Medical Specialties Commons^™

Regional Disparities In Melanoma Mortality: A Study Of The Lower Rio Grande Valley In South Texas, Jared Hensley, Smaran Marupudi, Neharika Penmetcha, Blake C. Martin, Natasha Quailes, Elias Arellano Villanueva, Maria Villegas

Research Symposium

Background: Melanoma, a serious skin cancer with substantial morbidity, is influenced by demographic, geographic, and healthcare access factors. South Texas' Lower Rio Grande Valley (LRGV) region—including Starr, Willacy, Cameron, and Hidalgo counties—has a predominantly Hispanic population facing unique barriers to timely diagnosis and treatment. This study investigates the primary causes of death among melanoma patients in the LRGV compared to other Texas regions, aiming to uncover regional disparities that could guide public health interventions.

Methods: We conducted a retrospective cohort analysis using data from the Texas Cancer Registry (1995-2019). Patients were grouped into two cohorts: Group 1 (LRGV counties) and …

Leveraging Ai In Teledermatology: A Literature Review On Advancing Health Equity For Underserved Populations, Jared Hensley, Smaran Marupudi, Blake Martin, Neharika Penmetcha, Maria Villegas

Research Symposium

Background: Health disparities in dermatological care tend to disproportionately affect underserved populations, particularly those in rural and resource-limited settings. Teledermatology, augmented by artificial intelligence (AI), presents an opportunity to address these inequities by providing underserved populations with improved diagnostic capabilities. Despite its promise, AI models in teledermatology can often exhibit biases, such as reduced diagnostic efficacy for Fitzpatrick skin types IV-VI, due to their training on non-representative datasets. This literature review explores AI's role in teledermatology and potential strategies to enhance its utility for underserved populations.

Methods: A comprehensive review of peer-reviewed literature was conducted to evaluate the integration of …

Intracavitary Left Ventricular Thrombus In A Patient With Severe Ischemic Cardiomyopathy And Nstemi: A Case Report And Management Approach, Ivan Mogollon, Luis Salcedo, Francisco Arias, Aura Calderon, Catherine Matos, Ismael Cantu

Research Symposium

Background: Intracavitary thrombi are a known complication of ischemic cardiomyopathy, often arising in the setting of severely reduced left ventricular ejection fraction. These thrombi can predispose patients to thromboembolic events and exacerbate cardiovascular compromise. Diagnostic challenges arise when intracavitary masses are identified in conjunction with other critical pathologies, such as acute coronary syndromes or peripheral artery disease. This report highlights the case of a 74-year-old male with multiple cardiovascular comorbidities who presented with near syncope, non-ST elevation myocardial infarction, and an incidental finding of an intracavitary left ventricular thrombus.

Case Presentation: A 74-year-old male with a history of coronary artery …

Progressive Multifocal Leukoencephalopathy (Pml) Induced By Jc Virus: A Case Report And Review Of Clinical Implications, Hugo Zamarron, Roberto Cruz

Research Symposium

Background: Progressive multifocal leukoencephalopathy (PML) is a rare but serious demyelinating disease of the central nervous system, caused by the John Cunningham (JC) virus. While the JC virus is common in the general population, it remains dormant in healthy individuals but can reactivate in immunocompromised patients, particularly those with HIV/AIDS or undergoing immunosuppressive treatments for organ transplants or autoimmune conditions. The virus attacks oligodendrocytes, leading to demyelination and significant neurological deficits. Immunosuppressive therapies such as natalizumab, rituximab, and mycophenolate increase the risk of PML. Diagnosing PML is challenging as its symptoms—focal neurological deficits, sensory-motor issues, and visual disturbances—overlap with conditions …

Staged Reconstruction And Salvage Of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report, Emmanuel Franco, Zayd Ayas, Frank Gerold

Research Symposium

Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.

Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage …

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Cancer Of Unknown Primary With Squamous Cell Carcinoma Phenotype Presenting As Isolated Axillary Mass, Nicole Liang, Mohamed Ashal, Lynne J. Goebel

Internal Medicine

Cancer of unknown primary (CUP) is a rare metastatic malignancy where no primary tumor can be found. We report the case of a 71-year-old female with a strong family history of breast cancer presenting with isolated axillary lymphadenopathy after a tick bite. A biopsy of the axillary mass revealed poorly differentiated squamous cell carcinoma and after extensive evaluation, she was diagnosed with metastatic squamous cell carcinoma with unknown primary tumor. We present this case because of the role of confounding history complicating her initial diagnosis and bringing awareness to a rare disease.

