Medical Specialties Commons^™

Characterization Of Prostate Cancer In Transgender Women, Simita Gaglani, Rajveer Purohit, Ashutosh Tewari, Dara Lundon, Natasha Kyprianou

Research Symposium

Background: The risk of developing prostate cancer (PC) in transgender women is unknown. Many patients are unaware that the prostate is not removed during male-to-female surgical transition. It is unclear what the exposure of estrogens and androgen blockers in these transgender patients has on the prostate. Our aim was to examine and characterize the different presentations of PC in published cases and augment this with an additional case series from one institute.

Methods: A retrospective review of prospectively maintained medical records was performed identifying features of PC diagnoses in transgender women. These included age, duration of feminizing hormone therapy, PSA …

The Importance Of A Broad Differential Diagnosis: Hepatitis C Virus Associated Cryoglobulinemic Vasculitis, Shadi Jafari-Esfahani, Christine E. Loftis, Juan Naranjo, Emilia Dulgheru

Research Symposium

Introduction: Mixed cryoglobulinemia syndrome (MCS) is a systemic inflammatory syndrome affecting small-medium sized vessels due to the presence of type II or III cryoglobulins in the serum. MSC can manifest as systemic vasculitis with symptoms varying from weakness, arthralgia, palpable purpura, peripheral neuropathy, and renal involvement. The most common cause of MCS includes lymphoproliferative disorders, autoimmune diseases and viral infections, with hepatitis C virus (HCV) being the most common etiology.

Case Presentation: A 60-year-old lady was referred to our office for evaluation of rheumatoid arthritis. She reported history of bilateral thumb pain, bilateral knee pain associated with episodes of swelling, …

Pelvic Fracture Urethral Trauma– Going With The Flow, Frank Burks

Website/Multimedia Contributions

No abstract provided.

Massive Transfusion In Trauma– The Basics And Beyond, Kristina Davis

Website/Multimedia Contributions

No abstract provided.

Elastic Stable Intramedullary Nail Fixation Versus Submuscular Plate Fixation Of Pediatric Femur Shaft Fractures In School Age Patients: A Prisma-Compliant Systematic Review And Meta-Analysis, Donglai Hu, Zihang Xu, Tao Shi, Hui Zhong, Yuting Xie, Junjie Chen

Faculty, Staff and Student Publications

BACKGROUND: Studies of clinical outcomes that compare the elastic stable intramedullary nail (ESIN) with the submuscular plate (SMP) were controversial. The meta-analysis was performed to summarize existing evidence, aiming to determine whether ESIN was superior to SMP in pediatric femur shaft fractures.

METHODS: Search strategies followed the recommendations of the Cochrane collaboration. Electronic searches such as PubMed, Embase, Web of Science, Cochrane were systematically searched for publications concerning ESIN and SMP from the inception date to March 2023. Two investigators independently searched, screened, and reviewed the full text of the article. Disagreements generated throughout the process were resolved by consensus, …

A Case Report: A Patient Rescued By Va-Ecmo After Cardiac Arrest Triggered By Trigeminocardiac Reflex After Nasal Surgery, Xu Zhang, Bin Sun, Chen Pac-Soo, Daqing Ma, Liwei Wang

Faculty, Staff and Student Publications

Rationale:

Cardiac arrest (CA) caused by trigeminocardiac reflex (TCR) after endoscopic nasal surgery is rare. Hence, when a patient suffers from TCR induced CA in the recovery room, most doctors may not be able to find the cause in a short time, and standard cardiopulmonary resuscitation and resuscitation measures may not be effective. Providing circulatory assistance through venous-arterial extracorporeal membrane oxygenation (VA-ECMO) can help healthcare providers gain time to identify the etiology and initiate symptom-specific treatment.

Patient concerns:

We report a rare case of CA after endoscopic nasal surgery treated with VA-ECMO.

Diagnoses:

We excluded myocardial infarction, pulmonary embolism, allergies, …

Structurally Competent Healthcare And Health Inequities, James Meza

Conference Presentation Abstracts

No abstract provided.

