Internal Medicine Commons^™

Risk Factors For In-Hospital Seizure And New-Onset Epilepsy In Coiling And Clipping Treatment Of Aneurysmal Subarachnoid Hemorrhage, Viet-Thang Le, Anh Minh Nguyen, Phuc Long Nguyen

Faculty, Staff and Student Publications

OBJECTIVE: To identify risk factors associated with in-hospital seizures and new-onset epilepsy in patients with aneurysmal subarachnoid hemorrhage (SAH) who underwent coiling embolization or clipping surgery.

METHODS: This retrospective descriptive study included 195 patients diagnosed with aneurysmal SAH and treated with coiling embolization or clipping surgery between January 2018 and June 2022.

RESULTS: Among the 195 patients meeting inclusion criteria, 9 experienced an onset seizure at the time of SAH. In-hospital seizures were observed in 33 patients, of which 24 were electrographic seizures detected in 24 patients with suspected subclinical seizures. After 12 months of follow-up, 11 patients met criteria …

Abatacept Pharmacokinetics And Exposure Response In Patients Hospitalized With Covid-19, Stephen J Balevic, Daniel K Benjamin, William G Powderly, P Brian Smith, Daniel Gonzalez, Matthew W Mccarthy, Linda K Shaw, Christopher J Lindsell, Sam Bozzette, Daphne Williams, Benjamin P Linas, John Blamoun, Heta Javeri, Christoph P Hornik

Faculty, Staff and Student Publications

IMPORTANCE: The pharmacokinetics of abatacept and the association between abatacept exposure and outcomes in patients with severe COVID-19 are unknown.

OBJECTIVE: To characterize abatacept pharmacokinetics, relate drug exposure with clinical outcomes, and evaluate the need for dosage adjustments.

DESIGN, SETTING, AND PARTICIPANTS: This study is a secondary analysis of data from the ACTIV-1 (Accelerating COVID-19 Therapeutic Interventions and Vaccines) Immune Modulator (IM) randomized clinical trial conducted between October 16, 2020, and December 31, 2021. The trial included hospitalized adults who received abatacept in addition to standard of care for treatment of COVID-19 pneumonia. Data analysis was performed between September 2022 …

Machine Learning-Enabled Maternal Risk Assessment For Women With Pre-Eclampsia (The Piers-Ml Model): A Modelling Study, Tünde Montgomery-Csobán, Kimberley Kavanagh, Paul Murray, Chris Robertson, Sarah J E Barry, U Vivian Ukah, Beth A Payne, Kypros H Nicolaides, Argyro Syngelaki, Olivia Ionescu, Ranjit Akolekar, Jennifer A Hutcheon, Laura A Magee, Peter Von Dadelszen, Piers Consortium

Faculty, Staff and Student Publications

BACKGROUND: Affecting 2-4% of pregnancies, pre-eclampsia is a leading cause of maternal death and morbidity worldwide. Using routinely available data, we aimed to develop and validate a novel machine learning-based and clinical setting-responsive time-of-disease model to rule out and rule in adverse maternal outcomes in women presenting with pre-eclampsia.

METHODS: We used health system, demographic, and clinical data from the day of first assessment with pre-eclampsia to predict a Delphi-derived composite outcome of maternal mortality or severe morbidity within 2 days. Machine learning methods, multiple imputation, and ten-fold cross-validation were used to fit models on a development dataset (75% of …

Rfx Transcription Factor In The Human-Associated Yeast Candida Albicans Regulates Adhesion To Oral Epithelium, Diana L Rodríguez, Elena Lindemann-Perez, J Christian Perez

Faculty, Staff and Student Publications

Adhesion to mucosal surfaces is a critical step in many bacterial and fungal infections. Here, using a mouse model of oral infection by the human fungal pathobiont Candida albicans, we report the identification of a novel regulator of C. albicans adhesion to the oral mucosa. The regulator is a member of the regulatory factor X (RFX) family of transcription factors, which control cellular processes ranging from genome integrity in model yeasts to tissue differentiation in vertebrates. Mice infected with the C. albicans rfx1 deletion mutant displayed increased fungal burden in tongues compared to animals infected with the reference strain. High-resolution …

4r-Cembranoid Suppresses Glial Cells Inflammatory Phenotypes And Prevents Hippocampal Neuronal Loss In Lps-Treated Mice, Luis A Rojas-Colón, John B Redell, Pramod K Dash, Pedro E Vegas, Wanda Vélez-Torres