Birth Planning, Audrey K. Gill, Kacie J. Easley

Student Scholarship & Creative Works

This is an informative presentation completed using evidence based practice regarding the importance of birth planning and the use of birth plans. It is used as a tool to educate nurses and healthcare providers about the benefits of implementing birth plan education into their patients portfolio. The birth plan is a written document that involves the collaborative efforts between nurses/healthcare providers and future mothers. It is used in order to personalize and improve the birthing experience for patients. This presentation uses qualitative research, quantitative research, and theoretical framework in order to deem positive results with the implementation of birth plans.

Scaling New Heights: A Prospective Survey Of Rock Climbing's Impact On Mental Health, Kathy Chen, Swetha Sundaram, David F Lo, Ahmed Gawash, Charalampos Papachristou, Altamash E Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Sport climbing, officially added to the 2020 Summer Olympics, has grown rapidly, with U.S. climbing gyms increasing from 310 in 2013 to 591 in 2021. Over the past decade, European research has identified bouldering as a potential psychotherapeutic treatment for anxiety and depression. Randomized controlled trials have compared bouldering psychotherapy (BPT) to cognitive behavioral therapy (CBT), showing that BPT produces comparable results and positively impacts mental health.

PURPOSE: There have been very few studies dedicated to the use of rock climbing as a therapy in the United States; further, there are few surveys that investigate whether American climbers would …

Response To: Correspondence On “Hyperleukocytosis In A Neuroblastoma Patient After Treatment With Natural Killer T Cells Expressing A Gd2-Specific Chimeric Antigen Receptor And Il-15” By Ataca Atilla And Atilla, Gengwen Tian, Amy N Courtney, Andras Heczey, Leonid S Metelitsa

Faculty, Staff and Students Publications

No abstract provided.

Every Jump Is A Leap Of Faith-Just Ask Evel Knievel!, Vicente Orozco-Sevilla, Joseph S Coselli

Faculty, Staff and Students Publications

No abstract provided.

Factors Driving Adolescent Tuberculosis Incidence By Age And Sex In 30 High-Tuberculosis Burden Countries: A Mathematical Modelling Study, Silvia S Chiang, Megan B Murray, Alexander W Kay, Peter J Dodd

Faculty, Staff and Students Publications

INTRODUCTION: During adolescence, tuberculosis incidence rises, with a greater increase in males compared with females. Tuberculosis notifications and estimates infrequently disaggregate adolescent age groups. Moreover, the factors that drive the increases in overall incidence and the male-to-female (MF) ratio remain unclear.

METHODS: We constructed a mechanistic model to estimate cumulative Mycobacterium tuberculosis infection and tuberculosis disease incidence in the WHO’s 30 high-tuberculosis burden countries (HBCs), which represent 86%–90% of global tuberculosis incidence. We derived infection risk from tuberculosis prevalence and assortative social mixing based on sex and age (10–14 years vs 15–19 years old). We adjusted age subgroup-specific risks of …

Photoacoustic Imaging For Image-Guided Gastric Tube Placement: Ex Vivo Characterization, Samuel John, Yeidi Yuja Vaquiz, Nikhila Nyayapathi, Loay Kabbani, Anoop Nilam, Jonathan F Lovell, Nicole A Wilson, Yan Yan, Mohammad Mehrmohammadi

Faculty, Staff and Student Publications

Over 250,000 gastrostomy tubes (G-tubes) are placed annually in the United States. Percutaneous endoscopic gastrostomy (PEG) is the most widely used clinical method for placing G-tubes within the stomach. However, endoscope detectability is limited due to the scattering of light by tissues. Poor organ visibility and low sensitivity of the palpation techniques cause blind needle insertions, which cause colon/liver perforations, abdominal bleeding, and gastric resections. Additionally, imaging artifacts and the poor distinguishability between water-filled tissues make ultrasound (US) imaging-based techniques incompatible with G-tube placement. The risk of ionizing radiation exposure and the confinement of fluoroscopy to radiology suites limits its …

First Documented Case Of A Third-Generation Lvad Rotor Dislodgement, Tyler Lee, Chaitra Janga, Enad Haddad, Kevin Hagan, Donald C. Haas

Abington Jefferson Health Papers

The third-generation left ventricular assist device (3G-LVAD) has significantly reduced adverse events and hospitalizations compared with previous generations. This case presents a rare 3G-LVAD rotor dislodgement malfunction, not previously documented, in a 77-year-old man. Further research behind the malfunction is warranted for early prevention and appropriate management.

