik, Christina G. Kurnik, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Background: During operative treatment of bunions, an attempt is made to correct the hallux valgus angle (HVA) and the intermetatarsal angle (IMA). In this study, the HVA and the IMA were measured using intraoperative C-arm fluoroscopic images obtained during surgical treatment of a bunion with chevron osteotomy. These angles were again measured using weight-bearing radiographs obtained 4 to 6 weeks postoperatively.

Methods: At our institution, we reviewed medical records of patients who underwent a bunion repair with chevron osteotomy between January 2013 and October 2017. A total of 26 feet from 24 patients were included. Three authors (ALP, TMH, and …

Patient Compliance With Follow-Up After Open Reduction And Internal Fixation For Treating Malleolar Ankle Fractures: A Retrospective Review, Matthew G. Wharton, Christopher L. Shultz, Benjamin D. Packard, Jory Wasserburger, Katherine J. Gavin, Richard A. Miller

UNM Orthopaedic Research Journal

Background: Compliance with follow-up after orthopaedic procedures is variable and does not always occur as recommended. Various factors such as medical, financial, cultural, and logistical reasons may contribute to this lack of compliance. The purpose of this study was to determine follow-up compliance of patients who had undergone open reduction and internal fixation (ORIF) for treating closed malleolar ankle fractures.

Methods: Medical records of patients who underwent ORIF for treating closed malleolar ankle fractures by the senior author (RAM) were reviewed to evaluate compliance with postoperative follow-up (n = 267). Inclusion criteria were patients with isolated, acute, closed fractures (n …