Faculty, Staff and Student Publications

Chronic neuroinflammation has been implicated in neurodegenerative disease pathogenesis. A key feature of neuroinflammation is neuronal loss and glial activation, including microglia and astrocytes. 4R-cembranoid (4R) is a natural compound that inhibits hippocampal pro-inflammatory cytokines and increases memory function in mice. We used the lipopolysaccharide (LPS) injection model to study the effect of 4R on neuronal density and microglia and astrocyte activation. C57BL/6J wild-type mice were injected with LPS (5 mg/kg) and 2 h later received either 4R (6 mg/kg) or vehicle. Mice were sacrificed after 72 h for analysis of brain pathology. Confocal images of brain sections immunostained for …

Tavr In Older Adults, Abdulla A Damluji, Gwen Bernacki, Jonathan Afilalo, Radmila Lyubarova, Ariela R Orkaby, Min Ji Kwak, Scott Hummel, James N Kirkpatrick, Mathew S Maurer, Nanette Wenger, Michael W Rich, Dae Hyun Kim, Roberta Y Wang, Daniel E Forman, Ashok Krishnaswami

Faculty, Staff and Student Publications

Calcific aortic stenosis can be considered a model for geriatric cardiovascular conditions due to a confluence of factors. The remarkable technological development of transcatheter aortic valve replacement was studied initially on older adult populations with prohibitive or high-risk for surgical valve replacement. Through these trials, the cardiovascular community has recognized that stratification of these chronologically older adults can be improved incrementally by invoking the concept of frailty and other geriatric risks. Given the complexity of the aging process, stratification by chronological age should only be the initial step but is no longer sufficient to optimally quantify cardiovascular and noncardiovascular risk. …

Definition Of Polypharmacy In Heart Failure: A Scoping Review Of The Literature, Keshav Patel, Jorge A Irizarry-Caro, Adil Khan, Travis Holder, Darrell Salako, Parag Goyal, Min Ji Kwak

Faculty, Staff and Student Publications

Patients with heart failure (HF) have a high prevalence of polypharmacy, which can lead to drug interactions, cognitive impairment, and medication non-compliance. However, the definition of polypharmacy in these patients is still inconsistent. The aim of this scoping review was to find the most common definition of polypharmacy in HF patients. We conducted a scoping review searching Medline, Embase, CINAHL, and Cochrane using terms including polypharmacy, HF and deprescribing, which resulted in 7,949 articles. Articles without a definition of polypharmacy in HF patients and articles which included patients < 18 years of age were excluded; only 59 articles were included. Of the 59 articles, 49% (n = 29) were retrospective, 20% (n = 12) were prospective, 10% (n = 6) were cross-sectional, and 27% (n = 16) were review articles. Twenty percent (n = 12) of the articles focused on HF with reduced ejection fraction, 10% (n = 6) focused on HF with preserved ejection fraction and 69% (n = 41) articles either focused on both diagnoses or did not clarify the specific type of HF. The most common cutoff for polypharmacy in HF was five medications (59%, n = 35). There was no consensus regarding the inclusion or exclusion of over-the-counter medications, supplements, or vitamins. Some newer studies used a cutoff of 10 medications (14%, n = 8), and this may be a more practical and meaningful definition for HF patients.

Middle Meningeal Artery Embolization In Acute Leukemia Patients Presenting With Subdural Hematoma, Binoy Yohannan, Juan Carlos Martinez Gutierrez, Peng Roc Chen, Adan Rios

Faculty, Staff and Student Publications

Intracerebral hemorrhage is a potentially fatal complication in patients with acute leukemia and contributing factors include thrombocytopenia and coagulopathy. Patients with acute leukemia may develop subdural hematoma (SDH) spontaneously or secondary to trauma. In patients with acute leukemia and SDH, the surgical evacuation of the hematoma causes significant morbidity and mortality. New approaches and strategies to reduce the need for surgical evacuation are needed to improve outcomes in patients with acute leukemia and intracerebral hemorrhage. We report two cases of acute SDH in patients with acute leukemia successfully treated with middle meningeal artery embolization, a minimally invasive interventional radiology technique, …

Evaluating The Readability Of Online Blood Cancer Education Materials Across Different Readability Measures, Ashley Shin, Surbhi Banubakode, Sara Taveras Alam, Anneliese O Gonzalez