Neurologic Outcomes For Adult Spinal Cord Ependymomas Stratified By Tumor Location: A Retrospective Cohort Study And 2-Year Outlook, Keanu Chee, Grégoire P Chatain, Michael W Kortz, Stephanie Serva, Keshari Shrestha, Timothy H Ung, Jens-Peter Witt, Michael Finn

Department of Neurosurgery Faculty Papers

Determine whether craniocaudal spinal cord tumor location affects long-term neurologic outcomes in adults diagnosed with spinal ependymomas (SE). A retrospective cohort analysis of patients aged ≥ 18 years who underwent surgical resection for SE over a ten-year period was conducted. Tumor location was classified as cervical, thoracic, or lumbar/conus. Primary endpoints were post-operative McCormick Neurologic Scale (MNS) scores at < 3 days, 6 weeks, 1 year, and 2 years. One-way ANOVA was performed to detect significant differences in MNS scores between tumor locations. Twenty-eight patients were identified. The average age was 44.2 ± 15.4 years. Sixteen were male, and 13 were female. There were 10 cervical-predominant SEs, 13 thoracic-predominant SEs, and 5 lumbar/conus-predominant SEs. No significant differences were observed in pre-operative MNS scores between tumor locations (p = 0.73). One-way ANOVA testing demonstrated statistically significant differences in post-operative MNS scores between tumor locations at < 3 days (p = 0.03), 6 weeks (p = 0.009), and 1 year (p = 0.003); however, no significant difference was observed between post-operative MNS scores at 2 years (p = 0.13). The mean MNS score for patients with thoracic SEs were higher at all follow-up time points. Tumors arising in the thoracic SE are associated with worse post-operative neurologic outcomes in comparison to SEs arising in other spinal regions. This is likely multifactorial in etiology, owing to both anatomical differences including spinal cord volume as well as variations in tumor characteristics. No significant differences in 2-year MNS scores were observed, suggesting that patients ultimately recover from neurological insult sustained at the time of surgery.

Cocaine Use Disorder Effects On Blood Oxytocin Levels And Oxtr Dna Methylation, Manassés Soares Souza, Breno Sanvicente-Vieira, Aline Zaparte, Talita Baptista, Maria Aparecida Nagai, Flávia Rotea Mangone, Ana Carolina Pavanelli, Thiago Wendt Viola, Rodrigo Grassi-Oliveira

School of Medicine Faculty Publications

Substance use disorders have been associated with alterations in the oxytocinergic system, but few studies have investigated both the peptide and epigenetic mechanisms potentially implicated in the regulation of oxytocin receptor. In this study, we compared plasma oxytocin and blood DNA methylation in the OXTR gene between people with and without cocaine use disorder (CUD). We measured the oxytocin levels of 51 people with CUD during acute abstinence and of 30 healthy controls using an enzyme immunoassay. The levels of DNA methylation in four CpG sites at exon III of the OXTR gene were evaluated in a subsample using pyrosequencing. …

Heterogenous Lung Inflammation Ct Patterns Distinguish Pneumonia And Immune Checkpoint Inhibitor Pneumonitis And Complement Blood Biomarkers In Acute Myeloid Leukemia: Proof Of Concept, Muhammad Aminu, Naval Daver, Myrna C B Godoy, Girish Shroff, Carol Wu, Luis F Torre-Sada, Alberto Goizueta, Vickie R Shannon, Saadia A Faiz, Mehmet Altan, Guillermo Garcia-Manero, Hagop Kantarjian, Farhad Ravandi-Kashani, Tapan Kadia, Marina Konopleva, Courtney Dinardo, Sherry Pierce, Aung Naing, Sang T Kim, Dimitrios P Kontoyiannis, Fareed Khawaja, Caroline Chung, Jia Wu, Ajay Sheshadri

Faculty, Staff and Student Publications

BACKGROUND: Immune checkpoint inhibitors (ICI) may cause pneumonitis, resulting in potentially fatal lung inflammation. However, distinguishing pneumonitis from pneumonia is time-consuming and challenging. To fill this gap, we build an image-based tool, and further evaluate it clinically alongside relevant blood biomarkers.

