Medical Specialties Commons^™

The Effect Of Co-Morbid Chronic Illnesses On The Outcomes Of Traumatic Intracranial Hemorrhage In The Rio Grande Valley: A Retrospective Analysis, Sowmya Duddu, Julia Paz, Andrea Argenal, Sonya Bhatia, Nina Mourao, Tori Sayers, Manoj Peiris, Kelsey Baker, Bharathi S. Gadad

Research Symposium

Introduction: Intracranial hemorrhage is bleeding occurring in or around the brain. The severity can range from mild to fatal with a variety of lasting symptoms. The severity and outcome depends on a number of factors such as the location, treatment, and pre-existing patient conditions. Previous studies have been done observing comorbidities in patients, such as hypertension or diabetes, and their role in intracranial hemorrhages. The purpose of this project is to identify how pre-existing health conditions, such as diabetes, hypertension, blood disorders, and more, influence the type and severity of intracranial hemorrhages.

Methods: A retrospective analysis was conducted …

Incidence Of Myocardial Infarction And Neurodegenerative Disease Co-Occurrence In The Rio Grande Valley: A Five-Year Retrospective Analysis, Sowmya Duddu, Maria Sophia Malbas, Allison Mcadams, Julia Paz, Miguel Quintanilla, Karina Zamora, Hansapani Rodrigo, Kelsey Baker

Research Symposium

Introduction: Neurodegenerative Diseases (NDDs) are a group of disorders leading to the degeneration of neurons causing varying degrees of functional loss. NDDs lead to a loss of independence for the patients and an emotional burden for the patients’ families or caretakers. Previous studies have shown that the prevalence of neurodegenerative diseases such as Alzheimer’s Disease or Vascular Dementia is high in the Rio Grande Valley. Due to the severity of these diseases, research is currently being done to determine the factors that correlate with the development of neurodegenerative diseases and whether there is a causative effect. The purpose of …

Who Leaves Orthopedics? Analyzing Attrition Among Texas Orthopedic Surgeons, Sean Corcoran, Anesu Karen Murambadoro, Paul Bonilla, Victoria Elizondo, Tori Sayers, Daniela Ramos, Mark Manickath

Research Symposium

Background: Nationally, attrition rates in surgical specialties have been reported to be as high as 20-26%. As of 2019, women comprised only 6.5% of the 29,613 orthopedic surgeons. Female residents showed significantly higher overall attrition rates compared to males (5.96% vs. 2.79%, p < 0.001), with unintended attrition nearly twice as high (2.09% vs. 1.01%, p < 0.001). Attrition can result from a wide array of variables, including sex, ethnicity, education, and background. The aim of this study was to evaluate the demographic and educational factors associated with career longevity beyond training among orthopedic surgeons, with a focus on identifying patterns of attrition in underrepresented groups.

Methods: Data from the Texas Medical Board Physician Database as of September 2024 was evaluated using Microsoft Excel. To determine length of practice, the date of license issuance was subtracted from the date of license expiration. Surgeons with license expirations after 2024 were excluded to maintain a focus on physicians that are no longer practicing. Entries …

Evaluating The Effectiveness Of Cryoneurolysis As A Preoperative Intervention In Total Knee Arthroplasty: A Literature Review, Paul Bonilla, Anesu K. Murambadoro, Juan Pablo Flanagan, Victoria Elizondo, Aamir Ahmad

Research Symposium

Background: Total knee arthroplasty (TKA) is a highly effective treatment for knee osteoarthritis, but significant postoperative pain often necessitates opioid use. Over 70% of patients use opioid drugs 3 weeks after TKA and up to 15% of TKA patients develop opioid dependence, increasing the risk of adverse effects, infections, and contributes to costly revision surgeries. Cryoneurolysis, a minimally invasive technique involving freezing peripheral nerves, has gained attention as a promising preoperative intervention. This study explores the potential of cryoneurolysis as a preoperative intervention to alleviate pain, reduce opioid dependence, and improve functionality.

