Internal Medicine Commons^™

The Impact Of Diabetes Mellitus On Hiv Virologic Control: Results Of The Macs/Wihs Combined Cohort Study, Sarah C Mann, Weiqun Tong, Alison G Abraham, Frank Palella, Anjali Sharma, Phyllis C Tien, Margaret A Fischl, Samy I Mcfarlane, Cecile D Lahiri, Susan Koletar, Daniel Merenstein, Michelle Floris-Moore, Jordan E Lake, Elizabeth Daubert, Aubri Hickman, Todd T Brown, Jose Castillo-Mancilla

Faculty, Staff and Student Publications

Objective: Diabetes mellitus (DM) is associated with lower antiretroviral (ART) drug exposure among persons with HIV (PWH) compared to PWH without DM. The association between DM and virologic control in PWH, however, remains unknown.

Methods: We included participants in the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MWCCS) who had initiated ART between 1999 and 2020 and had a suppressed HIV viral load (≤200 copies/ml) within 1 year of ART initiation. We compared the frequency of incident HIV viremia (HIV-1 RNA >200 copies/ml) between adult PWH with and without DM. Poisson regression was used to examine the …

Addressing Statistical Challenges In The Analysis Of Proteomics Data With Extremely Small Sample Size: A Simulation Study, Kyung Hyun Lee, Shervin Assassi, Chandra Mohan, Claudia Pedroza

Faculty, Staff and Student Publications

Background: One of the most promising approaches for early and more precise disease prediction and diagnosis is through the inclusion of proteomics data augmented with clinical data. Clinical proteomics data is often characterized by its high dimensionality and extremely limited sample size, posing a significant challenge when employing machine learning techniques for extracting only the most relevant information. Although there is a wide array of statistical techniques and numerous analysis pipelines employed in proteomics data analysis, it is unclear which of these methods produce the most efficient, reproducible, and clinically meaningful results.

Results: In this study, we compared 9 unique …

Need For Structured Pain Management Curriculum And Competency-Based Evaluation In Gme: An Observational Study In One Internal Medicine Residency Program, Sudhagar Thangarasu, Gowri Renganathan, Barney Soskin, Lela Ruck, Vishakh Prakash, Sumedha Unnikrishnan, Jyothsna Goranti, Everardo Cobos

School of Medicine Publications

OBJECTIVES

One of the major contributing factors to the opioid crisis, marked by a surge in opioid prescriptions, includes inadequate adherence to guideline-based pain management practices, highlighting the need for a comprehensive curriculum during residency training. In this study, we aim to assess opioid exposure prevalence among hospitalized patients and examine potential associations between disease conditions, patient demographics, and opioid prescriptions during their hospital stay.

METHODS

In this retrospective cohort study at a southern California county teaching hospital, we analyzed the medical records of 2272 patients admitted to the IM resident inpatient teaching service for 1 year, from September 2017 …

Evidence That Crispr-Cas9 Y537s-Mutant Expressing Breast Cancer Cells Activate Yes-Associated Protein 1 To Driving The Conversion Of Normal Fibroblasts Into Cancer-Associated Fibroblasts, Luca Gelsomino, Amanda Caruso, Emine Tasan, Adele Elisabetta Leonetti, Rocco Malivindi, Giuseppina Daniela Naimo, Francesca Giordano, Salvatore Panza, Guowei Gu, Benedetta Perrone, Cinzia Giordano, Loredana Mauro, Bruno Nardo, Gianfranco Filippelli, Daniela Bonofiglio, Ines Barone, Suzanne A W Fuqua, Stefania Catalano, Sebastiano Andò

Faculty, Staff and Students Publications

BACKGROUND: Endocrine therapy (ET) has improved the clinical outcomes of Estrogen receptor alpha-positive (ERɑ +) breast cancer (BC) patients, even though resistance to ET remains a clinical issue. Mutations in the hormone-binding domain of ERɑ represent an acquired intrinsic mechanism of ET resistance. However, the latter also depends on the multiple functional interactions between BC cells and the tumor microenvironment (TME). Here, we investigated how the most common Y537S-ERɑ mutation may influence the behavior of fibroblasts, the most prominent component of the TME.