MATERIALS AND METHODS: We studied CT images from 97 patients with pneumonia and 29 patients with pneumonitis from acute myeloid leukemia treated with ICIs. We developed a CT-derived signature using a habitat imaging algorithm, whereby infected lungs are segregated into clusters ("habitats"). We validated the model and compared it with a clinical-blood model to determine whether imaging can add …

New Jak3-Insl3 Fusion Transcript-An Oncogenic Event In Cutaneous T-Cell Lymphoma, Loka Reddy Velatooru, Cheng Hui Hu, Pedram Bijani, Xiaohong Wang, Pierr Bojaxhi, Hao Chen, Madeleine Duvic, Xiao Ni

Faculty, Staff and Student Publications

Constitutively activated tyrosine kinase JAK3 is implicated in the pathogenesis of cutaneous T-cell lymphomas (CTCL). The mechanisms of constitutive JAK3 activation are unknown although a JAK3 mutation was reported in a small portion of CTCL patients. In this study, we assessed the oncogenic roles of a newly identified JAK3-INSL3 fusion transcript in CTCL. Total RNA from malignant T-cells in 33 patients with Sézary syndrome (SS), a leukemic form of CTCL, was examined for the new JAK3-INSL3 fusion transcript by RT-PCR followed by Sanger sequencing. The expression levels were assessed by qPCR and correlated with patient survivals. Knockdown and/or knockout assays …

Evaluation Of The Effectiveness Of Foot-And-Mouth Disease Vaccination Of Animals In The Buffer Zone Of The Republic Of Armenia In 2016–2020, Satenik Kharatyan, Khachik Sargsyan, Hasmik Elbakyan, Tigran Markosyan, Pertsh Tumanyan, Varduhi Hakobyan, Vazgen Sargsyan, Manvel Badalyan, Gayane Chobanyan, Jenna E Achenbach

Faculty, Staff and Student Publications

BACKGROUND: Foot-and-mouth disease (FMD) is a high impact viral disease of livestock for which vaccines are extensively used for limiting the spread of infection. Armenia shares a border with both Turkey and Iran where FMD is endemic, making vaccination an important component of Armenia's control strategy. Additionally, Armenian veterinary services utilize both passive and active monitoring for prevention control.

METHODS: We sought to determine the immune status of animals vaccinated against FMD and to evaluate the effectiveness of our vaccination policy in Armenia. This was conducted in three regions including Shirak, Armavir, and Ararat Region which are located in the …

Efficacy Of Scrambler Therapy In Patients With Painful Diabetic Peripheral Neuropathy: A Single-Arm, Prospective, Pilot Study, Seung Hee Yoo, Won-Joong Kim, Ji Seon Chae, Bo Kyung Kang, Min Jeong Kang, Min Hyouk Beak

Faculty, Staff and Student Publications

BACKGROUND: A variety of medications are available to manage painful diabetic peripheral neuropathy (DPN), but the proper treatment remains challenging. Accordingly, various neuromodulation modalities have been used. However, no prospective clinical trials have evaluated the use of scrambler therapy (ST) in painful DPN. This study aimed to explore the long-term effects of ST in managing painful DPN.

METHODS: The patients received 10 consecutive STs of 45 minutes every 1 to 2 days. The primary outcome was pain score. We measured the visual analog scale (VAS) pain scores at baseline, during ST, immediately after ST, and at 1, 2, 3, and …