Methods: A literature search was conducted using the …

Dual-Modality Nerve Ablation: Preoperative Radiofrequency And Cryoneurolysis For Enhanced Pain Relief In Total Knee Arthroplasty, Paul Bonilla, Juan Pablo Flanagan, Anesu Karen Murambadoro, Victoria Elizondo, Aamir Ahmad, Devin Peck

Research Symposium

Background: Total knee arthroplasty (TKA) relieves debilitating knee osteoarthritis but is associated with significant postoperative pain managed by many modalities including opioid treatment. Current pain management strategies rarely address both deep and superficial pain sources effectively. This study aims to introduce a novel dual-modality preoperative pain management technique combining radiofrequency (RF) ablation and cryoneurolysis to improve patient outcomes and reduce opioid dependence postoperatively.

Methods: A literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database and PubMed with keywords including “cryoneurolysis” , “TKA” , “radiofrequency ablation”. Additionally, a semi-structured interview was conducted with a recognized …

Assessing Patient Satisfaction: The Role Of Net Promoter Scores In Healthcare, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: The Net Promoter Score (NPS) is a widely used tool for measuring customer satisfaction and loyalty through a simple question: “How likely are you to recommend [company name] to a friend or colleague?” Responses categorize individuals as Promoters (9–10), Passives (7–8), or Detractors (0–6), with the final score calculated by subtracting the percentage of Detractors from Promoters. Introduced in 2003, NPS has become popular across industries for its simplicity, predictive value, and benchmarking capabilities. In healthcare, NPS adoption is increasing as hospitals seek concise, standardized tools to assess patient satisfaction—an essential metric in the shift toward value-based care. …

Patterns And Outcomes In Urotrauma: An Analysis Of Fatality Trends And Contributing Factors, Neharika Penmetcha, Aun Bangash, Kelsey Baker

Research Symposium

Background: Urotrauma, involving injuries to the kidneys, ureters, and bladder, represents a critical subset of trauma cases, significantly impacting patient morbidity and mortality. Renal and urogenital injuries account for 10–20% of abdominal trauma in adults and children. Understanding urotrauma's epidemiology is vital for improving care protocols and resource allocation. Despite its impact, data on injury mechanisms, intent, and care modalities specific to urotrauma remain limited. This study investigates patterns in injury mechanisms, intent, transport modalities, and facility transfer status to identify factors influencing patient outcomes and inform trauma care improvements.

Methods: A retrospective review analyzed 3,492 trauma cases, filtered for …

Assessing And Addressing Distress For Informal Caregivers Caring For Oncology Patients, Megan Murphy, Carrie Ann Matyac (Project Chair)

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Between A Badge Buddy And Policy: An Ebqi Tool For Critical Care Nurses, Sean Robinson

Providence Nursing Research Conference 2023 – Present

No abstract provided.

I Like To Move It: Nurse Driven Protocol For Early Mobility In Icu Patients, Jenna Drazovich, Patrick Cink

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Skin-To-Skin Care To Decrease Length Of Stay For Late Preterm Newborns, Theresa Bowden, Colleen Applegate, Susan Stauffer, Alex Schmidt, Lisa Mcgill-Vargas, Barbara Bennett-Wolcott

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Bridging The Gap: A New Approach To Retaining Icu Nurses In Their First Year, Megan Jones, Kristen Mayberry, Sarah Sumner

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Timing Of Neurologic Pupil Index Assessments In Comatose Patients Undergoing Target Temperature Management After Out-Of-Hospital Cardiac Arrest, Jill Carington, Cherie Fox, Teresa Wavra, Michael P Simanonok

Providence Nursing Research Conference 2023 – Present

No abstract provided.

The Effect Of Artificial Intelligence On High Tibial Osteotomies, Mohammad Khalil, David Rakay, Mohammad Y. Karkoutly, Zayd Ayas, Omar Karkoutly

Research Symposium

Background: High tibial osteotomy (HTO) is a surgical procedure which helps in managing lower limb deformities, provides pain relief, and arrests the progression of osteoarthritis of the knee joint. This surgical method involves cutting and realignment of the tibia and this is only as effective as the accuracy with which the tibia is cut and realigned and this success is based on the understanding of the biomechanics and the anatomical characteristics of the patient. Artificial Intelligence (AI) is becoming more widespread in the field of orthopaedic surgery, with applications in diagnostics, pre-operative planning, and predictive models of outcomes following procedures. …

Return To Sport After Anterior Shoulder Stabilization Of Ncaa Football And Nfl Athletes – A Systematic Review, Yolanda V. Gutierrez, Mohammad Khalil, Aasim Ahmad, Aamir Ahmad

Research Symposium

Background: Anterior shoulder instability is an injury prevalent in contact and non-contact athletes and can result in limited movement, increased recurrence of dislocation, and decreased quality of sports activity. Notable sports that present with frequent anterior shoulder instability include wrestling, hockey, basketball, baseball, and most commonly, football. Athletes may undergo surgical management of anterior shoulder instability via arthroscopic repair, remplissage, Laterjet, or glenoid bone grafting procedures. This review aims to evaluate the return-to-sport rates among elite football athletes in the NCAA and NFL following surgical stabilization, assess post-surgical performance, and analyze the recurrence of instability or complications.

