Internal Medicine Commons^™

Beyond The Clot: A Rare Case Of Extensive Dvt And Pulmonary Embolism Revealing May-Thurner Syndrome, Jorge A. Aboytes, Jose J. Loayza, Ivan Mogollon, Daniel Pena, Michelle Lopez

Research Colloquium

Introduction: Deep vein thrombosis (DVT) in young adults is uncommon and typically associated with identifiable risk factors. In cases where DVT occurs without apparent provocation, congenital anatomical anomalies should be considered. May-Thurner Syndrome (MTS), a vascular compression disorder involving the left iliac vein, is a frequently overlooked cause of iliofemoral DVT in young individuals, particularly women.

Case Presentation: A 28-year-old woman with no significant medical history presented with acute left leg swelling, pain, and discoloration, along with new-onset dyspnea and chest discomfort. She had recently transitioned to a contraceptive patch and reported reduced mobility due to fatigue. Imaging confirmed left …

Sex-Based Differences In Clinical Outcomes Among Cardiogenic Shock Patients Treated With Mechanical Circulatory Support, Emmanuel Olumuyide, Ju Young Bae, Rongras Damrongwatanasuk, Ezaz Rahman, Barbara Malaga-Espinoza, Jiun-Ruey Hu, S. Elissa Altin

School of Medicine Publications

Despite advances in therapies, cardiogenic shock (CS) remains associated with high mortality rates, often necessitating mechanical circulatory support (MCS) to preserve end-organ perfusion. Despite increasing rates of MCS utilization, less is known about sex-related differences in clinical outcomes to guide practice. Additionally, standardized management protocols for CS patients requiring MCS that account for sex differences are lacking. In this study, we evaluate sex-specific outcomes in CS patients requiring MCS, examine patterns of MCS utilization by sex, and further stratify clinical outcomes by sex across the overall CS cohort, including the acute myocardial infarction-related CS (AMI-CS), acute heart failure-related CS (AHF-CS), …

Comparing The Effect Of Oral And Transdermal Estrogen Therapy On Lipid Profile In Postmenopausal Women: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials, Mohamed Doma, Jose J. Loayza Pintado, Aria Atwal, Angelica Lopez Jesus, Farhaan Zahrawi, Ibrahim Saleh, Ahmed El Gammal, Zeyad Maharm, Adham Galal Ramadan, Benito Vlassis, Mustafa Shafeeq Ali, Mohammad Khodr Aljamali, Ralph Pandey, Mounira Mefti, Merhan Badran, Muaaz Aslam, Anuj Subedi, Jaffer Shah, Hani Aiash

Research Colloquium

Introduction: Menopause is associated with significant physiological changes, including alterations in lipid profiles. Estrogen therapy plays a crucial role in managing symptoms and preventing long-term complications. This study aims to compare oral and transdermal routes of estrogen therapy among postmenopausal women and assess changes in lipid parameters from baseline.

Methods: Randomized clinical trials comparing oral and transdermal estrogen therapy in postmenopausal women were identified through searches in PubMed, Scopus, Web of Science, and ClinicalTrials.gov. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Statistical analysis was conducted using R version 4.3.2.

Results: Eight randomized …

Cardiovascular Response Patterns To Oral Versus Transdermal Estrogen Therapy In Postmenopausal Women, Mohamed Doma, Jose J. Loayza Pintado, Aria Atwal, Angelica Lopez Jesus, Farhaan Zahrawi, Ibrahim Saleh, Ahmed El Gammal, Zeyad Maharm, Adham Galal Ramadan, Benito Vlassis, Mustafa Shafeeq Ali, Mohammad Khodr Aljamali, Ralph Pandey, Mounira Mefti, Merhan Badran, Muaaz Aslam, Anuj Subedi, Jaffer Shah, Hani Aiash

Research Colloquium

Introduction: The comparative effects of oral versus transdermal estrogen therapy on cardiovascular parameters in postmenopausal women remain incompletely understood. This analysis aimed to evaluate blood pressure and heart rate responses between administration routes.

Methods: A systematic review of randomized trials comparing oral and transdermal estrogen therapy in postmenopausal women was conducted. Primary outcomes included changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate. Random-effects meta-analysis was performed to calculate pooled mean differences (MD) with 95% confidence intervals (CI).