Effectiveness Of Maternal Mrna Covid-19 Vaccination During Pregnancy Against Covid-19-Associated Hospitalizations In Infants Aged <6 Months During Sars-Cov-2 Omicron Predominance - 20 States, March 9, 2022-May 31, 2023., Regina M. Simeone, Laura D. Zambrano, Natasha B. Halasa, Katherine E. Fleming-Dutra, Margaret M. Newhams, Michael J. Wu, Amber O. Orzel-Lockwood, Satoshi Kamidani, Pia S. Pannaraj, Katherine Irby, Aline B. Maddux, Charlotte V. Hobbs, Melissa A. Cameron, Julie A. Boom, Leila C. Sahni, Michele Kong, Ryan A. Nofziger, Jennifer E. Schuster, Hillary Crandall, Janet R. Hume, Mary A. Staat, Elizabeth H. Mack, Tamara T. Bradford, Sabrina M. Heidemann, Emily R. Levy, Shira J. Gertz, Samina S. Bhumbra, Tracie C. Walker, Katherine E. Bline, Kelly N. Michelson, Matt S. Zinter, Heidi R. Flori, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Infants aged < 6 months are not eligible for COVID-19 vaccination. Vaccination during pregnancy has been associated with protection against infant COVID-19-related hospitalization. The Overcoming COVID-19 Network conducted a case-control study during March 9, 2022-May 31, 2023, to evaluate the effectiveness of maternal receipt of a COVID-19 vaccine dose (vaccine effectiveness [VE]) during pregnancy against COVID-19-related hospitalization in infants aged < 6 months and a subset of infants aged < 3 months. VE was calculated as (1 - adjusted odds ratio) x 100% among all infants aged < 6 months and < 3 months. Case-patients (infants hospitalized for COVID-19 outside of birth hospitalization and who had a positive SARS-CoV-2 test result) and control patients (infants hospitalized for COVID-19-like illness with a negative SARS-CoV-2 test result) were compared. Odds ratios were determined using multivariable logistic regression, comparing the odds of receipt of a maternal COVID-19 vaccine dose (completion of a 2-dose vaccination series or a third or higher dose) during pregnancy with maternal nonvaccination between case- and control patients. VE of maternal vaccination during pregnancy against COVID-19-related hospitalization was 35% (95% CI = 15%-51%) among infants aged < 6 months and 54% (95% CI = 32%-68%) among infants aged < 3 months. Intensive care unit admissions occurred in 23% of all case-patients, and invasive mechanical ventilation was more common among infants of unvaccinated (9%) compared with vaccinated mothers (1%) (p = 0.02). Maternal vaccination during pregnancy provides some protection against COVID-19-related hospitalizations among infants, particularly those aged < 3 months. Expectant mothers should remain current with COVID-19 vaccination to protect themselves and their infants from hospitalization and severe outcomes associated with COVID-19.

Vadadustat For Treatment Of Anemia In Patients With Dialysis-Dependent Chronic Kidney Disease Receiving Peritoneal Dialysis, Mark J Sarnak, Rajiv Agarwal, Neil Boudville, Pradip C P Chowdhury, Kai-Uwe Eckardt, Carlos R Gonzalez, Laura A Kooienga, Mark J Koury, Kwabena A Ntoso, Wenli Luo, Patrick S Parfrey, Dennis L Vargo, Wolfgang C Winkelmayer, Zhiqun Zhang, Glenn M Chertow

Faculty, Staff and Students Publications

BACKGROUND: Hypoxia-inducible factor prolyl hydroxylase inhibitors such as vadadustat may provide an oral alternative to injectable erythropoiesis-stimulating agents for treating anemia in patients receiving peritoneal dialysis. In two randomized (1:1), global, phase 3, open-label, sponsor-blind, parallel-group, active-controlled noninferiority trials in patients with dialysis-dependent chronic kidney disease (INNO2VATE), vadadustat was noninferior to darbepoetin alfa with respect to cardiovascular safety and hematological efficacy. Vadadustat's effects in patients receiving only peritoneal dialysis is unclear.

METHODS: We conducted a post hoc analysis of patients in the INNO2VATE trials receiving peritoneal dialysis at baseline. The prespecified primary safety endpoint was time to first major cardiovascular …

Pediatric Hepatocellular Adenomas: What Is Known And What Is New?, Andres F Espinoza, Sanjeev A Vasudevan, Prakash M Masand, Dolores H Lòpez-Terrada, Kalyani R Patel