METHODS: We conducted coculture experiments with normal human foreskin fibroblasts BJ1-hTERT (NFs), cancer-associated fibroblasts (CAFs), isolated from …

Management Of Covid-19 In A Patient With Kartagener Syndrome: A Case Report, Yatin Ramesh Babu, Shivani Patel, Andy Aleman Espino, Mallory Kazaleh, Hamlet Monteagudo, Odalys Frontela

HCA-NSU MD Research Day

The unprecedented global health challenge posed by COVID-19, caused by SARS-CoV-2, has driven research into its diverse clinical manifestations and underlying pathophysiological mechanisms. This report explores the interplay between pre-existing conditions, particularly Kartagener Syndrome, and COVID-19 outcomes. Kartagener Syndrome, characterized by primary ciliary dyskinesia, presents a unique perspective due to its anatomical and physiological features. The case details a 63-year-old female with Kartagener Syndrome admitted with COVID-19 symptoms. The gold-standard approach for Kartagener Syndrome involves comprehensive management strategies, including airway clearance techniques, pharmacotherapy, and surgical interventions. The patient's treatment encompassed bronchodilators, antibiotics, and subsequent improvements, leading to discharge with a …

Malignancy-Related Ascites: Thinking Outside The Liver, Nisha Chachad, Erica Pieper Do, Nisha Chachad, Ana Angeli, Pedro Bayonas Md, Jose Gonzalez-Pantaleon Md

HCA-NSU MD Research Day

Introduction. Our objective in discussing this case is to explore an approach to the various etiologies of ascites, thereby encouraging clinicians to consider extrahepatic differentials during disease management. To do so, we examined the following case of ascites in the setting of underlying malignancy. Case Presentation. An 85-year-old female presented with rapid-onset abdominal distension as well as dark stools and shortness of breath. She had also experienced progressive weakness, malaise, and weight loss over the last year. Past medical history was notable for endometriosis, hyperlipidemia, and xanthogranulomatous pyelonephritis. She was mildly tachycardic on admission. Labs were notable for leukocytosis with …

Be Suspicious Of Supplements: A Case Of Exogenous Cushing Syndrome From Hidden Ingredient, Brittany Puebla, Leidy Huie Martinez Md, Carlos Correa Md, Jose Melendez Md, Gerald Chang, Roberto Ruiz Md

HCA-NSU MD Research Day

Introduction: Cushing syndrome, resulting from hypercortisolism, can be caused by both exogenous glucocorticoid use and endogenous production. While exogenous Cushing Syndrome is usually associated with known glucocorticoid exposure, the risk of occult use through over-the-counter (OTC) supplements is a growing concern. Case Presentation: 60-year-old male presented to the ED with worsening dyspnea, bilateral lower extremity swelling, and intermittent chest pain. He was admitted for suspected congestive heart failure (CHF) exacerbation. Medical history includes obesity, hypertension, diabetes, and CHF. On day 2, a Cushinoid appearance was noted on physical exam with BLE muscle wasting, round faces, and prominent central obesity with …

Nosebleed No More: Recognizing And Diagnosing Factor Viii Inhibitor, Salam Harb, Leidy Huie Martinez Md, Jose Alvarado Md, Ajit Koli Do, Hazem Nasef Ms4

HCA-NSU MD Research Day

Acquired hemophilia is a condition characterized by the unexpected onset of severe bleeding due to an issue with coagulation factors. Typically, this disorder results from the production of autoantibodies against the Factor VIII coagulation factor. Although acquired hemophilia is an extremely rare condition, with an annual incidence of just 1.5 cases per million, it is crucial to recognize and understand it. This is because diagnosing this disorder is intricate, and if left undiagnosed and untreated, it can lead to high levels of morbidity and mortality. This case stands out as the condition typically targets older adults, with around 80% of …

When Aml Strikes Twice: A Case Of Acute Myeloid Leukemia With Concurrent Myopericarditis And Acute Pancreatitis, Veronica Benitez, Gabriella A. Morey, Veronica Benitez, Roberto H. Ruiz