Methods: This systematic …

Incidence Of Diabetes And Obesity In Adhesive Capsulitis Cases In The Rio Grande Valley, Mohammad Khalil, Blake Martin

Research Symposium

Background: Adhesive capsulitis, or frozen shoulder, is a condition characterized by pain and restricted motion in the shoulder joint. Previous studies implicate diabetes as one of the core risk factors for the condition, along with thyroid disease, female sex, and prolonged immobilization. This study aims to investigate the incidence of diabetes and obesity in patients diagnosed with adhesive capsulitis in the Rio Grande Valley, a region with a high prevalence of metabolic disorders.

Methods: A retrospective analysis (IRB-24-0306) was conducted on 836 patients diagnosed with adhesive capsulitis. Demographic variables, including age, sex, and ethnicity, were collected. Clinical data regarding shoulder …

Under The Surface: A Rare Case Of Morphea In The Rio Grande Valley, Miguel A. Lopez, Jared Hensley, Maria Villegas

Research Symposium

Localized scleroderma, also referred to as “morphea,” is a rare autoimmune disorder that occurs in an estimated one out of 10,000 patients per year. Research on the demographics of morphea has shown an increased prevalence in female patients. Its presentation may consist of skin lesions confined to the epidermis and dermis that appear erythematous and bruise-like, with signs of central skin tightening or sclerosis; deeper lesions may be identified as edematous, erythematous plaques in the absence of well-defined borders. A subtype named “En coup de sabre,” exists among the classification of “linear morphea” and presents with a linear induration either …

Maternal Health And Congenital Heart Defects: Investigating Ventricular Septal Defects In South Texas Region 11, Miguel A. Lopez, Sophia Moon, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

Congenital heart defects are a known risk factor for early childhood mortality and can be traced to poor maternal health, a crisis plaguing the South Texas region. This perspective research project utilizes previously computed data on the prevalence of ventricular septal defects (VSD) in South Texas region 11 combined with a comprehensive literature review to investigate the correlation between both maternal obesity and diabetes with VSD. Current literature supports a significant association between maternal diabetes and VSD, with one Russian study reporting an eight to nine fold increased risk in VSD in children born to diabetic mothers. By contrast, the …

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 …

Exercise And Hypertrophic Cardiomyopathy: Risks, Benefits, And Safety - A Systematic Review And Meta-Analysis, Arif Albulushi, Qasim Al Abri, Ahmed Tawfek, Ahmed Reza Bagheri, Said Al-Hinai

Journal of the Saudi Heart Association

Hypertrophic cardiomyopathy (HCM) is often associated with conservative exercise recommendations due to the risk of sudden cardiac death (SCD). However, emerging evidence suggests that tailored exercise programs may provide significant benefits to HCM patients. This systematic review and meta-analysis evaluated the impact of different types and intensities of exercise on clinical outcomes and quality of life in HCM patients, assessed the role of exercise in preventing disease progression and arrhythmias, and determined the safety and efficacy of structured exercise programs tailored to individual risk profiles.

A comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and relevant cardiology journals. …

The Unusual Suspect - Herpes Zoster As The Culprit For Severe Abdominal Pain. A Case Report., Edward Lovering, Ahmad Asif, Sean Sheih, Samuel B Holzman, Yani Zhang

Journal of Community Hospital Internal Medicine Perspectives

Reactivation of herpes zoster leading to disseminated and visceral organ involvement is an uncommon phenomenon and almost always associated with immunocompromised patients. Visceral herpes zoster is a challenging diagnosis to make as patients typically present with severe abdominal pain which precedes the typical rash of herpes zoster. We describe the case of a 68-year-old female who presented to the emergency department with abdominal pain and was subsequently diagnosed with disseminated herpes zoster and found to have underlying monoclonal gammopathy.