Faculty, Staff and Students Publications

Current understanding and classification of pediatric hepatocellular adenomas (HCA) are largely based on adult data. HCAs are rare in children and, unlike in adults, are often seen in the context of syndromes or abnormal background liver. Attempts to apply the adult classification to pediatric tumors have led to several "unclassifiable" lesions. Although typically considered benign, few can show atypical features and those with beta-catenin mutations have a risk for malignant transformation. Small lesions can be monitored while larger (>5.0 cm) lesions are excised due to symptoms or risk of bleeding/rupture, etc. Management depends on gender, age, underlying liver disease, …

Implementation Of An Immediate Postpartum Long-Acting Reversible Contraception Program In A Southern Texas Border Population, Samantha G. Alvarado, Elizabeth Cook, Dawn Jensen, Molly Chapman, Saul Rivas, Diane Ju

Research Symposium

Background: Expanding contraceptive access in a Southern Texas border population can reduce the number of unintended and short-interval pregnancies, which have been associated with poor maternal and neonatal health outcomes. Healthcare encounters can be maximized to include immediate postpartum long-acting reversible contraception (IPP LARC) as an additive to the healthcare access many women have during pregnancy. The implementation of the IPP LARC Program allowed for the provision of accessible LARCs to fulfill the contraceptive needs of our patient population. This program was supported by Medicaid reimbursements and a private teaching grant that was awarded to the University of Texas Rio …

An Ngqd Based Diagnostic Tool For Pancreatic Cancer, Ryan Ketan Ajgaonkar, Bong Lee, Alina Valimukhametova, Anton Naumov, Giridhar Akkaraju

Research Symposium

Background: Pancreatic cancer remains difficult to detect at early stages which contributes to a poor five-yearsurvival rate. Therefore, early detection approaches based on novel technologies should be explored to address this critical health issue. Nanomaterials have recently emerged as frontrunners for diagnostic applications due to their small size in the 1-100 nm range, which facilitates one-on-one interactions with a variety of biomolecules like oligonucleotides and makes them suitable for a plethora of detection and delivery applications. In this work, the presence of specific pancreatic cancer miRNA (pre-miR-132) is detected utilizing the fluorescence properties of highly biocompatible nitrogen-doped graphene quantum dots …

Palmitoylation As A Regulator Of Maguk Proteins Postsynaptic Localization, Rozena Shirvani-Arani, Santiago Balderas, Yonghong Zhang, Xioaqian Fang

Research Symposium

Synaptic plasticity is the ability of the brain to make changes and the changes occur at synapses. To achieve the complicated functions, a good number of proteins are present at synapse and are called synaptic proteins. To stabilize these proteins at synapses, proteins are modified through posttranslational modifications (PTMs). The most studied PTMs include phosphorylation, acetylation, ubiquitination, glycosylation, palmitoylation, etc. Palmitoylation is a type of lipid modification and has received more attention recently for its contribution to protein trafficking, localization, and interaction in various synaptic plasticity. The membrane-associated guanylate kinase (MAGUK) family includes PSD-95, PSD-93 (also known as chapsyn-110), SAP102, …

Recurrent Hemarthrosis Secondary To Erosive Patellofemoral Arthritis Treated With Arthroplasty: A Report Of 3 Cases, Rachael A. Turner, Justin N. Duke, Trevor G. Murray, Jared R.H. Foran

Research Symposium

Background: Spontaneous hemarthrosis of the knee joint in the elderly population is a rare phenomenon and is mostly seen in those with osteoarthritis. The identified causes of spontaneous hemarthrosis in this demographic include subchondral bone bleeding, meniscal tear, genicular artery bleeding, and the use of anticoagulants. Hemarthrosis caused by isolated patellofemoral bleeding, as in this case series, has been rarely documented and poorly described.

Case: Three patients presented with recurrent hemarthrosis secondary to erosive patellofemoral arthritis. Recurrent hemarthrosis from the eroded patellofemoral subchondral bone has not been well described. Each patient presented with symptoms secondary to painful effusions that …

Patients Achieving 90°/45°/0° Intraoperative Stability Do Not Require Hip Precautions Following Posterior Approach Total Hip Arthroplasty: A Prospective Randomized Study, Rachael A. Turner, Marlie R. Mounts, Nimesh B. Patel, Erin N. Snelling, Raquel E. Phillips, Dean A. Levesque, Jared R.H. Foran

Research Symposium

Background: Hip precautions are traditionally employed after posterior total hip arthroplasty (THA). The primary purpose was to investigate the necessity of hip precautions after posterior approach THA. We hypothesized that eliminating precautions in patients that achieved appropriate intraoperative stability would not increase the dislocation rate.