Faculty, Staff and Student Publications

Introduction The National Institutes of Health and the American Medical Association recommend patient education materials (EMs) be at or below the sixth-grade reading level. The American Cancer Society, Leukemia & Lymphoma Society, and National Comprehensive Cancer Network have accurate blood cancer EMs. Methods One hundred one (101) blood cancer EMs from the above organizations were assessed using the following: Flesch Reading Ease Formula (FREF), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook Index (SMOG), and the Coleman-Liau Index (CLI). Results Only 3.96% of patient EMs scored at or below the seventh-grade reading level in all modalities. …

The Internist's Post V.1 N.2, The University Of Texas Rio Grande Valley. School Of Medicine, Edgar Dorsey Trevino, Diana Othon Martinez, Jian Garcia Cruz, Eunbee Cho, Roque Mifuji Lira, Martha Solis

School of Medicine Publications

Newsletter of the University of Texas Rio Grande Valley School of Medicine - Internal Medicine Residency Program.

Vascular Complications And Outcomes Following Transcatheter Aortic Valve Replacement In Patients On Chronic Steroid Therapy: A Meta-Analysis, Song Peng Ang, Jia Ee Chia, Vikash Jaiswal, Muhammad Hanif, Ananya Vadhera, Sudarshan Gautam, Anuradha Raut, Saira Rafaqat, Vamsikalayan Borra, Harshwardhan Khandait

School of Medicine Publications

Background: Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with vascular complications after transcatheter aortic valve replacement (TAVR) remained uncertain, with conflicting results being reported.

Objective: The authors aimed to compare the rate of vascular complications and outcomes between patients with and without CS use after TAVR.

Methods: The authors conducted a comprehensive literature search in PubMed, Embase, and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects …

Modified Technique Improves Efficacy For In-Office Posterior Nasal Nerve Ablation, Daniel Gorelik, Aatin K Dhanda, Alexander Choi, Masayoshi Takashima, Najm S Khan, Nicholas R Rowan, Aria Jafari, Tariq Syed, Omar G Ahmed

Faculty, Staff and Students Publications

Objectives: Posterior nasal nerve (PNN) ablation is a minimally invasive treatment option for patients with chronic rhinitis. Recent evidence shows that parasympathetic innervation of the nasal cavity is more extensive and there are many fibers posterior to the lateral attachment of the middle turbinate. We describe a modified ablative technique that targets the extensive innervation of the posterior nasal nerves.

Methods: Description of the technique and retrospective cohort analysis. In addition to the traditional radiofrequency and cryoablation targets, three additional treatment sites posterior to the middle turbinate were targeted using radiofrequency ablation, as well as one focused treatment posteroinferior to …

Hubungan Rasio Neutrofil Limfosit Terhadap Komplikasi Kardiovaskular Pada Pasien Penyakit Ginjal Kronik Hemodialisis, Thariq Hikmatul Akmal, Agung Susanto, Ratih Tri Kusuma Dewi, Agus Jati Sunggoro

Jurnal Penyakit Dalam Indonesia

Introduction. The neutrophil-to-lymphocyte ratio (NLR) is a simple parameter to assess the inflammatory status, especially in chronic kidney disease (CKD) patients experiencing capillary damage due to increased glomerular capillary pressure. In a state of vascular endothelial inflammation, there is a higher tendency to form atherosclerotic plaques and calcification that can induce cardiovascular events such as heart failure, coronary heart disease, and stroke. This study aimed to determine the relationship between the NLR and cardiovascular complications in CKD patients undergoing hemodialysis.

Methods. An analytical observational study with cross-sectional approach was conducted among 119 CKD patients undergoing hemodialysis at Dr …

Faktor-Faktor Yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (Hfpef) Rawat Jalan Di Rsupn Dr. Cipto Mangunkusumo, Derin Anugrah Pratama, Sally Aman Nasution, Muhadi Muhadi, Arif Mansjoer, Idrus Alwi, Dyah Purnamasari, Aida Lydia, Dicky Levenus Tahapary

Jurnal Penyakit Dalam Indonesia

Introduction. The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is still no data regarding risk factors that affect the quality of life of HFpEF patients. This study aimed to determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) …

Evaluasi Pengukuran Kekakuan Limpa Dalam Memprediksi Perdarahan Varises Esofagus Berulang Pada Pasien Sirosis Hati, Andi Cahaya Tahir, Juferdy Kurniawan, Marcellus Simadibrata, Aulia Rizka, Hamzah Shatri, Cosmas Rinaldi A. Lesmana, Nadia Ayu Mulansari

Jurnal Penyakit Dalam Indonesia

Introduction. Esophageal variceal bleeding is one of the complications caused by an increase in pressure within the portal vein blood vessels. The gold standard examination for portal pressure is the hepatic venous pressure gradient (HVPG), but HVPG examination is invasive, involving transjugular catheterization of the hepatic vein. Currently, non-invasive methods for measuring portal hypertension are being developed to predict esophageal varices and esophageal variceal bleeding using spleen stiffness measurements. This study aimed to evaluate the accuracy of spleen stiffness measurement in predicting recurrent esophageal variceal bleeding in patients with liver cirrhosis.