Subcutaneous Insulin Aspart Every 4 Hours In The Treatment Of Covid-19 Patients With Mild-To-Moderate Diabetic Ketoacidosis: A Case Series, Dararat Chiewchalermsri, Chayanin Wanittansirichok, Chutintorn Sriphrapradang

Journal of Community Hospital Internal Medicine Perspectives

This case series evaluates the efficacy and safety of subcutaneous (SC) insulin Aspart administered every four hours for managing mild-to-moderate diabetic ketoacidosis (DKA) in COVID-19 patients, addressing a current evidence gap. We conducted a retrospective review of confirmed COVID-19 patients over 15 years old who developed mild to moderate DKA between July 2020 and October 2021. Insulin Aspart was administered at 0.4 units/kg SC every 4 hours, reduced to 0.2 units/kg when blood glucose (BG) decreased to/dL, and SC basal insulin was initiated at 0.15-0.2 units/kg at DKA diagnosis. A total of seven patients, with a mean age of 67.4±13.2 …

New Onset Atrial Fibrillation In Hospitalized Patients, Arafat Ali Farooqui, Syed Mohammad Mazhar Uddin, Sanjay Kumar Maheshwari, Kevin Clements, Rabiah Ashraf, Jay Keith, Neha Sharma, Haris Bilal, Naira Saleem, Vijay S. Shetty

Journal of Community Hospital Internal Medicine Perspectives

Objectives: To evaluate different factors precipitating new onset atrial fibrillation (AF) in hospitalized patients and their effect on in-patient mortality.

Design: Retrospective cross-sectional study

Setting: Urban tertiary care center in New York City

Measurements:

Primary outcomes:

• Determine different factors precipitating new onset atrial fibrillation in hospitalized patients and their effect on in-patient mortality

Secondary outcomes:

• Determine the duration of hospital stay after admission precipitating new onset atrial fibrillation and its effect on mortality
• Evaluate different factors in COVID-19 patients with new onset atrial fibrillation

Results: Out of 464 patients; 62.3% were males and 37.72% were females. Evaluation of patients before …

Navigating Thyroid Crises: A Nationwide Analysis Of The Weekend Effect And Mortality Trends In Myxedema Coma (2016-2020), Mariam Hashmi, Zubair Hassan Bodla, Fatima Niaz, Umer Farooq, Zahra Niaz, Christopher L. Bray, Peters Okonoboh

Journal of Community Hospital Internal Medicine Perspectives

Our objective was to utilize the National Inpatient Sample (NIS) database for analyzing the outcomes of myxedema coma based on the day of admission and explore five-year mortality trends. This retrospective cohort study examined in-patient mortality and secondary outcomes of patients with myxedema coma from 2016 to 2020 using the NIS database. Patients were selected using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and divided into weekday and weekend admission groups. From 174,776,205 discharges, 5,095 patients were included. Mean age of admitted patients was higher on weekdays (67.1 year) than weekends (66.5), with females constituting 69.4% and …

Assisted Reproductive Technology (Art) In The Mountain West, 2022, Caitlin J. Saladino, Kristian Thymianos, William E. Brown Jr., Monserrat Cristando-Romo, Taylor Volk, Yashesvi Sharma

Health

This fact sheet examines data on Assisted Reproductive Technology (ART) clinics located in five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. The Centers for Disease Control and Prevention 2022 Fertility Clinic Success Rates Report includes data from all 50 states and provides information on ART services offered by individual clinics, including data on total cycles, fertility preservation cycles, pregnancies, deliveries, and total infants born.

Future Applications Of Fluorescence Lifetime Imaging Ophthalmoscopy In Neuro-Ophthalmology, Neurology, And Neurodegenerative Conditions, Daniel M. Markowitz, Elizabeth Affel, György Hajnóczky, Robert C. Sergott

Farber Institute for Neuroscience Faculty Papers

Fluorescence lifetime imaging ophthalmoscopy (FLIO) has emerged as an innovative advancement in retinal imaging, with the potential to provide in vivo non-invasive insights into the mitochondrial metabolism of the retina. Traditional retinal imaging, such as optical coherence tomography (OCT) and fundus autofluorescence (FAF) intensity imaging, focus solely on structural changes to the retina. In contrast, FLIO provides data that may reflect retinal fluorophore activity, some of which may indicate mitochondrial metabolism. This review builds upon the existing literature to describe the principles of FLIO and established uses in retinal diseases while introducing the potential for FLIO in neurodegenerative conditions.