HCA-NSU MD Research Day

Introduction: Acute myeloid leukemia (AML) is a hematological malignancy characterized by the proliferation of undifferentiated hematopoietic stem cells, leading to symptoms like fatigue, fever, and bleeding. While AML can infiltrate various organs, myocardial and pancreatic involvement are extremely rare, with myopericarditis and acute pancreatitis being particularly uncommon. Case Description: A 72-year-old hispanic female with a history of pancreatitis and autoimmune disorders presented with worsening lower abdominal pain, dysuria, nausea, and vomiting. Her pancreatitis resolved, but she subsequently developed chest pain and was diagnosed with acute pericarditis. Her elevated white blood cell count, predominantly monocytic, led to the diagnosis of AML …

Lifestyle Effects On An Unusual Presentation Of Syncope: A Case Report, Rishma Gattu, Nisarg Shah, Ramya Ravulapalli, Vania Rodriguez, Gary Merlino

HCA-NSU MD Research Day

Introduction: This case study explores a unique presentation of syncope with a multifactorial etiology and discusses the impact of lifestyle behaviors on syncope exacerbation. Scant literature exists on behavioral modifications affecting cardiogenic responses. Case Presentation: We present a 53 year old Hispanic male with a past history of palpitations and chronic marijuana use coming to the emergency department (ED) with three episodes of sudden loss of consciousness that occurred after starting his job as a night shift worker, which led to severe chronic sleep deprivation. These episodes lacked prodromal (chest pain, shortness of breath, palpitations, diaphoresis) and postictal (drowsiness, nausea, …

The Complex Relationship Between Tuberculosis And Hyperglycemia, Michelle Byers, Elizabeth Guy

Faculty, Staff and Students Publications

Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to a more advanced presentation of pulmonary tuberculosis, thus increasing the likelihood of being smear positive and having cavitating lesions, and it impacts the duration and outcomes of treatment, with an increased one year mortality seen in patients with tuberculosis and diabetes. Additionally, any degree of hyperglycemia can have an impact on susceptibility to tuberculosis, and this effect …

Transcutaneous Electrical Nerve Stimulation For Fibromyalgia-Like Syndrome In Patients With Long-Covid: A Pilot Randomized Clinical Trial, Alejandro Zulbaran-Rojas, Rasha O Bara, Myeounggon Lee, Miguel Bargas-Ochoa, Tina Phan, Manuel Pacheco, Areli Flores Camargo, Syed Murtaza Kazmi, Mohammad Dehghan Rouzi, Dipaben Modi, Fidaa Shaib, Bijan Najafi

Faculty, Staff and Students Publications

This study investigated the effect of Transcutaneous Electrical Nerve Stimulation (TENS) for fibromyalgia-like symptoms including chronic widespread musculoskeletal pain, fatigue, and/or gait impairment in twenty-five individuals with long-COVID. Participants were randomized to a high dose (intervention group, IG) or low dose (placebo group, PG) TENS device. Both groups received daily 3-5 h of TENS therapy for 4-weeks. The Brief Pain Inventory assessed functional interference from pain (BPI-I), and pain severity (BPI-S). The global fatigue index (GFI) assessed functional interference from fatigue. Wearable technology measured gait parameters during three 30-feet consecutive walking tasks. At 4-weeks, the IG exhibited a greater decrease …

Ephb4-Rasa1 Inhibition Of Piezo1 Ras Activation Drives Lymphatic Valvulogenesis, Di Chen, Yipei Tang, Philip E Lapinski, David Wiggins, Eva M Sevick, Michael J Davis, Philip D King

Faculty, Staff and Student Publications

BACKGROUND: EPHB4 (ephrin receptor B4) and the RASA1 (p120 Ras GTPase-activating protein) are necessary for the development of lymphatic vessel (LV) valves. However, precisely how EPHB4 and RASA1 regulate LV valve development is unknown. In this study, we examine the mechanisms by which EPHB4 and RASA1 regulate the development of LV valves.