Results: Analysis of 8 randomized trials (N=885) showed no significant differences between oral and transdermal routes in mean …

Severe Cold Agglutinin Hemolytic Anemia Secondary To Mycoplasma Pneumoniae And Epstein-Barr Virus Co-Infection In An Elderly Patient, Aura Mc Calderon, Jose Loayza, Luis Salcedo, Ivan Mogollon, Asmik Asatrian

Research Symposium

Introduction: Cold autoimmune hemolytic anemia (AIHA) is an uncommon, complement-mediated hemolysis typically driven by IgM autoantibodies; secondary forms are often infection-related. Severe, transfusion-refractory presentations are rare in older adults. We present an elderly patient with Mycoplasma pneumoniae and Epstein–Barr virus co-infection complicated by life-threatening cold agglutinin hemolysis.

Case report: Upon admission, a 79-year-old male patient presented with a one-week history of fatigue, pyrexia, nasal congestion, and dyspnea; examination findings revealed pallor, bibasilar crackles, and mild splenomegaly. Laboratory investigations indicated the presence of severe hemolytic anemia accompanied by compensatory reticulocytosis and thrombocytosis (hemoglobin 5.5 g/dL, hematocrit 17.2%, MCV 100 fL, reticulocytes …

Iptacopan-Responsive Pnh With Pancytopenia: Hematologic Normalization And Dose Adjustment For Transaminitis, Aura Mc Calderon, Jose Loayza, Francisco Arias, Catherine Matos, Bharat Peddinani, Diane Nguyen

Research Symposium

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal hematopoietic stem-cell disorder driven by loss of GPI-anchored complement regulators (CD55, CD59), leading to complement-mediated intravascular hemolysis, cytopenias, and thrombosis. We report a new PNH diagnosis in a young woman with severe pancytopenia who achieved hematologic improvement on oral iptacopan, requiring dose adjustments for mild liver enzyme elevation.

Case Report: On February 27, 2025, a 38-year-old female patient exhibited symptoms of progressive fatigue, dyspnea, and jaundice. Initial laboratory assessments indicated the presence of severe hemolytic anemia accompanied by pancytopenia, hemoglobin level recorded at 4.7 g/dL, white blood cell count at 1.6×10³/µL (absolute …

Gper As A Therapeutic Target In Breast Cancer: Pharmacologic Inhibition And Microbiome Associations, Sierra E. Vidaurri, Shweta Singh, Valerie E. Ledezma, Rajesekhar Baru, Emma Garza, Francisco Flores, Muhammad Noorani, Shubhank Goyal, Aura Calderon, Alexander Lim, Anupam Dhasmana, Swati Dhasmana, Murali Yallapu, Subhash Chauhan, Diane Nguyen, Sheema Khan

Research Symposium

Background: The G protein–coupled estrogen receptor (GPER) mediates rapid estrogen signaling that promotes proliferation, migration, and therapeutic resistance in breast cancer, including in hormone receptor–negative subtypes. Notably, standard endocrine therapies may inadvertently activate GPER, highlighting the need for direct targeting of this pathway. The objectives of this study were to evaluate GPER as a therapeutic target using pharmacologic modulators and to determine how GPER-driven tumor behavior relates to tumor microbiome composition across breast cancer subtypes.

Methods: Breast cancer cell lines representing Luminal A (MCF7), Luminal B (BT474), HER2-enriched (SKBR3), and triple-negative (HCC38, MDA-MB-453, MDA-MB-231) subtypes were treated with Ormeloxifene (ORM). …

Secondary Cutaneous Involvement In Peripheral T-Cell Lymphoma: Diagnostic Frameworks, Staging Integration, And Therapeutic Implications, Aura Calderon, Jose Loayza Pintado, Cristina Kochi, Jared Hensley, Andres Suarez Parraga, Everardo Cobos

School of Medicine Publications

The occurrence of secondary cutaneous manifestations in peripheral T-cell lymphoma (PTCL) is relatively infrequent and can resemble benign dermatoses, leading to diagnosis delays. We present the case of a 78-year-old female patient with a diagnosis of PTCL affecting the left parotid gland, who experienced a 2-day sudden and intensely pruritic skin eruption, which progressed from both forearms to the trunk, involving more than 50% of the total body surface area. Initially, the eruption was managed as a hypersensitivity reaction with antihistamines and corticosteroids, with temporary symptomatic relief; however, the rapid clinical progression in the context of an established diagnosis of …

Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko

School of Medicine Publications

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ dysfunction, with high untreated mortality that can be effectively reduced with timely plasma exchange (PLEX) and immunosuppressive therapy. However, several conditions can produce a clinically similar pseudo-TMA picture, among which severe vitamin B12 deficiency is an underrecognized and potentially treatable mimic that occurs due to ineffective intramedullary erythropoiesis, megaloblastic fragmentation of structurally abnormal erythrocytes, and pancytopenia in the absence of true endothelial injury or ADAMTS13 deficiency. We present a 74-year-old female patient who presented with altered mental status, bradycardia, and severe …

Blinded By Relapse: A Rare Case Of Bilateral Vision Loss From Leukemic Meningeal Infiltration, Aun A. Bangash, Tejaswini Swamy, Chloe C. Harris, Victoria Parada

Research Symposium

Background: Acute lymphoblastic leukemia (ALL) accounts for 20% of adult leukemias, with outcomes improving through modern systemic and CNS-directed therapies. Leukemic meningeal relapse, defined as infiltration of the meninges and detected by cerebrospinal fluid cytology, is reported in 4–7% of adult ALL patients and remains a devastating complication despite CNS prophylaxis. CNS involvement typically presents with nonspecific symptoms such as headache, nausea, or cranial neuropathies; isolated, abrupt vision loss is rare. With a median survival of less than six months if untreated, timely recognition is critical. We present a case of intracranial hypertension with bilateral vision loss due to leukemic …

Navigating A Delicate Balance: Antibiotic Allergy In The Setting Of Renal Infection And Diabetic Ketoacidosis, Aun Bangash, Muhammad Bangash, Ruben M. Martinez Meza

School of Medicine Publications

Acute pyelonephritis is a bacterial infection of the renal parenchyma that requires prompt recognition and antibiotic therapy to prevent complications such as sepsis and chronic renal inflammation. We present a case of a 26-year-old woman with poorly controlled type 1 diabetes mellitus and a documented beta-lactam allergy who presented with atypical symptoms, including flank pain without urinary complaints. Laboratory evaluation demonstrated leukocytosis with a negative urinalysis. CT of the abdomen revealed left lobar nephronia with early contralateral involvement of the right kidney. Given her allergy history, she was treated with levofloxacin. During her hospital stay, she developed nausea, vomiting, and …

When Birth Control Turns Biliary: A Rare Case Of Profound Hyperbilirubinemia From Oral Contraceptives, Taiwo Ajani, Aura Calderon, Jose J. Loayza Pintado, Nayiri Derian, Catherine Matos, Ivan Mogollon, Andres Suarez Parraga

School of Medicine Publications

Oral contraceptives (OCs) are extensively utilized and generally considered safe (reference); nonetheless, infrequent hepatobiliary complications such as cholestasis and hyperbilirubinemia have been documented, particularly among individuals with a genetic predisposition. We present a case involving a 19-year-old female who exhibited significant conjugated hyperbilirubinemia shortly after the commencement of OC therapy. Comprehensive investigations ruled out alternative causes, and the findings from liver biopsy, in conjunction with the clinical context, indicated an estrogen-induced cholestatic injury, likely revealing an underlying Dubin–Johnson syndrome. This case underscores the critical necessity of acknowledging hepatic adverse effects associated with estrogen as well as the influence of genetic …

Assessing Social Determinants Of Health Training In Graduate Medical Education: A Narrative Review Using Kirkpatrick’S Model, Surya Namboodiri, Bharathi Gadad, Juan Lopez-Alvarenga, Chelsea Chang

School of Medicine Publications

Social determinants of health (SDOH) training is a critical component of medical education, equipping physicians to address factors such as economic stability, education, and health care access. Despite its importance, the evaluation of SDOH training often focuses on lower-level outcomes, such as learner satisfaction and knowledge assessment, with limited emphasis on behavioral change and patient outcomes. Kirkpatrick’s model offers a validated framework for addressing this gap by categorizing training outcomes into four levels: Reaction, Learning, Behavior, and Results.