Methods. This study used a retrospective cohort …

Efektivitas Terapi Antituberkulosis Empirik Pada Pasien Dengan Penyakit Hiv Stadium Lanjut: Sebuah Laporan Kasus Berbasis Bukti, Natasha Chandra, Dina Elita, Evy Yunihastuti

Jurnal Penyakit Dalam Indonesia

Patients with advanced human immunodeficiency virus (HIV) disease have a high risk of mortality, with tuberculosis (TB) being one of the leading causes. Empiric antituberculosis therapy could be considered as a strategy to reduced mortality although there is no strong evidence. This study aims to review the efficacy of empiric antituberculosis therapy in patient with advanced HIV disease compared to isoniazid prophylaxis therapy and assessed with mortality as outcome. A 46- year old male patient with advanced HIV disease on antiretroviral therapy (ARV) and liver cirrhosis was admitted to hospital due to difficulties in sleeping and walking. During hospitalization he …

Program Multidisiplin Pasien Gagal Jantung Kronik Untuk Menurunkan Angka Perawatan Ulang Rumah Sakit, Lusiani Lusiani, Nurhayati Adnan

Jurnal Penyakit Dalam Indonesia

Heart failure is a complex disease caused by abnormalities in the structure or function of the heart resulting in decreased cardiac output. The complexity of heart failure causes an increasing burden of mortality and morbidity. This has further exacerbated the burden of treatment costs as well as the high rate of hospital readmissions. Readmission rate in patients with heart failure within 30 days post-hospitalization can reach 17.5%. In order to reduce re-hospitalization rates, multidisciplinary programs were introduced. The program involves collaboration of cardiologists, specialty nurses, pharmacists, nutritionists, and social workers using home or clinic-based models. Studies show that special management …

Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (Tb-Ro) Dengan Kolonisasi Candida Sp. Di Rumah Sakit Hasan Sadikin Bandung, Hasna Rafifah Zahira Zalfa, Iceu Dimas Kulsum, Hendarsyah Suryadinata, Chrysanti Chrysanti, Intan Mauli Warma Dewi

Jurnal Penyakit Dalam Indonesia

Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization.

Methods. A cross-sectional study was conducted using secondary data from a …

Hubungan Tingkat Stres, Kecemasan, Dan Depresi Dengan Konstipasi Fungsional Pada Mahasiswa Kedokteran, Khafifah Z, Wilson Wilson, Agustina Arundina Triharja Tejoyuwono

Jurnal Penyakit Dalam Indonesia

Introduction. Stress, anxiety, and depression are factors associated with functional constipation that affect students’ quality of life. Stress, anxiety, and depression are often experienced by first-year medical students, but studies assessing these three variables with functional constipation are still limited.

Methods. This study used a cross-sectional analytical design. Study was carried out in July 2023 involving 88 first-year medical students from the Tanjungpura University Medical Study Program. Analysis of relationship tests was carried out using Kendall’s Tau-B tests.

Results. Most students were in the normal category of stress, anxiety and depression levels, however 21 students were in …

Etika Publikasi Di Bidang Kedokteran, Chyntia Olivia Murine Jasirwan, Edward Faisal, Evy Yunihastuti

Jurnal Penyakit Dalam Indonesia

Publikasi ilmiah merupakan penjelasan sistematis mengenai hipotesis, bukti, dan kesimpulan dari sebuah penelitian yang dimaksudkan untuk mengedukasi masyarakat. Publikasi merupakan tujuan utama dari penelitian, dan peer-review dilakukan untuk memverifikasi temuan dan meningkatkan kepercayaan penulis untuk evaluasi penelitian yang dipublikasi. Publikasi merupakan salah satu persyaratan khusus dalam suatu institusi akademik dan dapat mendukung promosi ke jabatan akademis. Publikasi (nasional dan internasional) telah menjadi norma yang dapat dikatakan wajib dalam dunia pendidikan. Berbagai pelanggaran etika banyak terjadi dan kita temukan, seperti plagiarisme, tata bahasa yang tidak pantas, dan praktik pengelolaan data yang meragukan. Kurangnya pemahaman tentang etika penelitian seringkali menjadi akar dari …

