Family Medicine Commons^™

Regional Disparities In The Diagnostic Age Of Skin Carcinomas: An Analysis Of The Rio Grande Valley, Miguel A. Lopez, Natasha Quailes, Elias Arellano Villanueva, Maria Villegas

Research Colloquium

The Rio Grande Valley (RGV) is a region of South Texas with limited dermatologic diagnostic data, particularly among non-melanoma skin carcinomas. The rising rates of chronic conditions and mortality can be attributed to the limited access to healthcare in the region, with skin conditions taking less priority in patients with numerous comorbidities. Data on the age of diagnosis for skin carcinomas between 1995-2019 for Hispanic and non-Hispanic individuals was obtained from the Texas Cancer Registry. It is important to note that the TCR considers primary skin cancers, such as basal and squamous cell carcinoma coded as C44.0-C44.9, as non-reportable cases. …

An Analysis Of The Diagnostic Age Of Skin Carcinomas Across Central Texas, Miguel A. Lopez, Natasha Quailes, Elias Arellano Villanueva, Hamaad Gohar, Maria Villegas

Research Colloquium

Patients seeking healthcare in medically underserved regions often require travel to larger metropolitan hubs across the state of Texas. The Rio Grande Valley (RGV) is home to many such patients who often travel to central Texas for care, which compounds expense and inconvenience. Pockets of central Texas have been reported to have an increased number of dermatologists per 100,000 people. Bexar county ranks among the five most populous counties in the state, with increased access to dermatologic care compared to nearby regions. Using data from the Texas Cancer Registry, this project aims to identify the mean (M) age of diagnosis …

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 …

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths): An Initiative To Address Health Disparities And Promote Equitable Care In The Rio Grande Valley (Rgv), Deepu George, Joanna Garza, Maria G. Hernandez, Yvette K. Cantu Cazares, Monica C. Perez, Yvette K. Cantu Cazares, Mayrin A. Perez

Research Symposium

Purpose: The Rio Grande Valley (RGV) faces significant socio-economic challenges, with 35.6% of residents living in poverty and uninsured rates as high as 40%. Each year, approximately 260,000 residents experience mild to moderate behavioral health conditions. Behavioral health care in the region is particularly scarce, with only 30.1 mental health providers per 100,000 compared to the statewide average of 72.7. Furthermore, approximately 90.5% of the population identifies as Hispanic/Latino, so culturally relevant interventions are critical. The Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) Initiative addresses these disparities by 1) developing a PCBH model tailored to …

Assessing Preparedness, Attitudes, And Knowledge Of Knapp-Utrgv Family Medicine Residents On Geriatric Nursing Home Care: Phase 1 - Creation Of Interactive Modules, Maria M. Ferreira Caceres, Miguel A. Alvarez Silva, Juan C. Lopez-Alvarenga

Research Colloquium

Background: Training in geriatrics and nursing home care are a critical element of medical education. This gap in knowledge becomes increasingly significant given the changing demographics and the need to provide adequate care for an aging population. Improving geriatrics curriculum and implementing nursing home rotations are essential to ensure optimal care for the elderly, thereby fulfilling both educational and healthcare imperatives.

Objective: We aim to analyze and assess the influence of geriatrics training through a survey to collect attitudes, skills, and knowledge of UTRGV Knapp Family Medicine residents. Additionally, the goal is to create interactive modules to boost their skills …

Use Of Translational Science, Continuous Glucose Monitoring In The Primary Care Setting For Management Of Nesidioblastosis: A Case Report And Literature Review, Karuna Manandhar, Othman Farahneh, Ahmad Damlakhy, Ali Lattouf, Gerardo Munoz-Monaco

School of Medicine Publications

Nesidioblastosis is a term used to describe histologic changes in the pancreatic cell, which are defined by beta cell hypertrophy and the formation of ductoinsular complexes. It is a disease previously most extensively identified in neonates and is a rare cause of endogenous hypoglycemia in the adult population. However, with increasing numbers of gastric bypass surgeries for the management of obesity in recent years, there has been a growing number of populations with post-gastric bypass surgery-related nesidioblastosis. Here, we will present a case of a 60-year-old female with a history of Roux-en-Y gastric bypass (RYGB) surgery who initially presented with …

The Fortify Resilience Initiative, Maria Hernandez, Yvette Cantu

Research Symposium

The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. In order to address the multitude of threats to physician wellness and to mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this Initiative from the Office of GME will strengthen existing wellbeing pathways while expanding additional solutions that will work to sustain wellbeing. Utilizing a combination of prevention, promotion, and intervention strategies targeted …