Methods: Randomized controlled trial of 346 consecutive eligible patients undergoing primary THA with a mean follow-up of 2.3 years (range 11 months to 3.7 years). Exclusion criteria: lumbar fusion, scoliosis, abductor insufficiency, inability to achieve intraoperative stability with combined 90° flexion and 45° internal rotation in 0° adduction. Fisher's exact test was used to compare …

Non-Syndromic Multi Focal Non-Ossifying Fibroma: A Diagnostic Challenge Of Giant-Cell Rich Lesions, Rachael A. Turner, Andres M. Burbano, Kevin J. Orellana, Duncan Ramsey

Research Symposium

Background: Diagnosing GCL can be extremely difficult due to the rarity of these lesions. Histologically many benign GCL mimic each other and can further be mistaken for a malignant GCL. Additionally confusing the diagnosis, many benign GCL have significant morphological overlap. However, it is of utmost importance to arrive at an accurate diagnosis as treatment varies significantly based on the pathology. Our patient presentation highlights that differentiating GCLs can be a diagnostic challenge as illustrated. Our review of the literature found scarce reports of multifocal non-ossifying fibroma. In this case report, we describe a non-syndromic multifocal non-ossifying fibroma successfully …

Giardia Lamblia Reactive Arthritis Mimicking Acute Periprosthetic Knee Infection: A Case Report, Rachael A. Turner, Justin N. Duke, Jared R.H. Foran

Research Symposium

Background: The difficulty in diagnosing Periprosthetic joint infection (PJI) is exacerbated by the more varied presentation of PJI and the lower synovial fluid WBC count thresholds applied when a prosthesis is present. Multiple reports have described pseudosepsis after total knee arthroplasty (TKA) due to gout or pseudogout. Further confusing the picture, periprosthetic infection also frequently coexists with crystalline arthropathy. Our review of the literature revealed no reports describing reactive arthritis (ReA) mimicking acute infection in the setting of previous TKA. In this case report, we describe a pseudo-periprosthetic infection of a well-functioning TKA secondary to ReA in the setting of …

Patchy Alopecia In A Young Adult With A Generalized Rash, Oscar Rodrigo Zamudio Herrera, Nevin Varghese

Research Symposium

Background: Syphilis is a sexually transmitted infection that has been increasing in the United States. The prevalence of syphilis rose by 6.8% during 2019-to 2020. Secondary syphilis typically presents with a generalized maculopapular rash on palms and soles, however, can also have subtle dermatological findings such as alopecia. Syphilitic alopecia is an atypical manifestation of secondary syphilis, seen in 2.9 to 7% of the cases.

Case presentation: An 18-year-old Hispanic male presented to the clinic after noticing patchy loss of hair on the scalp for 2 weeks and one week of generalized non pruritic rash. His past medical history was …

A Swinging Heart: Relevance Of Point Of Care Ultrasound In The Diagnosis Of An Atypical Complication Of Acute Pericarditis, Oscar Rodrigo Zamudio Herrera, Nevin Varghese

Research Symposium

Background: Cardiac tamponade is a life-threatening condition, that results from progressive or acute accumulation of fluid in the pericardial space impairing cardiac hemodynamics. It is a rare complication of acute pericarditis. About two-thirds of acute pericarditis present with pericardial effusion. Of which, hemodynamic instability is seen in 3-5% of the cases. Point of Care Ultrasound is a cost-effective tool that aids in the prompt identification of life-threatening conditions such as tamponade.