Infark Ventrikel Kanan Dengan Blok Atrioventrikular: Laporan Kasus Dengan Tinjauan Pustaka, Naomi Niari Dalimunthe, Refli Hasan, Herwindo Ahmad, Rahmad Isnanta, T Realsyah, Zainal Safri

Jurnal Penyakit Dalam Indonesia

Inferior myocardial infarction is frequently accompanied by right ventricular infarction. This report presents two cases of right ventricular infarction accompanied by hemodynamic disorder and atrioventricular block complications. These patients were diagnosed with right ventricular infarction based on history, clinical presentations, and electrocardiography findings. The management approach for these patients involved optimizing volume and fluid status, using temporary pacemakers, and urgent percutaneous coronary intervention. This report highlights the need to promptly identify right ventricular involvement in inferior myocardial infarction, as the treatment strategies for right ventricular infarction are different from left ventricular infarction.

Transcriptional Responses Of Different Brain Cell Types To Oxygen Decline, Camille Ravel-Godreuil, Ethan R Roy, Srinivas N Puttapaka, Sanming Li, Yanyu Wang, Xiaoyi Yuan, Holger K Eltzschig, Wei Cao

Faculty, Staff and Student Publications

Brain hypoxia is associated with a wide range of physiological and clinical conditions. Although oxygen is an essential constituent of maintaining brain functions, our understanding of how specific brain cell types globally respond and adapt to decreasing oxygen conditions is incomplete. In this study, we exposed mouse primary neurons, astrocytes, and microglia to normoxia and two hypoxic conditions and obtained genome-wide transcriptional profiles of the treated cells. Analysis of differentially expressed genes under conditions of reduced oxygen revealed a canonical hypoxic response shared among different brain cell types. In addition, we observed a higher sensitivity of neurons to oxygen decline, …

Gut Microbiota And Blood Metabolites Related To Fiber Intake And Type 2 Diabetes, Zheng Wang, Brandilyn A Peters, Bing Yu, Megan L Grove, Tao Wang, Xiaonan Xue, Bharat Thyagarajan, Martha L Daviglus, Eric Boerwinkle, Gang Hu, Yasmin Mossavar-Rahmani, Carmen R Isasi, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

BACKGROUND: Consistent evidence suggests diabetes-protective effects of dietary fiber intake. However, the underlying mechanisms, particularly the role of gut microbiota and host circulating metabolites, are not fully understood. We aimed to investigate gut microbiota and circulating metabolites associated with dietary fiber intake and their relationships with type 2 diabetes (T2D).

METHODS: This study included up to 11 394 participants from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos). Diet was assessed with two 24-hour dietary recalls at baseline. We examined associations of dietary fiber intake with gut microbiome measured by shotgun metagenomics (350 species/85 genera and 1958 enzymes; n=2992 at …

Hypermetabolic Lymphadenopathy Following The Administration Of Covid-19 Vaccine And Immunotherapy In A Lung Cancer Patient: A Case Report, Shreya Tripathy, Nathaniel Alvarez, Shubham Jaiswal, Ryan Williams, Munaf Al-Khadimi, Sarah Hackman, William Phillips, Supreet Kaur, Sherri Cervantez, William Kelly, Josephine Taverna

Research Symposium

Background: Given the current climate of the pandemic, lung cancer patients are especially vulnerable to complications from severe acute respiratory syndrome coronavirus 2 infection. As a high-risk population group, these patients are strongly advised to receive coronavirus disease 2019 vaccination in accordance with Center for Disease Control and Prevention guidelines to minimize morbidity and mortality. In recent years, immunotherapy has taken a preeminent role in the treatment of non-small cell lung cancer with dramatic improvement in overall survival. Reactive lymphadenopathy following the administration of a coronavirus disease 2019 vaccination can confound the radiographic interpretation of positron emission tomography-computed tomography or …

Reinforced Tissue Matrix To Strengthen The Abdominal Wall Following Reversal Of Temporary Ostomies Or To Treat Incisional Hernias, Spencer P Lake, Corey R Deeken, Amit K Agarwal

Faculty, Staff and Student Publications

BACKGROUND: Abdominal wall deficiencies or weakness are a common complication of temporary ostomies, and incisional hernias frequently develop after colostomy or ileostomy takedown. The use of synthetic meshes to reinforce the abdominal wall has reduced hernia occurrence. Biologic meshes have also been used to enhance healing, particularly in contaminated conditions. Reinforced tissue matrices (RTMs), which include a biologic scaffold of native extracellular matrix and a synthetic component for added strength/durability, are designed to take advantage of aspects of both synthetic and biologic materials. To date, RTMs have not been reported to reinforce the abdominal wall following stoma reversal.