By applying Kirkpatrick’s model in combination with Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality assessment and bibliometric network analysis, this …

Beyond The Rash: Cutaneous Peripheral T-Cell Lymphoma As A Diagnostic Pitfall In Primary Care, Jared Hensley, Aura Calderon, Blake Martin, Cristina Kochi, Andres Suarez Parraga

School of Medicine Publications

Cutaneous manifestations of T-cell lymphomas may resemble common dermatologic or infectious conditions, increasing the risk of delayed recognition. We report a 78-year-old woman with known peripheral T-cell lymphoma (PTCL) who presented with a rapidly progressive, diffuse erythematous rash accompanied by cervical lymphadenopathy. Initial evaluation prioritized more common etiologies; however, inpatient medicine broadened the differential diagnosis, prompting early hematology and oncology consultation. Contrast-enhanced CT of the neck demonstrated multiple enlarged, partially necrotic left cervical lymph nodes consistent with disease progression. After multidisciplinary discussions and consideration of prognosis, the patient elected palliative-focused management with oncology follow-up. This case underscores the importance of …

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …

A Review Of Recent And Developing Studies Regarding Percutaneous Coronary Intervention (Pci): A Narrative Review, Bisher Alsabbagh, Azeez Shala, Joshua Rupert, Abdallah Elsayed

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

This comprehensive literature review synthesizes the most recent evidence and evolving clinical guidelines concerning percutaneous coronary intervention (PCI) from 2015 to 2025. The study integrates findings from 42 peer-reviewed trials, meta-analyses, registries, and international guideline statements issued by the American College of Cardiology/American Heart Association (ACC/AHA), European Society of Cardiology (ESC), and related societies. Results reveal a decade-long evolution in PCI practice marked by a shift from anatomy-driven to physiology and imaging-guided decision-making, supported by tools such as fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), intravascular ultrasound (IVUS), and optical coherence tomography (OCT). Modern guidelines emphasize individualized, team-based revascularization …

Bridging The Gut And The Heart-Exploring Pathophysiology, Risk Factors, And Therapeutic Implications Of Cardiovascular Disease In Inflammatory Bowel Disease, Diana Othon-Martinez, Sylvia Valeria Peña-Muñoz, Margarita Riojas-Barrett, Genesis Vidales-López, Josué Moisés Sánchez Guzmán, Lukasz Kwapisz

School of Medicine Publications

Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic systemic immune dysregulated disorder affecting the gastrointestinal tract that often has extraintestinal manifestations. Limited data exist on the cardiovascular (CV) implications of IBD, but a higher prevalence of CV disease (CVD) has been observed compared to the general population, resulting in increased mortality risk. This review examines the pathophysiology and risk factors linking IBD to CVD, highlighting several key mechanisms: The “lipid paradox” in active IBD, arterial stiffness and endothelial dysfunction, proinflammatory cytokine activity, gut microbiota dysbiosis, and drug-induced myocardiopathy. The main findings include information about IBD …

What Time Is It? It Is 8 And 1/2 Time: A Rare Case Of Ischemic Stroke Consistent With Eight-And-A-Half Syndrome, Jessica Daza, Marcelo Bedoya-Sommerkamp, Eunbee Cho, Celia Patricia Daza, Francisco Gomez, Fatimah Bello, Jia Lin

School of Medicine Publications

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion …

The Sodium Chronicles: Unraveling The Enigma Of Hypothyroidism-Induced Hyponatremia, Raquel Z. Lara, Tejaswini Swamy, Jennifer Rojas Huen, Ricardo Serna

Research Colloquium

Background: Hyponatremia is an electrolyte disturbance with various etiologies, but hypothyroidism is rarely the primary cause. Literature suggests that hypothyroidism-related hyponatremia occurs primarily in severe cases, with some studies suggesting that hypothyroidism should not be considered a sole contributor if TSH levels are below 50 mIU/L. Patients with hyponatremia have a high risk of prolonged hospital stays and readmission, underscoring the clinical importance of identifying uncommon causes such as severe hypothyroidism. This case highlights this rare association, contributing to the existing limited literature.

Case Presentation: A 74-year-old woman with Type 2 Diabetes, complicated nephrotic syndrome and nephropathy, congestive heart failure, …

Deprescribing And Polypharmacy In Heart Failure Patients Aged 80 Years And Older: A Case Report, Learsi R. De Hoyos, Elizabeth Mills-Reyes, Chelsea Chang

Research Colloquium

Background: Since 2004, the number of adults aged 65 and older has increased by 5.6%. With a growing geriatric population, medical management should maximize benefits and minimize risks. Polypharmacy, defined as the concurrent use of 5 or more medications, is a common concern in older adults. In adults 80 years and older, the prevalence of polypharmacy is 67.1%. Among adults with heart disease, the prevalence of polypharmacy increased from 40.6% to 61.7% between 2000 and 2018. In the context of heart failure, guideline-directed medical therapy (GDMT) includes beta-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter 2 …

Bilateral Small Vessel Strokes In A Young Male With Coccidioidal Meningitis And Suspected Cns Vasculitis, Hugo Zamarron, Ahsan Ali

Research Colloquium

Background: Cerebral small vessel strokes in young, otherwise healthy adults without traditional vascular risk factors are rare and warrant further investigation. Central nervous system (CNS) vasculitis is an uncommon etiology that may be triggered by infections, including fungal pathogens. This case is notable for a suspected primary CNS vasculitis manifesting as bilateral deep infarcts in the setting of Coccidioidal meningitis. It highlights the importance of considering fungal infections and vasculitis in the differential diagnosis of stroke in younger patients.