METHODS: We used LV-specific inducible EPHB4-deficient mice and EPHB4 knockin mice that express a form of EPHB4 that is unable to bind RASA1 yet retains protein tyrosine kinase activity (EPHB4 2YP) to study the role of EPHB4 and RASA1 in LV valve development in the embryo and LV …

Harmonizing Data Across The Accelerating Colorectal Cancer Screening And Follow-Up Through Implementation Science (Accsis) Program To Enhance Data Quality And Promote Data Sharing., Sujha Subramanian, Sarah Kobrin, Sonja Hoover, Sylvia Tan, Alison T. Brenner, Janis E. Campbell, Jennifer Hatcher, Bin Huang, Madeleine Jones, Erin S. Kenzie, Helen Lam, David Liebovitz, Shiraz I. Mishra, Meghan C. O'Leary, Kristine N. Ortwine, V. Shane Pankratz, Electra D. Paskett, Michael Pennell, Amanda F. Petrik, Scott Roesch

Internal Medicine Faculty Publications

BACKGROUND: The purpose of the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) Program, a Cancer Moonshot℠ Initiative, is to support research to build the evidence base on multilevel interventions that increase rates of colorectal cancer screening, follow-up, and referral to care to address disparities in colorectal cancer screening. The National Cancer Institute funded eight Research Projects to implement multilevel interventions to improve colorectal cancer screening among communities who traditionally have been medically underserved. To analyze the impact of ACCSIS across Research Projects, the consortium developed a set of common data elements. The purpose of this paper is …

How Did Dat Happen? A Coombs Negative Delayed Hemolytic Transfusion Reaction In A Patient With Myelodysplastic Syndrome: A Case Report, Aniket Vijay Rao Dr, Aditya Sanjeevi, Daniel Jose Idoate, Nagesh Jadhav, Basil Verghese, Himal Kharel

Advances in Clinical Medical Research and Healthcare Delivery

Delayed hemolytic transfusion reactions (DHTRs) present significant challenges in diagnosis and management despite advancements in pre-transfusion testing. We report a case of a 76-year-old female with myelodysplastic syndrome (MDS) who developed severe hemolytic anemia following a seemingly compatible blood transfusion and appropriate pretransfusion testing. Evaluation revealed characteristics consistent with DHTR. Diagnostic uncertainty arose due to a negative Direct Antiglobulin Test (DAT) in the setting of a concomitant Vitamin B-12 deficiency. She was supported with prednisone and B12 supplementation. We discuss challenges in diagnosis, including the limitation of DAT, and propose strategies for comprehensive antibody identification. The case underscores the importance …

Cardiac Arrest Following Svc Intravascular Stenting: A Case Report, Afrah Ali, Shahtaj Shah, Varun Mehta, Lubna Ziauddin, Asma Khan, Sameen Khurshid, Fawaz Ali

Advances in Clinical Medical Research and Healthcare Delivery

Superior vena cava (SVC) syndrome is a known collection of symptoms caused by obstruction of blood flow through the superior vena cava. Symptoms notably seen include difficulty breathing, coughing, hoarse voice, and swelling of the head, neck, and arm. It is most commonly seen secondary to malignancy from tumor infiltration of the vessel wall and is frequently associated with lung cancer due to anatomic location.

Treatment of SVC syndrome largely depends on severity of symptoms. While treatment of underlying cause is considered first line, intravascular stenting is also commonly considered in life threatening cases and for symptomatic relief.

We report …

Recurrent Deep Vein Thrombosis In May Thurner Syndrome Precipitated By Heparin Induced Thrombocytopenia: A Case Report And Review Of Literature, Abhishek Bhandari, Chengu Niu

Advances in Clinical Medical Research and Healthcare Delivery

May Thurner Syndrome involves the extrinsic compression of the left common iliac vein by the right common iliac artery, which predisposes to venous thrombosis. This case report and review of literature details a complex instance of recurrent Deep Vein Thrombosis (DVT) in a 58-year-old female patient with May Thurner Syndrome (MTS), exacerbated by Heparin-Induced Thrombocytopenia (HIT). The patient, post Coronary Artery Bypass Graft surgery, developed leg symptoms leading to the discovery of an extensive DVT from the calf veins to the external iliac vein. She was initially treated with heparin, which was switched to bivalirudin following a significant drop in …