Carm1 Regulates Tubulin Autoregulation Through Pi3kc2Α R175 Methylation, Yena Cho, Jee Won Hwang, Mark T Bedford, Dae-Geun Song, Su-Nam Kim, Yong Kee Kim

Faculty, Staff and Student Publications

Tubulin is crucial in several cellular processes, including intracellular organization, organelle transport, motility, and chromosome segregation. Intracellular tubulin concentration is tightly regulated by an autoregulation mechanism, in which excess free tubulin promotes tubulin mRNA degradation. However, the details of how changes in free tubulin levels initiate this autoregulation remain unclear. In this study, we identified coactivator-associated arginine methyltransferase 1 (CARM1)-phosphatidylinositol 3-kinase class 2α (PI3KC2α) axis as a novel regulator of tubulin autoregulation. CARM1 stabilizes PI3KC2α by methylating its R175 residue. Once PI3KC2α is not methylated, it becomes unstable, leading to decreased cellular levels. Loss of PI3KC2α results in the release …

Neonatal Outcomes In Periviable Births Weighing ≤ 500 Grams, Bijan Morshedi, Diego Maurente, Ursula Griffiths-Randolph, Elisabeth Kamano, Katharine Hopkins, Dana Baraki, Juliana Martins, Steven Warsof

Eastern Virginia Medical Journal

Background: The average rate of preterm birth in the US in 2021 was 10.1%. Although the rate of mortality from preterm birth has been decreasing, complications remain the leading cause of death in infants under the age of 5 years worldwide. Gestational age (GA) and birth weight (BW) remain the 2 most important variables for predicting survivability in preterm births, and lower GA and BW are both correlated with lower survivability.

Objective: To explore outcomes of neonates born in the periviable period (20 weeks and 0 days to 25 weeks and 6 days) with BW ≤ 500 g and to …

A Bland–Altman Comparison Of The Lead Care® System And Inductively Coupled Plasma Mass Spectrometry For Detecting Low-Level Lead In Child Whole Blood Samples, Christina Sobin, Tanner Schaub, Natali Parisi, Eva De La Riva

Departmental Papers (PH)

Chronic childhood lead exposure, yielding blood lead levels consistently below 10 μg/dL, remains a major public health concern. Low neurotoxic effect thresholds have not yet been established. Progress requires accurate, efficient, and cost-effective methods for testing large numbers of children. The LeadCare® System (LCS) may provide one ready option. The comparability of this system to the “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS) for the purpose of detecting blood lead levels below 10 μg/dL has not yet been examined. Paired blood samples from 177 children ages 5.2–12.8 years were tested with LCS and ICP-MS. Triplicate repeat tests …

Atypical Dengue Fever With Severe Hematological Manifestations: A Case From The Rio Grande Valley, Elias Arellano Villanueva, Alhasan Asaad, Jose Campo Maldonado

Research Symposium

Background: Dengue fever, a mosquito-borne viral illness, is endemic in tropical regions, including border regions like the Rio Grande Valley while often self-limited, severe presentations such as dengue hemorrhagic fever and dengue shock syndrome highlight its challenges and complexities. This report describes an atypical dengue case with severe hematological manifestations, underscoring the diagnostic challenges and the importance of early recognition, multidisciplinary evaluation, and evidence-based management.

Case Presentation: A 22-year-old Hispanic female with no significant past medical history presented to the ED with hematemesis and fever following her travel to Monterrey, Mexico. Initial symptoms included high fever (107.6°F), chills, diarrhea, vomiting, …

A Peculiar Pancreatitis: Investigating The Adverse Effects Of Mesalamine, Elias Arellano Villanueva, Miguel Lopez, Alhasan Asaad, Jose Campo Maldonado