Case Presentation: A 32-year-old previously healthy male presented with fever, headache, and was diagnosed with aseptic meningitis. He was later readmitted …

Delayed Diagnosis Of Systemic Lupus Erythematosus Presenting As Autoimmune Hemolytic Anemia: A Case For Heightened Clinical Suspicion, Diana Acosta Pozo, Luis Álvarez Pérez

Research Colloquium

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem involvement, including hematologic manifestations. Autoimmune Hemolytic Anemia (AIHA), though an established feature, is relatively uncommon and may occur early or in isolation. When AIHA presents without overt systemic symptoms, the underlying autoimmune etiology may be overlooked, resulting in delays in diagnosis and treatment. Prompt recognition is essential to prevent unnecessary interventions and prolonged morbidity.

Case Presentation: A 39-year-old woman residing in Texas presented to the Rheumatology office with persistent synovitis and severe transfusion-dependent anemia, requiring red blood cell transfusions every 48 hours for over three months. She …

A Puzzling Case Of Visual Disturbances Leads To A Fatal Neurodegenerative Diagnosis, Courtney J. Austin, Aaron Carrillo, Jennifer Rojas Huen, Victoria Parada

Research Colloquium

Background: Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease in which early diagnosis is complicated by the presence of early non-specific and atypical presentations. Sporadic CJD (sCJD), the most common type of CJD, is caused by the spread of a disease-forming prion known as PrPSc. PrPSc multiplies and binds to the normal form of prion, or PrP, converting it to an abnormal, structurally altered disease form that spreads throughout the brain. sCJD can initially present with six different phenotypes: cognitive, affective, classic, visual (Heidenhain variant), atactic (Oppenheimer-Brownell variant), and indeterminate. The classic presentation of CJD includes rapidly progressive dementia with …

Optimizing Antibiotic Stewardship In Pneumonia: Evidence-Based Protocols For Enhanced Treatment And Resistance Reduction In A University-Affiliated Community Hospital, Carlos Luis Alejos, Jennifer Rojas Huen, Joan Beatrice Capellan, Ricardo Serna, Tejaswini Swamy, Jose Campo Maldonado

Research Colloquium

Introduction: National guidelines recommend early, targeted diagnostics such as respiratory viral panels, procalcitonin testing, Methicillin resistant staphylococcus aureus (MRSA) nasal swabs, and sputum cultures, for the effective management of pneumonia. However, our retrospective review at a university-affiliated community hospital revealed inconsistent application of these tools. These may contribute to excessive use of broad-spectrum antibiotics, higher costs, and increased antimicrobial resistance. The reason is that we aim to implement a standardized pneumonia order set in the electronic medical record (EMR) to improve diagnostic accuracy and antibiotic stewardship.

Methods: We conducted a retrospective chart review of adult inpatients admitted with community-acquired, hospital-acquired, …

The Intersection Of Obesity And Breast Cancer In South Texas: Clinical Implications And Regional Disparities, Aura M. C. Calderon, Ivan Mogollon, Luis Salcedo, Jose Loayza, Diane Nguyen

Research Colloquium

Introduction: Breast cancer continues to be the most frequently identified malignancy among females in both Texas and the broader United States. Although South Texas presents a marginally diminished incidence rate overall, the area persists in confronting significant disparities in terms of disease burden and health outcomes. These discrepancies are particularly pronounced among Hispanic women residing in the Rio Grande Valley (RGV), who encounter heightened probabilities of receiving diagnoses at advanced stages despite a lower general incidence rate. Structural inequities, such as restricted access to healthcare services, socioeconomic deprivation, and inadequate health literacy, interact with obesity-associated biological risk factors, thereby engendering …

Progressive Pulmonary Sarcoidosis In A Young Adult Mimicking Miliary Tuberculosis: A Case Report And Literature Review, Aura M. C. Calderon, Luis Salcedo, Ivan Mogollon, Francisco Arias, Juan Pablo Gomez

Research Colloquium

Introduction: Pulmonary sarcoidosis can pose considerable diagnostic challenges, particularly in young adults hailing from regions endemic to tuberculosis (TB), wherein radiographic manifestations may closely mimic those of miliary TB. This case underscores the necessity of sustaining an extensive differential diagnosis and accentuates the critical role of histological verification in the assessment of diffuse pulmonary micronodular infiltrates, especially in instances where the infectious workup yields negative results.