Nepali Oral Microbiomes Reflect A Gradient Of Lifestyles From Traditional To Industrialized, Erica P Ryu, Yoshina Gautam, Diana M Proctor, Dinesh Bhandari, Sarmila Tandukar, Meera Gupta, Guru Prasad Gautam, David A Relman, Ahmed A Shibl, Jeevan Bahadur Sherchand, Aashish R Jha, Emily R Davenport

Faculty, Staff and Student Publications

Background: Lifestyle plays an important role in shaping the gut microbiome. However, its contributions to the oral microbiome remain less clear, due to the confounding effects of geography and methodology in investigations of populations studied to date. Furthermore, while the oral microbiome seems to differ between foraging and industrialized populations, we lack insight into whether transitions to and away from agrarian lifestyles shape the oral microbiota. Given the growing interest in so-called "vanishing microbiomes" potentially being a risk factor for increased disease prevalence in industrialized populations, it is important that we distinguish lifestyle from geography in the study of microbiomes …

Sevelamer-Induced Gastrointestinal Mucosal Injury: A Critical Review For Clinicians, Lefika Bathobakae, Phenyo Phuu, Saif Yasin, Rammy Bashir, Jessica Escobar, Ruhin Yuridullah, Gabriel Melki, Mohamed Elagami, Yana Cavanagh, Walid Baddoura

Journal of Community Hospital Internal Medicine Perspectives

Sevelamer is a non-absorbable polymer used to treat hyperphosphatemia in individuals with end-stage renal disease (ESRD) undergoing hemodialysis. The deposition of sevelamer crystals in the gastrointestinal (GI) tract, especially in the colon, can cause mucosal inflammation, pseudopolyps, ulceration, ischemia, or necrosis. Owing to its rarity and lack of physician awareness, the actual incidence and prevalence of sevelamer-induced gastrointestinal mucosal injury (SIGMI) remain unknown. The current evidence is retrospective, in the form of observational studies. This systematic review of case reports provides an overview of SIGMI, with a focus on its etiology, signs and symptoms, pathogenesis, diagnosis, and management. Electronic databases, …

Peptide Receptor Radionuclide Therapy And Clinical Associations With Renal And Hematological Toxicities And Survival In Patients With Neuroendocrine Tumors: An Analysis From Two U.S. Medical Centers, Tao Xu, Joseph S. Dillon, Mary A. Maluccio, Dawn E. Quelle, Sarah H. Nash, Hyunkeun Cho, Kristen E. Limbach, Nicholas J. Skill, Yvette Bren-Mattison, Michael A. O’Rorke

School of Medicine Faculty Publications

Purpose: Renal and hematological toxicity are side effects and dose-limiting factors of Peptide Receptor Radionuclide Therapy (PRRT). We aimed to assess the changes in renal and hematological function and associations with survival in neuroendocrine tumor (NET) patients treated with PRRT. Methods: A retrospective cohort of 448 NET patients treated with either 177Lu-DOTATATE or 90Y-DOTATOC were followed for changes of renal and hematological function. Renal function was assessed by monitoring changes in serum creatinine, blood urea nitrogen and estimated glomerular filtration rate. Hematological function was determined by examining changes in white blood cell counts (WBC), platelet counts, and hemoglobin levels over …

Musical Hallucinations In An Elderly Female With Hearing Loss, Jacqueline Cavendish, Lynne J. Goebel

Internal Medicine

Musical hallucinations (MH) are rare auditory phenomena in which patients perceive music without a known source. Risk factors for MH include hearing loss, older age, female gender, epilepsy, and certain medications. This case report details the presentation, diagnosis, and treatment of an 82-year-old woman who developed MH following the onset of hearing loss. Despite treatment attempts with gabapentin, quetiapine, and donepezil, the symptoms persisted, demonstrating the difficulty in treating this condition.