Research Symposium

Background: Acute pancreatitis (AP) is a leading cause of gastrointestinal-related hospitalizations in the United States, accounting for approximately 300,000 emergency department visits annually. It is characterized by parenchymal and peripancreatic fat necrosis accompanied by inflammation. The clinical diagnosis of AP is based on elevated serum amylase and lipase levels, characteristic imaging findings, and epigastric pain often radiating to the back. While gallstones and alcohol use are the most common causes of AP, drug-induced pancreatitis (DIP) is a rare but increasingly recognized etiology, contributing to 0.1–5% of cases. DIP is typically diagnosed by excluding other causes and is often associated with …

A Case Of Microscopic Colitis Masquerading As Chronic Inflammatory Diarrhea, Corey Haines, Sophia Moon, Giani Tah, Diana Acosta Pozo, Alejandro Aquino, Fatimah Bello

Research Symposium

Introduction: Microscopic colitis is an idiopathic, inflammatory form of colitis that is characterized by a normal macroscopic appearance of bowel but abnormal histological appearance on microscopy. Microscopic colitis can be subdivided into two histological subtypes: collagenous and lymphocytic. The collagenous subtype is characterized by proliferation of collagenous connective tissue that forms a thick subepithelial collagen band while the lymphocytic subtype is characterized by lymphocytic infiltrates and little to no proliferation of connective tissue. Classically, microscopic colitis presents with chronic, nonbloody, watery diarrhea lasting more than one month. It is typically associated with weight loss, abdominal pain, tenesmus, and nocturnal stools. …

Impact Of Diabetes On Fall Related Lower Limb Fractures, Bryce M. Bellon, Daniel Salinas, Patrick De La Torre Shutz, Hunter Butler, Sean Corcoran, Kelsey Baker

Research Symposium

Background: Diabetes is a disorder that affects many Americans, characterized primarily by hyperglycemia due to either insulin resistance or lack of insulin secretion. This condition not only impacts blood sugar levels but also has significant effects on bone health. In diabetes, bone density is often decreased due to reduced osteoblast activity, which is responsible for bone formation, and increased osteoclast activity, which leads to bone resorption. This imbalance accelerates the breakdown of bone. Additionally, diabetics frequently suffer from lower extremity arterial disease (LEAD), which results in poor vascularization of the lower limbs. These factors contribute to an increased risk of …

The Influence Of The Covid-19 Pandemic On Spinal Cord Injury Prevalence And Cause Of Injury In Texas: A Four-Year Retrospective Analysis, Blake C. Martin, Daniel Salinas, Kelsey Baker

Research Symposium

Background: COVID-19 was the most significant medical issue since the Spanish Flu and was declared a pandemic on March 11, 2020. Current literature states that during the COVID-19 pandemic, in which about 10% of the global population was affected, there was a decrease in the frequency of trauma injuries observed in the clinic. Of note, spinal cord injury (SCI) has been suggested to show changing epidemiology from the COVID-19 pandemic. For example, a study in Scotland has suggested that the cause of SCI was significantly influenced during the pandemic, with an increase in self-harm. Such epidemiological changes may influence economic …

Various Bone Disorders Affecting The Rio Grande Valley, Blake C. Martin, Justin Z. Heckman, Manoj Peiris

Research Symposium

Background: The underserved community that is the Rio Grande Valley (RGV), has a distinct demographic profile, with a high prevalence of chronic conditions such as diabetes and obesity, that warrants investigation of various health issues. The main objective of our study was to analyze the demographic disparities between osteoporosis, osteomalacia, rickets, Paget bone disease, and osteonecrosis in the RGV. We hypothesized that the frequency of osteoporosis would be the most common bone condition (of those analyzed) in the Rio Grande Valley and that the demographics between the various bone conditions would vary depending on age, sex, BMI, and ethnicity …

Joint Involvement In A Psoriasis Affected Population In A Medically Underrepresented Region, Blake C. Martin, Jared Hensley, Manoj Peiris

Research Symposium

Background: Psoriatic arthritis is an aggressive condition that may be characterized by compromised quality of life and significant morbidity. The prevalence of psoriatic arthritis in patients with psoriasis is around 1.7% at 5 years, 3.1% at 10 years, 5.1% at 20 years, and 20.5% at 30 years which shows an increase in joint involvement with increasing age, at least until the age of 30. The objective of this study was to explore joint involvement in psoriatic patients in this region and determine what are the demographic disparities in Psoriatic patients regarding joint involvement. We hypothesized that individuals with psoriasis between …

Gout Versus Pseudogout In The Medically Underserved Rio Grande Valley, Blake C. Martin, Fernando Cisneros, Kristina Vatcheva