AIM: To …

New Onset Dyspnea In A Patient With Pacemaker, What Does The Ecg Tracing Show?, Jakob Nypaver, Robert Libera Do, Arun Kundra, Ravi Choxi

Transformative Medicine

Dual chamber pacemakers are programmed to allow for AV synchrony. Whenever a patient with a dual chamber pacemaker with underlying sinus rhythm presents with AV dissociation, the lack of AV synchrony should be questioned. The authors present a case of new onset dyspnea diagnosed as pacemaker syndrome. The diagnosis was initially delayed due to underlying ventricular paced rhythm as misidentified as normal pacemaker behavior.

A 69-year-old female with a past medical history of 2:1 atrioventricular block status post dual-chamber pacemaker implant presented with complaints of new onset shortness of breath and dyspnea. The ECG showed a ventricular rate of 66 …

Too Yellow: An Idiopathic Case Of Autoimmune Hemolytic Anemia, Shreel Patel, Kashif Ali, Donnel Dockery-Joseph, Eunbee Cho, Sriharsha Koneru, Taha Al Hassan, Aramide Tijani, Elimar Gonzalez Morales

Research Symposium

Background: Autoimmune hemolytic anemia is caused by autoantibodies that react with self red blood cells and cause them to be destroyed. Warm AIHA, due to antibodies that are active at body temperature, is the most common type of the AIHA. It is mostly caused by the underlying disease like infections, autoimmune disorders, lymphoproliferative disorders, immunodeficiency or physiologic state like pregnancy. Rarely it happens that there is no underlying cause. Therefore, here we present a case of idiopathic autoimmune hemolytic anemia without any underlying cause.

Case Discussion: A 77 year old lady with known history of the diabetes mellitus type 2, …

Spontaneous Tumor Lysis Syndrome In A Patient With Recent Diagnosis Of Multiple Myeloma — An Unusual Presentation, Taha Al Hassan, Olga G. Cantu-Rodriguez, Eunbee Cho, Edgar G. Dorsey Trevino

Research Symposium

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, …

Little Bit About Liddle: Big Improvement In Blood Pressure, Shreel Patel, Roy Kondapavuluru, Eunbee Cho, Fatimah Bello, Jian Garcia Cruz

Research Symposium

Background: Liddle syndrome is a rare autosomal dominant disorder associated with abnormalities in function of the collecting tubule sodium channel, also called the epithelial sodium channel (ENaC). ENaC function is increased in the Liddle’s syndrome leading to the manifestations of mineralocorticoid excess symptoms, such as hypertension, hypokalemia, and metabolic alkalosis. The diagnosis is made when these features are seen with low renin and low plasma or urinary aldosterone. Genetic testing is not required for the diagnosis of Liddle syndrome. Liddle's syndrome has an excellent response to amiloride.

Case Presentation: A 56-year-old gentleman, with longstanding uncontrolled hypertension was seen for functional …

Pilot Study To Assess The Effectiveness Of The Sustainable Culturally Adaptive Nutrition Program (Scan) To Improve Adherence To The National Diabetes Prevention Program, William B Perkison, Pierre Fwelo, Fernanda Velasco-Huerta, Natalia I Heredia, James J Yang, Sidra S Beg, Belinda M Reininger, Serena A Rodriguez, Maha Almohamad, Catherine Pulicken, Ella Garza, Grace E White, Maria E Fernandez

Faculty, Staff and Student Publications

PURPOSE: The Sustainable Culturally Adapted Nutrition Program (SCAN) is a novel adaptation to the National Diabetes Prevention Program (NDPP) that aims to improve attendance and effectiveness. This paper presents its feasibility and impact through the initial 6-month outcomes.

DESIGN: A pragmatic quasi-experimental pilot study with intervention (DPP plus SCAN) and control (DPP only) groups.

SAMPLES AND INCLUSION CRITERIA: Sustainable Culturally Adapted Nutrition Program participants were recruited from federally qualified health center (FQHC) clinic patients enrolled in a NDPP in Houston, Texas. Participants needed to be (1) ≥18 years old, (2) body mass index >25, (3) no prior diagnosis of diabetes, …