Persistent Post-Dural Puncture Headaches One Year After Lumbar Puncture: A Case Report, Zamanali Khakhar, Maeheq Mir, Soraiya Manji, Sheila Waa, Sayed Karar

Internal Medicine, East Africa

Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture. A spinal magnetic resonance imaging (MRI) revealed a CSF collection in the epidural space. This was treated successfully by an epidural blood patch (EBP) which resolved the patient's symptoms. This case highlights the necessity of recognizing delayed lumbar puncture complications and the need for a …

Diaphragmatic Myopathy Associated With Dual Immune Checkpoint Inhibitors In A Patient With Renal Cell Carcinoma, Jeremy R Walder, Saadia A Faiz, Sudhakar Tummala, Shiao-Pei Weathers, Nicolas L Palaskas, Maryam Buni, Ajay Sheshadri, Lara Bashoura

Faculty, Staff and Student Publications

Immune-related adverse events (irAEs) have become increasingly prevalent with immune checkpoint inhibitor (ICI) cancer treatment. We present a 79-year-old man with metastatic renal cell carcinoma who developed shortness of breath and hypercapnic respiratory insufficiency after his first cycle of nivolumab and ipilimumab. Laboratory data showed elevated creatinine kinase, troponins, and transaminases. Computed tomography of the chest demonstrated bilateral lower lobe atelectasis. Heart catheterization and endomyocardial biopsy were unremarkable. Electromyogram (EMG) and nerve conduction studies (NCS) of the limb muscles revealed mild diffuse myopathy, normal sensory nerve conductions, and low-amplitude motor responses. Subsequent diaphragmatic EMG and NCS demonstrated severe myopathy. ICI-mediated …

A Putative Camp-Binding Protein In Trypanosoma Brucei Cooperates With Flam3 To Promote Flagellar Connection And Cell Morphogenesis, Qing Zhou, Phu Van Nguyen, Ziyin Li

Faculty, Staff and Student Publications

Trypanosoma brucei is a flagellated parasitic protozoan, and within the insect vector the parasite transitions from the trypomastigote form to the epimastigote form by repositioning its mitochondrial genome and relocating the flagellum. The mechanisms underlying such morphology changes are still poorly understood, but several flagellum-localized proteins are involved in this process by modulating the flagellum attachment zone (FAZ) that adheres the flagellum to the cell membrane. We report here a putative cAMP-binding protein named cAMP-BP1, which promotes flagellar connection and morphology transition. cAMP-BP1 contains two cyclic nucleotide-binding domains and five calcium-binding C2 domains and localizes to the flagella connector and …

Discovery, Characterization, And Structure Of A Cofactor-Independent Histidine Racemase From The Oral Pathogen Fusobacterium Nucleatum, Tess Lamer, Pu Chen, Marie J Venter, Marco J Van Belkum, Anjalee Wijewardane, Chenggang Wu, M Joanne Lemieux, John C Vederas

Faculty, Staff and Student Publications

Fusobacterium nucleatum is an oral commensal bacterium that can act as an opportunistic pathogen and is implicated in diseases such as periodontitis, adverse pregnancy outcomes, colorectal cancer, and Alzheimer's disease. F. nucleatum synthesizes lanthionine for its peptidoglycan, rather than meso-2,6-diaminopimelic acid (DAP) used by most Gram-negative bacteria. Despite lacking the biosynthetic pathway for DAP, the genome of F. nucleatum ATCC 25586 encodes a predicted DAP epimerase. A recent study hypothesized that this enzyme may act as a lanthionine epimerase, but the authors found a very low turnover rate, suggesting that this enzyme likely has another more favored substrate. Here, we …

The Evolving Pathophysiology Of Tbi And The Advantages Of Temporally-Guided Combination Therapies, Laura Zima, Anthony N Moore, Paul Smolen, Nobuhide Kobori, Brian Noble, Dustin Robinson, Kimberly N Hood, Ryota Homma, Amar Al Mamun, John B Redell, Pramod K Dash

Faculty, Staff and Student Publications

Several clinical and experimental studies have demonstrated that traumatic brain injury (TBI) activates cascades of biochemical, molecular, structural, and pathological changes in the brain. These changes combine to contribute to the various outcomes observed after TBI. Given the breadth and complexity of changes, combination treatments may be an effective approach for targeting multiple detrimental pathways to yield meaningful improvements. In order to identify targets for therapy development, the temporally evolving pathophysiology of TBI needs to be elucidated in detail at both the cellular and molecular levels, as it has been shown that the mechanisms contributing to cognitive dysfunction change over …