Research Symposium

Background: Gout and pseudogout are inflammatory joint conditions, with gout being one of the most prevalent etiologies of chronic inflammatory arthritis in the United States. The patient population in the Rio Grande Valley (RGV) has a distinct demographic profile that warrants exploration of various health conditions. The primary objective of this study is to compare the frequencies of gout and pseudogout in the Rio Grande Valley to national frequencies and determine if there were demographic disparities between Gout and Pseudogout in this community. We hypothesized that the frequency gout and pseudogout would be higher in the RGV compared to the …

Demographic And Clinical Characterization Of Bone Metastases And Primary Malignant Bone Neoplasia In The Rio Grande Valley, Blake C. Martin, Neharika Penmetcha, Aun Bangash, Juan Lopez Alvarenga

Research Symposium

Background: The Rio Grande Valley (RGV) is a developing clinical research region characterized by its distinctive demographic profile that offers an opportunity to investigate diverse health issues. This pilot investigation seeks to identify the characteristics of patients diagnosed with bone metastasis and primary malignant bone neoplasia (PMBN) in the RGV. The main objective was to evaluate the demographic and clinical characteristics linked to bone metastases and PMBN in patients from the Rio Grande Valley. We hypothesized that older age and higher BMI individuals would have greater frequency of metastatic lesions compared to PMBN.

Methods: Data was gathered from the …

Demographic And Clinical Characteristics Of Patients With Benign Bone Tumors: Evidence Of Bimodal Age Distribution In A Hispanic Population, Blake C. Martin, Mohammad Khalil, Juan Lopez Alvarenga

Research Symposium

Background: As far as researchers know, there’s no way to prevent BBTs from forming. Although these tumors generally do not metastasize, they can still be dangerous as they may grow and compress healthy tissues and lead to poor outcomes. The principal objective was to evaluate the demographic and clinical characteristics linked to BBTs in individuals from the Rio Grande Valley. We hypothesized that older age, males, and higher BMI individuals would have greater frequency of BBTs.

Methods: This was a retrospective chart review and IRB approval was obtained prior to starting this study. We obtained medical charts for individuals who …

Comprehensive Management Of A High-Risk Pregnant Woman With A Meningoendothelial Meningioma: A Case Report, Blake C. Martin, Kevin Garcia Valdez, Anesu Karen Murambadoro, Tirath Patel, Bharathi S. Gadad, Kelsey Baker

Research Symposium

Background: Meningiomas are the most common CNS tumors and are associated with complications including localized neurological impairments, seizures, and reduced quality of life. These tumors have an incidence twice as high in women as in men, increasing with age and peaking in the seventh and eighth decades of life. The main risk factor for developing meningiomas is exposure to ionizing radiation, although research suggests hormones also contribute. The higher incidence in women, presence of hormone receptors in some tumors, and changes during pregnancy, the menstrual cycle, and menopause, suggest a hormonal link. While pregnancy does not increase meningioma incidence, symptoms …

Characterizing Fracture Distribution By Sex, Age, And Body Region: Insights From A Regional Population Study, Blake C. Martin, Jared Hensley, Juan Lopez Alvarenga

Research Symposium

Background: This Rio Grande Valley (RGV) region of South Texas is a unique region that is impoverished and medically underserved. We conducted this study in order to further the knowledge of orthopedics in this unique, medically underserved community. We sought to determine if certain body regions, based on sex and age, were at increased risk for fracture in this population. We hypothesized that females would have increased fracture frequency at older ages while males would have increased fracture frequency at all other ages. We also hypothesized that femur and forearm fractures would be increased in females compared to males.

Methods …

Bone And Joint Infections: A Retrospective Chart Review Of The Medically Underserved Rio Grande Valley, Blake C. Martin, Chloe Harris, Manoj Peiris

Research Symposium

Background: The Rio Grande Valley (RGV) is a demographically unique region that is impoverished and medically underserved. Because of its unique patient population, this community may be at increased risk for bone and joint infections and the morbidity and mortality that follows. The goal of this study was to analyze individuals with osteomyelitis, septic arthritis, and periprosthetic joint infections and determine which infectious bone or joint conditions are most prevalent in the Rio Grande Valley and determine if there were any demographic disparities between the various types of bone and joint infections and healthy individuals. We hypothesized that age and …