Chemoradiation Treatment With Or Without Concurrent Tumor-Treating Fields (Ttfields) Therapy In Newly Diagnosed Glioblastoma (Gbm) Patients In China, Liping Liang, Lingchao Chen, Chunxia Ni, Wenyin Shi, Zhirui Zhou, Shu Chen, Wenjia Zhu, Jiabing Liu, Xianxin Qiu, Wanzun Lin, Junyan Zhang, Zhiyong Qin, Yang Wang

Department of Radiation Oncology Faculty Papers

BACKGROUND: Tumor-treating fields (TTFields) therapy and radiotherapy may have synergistic anti-glioma effect based on preclinical studies. The combination of chemoradiation therapy (CRT) with TTFields therapy has noticeably attracted clinicians' attention. This study aimed to provide insights into the clinical outcomes of patients with newly diagnosed glioblastoma who received either concurrent CRT and TTFields therapy or adjuvant TTFields therapy following CRT. The findings were based on a cohort of patients who were treated at Huashan Hospital (Shanghai, China).

METHODS: This retrospective study analyzed ndGBM patients' clinical outcomes who were treated at Huashan Hospital and received TTFields therapy. Patients were categorized into …

Association Of Inflammatory Biomarkers With New Functional Morbidity At Hospital Discharge In Children Who Survive Severe Sepsis, Mallory Perry-Eaddy, Walter Faig, Martha Curley, Scott Weiss

Department of Pediatrics Faculty Papers

OBJECTIVE: New functional morbidity is common in critically ill children who survive sepsis; yet, the underlying biological mechanisms, particularly the impact of inflammation, remain unknown. We sought to test the hypothesis that increased levels of inflammatory biomarkers during the acute phase of pediatric sepsis are associated with new functional morbidity at hospital discharge.

METHODS: We conducted a post hoc secondary analysis of the MitoPSe clinical study, including N = 119 critically ill children who survived sepsis. Data collected included demographic and clinical variables and 31 inflammatory biomarkers collected at three distinct timepoints (within days 1-2 of PICU admission, days 3-5, …

Heart Failure In Black Populations: Epidemiology, Pathophysiology, And Treatment Disparities, Kazi N. Islam, Rahib K. Islam, Ivan Nguyen, Yasmeen Magherahabed, Humza Pirzadah, M. Bazlur Rashid

School of Medicine Faculty Publications

Heart failure (HF) remains a significant health challenge globally, placing a heavy burden on individuals, families, and healthcare systems. The prevalence of HF continues to rise, posing substantial public health concerns. This burden is particularly pronounced among the Black Population, who face higher prevalence, earlier onset, and greater severity of HF compared to other racial and ethnic groups. This review explores the multifaceted landscape of HF in Black individuals by examining epidemiological patterns, pathophysiological mechanisms, clinical presentations, treatment disparities, and clinical outcomes. Black individuals exhibit distinct pathophysiological characteristics, such as genetic variations contributing to heightened susceptibility and severity of HF. …

High Rate Of Complications With Exchange Nailing For Femoral Nonunions, Benjamin Averkamp, Ziqing Yu, Julia C. Mastracci, Matthew J. Braswell, Andrew T. Chen, Luke A. Lopas, Ishani Sharma, Hassan Farooq, Hassan Mir, Jessica Rivera, Rachel B. Seymour, Joseph R. Hsu, Evidence-Based Musculoskeletal Injury & Trauma Collaborative, Robert D. Zura, Marc Schatz, Et Al

School of Medicine Faculty Publications

Objectives: To evaluate rates of nonunion repair, osseous healing, and outcomes in femoral nonunions with contemporary healing. Design: Retrospective review. Setting: Five academic level 1 trauma centers. Patients/Participants: This study includes adult patients (age older than 18) seen at one of the participating institutions between 2012 and 2019 who sustained a femur fracture (OTA/AO 31, 32, 33) initially treated with intramedullary fixation that developed nonunion and were treated with exchange nailing for the index nonunion surgery. Seventy-nine patients with femoral nonunion met inclusion criteria. Intervention: Exchange nailing for treatment of femoral nonunion. Main Outcome Measurements: The primary outcome measure was …