A Community-Engaged Interprofessional Project Led By Medical Students, School Of Social Work Students, And Resident Physicians: Lessons Learned And Recommendations For Success, Sabrina Orta, Daniela Santos Cantu, Giuiseppe Allan Fonseca, Luis R. Torres-Hostos, Chelsea Chang

School of Medicine Publications

Addressing health disparities through community engagement and interprofessional partnerships is increasingly critical. However, learner-led approaches that integrate medical students, resident physicians, and social work students are not well-studied. We designed a learner-led, interprofessional, public health campaign for a majority Hispanic community, with the goals of building interprofessional leadership skills, engaging learners to address COVID-19 inequities, and disseminating lessons learned. Faculty and students from the University of Texas Rio Grande Valley Schools of Medicine and Social Work partnered with community leaders to pilot an interprofessional project supported by the American Association of Medical Colleges’ Nurturing Experiences for Tomorrow’s Community Leaders (AAMC …

Glp-1 Receptor Agonists And Risk For Cirrhosis And Related Complications In Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease, Fasiha Kanwal, Jennifer R Kramer, Liang Li, Yu-Xiao Yang, Yumei Cao, Xian Yu, Ronald Samuel, Basim Ali, Roxanne Desiderio, George Cholankeril, Mandeep Bajaj, Hashem B El-Serag, Steven M Asch

Faculty, Staff and Students Publications

IMPORTANCE: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasing cause of cirrhosis. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are effective in improving liver inflammation in patients with MASLD.

OBJECTIVE: To determine whether use of GLP-1 RAs is associated with lower risk of developing cirrhosis and its complications, including decompensation and hepatocellular cancer (HCC), among patients with MASLD.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study with an active comparator, new-user design used data from the national Veterans Health Administration Corporate Data Warehouse and Central Cancer Registry. Patients with MASLD and diabetes who were seen at 130 Veterans Health …

Macrophage Iron Dyshomeostasis Promotes Aging-Related Renal Fibrosis, Lingzhi Wu, Hongchun Lin, Shaomin Li, Yuebo Huang, Yuxiang Sun, Shuangshuang Shu, Ting Luo, Tiantian Liang, Weiyan Lai, Jialing Rao, Zhaoyong Hu, Hui Peng

Faculty, Staff and Students Publications

Renal aging, marked by the accumulation of senescent cells and chronic low-grade inflammation, leads to renal interstitial fibrosis and impaired function. In this study, we investigate the role of macrophages, a key regulator of inflammation, in renal aging by analyzing kidney single-cell RNA sequencing data of C57BL/6J mice from 8 weeks to 24 months. Our findings elucidate the dynamic changes in the proportion of kidney cell types during renal aging and reveal that increased macrophage infiltration contributes to chronic low-grade inflammation, with these macrophages exhibiting senescence and activation of ferroptosis signaling. CellChat analysis indicates enhanced communications between macrophages and tubular …

A Scoping Review Of Geriatric Emergency Medicine Research Transparency In Diversity, Equity, And Inclusion Reporting, Anita N Chary, Michelle Suh, Edgardo Ordoñez, Lauren Cameron-Comasco, Surriya Ahmad, Alexander Zirulnik, Angela Hardi, Alden Landry, Vivian Ramont, Tracey Obi, Emily H Weaver, Christopher R Carpenter

Faculty, Staff and Students Publications

Introduction: The intersection of ageism and racism is underexplored in geriatric emergency medicine (GEM) research.

Methods: We performed a scoping review of research published between January 2016 and December 2021. We included original emergency department-based research focused on falls, delirium/dementia, medication safety, and elder abuse. We excluded manuscripts that did not include (1) original research data pertaining to the four core topics, (2) older adults, (3) subjects from the United States, and (4) for which full text publication could not be obtained. The primary objective was to qualitatively describe reporting about older adults' social identities in GEM research. Secondary objectives …