Case Report: A 26-year-old male from the Democratic Republic of Congo, with no significant medical history, presented with a 10–12 month history of chronic dry cough and exertional dyspnea. He denied fever, weight loss, …

Posterior Reversible Encephalopathy Syndrome (Pres) Secondary To B-Cell Acute Lymphoblastic Leukemia: A Case Report, Aura M. C. Calderon, Luis Salcedo, Ivan Mogollon, Jeyilis Carmona, Juan Pablo Gomez

Research Colloquium

Background: Posterior Reversible Encephalopathy Syndrome (PRES) represents a rare and potentially reversible neurotoxic disorder, distinguished by the presence of acute neurological manifestations and vasogenic edema, frequently detected through neuroimaging techniques. Although traditionally linked to hypertensive crises, renal insufficiency, and cytotoxic therapies, a growing body of evidence suggests that hematological malignancies, specifically acute lymphoblastic leukemia (ALL), should be regarded as an independent risk factor.

Case Presentation: A 73-year-old Hispanic female with a medical history significant for hypertension, type 2 diabetes mellitus, end-stage renal disease requiring hemodialysis, and Parkinson’s disease presented with a progressive decline in strength and altered cognitive status. Upon …

Cervical Cancer Disparities In Hispanic Women: A Multilevel Analysis Using Seer And Texas State Data, Aura M. C. Calderon, Ivan Mogollon, Shubhank Goyal, Jose Loayza, Everardo Cobos, Diane Nguyen

Research Colloquium

Background: Cervical carcinoma continues to exert a disproportionate burden on Hispanic women within the United States, notably in jurisdictions such as Texas, where individuals of Hispanic descent constitute more than 40% of the demographic populace. Notwithstanding progress in screening methodologies and preventive measures, considerable disparities persist in incidence rates, mortality figures, and survival outcomes when assessed through the lens of racial and ethnic stratifications.

Objective: To examine and visually communicate disparities in cervical cancer burden among Hispanic women through a combination of national survival data and Texas state-level incidence and mortality statistics.

Methods: Publicly accessible datasets were employed from the …

Case Report: Familial Hypomagnesemia In A Patient With History Of Hodgkin Lymphoma, Aura M. C. Calderon, Ivan Mogollon, Catherine Matos, Jose Loayza, Everardo Cobos

Research Colloquium

Introduction: Magnesium constitutes an essential electrolyte integral to the functioning of neuromuscular systems, the regulation of cardiovascular parameters, and the facilitation of metabolic processes. Chronic hypomagnesemia may precipitate significant complications, including the onset of arrhythmias and seizures. In cases where hypomagnesemia is refractory to supplementation and manifests in multiple family members, a hereditary tubulopathy, such as Gitelman syndrome (GS), warrants consideration. Gitelman syndrome is classified as an autosomal recessive disorder, resulting from mutations in the SLC12A3 gene, which impairs the thiazide-sensitive sodium-chloride cotransporter located in the distal convoluted tubule.

Case Presentation: A 39-year-old female with a history of classical Hodgkin …

Case Report: Clonidine Withdrawal-Induced Posterior Reversible Encephalopathy Syndrome (Pres), Aura M. C. Calderon, Francisco Arias, Ivan Mogollon, Luis Salcedo, Hector Arredondo

Research Colloquium

Introduction: Clonidine, an agonist of central α2-adrenergic and imidazoline receptors, possesses the capacity to elicit transient episodes of hypertension succeeded by hypotension and bradycardia. This particular case underscores a rare yet significant complication, Posterior Reversible Encephalopathy Syndrome (PRES), that can occur subsequent to the abrupt cessation of clonidine administration.

Case Presentation: An 18-year-old male with severe asthma and prior ICU admissions presented to the emergency department after two seizures. He had recently been treated for an asthma exacerbation complicated by hypertension, for which clonidine was initiated. He was discharged on clonidine and prednisone but discontinued clonidine the day before admission …