Case presentation: 36-year-old male presented with complaints of fever and dyspnea on exertion for 4 days. He reported being tachycardic at home on his personal pulse oximeter. Past medical …

Mediastinal Mass Presenting As An St-Elevation Mi, Oscar J. Lopez, Gabriel J. Lora Ferreira, Carlos B. Ceron

Research Symposium

Background: MINOCA is defined as a clinical syndrome in which there is myocardial ischemia in the setting of normal coronary arteries. Different causes include coronary spasms, SCAD, or external compression, e.g., by a mediastinal mass. CT or MRI would show presence of the mass, deferring any need for coronary angiography.

Case: The patient is a 57-year-old lady with a past medical history of hypertension who presented to the ED complaining of shortness of breath associated with chest pain. Upon evaluation her vitals were BP 126/76, HR 94, RR 18, O2 98% on room air. Physical exam was unremarkable. Troponin peaked …

Critical Reflection In Practice: Generating Knowledge From The Interactions With Promotores For Engagement In Neurocognitive Disorders, Noe Garza, Ney Alliey-Rodriguez, Rosa V. Pirela, Gladys E. Maestre

Research Symposium

Background: Colonias are underserved areas along the Texas-Mexico border, with high incidences of neurocognitive disorders, dementia, and Alzheimer's disease (AD). Our goal is to build capacity to reduce risk, facilitate treatment for affected individuals, and provide caregiver support. Our aim was to construct an approach that was reflective and would reveal the rich and diverse ways in which people make meaning of their experiences and interactions with scientists, faculty, staff and students.

Methods: We examined our work with local community health workers. (CHWs), promotores in Spanish, to establish contact with, engage, mobilize, and educate the Hispanic communities of the Lower …

Frequency Of Icu Specific Interventions After Middle Meningeal Artery, Niti Dharwadkar, Sohum Desai, Ameer E. Hassan, Wondwossen G. Tekle

Research Symposium

Background: Middle meningeal artery embolization (MMAE) is increasingly performed for the treatment of chronic subdural hematomas. Some authors have described managing minimally symptomatic patients with MMAE in the outpatient setting. Our practice, however, has been to routinely admit patients after MMAE to the neuro-intensive care setting. Objective of this research is to analyze the frequency of ICU level interventions after MMAE in the neuro-intensive care unit.

Methods: A consecutive series of MMA embolizations for cSDH were retrospectively reviewed from 2020 to 2022 at Valley Baptist Medical Center in Harlingen, TX, USA. Frequency of ICU specific interventions such as need for …

Generalized Lymphadenopathy As The Initial Presentation Of A Young Woman With Systemic Lupus Erythematous, Mery Bartl, Christine E. Loftis, Jose Gomez, Daniela Hernandez, Emilia C. Dulgheru

Research Symposium

Background: Generalized lymphadenopathy (LAP) refers to abnormal enlargement of more than two non-contiguous lymph node regions. There are various causes of LAP, including malignancy, infection, autoimmune disorders, medications, and iatrogenic causes. Obtaining a thorough history and physical examination is paramount in identifying the underlying etiology. Most of the time further investigation with laboratory and radiographic studies should be performed to identify the cause. Patients with high-risk features should undergo a biopsy for the diagnosis of malignancy.

Case presentation: A 36-year-old lady with a remote history of COVID-19 presented with complaints of orthopnea, cough, arthralgia, and left-sided abdominal pain for the …

A Whole Clotta Pain: A Case Of Ivc Thrombosis Presenting As Severe Abdominal Pain In A Patient With Anti-Phospholipid Syndrome, Mery Bartl, Christine E. Loftis, Josenny Rodriguez-Paez, Emilia C. Dulgheru

Research Symposium

Background: Anti-phospholipid syndrome (APS) is an immune-mediated condition characterized by the presence of antiphospholipid antibodies in the setting of venous and arterial thrombosis and or pregnancy loss [1]. APS can be a primary syndrome or can be associated with connective tissue diseases such as systemic lupus erythematosus. The goal of treatment in patients with APS is to decrease the risk of thromboembolic events and the standard of care is warfarin therapy. We describe a case of a 42-year-old gentleman with a history of APS on anticoagulation with apixaban who presented to the hospital with severe abdominal pain secondary to infrarenal …