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Salvador Arellano Iii, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I2PBH) Initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I2PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality IBH clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students will serve as Behavioral Health Consultants (BHC) …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Baclofen Induced Excessive Perspiration; A Case Report, Othman Farahneh, Lois C. Akpati, Miguel Alvarez Silva

Research Symposium

This case report highlights an unexpected side effect of Baclofen, a well-known medication, excessive sweating, a rare occurrence not typically associated with the drug. The patient, a 63-year-old woman, experienced persistent sweating despite initial attributions to postmenopausal symptoms and subsequent medication adjustments. Extensive testing revealed an association between Baclofen use and the symptoms, which resolved upon discontinuation of the drug.

The significance of this case lies in drawing attention to the underreported side effects of excessive sweating linked to Baclofen, emphasizing the importance of considering medication-related effects even with established drugs. The report urges increased awareness among healthcare professionals, addressing …

A Rare Case Of Acute Pancreatitis Associated With Cannabinoids Consumption, Mays Abdulazeez, Michael Perez, Alejandro Hidalgo Parada, Rani Rabah, Greity Dominguez, Rowel Perez Vargas, Jose Cano, Jesus Garza-Tamez, Sunand Kallumadanda

Research Symposium

Introduction: Acute pancreatitis is an inflammatory condition of the pancreas characterized by abdominal pain and elevated levels of pancreatic enzymes in the blood. Acute pancreatitis is a leading gastrointestinal cause of hospitalization in the United States. Several conditions are associated with acute pancreatitis, of which gallstones and chronic alcohol use disorder account for approximately two-thirds of the cases. Others, including smoking, hypertriglyceridemia, infections, trauma, drugs, malignancy, scorpion stings, hypercalcemia, endoscopic retrograde cholangiopancreatography (ERCP), opioids, angiotensin-converting enzyme (ACE) inhibitors, macrolides, diuretics, statins, and cannabis have also been associated with acute pancreatitis. Cannabis is the most widely used recreational drug worldwide, with …

Use Of Translational Science, Continuous Glucose Monitoring In The Primary Care Setting For Management Of Nesidioblastosis. A Case Report, Karuna Manandhar, Othman Farahneh, Gerardo Munoz-Monaco

Research Symposium

Background: Nesidioblastosis is a term used to describe histologic changes in the pancreatic cell defined by beta cell hypertrophy and formation of ductoinsular complexes. It is a disease previously most extensively identified in neonates and is a rare cause of endogenous hypoglycemia in the adult population. However, with increasing numbers of gastric bypass surgeries for management of obesity in recent years, there has been a growing number of populations with post gastric bypass surgery related nesidioblastosis.

Case Description: Our case report follows a 60-year-old female with previous history of Roux-en-Y gastric bypass surgery who initially presented to an acute-care hospital …

Sacral Pain "Recurrence" Not Exactly The Teenage Dream, Evan D. Perez

Research Symposium

Background: This case is a great example of remembering the basics. We teach our medical students, residents and fellows the importance of getting a thorough history and exam. However, this case is a reminder to apply those lessons in the real world.

Case Presentation: 15 yo Female came in complaining of sacral pain. 2 years prior she had a fall causing a coccyx fracture which resolved with conservative treatment. She didn’t have any issues since then until 3 weeks prior to today when she began to have pain in the same area. She denied any new inciting events such as …

Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu

Research Colloquium

Background: Penile Calciphylaxis occurs in about 1–4% of hemodialysis patients worldwide. Associated mortality rates are very high, and hyperparathyroidism is the second most frequently associated disorder. Addressing the resulting metabolic imbalance, and surgical intervention guided by findings of radiological studies may improve quality of life. The pathogenesis is thought to be mediated by vascular smooth muscle cells which differentiate into osteoblast-like cells. Decrease in vascular calcification inhibitory proteins fetuin-A and matrix Gla is found in patients on dialysis causing systemic medial calcification of arterioles, leading to epidermal ischemia, tissue infarction, and ulceration.

Case presentation: 47-year-old male with history of coronary …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Comparing Stroke Symptom Recognition And Intervention Times In The Rio Grande Valley, Joshua M. Ninan, Kelsey Baker

Research Symposium

This is a retrospective study that aims to evaluate the duration from onset of stroke-like symptoms to presentation to medical facilities for aid in the Rio Grande Valley. The main goal of the study is to understand the extent of pre-hospital delays with regards to the treatment of stroke in the RGV.